depression

There’s an emptiness that many of us feel every day. Sometimes we feel it when we’re away from someone. Sometimes we feel it when we’re surrounded by people. It isn’t depression, per se. We have all experienced it. Unless you’re schizoid, of course. Loneliness is a want. When we want, we create a gap between what we have, and what we don’t. That gap hurts. Commonly we try to distract ourselves so we don’t have to pay attention to that pain. We don’t want to feel it. We have this deep fear it will consume us. It is almost as

Not a Lab Rat

Minnie was forty years old, and came to see me in my office to discuss being depressed. She had felt depressed off and on for many years, but had rarely told anyone about it. It was like dragging a weight around. She could still get things done in her, just not quite as well as she’d like. At one point she had told her family physician about this, and she was offered an antidepressant, lexapro. She took it for a few days, didn’t like how it made her feel, and stopped it. Her physician told her they could try something

Chemicals, Depression, and the Mythos of Natural

natural stalactite looking like the head of a dog upside down

Usually by the time a depressed person comes in to see me, it’s because what they’re doing hasn’t been working. Therapy hasn’t been helping, or they don’t have the time or finances to do therapy. So as a psychiatrist, I offer an antidepressant. And almost every day, people hesitate. They don’t hesitate because they doubt whether the medications work (a separate debate). They hesitate because they want to follow a “natural” lifestyle or philosophy. Now I follow a principle of using as little medication as needed, recognizing a propensity in many colleagues to use more and chase every symptom with