Considering Medication for Depression or Anxiety?

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There often exists great reluctance about taking pills to get better……I myself grew up that way, with a predisposed negativity. I still remember the first time I took adult aspirin & what a miracle it seemed to be, when I was a freshman in college. Even in High School, I had never had anything more than baby aspirin.

I remember my own reluctance when I talk to my clients about considering medication. I look at medication as an experiment, it may or may not be effective but it’s worth finding out……

Medication can be a lifesaver for some people, there is no doubt in my mind.

Medication will not make you a “zombie” which is the fear most often voiced by clients. Medication for anxiety or depression is not about tranquilizers. SSRI’s are most often prescribed in these situations. It really is remarkable how they can help people feel able to function…..

Recently I asked one young woman to write a few words about her positive experience with medication (reprinted with her permission):

“When I started to experience severe anxiety symptoms, I was convinced that there was something physically wrong with me. It had seemed to come out of nowhere, and felt really out of control. I was having panic attacks, very physical fight or flight symptoms, and I just couldn’t figure it out. I had all the tests done, and everything came back clear.

I thought that there must be something that they hadn’t found (another reason I should have realized it was anxiety!) I was prescribed Xanax by my PCP to take when I felt a panic attack coming on, and I began to see my first therapist. I hated taking the Xanax, and just felt like medication wasn’t for me.

Things started to get more manageable, but I still felt really uneasy about everything, like an attack could come on anytime, and I had no trust left for my body. A pretty tough year went by, and then, almost exactly a year from when I had the first attack, I had another one. (The first bad one in months.)

I started seeing Rhoda, and we began to make some progress, but I had started having obsessive thoughts about death and dying, which seemed to come out of nowhere also and were utterly miserable. It was like they were on an infinite loop, and I had no control over them. After showing up to therapy and bursting into tears when Rhoda asked me, “How are you?”, we began to talk about the possibility of medication.

I was opposed to the idea.

I had the idea that I think many people have– I should be able to just “get over” this on my own. I didn’t want to alter my natural thoughts, my natural chemistry.

After suffering for weeks, I finally, with the help of Rhoda, decided to begin taking Celexa, a relatively mild anti-depressant/anti-anxiety medication. I was extremely nervous about it, read about every single side effect possible, and went back and forth about it for about a week. I finally bit the bullet and began taking it, and I can’t even believe how long I waited.

This medication has made everything easier, in every way, and has taken nothing away from me. I don’t feel “different.” I feel like I’m finally myself again. I’ve always been a worry wart, and I still worry, but the medication has taken the edge off. I have been taking it for several months now and I am so, so much happier.

I finally feel confident that I won’t have a panic attack, which has taken the huge black cloud of worry that hovered over me away. It hasn’t changed me, it has changed my anxiety. I now realize that being debilitating anxious wasn’t “natural” for me, I had an imbalance. The medication has corrected this, and it has made it possible for me to move forward in my life.

I feel like its given me space, breathing room. I can now enjoy a day without feeling anxious, and when I do feel anxious, it is manageable. It is normal. I have even had similar thoughts about death, but they go away. I’m still skeptical of medication in general, but my attitude about medication for depression and anxiety has changed.

I can’t even begin to describe how much it has helped me, and it’s been less than 4 months.”

Medication is an experiment that can be started or stopped, it is not a lifetime decision. It might even be the beginning of getting better….

The Link Between Depression & Expectations (& the movie Midnight in Paris)

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Many people struggle their whole lives to learn how to make disappointment bearable. One of the great parts of aging (that almost makes up for gravity) is how much easier it is to roll with disappointment. You understand & accept that disappointment is a huge part of life. One example would be to know you will not always be lucky enough to spend your holidays with your family intact.

Growing up is honestly accepting painful situations. Many depressed people are fighting the acceptance of the hard parts of life. So if you lose your job, though it’s depressing, you still have to find things to do that matter, besides job hunting to restore self-worth.

Transitions are tough for everyone. Transitions, in general, are often depressing. Moving to a new place may be your own idea but that doesn’t mean you won’t get overwhelmed and depressed wondering if you’ve made a big mistake. You have to expect that all change is going to have lots of struggle, not just rewards.

Transitions mean beginning a big change can be scary, like graduating from college and having to move back in with your parents. Often, it’s a big transition for many parents when the last kid leaves the nest, so they annoy their kid with 5 or 6 phone calls a day under the pretense of worrying about them when maybe they need to worry about themselves. Groping around finding new interests to recapture some life vitality is not an easy thing to do.

