Lexapro

[Crankin]

I am not anti-medication, but I think we need to be very informed. There are other ways to treat depression, or at least use in conjunction with meds, until you can wean off of them, and I am not talking about quackery here. It's just that the development of these medications has changed the field of psychotherapy so much, that meds are the only thing many think of, in terms of treatment. It scares me when one of my close friends has been prescribed Lexapro by her gyn. She has a mess of issues and has not had any counseling. The medication does not seem to be effective (there was some good response in the beginning), but after 5-6 years, she just takes her dose and wonders why no one can stand to be around her. How is her case being monitored?
I know that Aggie is not in that position, but many people are.

[jobob]

No sweat, limewave!

And Crankin, you're making a very good point. Is your friend willing to look into counseling? When one is in that sort of position, it's very hard to take those kinds of steps (been there, avoided that) but sometimes one has to take the bull by the proverbial horn and be a bit self-reliant to get the kind of help one needs. Much easier said than done, unfortunately.

[alpinerabbit]

agree with jobob here - what is a gyn doing prescribing antidepressants?

[skinimini]

agree with jobob here - what is a gyn doing prescribing antidepressants?

In defense of gynecologists--they are primary care physicians, just as internists and family practitioners. Most have done advanced work in psychopharmacology and are highly qualified to prescribe antidepressants. Reputable physicians of all sorts know when to refer to specialists and do so regularly--including to psychiatrists, psychologists, therapists, etc. It's true that I am married to a very well-respected gynecologist, so I suppose I'm a little biased.

[sundial]

Since depression occurs in more women than men, it is not unreasonable for a gyne to prescribe antidepressants. Depression can be triggered by hormonal imbalance, such as post-partum depression, and ob-gyne docs are trained to diagnose and treat this illness.

[Crankin]

I guess he prescribes it for her because he is her primary care physician. I know him socially (not a friend, but belongs to my temple) and he is a good doc, but I think it needs to be monitored.
Jobob, my friend has had counseling in the past, when things were really bad in her marriage and when there were kid issues. That was quite awhile ago. It is a long and complicated story. I truly think that she knows she has issues, but she is so rigid in her thinking that she just says, well, this is the way it is. Eventually, I may say something to her, but even as a therapist in training, I know I shouldn't be "counseling" a friend. For me, it's a situation of not being able to cut off ties all the way, for many reasons, but not being able to stand being around her, either. So, I limit my phone calls to 1-2x a month and we rarely get together socially as opposed to in the past. She also has ADD and can't remember anything. It's getting worse, or maybe I didn't notice it before. If something was a certain way, like 10-15 years ago, that's how she remembers it. Like, if when my son was 12, he liked something or did something, then she thinks thats how it is today, even though he's an adult. She thinks she has to do things the way "mommy and daddy (her words)" did them, even though, she overtly hostile to her mother and says how judgmental and demanding she is; guess what? She is exactly the same.
OK, enough of my example. I will end with this: She came to yoga with me one time last year. At the end, she said, "Oh, I never get this relaxed. This is really great." I told her that's a good reason to practice yoga and that it might help her in various ways. Her reply was, "Oh, I don't really believe in this stuff."

[Dogmama]

Crankin, I have several friends like that. They swear they can't afford counseling, even though their insurance probably covers it if they'd bother to look, but whine about the same stuff over & over. As a counselor-in-training too, I am learning to hold my tongue & let them "go through their process." Hopefully they'll get sick & tired of being sick & tired. In the meantime, I limit contact too.

BUT, back to the OP & meds - primary care docs prescribe most antidepressents. If it's working, don't fix it. If it isn't working, I'd see a Pdoc.
They know the latest about meds & sometimes can add something that tweaks things. Fact is - nobody knows what will work for any single person. A Pdoc just has more experience. After all, I'd NEVER let my Pdoc do a pelvic exam on me.

[Jolt]

I am not anti-medication, but I think we need to be very informed. There are other ways to treat depression, or at least use in conjunction with meds, until you can wean off of them, and I am not talking about quackery here. It's just that the development of these medications has changed the field of psychotherapy so much, that meds are the only thing many think of, in terms of treatment. It scares me when one of my close friends has been prescribed Lexapro by her gyn. She has a mess of issues and has not had any counseling. The medication does not seem to be effective (there was some good response in the beginning), but after 5-6 years, she just takes her dose and wonders why no one can stand to be around her. How is her case being monitored?
I know that Aggie is not in that position, but many people are.

I agree with this. Yes, the meds have their place, but too often people look for the "quick fix" of a pill instead of trying other things (like counseling and lifestyle changes) as the first line of treatment. This really applies to a lot of things (weight loss, cholesterol, blood pressure) and not just depression. Sometimes the meds are still necessary, but in many cases I think things can be solved without them and that eliminates the possibility of side effects.