- 8 Important Things to Do About Depression
- 10 Benefits of Depression TreatmentTreating your depression can do more than just boost your mood.
- Is It Depression or the Blues?Find out how to tell when you need help, and what to do.
- What Stops You From Seeing a Doctor?How to overcome common reasons people avoid asking their doctor about depression.
- Finding a Doctor & TherapistWhy it's important to have both when treating depression.
- Facts About AntidepressantsFind out what's a myth and what's a fact when it comes to depression medication.
- Depression Treatment TipsHow you can help your antidepressant work better.
- Managing Pain and DepressionHow pain and depression are connected.
- Cognitive Therapy for DepressionAre negative thoughts dragging you down? See how cognitive therapy can help.
To get better, you need expert help. Many people with depression have a team working with them. This might include your regular health care provider, a psychologist or therapist, and a psychiatrist or psychiatric nurse.
But getting the right people may seem intimidating. Here are some answers to common questions about finding a doctor and psychologist or therapist. Below these questions, you'll find a list of tips for how to prepare for your first appointment.
- What kind of expert do I need to see? People with depression often see a few different experts. You might see a therapist as well as a doctor or nurse for medicine. You might contact your health insurer first to see what types of care they cover. If you are not covered for psychological therapy, you can look for a therapist or clinic that offers a sliding scale based on income.
- Why can't I just see one doctor? Your primary care doctor can prescribe antidepressants, but those doctors usually are not trained to practice psychotherapy. So you may turn to a psychologist or social worker for therapy. Psychiatrists are doctors who can prescribe antidepressants and offer therapy, but they are often more expensive. Your primary care doctor may refer you to a psychiatrist if the first or second antidepressant you try does not help.
- How do I find a therapist or a psychiatrist? Ask your regular doctor for a recommendation. You can also get in touch with organizations such as NAMI, the National Alliance for the Mentally Ill, which can suggest experts in your area. Keep in mind that anyone can call himself or herself a "therapist." Your therapist should be a licensed psychiatrist, psychologist, social worker, psychiatric nurse, or counselor.
- What should I look for? Therapists and psychiatrists use many different approaches. Some focus on practical, here-and-now issues. Others go deeper, probing events from your past that might have played a role in your depression. Many use a mix of styles. Shop around. When you first talk to a potential therapist or psychiatrist, ask about his or her approach. See if it's a good fit. If it's not, find someone else. If you don't click with a person, therapy is less likely to help. You may also want to look for someone who specializes in your particular problem. For instance, if you have a substance abuse problem, find a knowledgeable doctor and/or nonmedical therapist who specializes in treating people struggling with addiction.
- What if treatment doesn't help? Once you've settled on a therapist and doctor, you need to give therapy and medication a chance to work. Getting better takes time, often several months. Treatment for depression can be hard at first. Opening up to someone about very personal things in your life isn't easy. But most people do get better with treatment.
Depression Therapy: Preparing for Your First Appointment
It's easy to get flustered when you're first meeting with a doctor, psychologist, or other therapist. So be prepared. Before you first see your doctor or therapist, decide what you'd like to talk about. Think about what you want from treatment. Go in with information and questions.
Here are four key ways to prepare.
1. Write down questions.
Come up with some specific things you want to ask. Don't assume that your
doctor will tell you everything you need to know.
For instance, you might ask your doctor:
- Do I need medicine for my depression?
- What kind of medicine will you prescribe?
- What are the side effects and risks?
- How often do I need to take it?
- How quickly will it work?
- Will any of my other medications, herbs, or supplements interact with this medicine?
You could ask your therapist:
- What kind of approach do you use? What will our goals be?
- What will you expect of me? Will you give me specific assignments to do between sessions?
- How often will we meet?
- Will this therapy be short-term or long-term?
- How much does each session cost?
2. Keep a log or journal.
Keeping track of your mood changes in a diary can be helpful to you, your doctor, and your psychologist or therapist. Just jot down a few lines each day. In each entry, include:
- How you're feeling that day
- Your current symptoms
- Any events that might have affected your mood
- How much sleep you got the night before
- The exact doses of any medicines you took
Bring your journal to your first appointment. Show it to your doctor and therapist. If you keep a journal for a few weeks or months, you may start to see patterns to your mood changes that you never noticed before.
