Answers to Major Depression (4): Depression Treatment -“Heart-to-Heart: Loving Community” Series

Physical activity will improve your mood, but some people with depression really don’t want to move; are people in a depressed state usually unmotivated? How to overcome it?

Not wanting to move and losing interest in what you usually enjoy doing are the most obvious manifestations of depression. In this case, you can first classify the things you don’t want to do and evaluate how much you don’t want to do them. Then, start from the simplest things, from simplest to hardest, from things you are most willing to do to what you are most unwilling to do, and complete these things one at a time. In terms of physical activity, it depends on the individual. It does not necessarily have to be swimming, running, etc. In fact, walking is also an exercise. For some people who have difficulty even getting out of bed, as long as they are willing to get up to wash their face, brush their teeth, or drink water, it is considered exercising for them.

In my past experience, some patients with depression are completely unwilling to exercise. We will find pets, such as cats and dogs, to keep them company, so that they can follow the pets’ activities unconsciously. You can also start by looking for things that are easy to do based on the patient’s preferences or interests. For example, if the patient likes to listen to music, you can encourage him to swing his body while listening to music and let him move slowly. Don’t rush to ask patients with depression to exercise. Physical activity is very helpful in regulating mood, but it should be determined according to each person’s different circumstances.

For patients with mild depression, we generally do not recommend taking medication right away. Instead, we first use psychological counseling and add some social interaction, physical activity, and things they like to do, such as chatting, reading, etc., so as to slowly help them overcome inactivity or passivity.

Are there any side effects to taking depression medication? Will I develop a drug-dependent habit?

There are three main types of antidepressants: 1) Tricyclic Antidepressants (TCA), 2) Monoamine Oxidase Inhibitors (MAOI), 3) Selective Serotonin Reuptake Inhibitors (SSRI) or Serotonin/Noradrenaline Reuptake Inhibitor (SNRI).

Everyone’s physique, genetics, and health conditions are different, and their reactions to drugs are also different. Antidepressants mainly change the chemical balance of the brain. Possible side effects include nervousness, strange dreams, dry mouth, diarrhea, etc. The early drugs TCA may cause fatigue, dizziness, insomnia, sensitivity, anxiety, constipation, and weight gain. However, more recent drugs have greatly improved. Side effects usually disappear after a week or two. If these conditions do not disappear within a period of time, you need to consult with your doctor about whether you need to change your medication. Taking antidepressants may also cause a decrease in sexual function, which will last for a relatively longer time.

Antidepressants are not addictive. Currently, we commonly use SSRI or SNRI to regulate (enhance) the functions of serotonin, dopamine, norepinephrine, or/and melatonin. This kind of medicine has relatively few side effects, but it takes at least one to three weeks, or even four to six weeks, to take effect. When you first take the drug, the dosage is slowly increased, and when you stop taking it, the dosage is also slowly reduced. You need to discuss the increase or decrease in dosage with your doctor, and you should not stop taking the medicine on your own.

Content provided by: Dr. Agnes Ip, Ph.D., LMFT

*The content of this article was adapted from Dr. Agnes Ip’s interview with the “Hear and See” organization.

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