Do Pills Help Us Feel Better? Alessandria Gets Relief from Anxiety

Alessandria needed relief to be successful in her life. She sat across from me and sputtered, “I am pissed that I can’t study!” 
She is railing against the annual February depression that prevents her from concentrating. Sometimes it also prevents her from getting out of bed before lunch. Newly returned to Atlantic Cape Community College to see if she can get through school, she has battled depression for 11 of her 21 years. 
She whacks at this severe, chronic illness with a combination of cognitive therapy, and the family of anti-depressant medications that really help. One of her friends recently convinced her that medication is “stupid” so she is opting to tackle exams on her own this year.
It feels to Alessandria like she is a disaster in the making: she has trouble taking tests, exams are looming on the horizon, and she can’t concentrate long enough to move forward in her work. Her hand reached for the Kleenex. “I’m sorry. I do not mean to cry in your office. I always cry in here and I hate that.”
“How much are you crying at home these days?” I asked.
“Too much! It is all so immature.” Her acerbic, self-critical words seemed to bounce off the walls of my office. Alessandria’s sharp intellect and self-denial was driving her ever deeper into a needlessly severe depression that was dangerous for her future. I decided to appeal to logic.
“You know that I am a psychologist. You know that I do not prescribe medications and never suggest that you call the psychiatrist unless you need meds to live your life. You need these meds now. They have proven to help you with concentration, needed sleep, and a positive outlook towards school. I think your body knows that medication could help, but your depression is preventing your brain from absorbing this. Might we contact the psychiatrist who can help?”
Alessandria looked abashed. I seemed to have made a dent in the defensive armor that was currently preventing her from living the life she wanted. “I hate it when you make such good sense. The depression is so convincing that I believe it until you talk back to it like you did just now. It overtakes my own good common sense, and I give in to it. I better call the psychiatrist on my cell right now for an appointment, before the depression wins this round too.” Alessandria looked resigned, and the anger faded. 
“That is such a good idea. I bet your body will thank you. It is exhausting to be anxious and depressed so much of the time.”  I could feel my shoulders drop as I absorbed that we had handled the current crisis. But this depression was far from treated, and I knew it.
Many of our friends and neighbors fight depression without treatment. Others seek relief from counseling or exercise alone, and both can help. However, when things get too serious, medication becomes a foundation for the treatment triad of meds, therapy and healthful living.
Not medicating a serious depression is similar to “toughing out” diabetes without needed biochemical assistance. Not only does it not work, it can make the situation worse. 
As a clinical psychologist, part of my job is to diagnose mental illness and help clients find appropriate treatment. I do not prescribe but I do refer.  Below are two questions to ask about yourself or someone you love:  
1. Is it hard to get through work or school or my day without feeling down or worried? Does the worry and depression stop me from living my life like I used to and want to?
2. Does somebody I respect tell me I am off balance?  Am I fooling myself by ignoring important signs that I need help?
When I am not in Stone Harbor, I teach in the Department of Psychiatry at The Medical School of the University of Pennsylvania. One of my psychiatric colleagues says that “medication is very valuable because it helps us to live our lives better.” She’s right, of course. Handled skillfully, medication would not only help Alessandria with exams, it might help her free energy that now is wrapped up in coping with an illness that has overtaken who she is. It might free her from the prison that is her current daily existence.
To consider: If you or a loved one might benefit from a clinical evaluation, please consider taking that step. Your body, your spirit, and your family will thank you for taking good care of yourself.
To Read:  David Burns, M.D.  Feeling Good.  Available wherever books are sold.
Dr. Judith Coche treats depression and anxiety for all ages.  You can find her at The Coche Center, LLC, a Practice in Clinical Psychology in Stone Harbor and at Rittenhouse Square. Reach her at www.cochecenter.com.
ED. NOTE: Names and key information of clients have been changed.