Depression. iv c: “All that glitters is not gold”.

Although much that relates to “state of the art” thinking about and insight into human depression lies beyond the aims of these blogs, it is nevertheless important to recognize that its study and ensuing insight has come a long way from being regarded as a ‘from the neck up’ disorder. In fact, it is now being perceived as being implicated in illnesses as diverse as heart disease on the one hand and bone mass changes in osteoporosis on the other. The treatment of depression – where appropriate – with one of a ‘family’ (because that is what the different types of antidepressant medication amounts to) of antidepressant drugs, needs to be administered with a fairly detailed knowledge in the form of history of the person concerned and the kind of problems being experienced. (I have already referred to the cost-benefit exercise concerning their side-effects).

Given the evidence of Geraldine’s symptoms of quite severe depression (referred to in recent blogs) the possibility of side effects – even of what I have here described as of “a bothersome nature” – were, under the circumstances, regarded as a small price to pay. However, there are other potential hazards, such as harmful interactions with other drugs, which a patient may be taking at the time. And to the above ‘list’ should also be added a point well understood in practice; namely that relief from symptoms can vary widely, as can the length, i.e. period of treatment, required.

Nor are these the only caveats that require to be entered, e.g. genetic vulnerability, pre-morbid (pre-depressive illness) history and influence, emotional ambivalences generated etc. All of these and more beside need fully to be taken into account. Moreover, there are indeed, many more than a handful of ‘shades of grey’ displaying differing degrees in severity, ranging from mild psychogenic, through to severe major depression, which again, have received little more than ‘lip service’ here. The “bottom line” must surely be (as is my reason for including the above list of potential difficulties and complications here) is to assert that antidepressant medication, although extremely useful and often affective where appropriately prescribed, is by no means a panacea. Skilled and experienced applied psychologic assistance and support, together with self-help (which I intend to write to you about in future blogs) can also afford much relief and support in the need to restore that essential sense of equilibrium.

Should you think that you – or someone in your care – is/are depressed, in the sense that they are manifesting some combination of the symptoms of depression as outlined in these writings, don’t just keep it to yourself. Rather be advised to seek help promptly from some source possessing the knowledge and experience to give appropriate counsel. In the vast majority of cases, this is likely to be your GP or hospital consultant. Moreover, he/she – in addition to possessing at least some knowledge of you as a person – will be aux fait with your medical background and history and in possession of the necessary powers of referral, should the need arise.

Having thus made all the points outlined in the above paragraphs, let me finally return once more to my intention in posting these blogs in the first place. Their purpose has, in truth, been to introduce you to what depression both is and is not; hopefully, with some helpful indications along the way, as to how it may be appropriately and successfully treated. That certainly has been very much the spirit in which I have written to you and I can only hope that to this end at least, their contents will prove to be helpful and informative.

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