Dr. Jesse H. Wright on Dealing with Depression

Jesse H. Wright, M.D., Ph.D., is a professor of psychiatry at the University of Louisville and medical director of the Norton Psychiatric Center. He developed the first multimedia program for computer-assisted therapy of depression and is the founding president of the Academy of Cognitive Therapy. He is a recognized authority in the treatment of depression and depression-related problems, and is the author of Getting Your Life Back: The Complete Guide to Recovery from Depression, and the multimedia program "Good Days Ahead: The Interactive Program for Depression and Anxiety." Here, Wright explains why dealing with depression can be difficult for some patients.

Why are the first 30 days of dealing with depression such a vital time?

Most people delay treatment of depression. A research study found that more than 50% of people received no treatment in the first year after their diagnosis. Delaying treatment can often make the condition worse. If depression becomes chronic, it’s much harder to treat.

Does everyone need medication to deal with depression?

Not always. A patient’s treatment plan depends on the extent of their depression. Medical breakthroughs, particularly over the past ten years, have led to newer and safer pharmacological treatments for the symptoms of depression. These medications can be extremely effective when used as prescribed. For patients who have both the physical and psychological symptoms of depression, a combined treatment approach using both antidepressant medications and psychotherapy has proven to be effective.

What if someone is opposed to taking medicine for depression?

I recommend professional help when there are symptoms of depression that are causing significant distress and don’t go away. My book is also full of exercises that can help you gain control over your emotions and your life. The book contains the same types of self-help exercises we give our patients in our clinical practices and the same exercises that have been used in research studies on depression. The exercises help patients to develop their own personal recovery plan for depression.

What questions do you hear from patients after they’ve been diagnosed with depression?

Most often I hear: “What will others think of me?” “Will they think I’m weak?” “Should I hide my depression from others?” “Will I ever get back to normal?” “How can I go on with my job and all of my other responsibilities when I feel so bad?” “What treatment is the best for my depression?” “Should I take medication?” “Can I get hooked on medication?” “Is taking medication a sign of weakness?” “Does counseling work?” “How could a medication help me if I have real-life problems?”

What are some typical emotions expressed by depressed people?

Many people feel deep sadness and intense anxiety. Persons with depression typically have very low energy and a loss of interest in their normal activities. They may also feel guilt and have low self-esteem.

How do you recommend they overcome these feelings?

One of the most important things to combat depression is to try to keep active, even if you feel like doing nothing. The natural tendency is to stop doing your normal activities—it’s important to resist this urge. Even if you have to push yourself to participate in activities, it’s better to “go through the motions” than to isolate yourself. If it seems too difficult to be active, just do a little at a time. For example, if you haven’t been exercising, start with a short walk and then build up your endurance gradually.

Depression can breed a very negative, hopeless outlook on life. If your attitude has become very pessimistic, try to break through the negative cloud of depression to identify some of your strengths and potentials. Before you became depressed, what were your positive points? If you had a very effective life coach, what would they say about your strengths? What encouraging messages would this person give you?

If you’re diagnosed with depression, remember you’re not alone. More than 20% of people in the United States suffer with depression or bipolar disorder during their lifetimes. While the bad news is you’re depressed, the good news is that very effective treatments are available. It may take several weeks for the treatment to start working but most people see great benefits.

What are the most important things people can do after being diagnosed with depression?

See a doctor who is skilled at treating depression. Most family physicians can help you get started on an effective medication; however, if you have severe or recurrent depression, you may need to get the most help from a psychiatrist who specializes in treating depression.

Make an effort to learn about the diagnosis. Read one of the many good books on the topic and see if you can apply any of self-help strategies to your own life.

Consider participating in “evidence-based” psychotherapy for depression. Cognitive behavior therapy (CBT) is the most heavily researched, widely available form of psychotherapy for depression. CBT is very practical and usually involves short-term—about five to 20 sessions—with a therapist. The goal of CBT is to help people gain a more realistic view of themselves and their world, and to take action to solve their problems.

How can people empower themselves and beat depression?

Stick with your treatment for the recommended course of time. Don’t stop your medication or therapy just because you start to feel better. The chances of relapse are much higher if you stop treatment prematurely.

Psychotherapy with CBT or another specific therapy for depression may increase your chances of recovery and staying well.

Make positive lifestyle changes, including regular exercise, consuming only moderate amounts of alcohol, getting involved in meaningful activities and cultivating your sense of humor.

SIGNATURE QUESTIONS

What is the belief you personally go to during times of change?

I believe that times of stress and change are times for growth.

“The best thing about change is...”

...it can make you stronger.

What’s the best change you have ever made?

I learned how structure and persistence could defeat procrastination.

For more information on Dr. Jesse H. Wright, visit www.mindstreet.com.