Depression: My First Time Seeking Treatment—Fear and Trepidation

 A disclaimer: I am not a mental health professional. I am not a psychologist, a social worker, or a psychiatrist. However, I’ve been on the receiving end of such professionals enough to share experiences I truly hope can be helpful to my fellow sufferers.

I first knew I needed help with an nascent depression in 1989. I had flown into the San Francisco Bay area where I had previously worked, for a business meeting the next day. That evening, I had dinner with a former colleague, a young woman I’d hired out of Purdue. Susan (not her real name) and I met at a restaurant of her choosing somewhere in a trendy Silicon Valley watering hole.

Susan was someone I trusted implicitly. This was critical in light of what I felt I needed to tell someone, but not just anyone. I had begun experiencing depressive episodes that were, in my mind, severe enough to cause me to consider finding treatment. The timing was interesting, in light of the new wonder drug, Prozac, recently being introduced with the promise to alleviate this disease. I had considered seeing my family doctor and asking for a prescription—what seemed to be a reasonable and rational thing to do given my distress, and the enormous positive publicity surrounding Eli Lilly’s introduction of this new medication, including a cover story in publications such as Newsweek, provided added impetus.

Even with a feeling that whatever I said to Susan was completely safe and confidential, it was with a great amount of apprehension that I ratcheted up my courage to disclose the difficulties depression was creating. After breaking the ice with this disclosure, I went on to tell her about my desire to access this medication, along with my tremendous fear that I would somehow be found out by my employer. I imagined the doctor’s office reporting to my company’s HR department that one of its employees (me) had obtained a script for this drug. And yet, unlike a prescription for an antibiotic, for example, this drug designed to treat mental illness would brand me as a pathetic and impaired loser, with horrific consequences for my status as a founder of the company and my role as VP. Susan was supportive, encouraging me to get treatment, which I eventually did a few months later. But that original fear of being branded a head-case lingered like a guillotine over my neck, never knowing if that communication from the doctor to the company would occur.

The stigma of seeking treatment for a mental health condition has somewhat abated, but we have a long way to go. The on-line magazine, Medium, reported this from The Economist: “As the stigma surrounding mental illness fades, more people may be willing to admit to it. Society has certainly come a long way in its treatment of mental health. Nowadays treatment is much more likely to be associated with pharmaceuticals (though admittedly this can bring its own problems, notably the risk of addiction) and with therapy. Workers are more inclined to accept help if they feel the treatment regime will be considerate. “Cognitive behavioral therapy”, which teaches people to bypass unhelpful thoughts, has few negative connotations. The business world has also made great strides in dealing with mental health. A 2017 report by Business in the Community, a British charity, for example, found that 53% of workers said they felt comfortable about discussing mental-health issues at work. But plenty of progress still needs to be made. Only 13% of those with a problem felt they would be able to discuss it with their line manager.” https://medium.com/@the_economist/minds-do-matter-d95fb47b16b6

Even today, with countless articles imploring executives and managers to lighten up on stigma, there are still many who just don’t get it. Too many executives view conditions like depression and anxiety as character flaws that just need to be willed away, rather than as the serious medical conditions they represent. The tired analogy that’s become tired because it’s true, comparing mental illness to physical illness, doesn’t register for many. In other words, suggesting the ridiculousness of attempting to simply rid oneself of a debilitating disease like cancer or heart disease through exercising greater will power doesn’t compute in too many cases. Later this week, I’m interviewing a former colleague about his own horror story in disclosing his battle with depression to his boss, his request to take a short medical leave, and the terrible aftermath. Stay tuned!

And to add to the frustration of seeking relief from depression if one is able to overcome the embarrassment of actually seeing a mental health professional, along with having medical insurance to cover the costs, and the flexibility in one’s schedule to research and take the time off is the hit and miss success rate of these medications. There is evidence that antidepressants are more effective for those suffering MDD (major depressive disorder). This is from the Mayo Clinic: “Antidepressants don't work for everyone. For some people with mild depression, antidepressants seem to have little effect. However, for people with more severe depression, antidepressants often make a big difference.

Although antidepressants generally aren't as effective for mild depression, that doesn't mean that they never help. Depression affects each person differently, and each person responds to medications differently. Finding the right medication may take some trial and error.

If an antidepressant seems to ease your symptoms, it may be a good treatment choice for you. If you're taking an antidepressant, don't stop taking it without talking to your doctor (I’ll explore this last point, and the effects of abruptly stopping antidepressant medications in an upcoming post. For now, never, ever go cold turkey off one of these drugs).

For many people with mild depression, talk therapy (also called psychotherapy or psychological counseling) appears to be an effective treatment. Some people benefit from a combination of talk therapy and medications. Lifestyle changes — such as stress reduction and regular exercise — also can make a difference.

If you have signs and symptoms of depression, don't ignore them. Even mild depression can take a toll on your enjoyment of life, your performance at work or school, and your relationships with other people. And, left untreated, depression can get worse.” https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/mild-depression/faq-20057948

For the past three decades, I’ve tried so many different antidepressants I’ve lost track of all their names. Suffice it to say I’m not a good candidate for these drugs. And I’ll also add that there are, in fact, many who do experience relief on an antidepressant regimen. To those folks, I can only say, count your blessings! You’re one of the lucky ones! And as the Mayo information stated, talk therapy has been enormously helpful to many. The trick is finding a therapist you view as competent and caring. Those, to me at least, are the bare essentials in engaging with a therapist.

Hoping you have an understanding boss if you ever feel the need to seek treatment for any type of mental illness.

https://medium.com/@the_economist/minds-do-matter-d95fb47b16b6