It can be very depressing to stay stuck in the past instead of adapting to a new reality. Gil (Owen Wilson) discovers exactly this in Woody Allen’s Midnight in Paris. He is whisked back in time where he learns that life can be unsatisfying in the present, even to legends (Gauguin etc.) from a previous era.

On some level, overcoming depression means accepting the unsatisfying chunks of life & having the tenacity to sort out, how to become satisfied in new ways. Gil does both these things as he dumps his girlfriend & decides to live in Paris.

To emerge out of depression, you don’t need to move to another country like Gil. You do need to find the willingness to try small experiments in new efforts.

Gil is in love with walking in Paris, at night or in the rain (one of the pure delights of this movie is that it is a love song to Paris). Try driving around & finding 3 different neighborhoods to walk in 3 nights a week. The small step of changing the scenery can make the endeavor more interesting. Small efforts can work.

It reduces depression if you are able to let go of your ideas of how life is supposed to be. The more you set yourself up with false beliefs; “My children should…”, “My boyfriend should know what I want without my asking” etc., the worse you will feel, because you are drowning in unmet wants.

Life is a whole lot easier when you reduce your expectations & shoulds for other people. It’s way too easy to stay silent & be judgmental; instead of asking for what you want & coping with rejection. Dealing with rejection really does make “Yes” sweeter when it happens.

Living life with a bit of humbleness is what I’m suggesting. There can be real arrogance & self-righteousness to shoulds that can trigger the darkness of depression. False expectations are inextricably connected to depression.

Climbing Out of Depression

Depression opens the door to beauty of some kind.” ┬áJames Hillman, psychologist


Curiosity, music and exercise are three of the smallest stepping-stones to help someone climb out of the grip of depression. Depression is often a dark pit of stuckness and it becomes a trap that appears to be impossible to leave behind, like gum stuck on a shoe. It’s important to decide this is not the truth. Every small step out of the pit matters. Perception is 9/10’s of reality. If you believe it’s impossible to change, you won’t. If you believe it’s a long journey and taking some small steps can be the beginning, it will.

Depression is a very huge obstacle to overcome. One of the smallest steps anyone can take is to find out what they might have some curiosity about. Curiosity is both small and huge at the same time. Depression is often overwhelming and it is curiosity that can give someone a toehold out.

Ways to restore your curiosity:

#1. Start small with noticing a sunny spot in your home. Drag a chair over to that spot and like a cat stretch and enjoy being in the sun in the present. This is an example of using your five senses to expand your sense of life in the moment.

2. Consider going back in time to when you were a child, remember what you were curious about. the stars in the sky, kite flying, or a visit to the zoo. These are small things that give a glimpse that life is woth living.

3. Buy the edition of the newspaper that tells you what’s going on (In Pittsburgh it’s the Thursday Weekender). Do any of the descriptions appeal to you about anything that’s going on?

4. Be curious about your disease. Read a book about depression and learn some new ways to think about your struggle, such as Feel Good Now by David Burns or Mind Over Mood by Padesky and Greenberger are only two suggestions. If you can change your beliefs you can change your life.

Music is another small step. Music does not require anything from you and it gives a lot. If you’re driving to work on Monday AM and dreading the week ahead, pop in some fun music to shift your mood.

Exercise may seem like a big step but it can begin with taking a walk. You can drive to a different neighborhood to walk somewhere different. The research says that exercise is very helpful to making people feel better.

Consider depression as a gift from the soul; that it is an invitation to be more creative with your life. James Hillman, who is quoted above, writes about this idea in his book The Blue Fire.

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Women: Listen to Yourselves

Top Chef Finale

Top Chef Finale

I watched the final episode of Top Chef with great anticipation, only to watch Carla who could cook with both soul & talent lose the contest. She lost as so many women do, by not listening to herself. It was heart breaking to watch. The worst part of it was that she made this same mistake in an earlier episode and didn’t learn from it.Her assistant chef (a loser from an earlier season) in the final contest made two suggestions which Carla followed instead of her original agenda. Neither suggestion was right for Carla. It’s heart breaking because this is what too many women do, they discover lies, smells, things that don’t add up and pretend it’s not true. When Women deny their own truth, they allow themselves to get lost. I know that many times depression in women is about not listening to themselves. I suspect Carla’s tears that night were about a pure, searing honesty with herself that this time she learned a very expensive lesson. Women stay in bad relationships too long. Women must find more courage to listen from within & believe. The voice that whispers “When will it be time for my needs?” or asks “Am I being used?” often has merit. Risk putting more truth on the table to find a relationship that’s worth it.