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What can a person do when they can not tolerate antidepressants?

04 Feb
A woman whose depressed adult daughter cannot tolerate antidepressants, asks what else her daughter might do to fight the enervation, hopelessness, negative self-talk, fatigue, impaired sleep, and misery she faces every day..
My 32-year-old daughter suffers from depression. She has seen psychiatrists and has tried many kinds of medication, but she gets very unpleasant side effects and cannot tolerate them. She is also sensitive to herbal remedies like St. John’s Wort. Do you have suggestions for her? This is taking a toll on the entire family. I worry about what this is doing to her children and her marriage. Thank you in advance.
Laura K. in Vermont.

Dear Laura,
That’s too bad about the medication, because it can be a big help in jump-starting her healing. If she hasn’t been evaluated by a psychiatrist who’s up on the latest pharmaceutical interventions, she should give it another shot.

But, assuming she in fact cannot tolerate antidepressants, and some people can’t, here are some suggestions for her - ways of putting her system on "manual" so to speak, to help remind her body and mind that it does in fact remember how to get back into balance. We have some great materials and audio resources to suggest, but first, let me give some all-purpose behavioral suggestions that, when used in combination, should help:
  • Counseling or therapy can be a huge help here, even if the depression is biochemically based, because it has such an erosive effect on work performance, relationships and confidence. A good clinician can be just the right kind of sounding board to help her get back her perspective and return her to balance.
  • She should make herself get up in the morning and avoid sleeping in, even though, if she’s depressed, she won’t feel like it. Getting up and moving around helps fight depression; sleeping late feeds it.
  • She needs to reduce her intake of carbs and especially sugar, while amping up the protein. Again, it feels counter-intuitive, because if she’s depressed she’s going to want that quick charge of energy that sugar and simple carbs provide; but that very same jolt of sugar floods the bloodstream, spikes, and then causes a crash, leaving her more depressed than ever. The same is true for caffeine and alcohol.
  • The more she can move and exercise, the better off she’ll be. Don’t forget, depression is blocked or deadended energy, and she can get it moving again by literally moving more. (And, yes, if she’s depressed, she won’t feel like it, but it will make her feel better afterward.)
  • If her depression is seasonal or fed by lack of light, those special lamps that imitate the sun’s rays are available at many clinics, mental health centers and private practices. A half hour a day under those rays can make a palpable difference.
  • Let your more reliable friends, family and/or support system at work know that you’re needing extra support, concern, encouragement or sensitivity (as long as it doesn’t get you in trouble or create a new set of problems for you). If you haven’t already worn them out or frustrated their efforts to help you too many times in the past, the right people will come through for you. But do be smart about who you talk to, and don’t try to get blood from a stone.
  • Try to catch yourself at negative self-talk, criticism, scolding and name-calling, and instead deliberately change your internal voice to say something positive, encouraging and kind. I know it sounds hokey, but it works, (even if you think it’s hokey) ’s an important skill to learn for healing depression.
  • Try to force yourself to keep up your schedule, meet your responsibilities and stay active. But if you just can’t hack it here and there, forgive yourself and use the time in as kind and nourishing a way as possible to yourself.
  • Listen to guided imagery and other low-demand self-help strategies on a regular basis. It can make a huge difference - we hear this all the time. We have many titles that might help, starting of course with Combat Depression. But Ease Grief, Healthful Sleep (depression usually impairs sleep), Anger & Forgiveness and our Affirmations can all be important here. Try one and see if you respond well to it. If you do, listen to it ‘til you’re sick of it, and then try another. Other allied techniques that are powerful energy-boosters and terrific for depression would be Amy Weintraub’sBreathe to Beat the Blues, which uses the breath to rev your engines back to normal; Suzanne Scurlock-Durana’s Healing from the Core, which uses energy work and guided meditation to do the same; and Michael Reed Gach’s CD, Increase Vitality, which uses his technique of Acu-Yoga to get the job done.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award