Question:

Dear Dr. Raj, I am currently struggling with my mental health. Following many years of taking anti-depressants and anti-anxiety meds I decided it was time to detox, and in Jan. discontinued taking Effexor XR and buspar.  I weaned myself with physician guidance, but not necessarily approval.  I’m sure you are aware that discontinuing the Effexor w/o the proper guidelines is awful.  It was difficult enough…since that time I have undergone, treatment by an accupuncturist for my depression.  However I feel like as hard as I try to be “happy” I continually struggle.  I’ve listened to Oprah’s “The Secret”, recently read The Four Agreements, constantly tell myself, I am enough, I have enough, I do enough.

My question and concern are if I do have altered brain chemistry can I correct it through will power, and positive thinking? How do I avoid my dark side?  Should I go back on meds?  If so what’s out there that doesn’t cause sleep disturbances or sexual side effects?  Since currently I feel like my system is clean are there herbs or supplements that you might suggest?  Thank you so much for your time and consideration.

Answer:

Dear Cara,

It seems that you are committed to overcoming your depression which I commend you on; sometimes making the commitment to getting treatment can be one of the hardest steps.

First, it will be important for you to identify and understand what gives rise to your “unhappiness”; it is through this understanding and insight that you will eventually find “Happiness”.  The first question that comes to mind is, what is happiness to you?  It will be important to know what this word exactly means to you, as we all have different definitions. It is important to note that one can be satisfied and “happy” with certain aspects of one’s life while simultaneously discontent or “unhappy” in other areas.  It does not have to be mutually exclusive.

With regards to depression, it has both a biological and a psychological basis and can be a part of a variety of clinical presentations; again, the key is to have a good understanding to what’s giving rise to your symptoms. Medications may be necessary if your symptoms interrupt your normal function; I would suggest you to discuss this with your psychiatrist; if you feel that your psychiatrist does not spend an ample amount of time with you, find another one who will; you deserve to have one that is interested in listening to you and one that is genuinely committed to finding the right diagnosis and treatment.

Remember, prescription medications must be taken under the care of a physician and should be monitored closely for any side effects as well as efficacy; as a category, the Selective Serotonin Reuptake Inhibitors (SSRI’s) have a high association of sexual side effects; this doesn’t mean that they will all cause this as each individual is different; one SSRI may cause sexual side effects in one person and not in the next; there are anti-depressant medications that do not have a high association of sexual side effects; one such anti-depressant is Wellbutrin; again, the decision to be on Wellbutrin should be made with a physician and be taken under his or her guidance.

As far as herbal preparations for mild depression, please read the answer I posted for a question on homeopathic medications for mild depression (on May 27th; you can click on medication? under categories).

Your question about thoughts changing our brain function is an area in which there as been a great deal of interest recently; research has shown that talk therapy does change brain function and hence structure. I find it fascinating that after every conversation we have with someone, our brain has changed in some way; this then means that after every session in therapy, our brain has changed; now keep in mind that talk therapy is more time consuming and requires a great deal of effort but I believe that it gets to the deeper causal layers (psychologically speaking) and is tremendously important to include in a treatment plan.

Thus, I highly recommend finding a good psychiatrist and therapist who you can work with in understanding the biological and psychological underpinnings of your “unhappiness”; this will be fruitful in the long run.  Remember, you are enough, you always have been and you always will be. Healing will take time and will happen as long as you are committed and stay in treatment; if your need support, please send in any questions that I can help you with.