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Medicine and psychotherapy may be the right mix to treat depres

November 17, 2003

Advances in the treatment of mental health have made significant strides in the past decades.

According to Mike Shea, administrative director of Behavioral Health Services of Washington County Hospital, with the introduction of new medications and treatment, higher success rates are now achieved. Recent studies at Brown University have demonstrated that a combination of medication and psychotherapy achieve more effective results in treating depression than either medication or therapy alone. It has been suggested medication reduces symptoms while therapy helps improve social functioning.

People taking an antidepressant should not be embarrassed. A study showed that more than 130 million prescriptions for antidepressants were written in the United States in 1998 alone. Prozac, Paxil and Zoloft - all antidepressants - were among the top six selling drugs of that year. Most antidepressant prescriptions are written by general practice physicians. Although the family doctor may know the patient best, a doctor may want to refer the patient to someone who specializes in mental health issues.

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During the assessment, the mental health professional will ask lots of questions to gain a better understanding of what the person is experiencing and why. One can expect to be asked medical questions, as the professional will be attempting to determine whether symptoms could have a physical basis. For example, symptoms of depression often occur in people with thyroid problems and those who have experienced recent heart attacks or strokes. Expect to be questioned about medications, education, work history, family relationships and previous history of mental health problems in your family. One also should expect questions related to any history of abuse - physical, sexual or mental - as these can reflect how we view ourselves. The first appointment should take about an hour and conclude with a summary of the discussion and questions about what specific areas one may wish to work on first.

If the individual is having problems that interfere with the ability to work, sleep or manage the daily stress of life, the mental health professional may suggest a referral to a psychiatrist, a medical doctor specializing in the emotional and mental aspects of life. The psychiatrist will conduct a similar interview to ensure all the areas have been addressed and to determine what medication may be most effective for you. It is important to remember, medication treats the symptoms to enable you to better address the issues in therapy.

"One should expect a minimum of three to four weeks for the medication to take full effect," noted Shea, "with sleep and appetite usually the first symptoms to improve, as well as less of a feeling of doom." Through a combination of medication and therapy, a person should begin to experience fewer symptoms of depression after several weeks, and more of a return to their normal functioning level about three to six months after beginning treatment.

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