Depressed, or in a Rut?

The cultural bar for what is considered depression continues to get lower and lower. And fueled by direct-to-consumer-advertising, people are lured into a false sense of security when, as a result of antidepressants, they see presumably happier people dancing in green pastures or enthusiastically petting their dog in the backyard. Such is the lure of a pill for our ills.

depressed_client2The core of my practice is treating depression and I know it when I see it; I know it when I hear it. But I don’t see it and/or don’t hear it in many of those I work with in my office or via telephone. These people are mostly in a rut, and either expect or want antidepressants to get them out of it. This is a disappointment waiting to happen, because a paltry 30 percent of antidepressant users achieve sustained symptom remission. And I’m speaking here of those who meet bona fide criteria for depression.

The single most important question that an antidepressant user should ask themselves is this: What do I want the drug to do? When I pose this very question, I get answers that run the gamut from “give me a lift” to “make me very happy and take my troubles away.” Consistently, people don’t comprehend the artificiality in such answers, failing to understand that drugs don’t change behavior. And the more I attempt to channel the conversation away from drugs, the more some people dig in, often adamantly. They’ll tell me that dietary changes, exercise, spirituality and psychotherapy don’t work, yet conceal that their efforts were half-hearted or they’ve just quit altogether.

To get out of a rut, someone has to change something about their life or daily routine – no matter how big or how small. They try something new and shake up the system by challenging the hum-drum. And if they keep at this by making it a conscious part of their day, week, month; they’ll gather momentum and establish a new rhythm – a paradigm shift for the way they live their life.

Learning to play that musical instrument or taking that stand-up comedy class is a guarantee for success. Why? Because they’ll either get better and better at the new venture or simply decide that it’s not for them, freeing them up to try something else or move in a different direction.

The most contented people I know are routinely changing up their world. And they’re all seeking success, not perfection. They’re not afraid to lose or fail, because success is a work in progress predicated on starting something and getting better and better at it, modifying in midstream or anywhere along the way. Perfection isn’t in their vocabulary because it’s restricting, paralyzing, and an impossible standard to achieve. But mostly, perfection is no fun because it doesn’t tolerate gaffes, miscues or missteps – all of which serve as vehicles for laughing at ourselves and taking ourselves less seriously.

If someone is thinking they’re depressed but really in a rut, they’d best eschew the false hope portrayed by antidepressant commercials and embrace this question instead: What one thing can I change for the better about my life or routine TODAY?

Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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