depression, part 2: seeking treatment

16 May

PCOS is associated with elevated risk for depression, anxiety, and possibly other psychiatric disorders as well. Maybe it’s hormonal; maybe it’s just the situational result of some of the issues that accompany PCOS, such as infertility and body image problems. Either way, the correlation is real!

So, how do you know if you are depressed? You may not feel “sad,” which is what sometimes springs to mind when you hear the word “depression.” Instead, you may:
* feel aimless or empty
* overeat or lose your appetite
* sleep too much or too little; suffer insomnia
* feel like everything takes too much effort
* stop enjoying things that used to bring you pleasure [a condition called “anhedonia”]
* be crabby or have mood swings
* lose patience easily
* cry frequently
* feel angry often

All of these can be symptoms of depression. Whether they indicate depression or just the normal vicissitudes of life is a matter of degree. Ask yourself whether these things interfere with your life or relationships. If yes, it’s worth seeing a therapist or doctor.

It’s easy to say this, but it’s often hard to do for a number of reasons. Does any of the following things sound like YOUR excuse?

1. “I’m too busy.” If you’re really suffering depression, the time you spend will be more than made up by the time you stop wasting when you feel better. You don’t have time? Then why do you waste so much time on the internet reading my blog? [I’m kidding, but only sort of: most of us waste so much time that an hour a week is like a drop in the bucket.]

2. “I can’t afford it.” This, unfortunately, is often true for many people–at least, as long as therapy is not a priority for them. If you have health insurance, check and see: you may find that therapy is partially or totally covered, especially now that there are laws in place in some states to require parity of coverage between mental and physical health. You might only have to pay a co-pay, as for a doctor’s visit. If you are uninsured or if your insurance doesn’t cover it, call around: there are many therapists and clinics that provide care with prices that are on a sliding scale depending on your income. If you are religious, check with your church or place of worship–many of them provide free or inexpensive counseling.

If all else fails, you can always talk to your primary care doctor. Sometimes a psychiatrist is covered even if a therapist is not, and if you are interested in trying medication, your primary care doc can prescribe that. It is best [in my opinion] to see a specialist, because antidepressants are such tricky drugs to get right, but it’s by no means required.

The bottom line: therapy does cost money. The amount varies, depending on your situation, but it does cost money. But if you ask yourself, what else would I buy with this money, and your answer is “something I can live without,” then you can afford it. And you should.

3. “I feel stupid talking about my problems.” First of all, your problems are not stupid, and your doctor is not going to think that they are. But beyond that, you don’t have to go into a therapist’s office and describe your childhood traumas [unless that is relevant for you]. Those stereotypes about therapy are not what most counseling is immediately or primarily about. Rather, a counselor can help you figure out how to change your approach to a challenging life situation, rewrite the scripts that your brain runs daily without you thinking about them, or reshape your relationship with food, alcohol, or other destructive elements in your life.

4. “I don’t need it.” Do you not need it? Or do you not want to do the work required? Be honest with yourself.

5. “I don’t know where to find a counselor.” This can also be challenging, but it’s definitely doable! If you are working with insurance, you can get a list of the counselors in your area who take your plan, and then narrow down by availability. If you have more than one choice, ask if you can meet once for a consultation and see whether that therapist has a good vibe for you. If you’re uninsured, you have more choices, and you can call around and ask a few questions of the practice to get a feel for which one you want to try. For many PCOS ladies, food is a central problem, and it’s not a bad idea to look for a therapist with some experience with eating disorders.

The big issue is that you do SOMEthing. There is no right first step toward treating depression, aside from no step at all. It is a lifelong journey. I have only recently come to terms with the fact that I will probably never be cured, per se; I am just managing and living with this disease, and I hope that I will get better at it over time.

There will be more on living with this and managing it in a future post, as well as information about anxiety.

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