From medication to exercise, patients and psychiatrists get candid about their methods of treating depression.
Kelli María Korducki wanted options. While she appreciated the arsenal of medications being offered to treat her depression, she also wanted to explore the emotional, personal side of the disease, not just the chemical imbalance.
“A more realistic, nuanced approach to the way we conceive of mental illness would go a long way toward validating the myriad potential causes for human suffering and clearing paths for many more in need,” Korducki wrote in a July 27 editorial for The New York Times.
Korducki argued that psychiatry has become “medication management.”
“To be sure, many people need medication, and greatly benefit from it,” she wrote. “The right drugs have made my life better too. But I fantasize about a future in which mental illness is understood less in terms of static diagnoses and psychopharmaceutical stopgaps than each individual’s symptoms and the circumstances that might inform them.”
In response to Korducki’s editorial, many people—doctors and patients—shared their experience with treating depression.
Insurance Changes the Game
John M. Oldham, chief of staff at the Menninger Clinic and former president of the American Psychiatric Association, said that insurance requirements have transformed psychiatry into short, 20-minute med-check visits that do not have the length or intimacy to address a patient’s underlying concerns.
“Don’t get me wrong,” Oldham writes. “Psychiatric medications are valuable components of treatment. But mental illnesses are complicated. Medications can do part of the job, but the rest must be done by a careful partnership between psychiatrist and patient, a thoughtfully crafted treatment plan that includes psychotherapy and/or high-quality psychosocial interventions.”
Christopher Lukas, author of Shrink Rap: A Guide to Psychotherapy From a Frequent Flier, shared that his doctor told him that antidepressants weren’t serving him—instead, talk therapy was what really made a difference for Lukas.
“My psychotherapist believes in listening,” Lukas writes.
Jenny Orme, who has struggled with major depression, said that she refused to believe she was a “victim of her genes” even though her mother died from complications of depression at 45. Orme took her health into her own hands, with what she describes as a “rigorous program of yoga, tai chi, swimming and meditation.” That, combined with Eastern medicine and the support of friends and family, help Orme stay stable.
“The epidemic of mental illness and suicide calls for a multifaceted, enlightened approach to the treatment of this serious personal and public health problem,” Orme writes.
Like Orme, Kordicki says she now views her depression as more than a biological process, and now treats it as so.
“Rather than view my psychological experience as a biologically fated roller coaster, I’ve come to think of my mental health as a reflection of the complex ebbs and flows of life; accordingly, I’ve developed tools to better mitigate that which I can’t control, an agency I once wouldn’t have imagined possible,” she wrote. “I feel, for the first time, like a person who belongs to the world.”