Who and What Can Help?

The family doctor is typically the first course of action for many with depression, and Malone indicates that 35 to 40 percent of an internist’s practice is psychiatric. “Depression is second only to hypertension as the most common chronic condition encountered in the general medical practice, with at least one in 10 outpatients having major depression,” states Malone.

With a call for internists to address the psychiatric needs of their patients, antidepressant medications are now regularly prescribed. Current antidepressant drugs effectively treat depression by influencing the function of certain neurotransmitters in the brain, primarily serotonin and norepinephrine, known as monoamines—the chemicals that allow nerve cells in the brain to communicate with each other. The benefit of the newer medications, such as selective serotonin reuptake inhibitors (SSRIs) like Prozac, is that they have fewer side effects than the previously prescribed tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

While both the old and new drugs effectively relieve depression, it’s important to remember that some people will respond to one kind of antidepressant, but not another. A recent study indicates that more than 80 percent of depressed patients have a response to at least one medication, but individual antidepressants are effective in only 50 to 60 percent of patients.

So, what do patients do when medication doesn’t lift their depression? Both Malone and Butler agree that too much emphasis on antidepressants has caused many to overlook the actual cause of their patient’s depression. “We’re often forgetting to look at the psychiatric root of the problem,” explains Butler. “Something that can often be addressed effectively with psychotherapy.”

Unfortunately, the fast-track life of most baby boomers has caused what Malone describes as a never-ending cycle in treating their depression. “With everyone in such a hurry, the last thing most want to hear is that they should go to therapy each week for treatment. Instead, they opt for the easy and quick route of medication, which may or may not work,” Malone says. “What they forget is that it is often their stressful lifestyle that brought them in to begin with.”

Malone states that psychotherapy may be the answer for many patients. Types of therapy include cognitive-behavioral, problem-solving and interpersonal psychotherapy. Each allows the patient to focus on the personal reasons that may lead to their depression, and many see improvement in their condition within six to eight weeks of therapy.

“While there is no quick cure that can end depression for baby boomers, there are several options that can make their lives better,” says Malone. “With more education of the doctors who treat them and better informed patients, we will hopefully see relief for a generation that is facing depression too often.”

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