So you mean, based on what you read from my previous threads/posts, you think I really need serious help? Don’t other people, including you, all go through some anxiety and depression everyday?</p>
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Now YOU make me depressed and anxious! But do you have any constructive advice on how I can really get these issues under control? The source of my depression and anxiety is very complex (includes issues like sexual orientation, right-brainedness, etc.).</p>
<p>I am currently meeting with a counselor biweekly. Four weeks ago I was also meeting with a psychiatrist from the hospital I was hospitalized at. But after they diagnosed me as not having psychosis, they dismissed me and suggested that meeting my counselor will be enough for me. So I guess my question is, do you think it is enough to be meeting with a counselor? You seem to suggest I get help from more professionals, but it seems that in my area, they don’t allow you to meet with psychiatrists unless you have serious mental illnesses.</p>
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I sent you a PM of the website. You try it and see how sucky the volunteers are (except that they won’t be able to make the police go to your house because you’re in the US, lol). The website is actually a legitimate one that is often recommended in my area. It is ridiculous how such a website is considered helpful. Now don’t get me wrong. Some of the articles and other contents like videos are quite good, but the chat feature sucks big time because the volunteers SUCK!</p>
<p>I think you’re depressed. Suicidal ideation is never normal. I’m not your doctor. But, if your doctors think you should be on antidepressants, I can’t help but agree after reading some of your posts. Honestly, it doesn’t get better in medical school. You had better get this stuff under control before you think about applying to medical school. One stressor at a time. SSRI’s take 4-6 weeks before they start working so don’t give up on them.</p>
Wow, that thread of mine brings back a lot of memories. Guess what? I actually ended that semester with a decent GPA, not 3.4! But it’s quite refreshing to look at that thread again because I can objectively see how I was at that time as well as how I tend to be. I think the good side of my tendency to worry a lot or be depressed is that I tend not to leave anything to chance, which I think contributed to my past successes/achievements, however small or large those would have been.</p>
<p>You said you don’t make posts like that, but can you be honest and say that you also don’t ever have any such thoughts?</p>
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The fact is, it’s been over 1.5 month since I stopped it and I don’t feel anything particularly bad by not taking antidepressants. After all, I believe I would feel the same way even with antidepressants because that’s been my experience while taking the drugs, though it’s not to say that I don’t acknowledge the fact that it takes 4-6 weeks to get any effect. But ever since I was young, I had a bad impression of people who depend on medications for mental illness. I view them as unintelligent, stupid, poor, not normal, etc., though that may not be the case. My parents also don’t want me to do this, and they insist that I am normal, adding that they believe I shouldn’t have been hospitalized in the first place and my depression is normal, like what others all go through daily.</p>
<p>I feel life is unfair because people like me have to suffer from this and waste time while some people of my age just cruise through undergrad and get into med school. Unfortunately I can’t do anything about it, life will always be unfair… And it’s one of the things that makes me depressed from time to time.</p>
<p>I won’t argue with you. If there’s one thing I’ve learned from a few weeks of doing psych, it’s that denial is a powerful defense mechanism. </p>
<p>I will end with this since you don’t seem to know very much about your illness:</p>
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<ol>
<li><p>Major depressive disorder is episodic. That means it’s characterized by episodes of depression. In between episodes, you can feel completely fine. </p></li>
<li><p>Look up “flight into health.”</p></li>
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<p>Back to my original question, it seems that the best approach I should take would be to tell adcoms I had depression, which was treated, and I got some CBT to deal with anxiety (I won’t tell them I’m still on antidepressants though… I’m not even willing to try them again).</p>
<p>Norcalguy, did you choose to go into psychiatry? What gives you such a conviction/belief that antidepressants work? I read up on several articles but it seems that any evidence available isn’t that strong.</p>
<p>You’re going to answer me with youtube videos? Come on.</p>
<p>If you look at the STAR*D trial, which is the major study that was done to develop an algorithm for treating depression, the response rate to antidepressants is approximately 70% and the remission rate is approx 30%. It’s not super but it’s something. Back when we only had TCA’s and MAOIs as antidepressants, you can make a greater case for not treating depression since those drugs were dangerous. Today, we have SSRI’s which are pretty safe so the risk/benefit analysis changes dramatically.</p>
<p>I also think it’s very important to see who your sources are before you cite them. Many of those who decry antidepressants are psychologists who obviously have a vested interest in their clients not being on antidepressants. Pharmacotherapy is equivalent or better than psychotherapy for the treatment of many mental illnesses.</p>
<p>The first link you cited: Dr. Gary Kohls believes autism is linked to vaccines. Nuff said about his credibility.</p>
<p>Dr. Gary Kohls is an MD himself (graduated from University of Minnesota med school). Should I give more credibility to you (a med student) than many other MDs who are against antidepressants?</p>
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That’s easier said than done, especially when it comes to controversial matters like this. It’s quite hard to know what to believe without doing a lot of reading and studying by yourself.</p>