3. Don't forget about your physical symptoms.
You might not think that they're relevant, but physical symptoms are often signs of depression. Make sure to tell your doctor or therapist about pain, stomach problems, sleep problems, or any other physical symptoms. In some cases, you may need treatment for these symptoms.
4. Get help from friends or family members.
Ask them about changes they've noticed in your behavior. They may have seen symptoms that you missed. And if you're nervous about your first appointment, ask for a friend or family member to come along.
Reviewed by Joseph Goldberg, MD on September 14, 2012.
© 2012 WebMD, LLC. All rights reserved.
Important Safety Information About Cymbalta®
The most important information you should know about Cymbalta:
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away or seek emergency help if you have new or worsening depression symptoms; unusual changes in behavior, such as agitation, irritability, impulsivity, or restlessness; or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
Cymbalta may be associated with serious side effects. Call your healthcare provider right away or seek emergency help if you experience any of the following:
- Itching, right upper-belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of life-threatening liver problems. Severe liver problems, some fatal, have been reported
- High fever, confusion, stiff muscles, muscle twitching, or racing heart rate, which may be signs of serotonin syndrome, a potentially life-threatening condition
- Abnormal bleeding, especially if Cymbalta is taken with aspirin, NSAID pain relievers (like ibuprofen or naproxen), or blood thinners
- Serious, possibly life-threatening skin reactions, which may include skin blisters, peeling rash, mouth sores, hives, or other allergic reactions
- Abnormal mood (mania), which may include greatly increased energy, severe trouble sleeping, racing thoughts, talking more or faster than usual, and reckless behavior
- Seizures or convulsions
- Decreased blood pressure upon standing, which can cause dizziness or fainting, mostly when first starting or increasing the dose. Cymbalta can also increase blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- Headache, weakness or feeling unsteady, confusion, problems concentrating, or memory problems, which may be signs of low sodium levels in the blood. Elderly people may be at greater risk
- Problems with urination, including decreased flow or inability to pass any urine
- Changes in appetite or weight. Children and adolescents should have height and weight monitored
Do not stop Cymbalta or change your dose without talking to your healthcare provider, as you could have side effects.
Cymbalta is not for everyone. Do not take Cymbalta if you:
- Are taking or have recently taken a monoamine oxidase inhibitor (MAOI), including the antibiotic linezolid, or Mellaril® (thioridazine). Taking Cymbalta close in time to these medicines can cause serious or even life-threatening side effects
- Have uncontrolled narrow-angle glaucoma (eye pain due to increased eye pressure)
Before taking Cymbalta, talk with your healthcare provider:
- About all your medical conditions, including
- kidney or liver problems, heart problems, or high blood pressure
- glaucoma or diabetes (Cymbalta may worsen diabetes or a type of glaucoma)
- seizures/convulsions, mania, or if you have bipolar disorder
- if you have ever had or been told you have bleeding problems, low sodium levels in your blood, or delayed stomach emptying
- About all prescription and over-the-counter medicines and supplements you take or plan to take, including
- antibiotics or medicines for migraine, mood, or psychotic disorders, to avoid a potentially life-threatening condition when taken with Cymbalta
- aspirin, NSAID pain relievers, or blood thinners, because they may increase risk for bleeding
- About your alcohol use (you should not take Cymbalta if you drink heavily)
- If you are pregnant or plan to become pregnant during therapy or are breast-feeding
Most common side effects of Cymbalta (this is not a complete list):
Nausea, dry mouth, sleepiness, fatigue, constipation, decreased appetite, increased sweating, dizziness. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Other safety information about Cymbalta:
- Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you shouldn't drive a car or operate hazardous machinery
- People age 65 and older who took Cymbalta reported more falls, some resulting in serious injuries
How to take Cymbalta
Take Cymbalta exactly as directed by your healthcare provider. Do not open, break, or chew capsule; swallow it whole. Cymbalta is available by prescription only.
DD CON ISI 02OCT2012
©Lilly USA, LLC 2013. All rights reserved.
Cymbalta is a registered trademark of Eli Lilly and Company.
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