Conclusion - Final words of advice

 

Don't let your computer get overloaded looking at all these methods. Remember just reading will not make you happy; you must DO SOMETHING with the ideas you read! You must change how you act and think. Find two or three methods that seem practical to you and give them an earnest try! If your first attempts don't work, try something else until you feel less depressed.

 

Don't assume that the psychological methods above will instantly change or overcome the ways you have been acting, feeling, or thinking for many years. You can't just plan one active, fun weekend and, then, expect the depression to lift forever. You can't try stopping depressing thoughts for two or three hours and, then, expect these upsetting ideas to stop forever. You can't just try for an hour to think of positive things about yourself and, then, expect to like everything about yourself ever after. It is a major undertaking to change yourself from a pessimist into an optimist. We are talking attending to details for weeks or months.

 

Note again: If your depression is serious or dangerous, get professional help immediately. Even if your depression is not serious but a support group and/or your self-help efforts are not helping, get individual therapy from two experienced professionals--a MD and a psychotherapist. If medication has not helped, see a psychotherapist. If several sessions of psychotherapy has not helped, get medication from a MD and consider getting another psychotherapist.

 

I must repeat that anti depressive medication and PMS treatment are important sources of help. Scientists don't know exactly how the drugs work, but for some people antidepressants are a godsend. Strangely, many studies have shown that 30%-40% of depressed people improve when given a sugar pill for the depression, while about 50%-65% improve on an antidepressant. We don't know why placebos are so powerful with briefer and milder depressions. But for deep depression (including weight loss, early morning awakening, continuous sluggishness, total loss of interest and pleasure in life) antidepressants are necessary and far more effective than a placebo.

 

About half of all people evaluated by a psychiatrist for any problem are prescribed drugs! Over half of patients ordered to take drugs by psychiatrists are told to take anti-depressive medication! And, private psychiatrists, the most expensive kind, prescribe about 70% of all anti-depressive drugs, not Mental Health Centers or family physicians or other public clinics (this may be changing as selected psychoactive drugs, such as Prozac, become popular and fashionable). As mentioned, the benefits of drugs can be life-saving for some people, so psychiatrists like Kramer (1993) strongly advocate Prozac for depression. Likewise, treatment for PMS helps many women avoid depression and tension.

 

Many depressed patients feel certain that their prescriptions are very beneficial. Yet, everyone shouldn't assume that drugs will be an easy, cheap panacea for them. Drug companies spend $5 billion a year to promote drugs. Recent studies, however, using patient ratings and effective designs, have found that for many people anti depressive medication gave little relief from depression. Even psychiatrists admit that perhaps 30% of severely depressed patients are not "cured" by antidepressants. Nevertheless, the point is: millions of other people have gained relief by using prescribed drugs even though less than 20% of depressions have identifiable medical causes. Drugs should not be avoided, but the truth is that many people won't use drugs, and when they do, the drop out and relapse rates are higher with drugs than with psychotherapy. Effective drugs (which include placebos) should be used cautiously in conjunction with psychological methods (treatment and self-help).