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I see that autism-vaccine issue is one of the controversies in the medical community. Dr. Kohls may be wrong or he may be right, but just because you discount his belief in certain topic doesn’t mean you can dismiss his credibility entirely. That seems like an all-or-nothing mentality.</p>
<p>Credibility comes from evidence, not from the letters behind your name. He is not suggesting you go the psychotherapy route. He’s one of those “natural” physicians, pimping “natural” amino acid supplementation instead of SSRI’s for treatment of depression. Amino acid supplementation for depression has far worse evidence behind it than SSRI’s. There’s been very few studies that show it works any better than placebo. Furthermore, unlike medications, herbal and natural supplements are not regulated by the FDA. There’s no guarantee how much of the natural stuff you’ll actually receive in your bottle nor is there guarantee that you won’t experience unacceptable side effects. I don’t automatically discount natural treatments for things. But, I have a problem when someone’s trying to discount one thing while advocating for a different thing that has no evidence behind it (you know, sorta like how autism is supposedly linked to the MMR vaccine).</p>
<p>Norcalguy, so then you think I should take antidepressants for the rest of my life. During my hospitalization, my doctors said I can try it for 1-2 months and then slowly decrease the dose until completely stopping it. But really, I don’t need it and it’s not like I’m still in a depressed mood these days.</p>
<p>I didn’t say you need to be on antidepressants for the rest of your life. I personally think you should give antidepressants an 8-week trial because they typically take 4-8 weeks to work. If they don’t work, then they don’t work. SSRI’s are very safe and there is little downside to trying them. </p>
<p>And, as I explained to you earlier, major depressive disorder is characterized by major depressive EPISODES. This means you will most likely feel fine most of the time and then you get an episode of major depression. The way to prevent getting these is to be on antidepressants. </p>
<p>The diagnosis of major depressive disorder requires just 1 lifetime major depressive episode which it seems you had when you were hospitalized. You could be fine the rest of your life and you will still have major depressive disorder. And, I will say it again: you have major depressive disorder regardless of how you are feeling now or how you will feel in the future. All it takes is one major depressive episode, which you’ve already had.</p>
Hmm, if you are saying that (which is also what my psychiatrists told me), then I guess I should give Effexor another try, this time for 8 weeks. If I don’t feel any effect after 8 weeks, then I’m completely done with antidepressants for the rest of my life. A psychiatrist told me during my hospitalization that if one type of antidepressant (in this case Effexor) doesn’t work, then I should try other types until I find the one that works. I thought this was ridiculous… I’m not willing to spend 8 weeks each on different antidepressants. Effexor will be the one and only antidepressant I ever take! I don’t want to abuse my body by stuffing it with different medications because I am otherwise perfectly healthy and taking no medication is better than taking some.</p>
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That’s an interesting criterion, which I don’t have much confidence in. But seriously, doesn’t almost everyone have at least one severely distressful situation in their lifetime?</p>
<p>*You try it and see how sucky the volunteers are (except that they won’t be able to make the police go to your house because you’re in the US, lol). *</p>
<p>???</p>
<p>Are you in another country? </p>
<p>Where will you be applying to med school? Most med schools in the US don’t take int’l students.</p>
<p>Effexor is actually not a SSRI. It’s a SNRI. I’m mildly surprised they started you off on that instead of a SSRI but I think what your psychiatrist suggested is a good idea. Different people respond to different medications differently. If you look at the STAR*D trial, some of the people who didn’t initially respond to a SSRI, responded after they were switched to an antidepressant of a different class. Typically, we start people on a SSRI and then switch them to Effexor or Welbutrin or something like that if they don’t respond.</p>
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<p>You need to realize that you have a mental illness. Everyone encounters stress and anxiety and bad things but not everyone has suicidal thoughts or needs to be hospitalized. Do you know what % of my patients actually have enough insight to realize they need hospitalization? Not many. So, it doesn’t surprise me that you didn’t think you needed to be hospitalized. Denial is very powerful indeed. The people you see on those TV shows with 100 lb tumors? They weren’t blind. They were in denial when their tumor was 10 lbs, 25 lbs, 75 lbs. I dated a girl with multiple suicide attempts requiring hospitalization and her mom still didn’t like the fact she was on antidepressants and thought all she needed was some “exercise.” Last week, when I was on call in the ER, I admitted a patient who took a bottle of her clonazepam and then took some of her boyfriend’s Xanax for good measure and then knocked back a couple of martinis and her boyfriend was still ****ed when we hospitalized her involuntarily. He thought she would be okay going home with him and that it was just her being “dramatic.” Yea, buddy, she didn’t take 20 benzos because she wanted to be dramatic. People’s capacity to deny what is obvious amazes me each time I see it. I’ve seen people lose 80 lbs in 4 months from cancer and still not go to the doctor. I saw a girl who first acknowledged she was pregnant when she was 36 weeks along and then gave birth 1 week later. Denial. </p>
<p>Good luck to you. I hope you straighten out your issues before medical school or else you will be in a world of hurt.</p>
I’m in Canada, and I’ll be applying to both Canadian and US schools.</p>
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One concern is if my “issues” will really be able to be “straightened out”. What if I don’t resolve problems with my depression/anxiety during my break until September and then end up not applying to med school?</p>
What if I don’t resolve problems with my depression/anxiety during my break until September and then end up not applying to med school?</p>