Medical Matters:At any one time, 10 per cent of women in Ireland will be going through a bout of depression; two out of four will be doing so without getting help and suffering in silence, many in real pain, writes Dr Harry Barry.
Some will be reading this article with difficulty as poor concentration (often revealed by problems reading the daily paper), along with other physical symptoms, such as extreme exhaustion, difficulties with sleep, appetite, libido, memory and drive.
These are accompanied by the classical psychological symptoms of anxiety, loss of enjoyment of life, negative thinking, and extremely low mood. Some may be even considering ending it all.
It may have started during teenage years, or following pregnancy - everybody expecting you to be happy, while you struggle bonding with your new baby. Or it may have been the stress of trying to be a modern "superwoman" (coping with an impossible juggling of job, commuting, creches, housework, and trying to keep your personal relationship intact), which triggered a bout.
You may be using alcohol (particularly wine) as an anaesthetic to numb the pain. Those around you may be totally unaware of the "dark world" you are living in. Stigma, the negative thoughts that nobody can help, and the fear of being thought of as "weak" or "mad" are keeping you living in a silent hell.
You are probably completely confused as to what help is available. You may be reluctant to attend your GP, afraid he/she will simply "drug" you with an antidepressant (about which the media has such a bewildering range of conflicting views regarding their use).
Some will recommend you see a counsellor, even if you are too exhausted to talk to them; others will recommend cognitive behaviour therapy even though therapists are impossible to access. Still others feel you will only improve with in-depth psychotherapy. Move into alternative medicine and there is a plethora of "instant cures", but can you really trust any of them?
As a family doctor with lots of experience in helping women with depression, I feel we are creating a lot of unnecessary confusion in dealing with this illness. The most important message is to approach your GP and tell him "how you feel". Even the act of opening up to somebody you trust has been shown to start the journey towards recovering from your depression.
After that the real secret is to approach treatment holistically. Always start with the basics - 30 minutes of daily exercise, eat healthily, avoid alcohol for a period of at least six months, and take supplements such as vitamin B or omega 3 fish oils.
If you are really struggling with the physical symptoms, such as fatigue, sleep, concentration, drive and appetite, along with very depressed mood, then it's unlikely you will be able to respond to counselling or cognitive behavioural therapy (CBT) or deal with the stress triggers that started the bout.
In such cases, don't be afraid to accept an antidepressant from your family doctor if he/she feels it is necessary. In most cases, the course will only last for six to eight months. The antidepressants will start to kick in within two to four weeks and you will often feel greatly improved within six to eight weeks.
They are not addictive; they have some side effects but many women's lives have improved dramatically with their help, allowing them to move on to the next phase of the recovery process.
In my experience, women, once they start to feel better, are extremely adept at making the changes necessary. Sometimes this may involve counselling or lifestyle changes, such as assessing the possibility of part-time work, if available.
CBT is hugely helpful as a way of improving the negative thoughts that often plague women with depression. The Irish College of General Practitioners is at present involved in an innovative project training a core group of family doctors in CBT concepts. Hopefully, in time, these concepts will become more available to a wider number of patients.
In some cases, moving on may involve revisiting the past for many women traumatised by abuse. This can mean more intensive psychotherapy/counselling. In all cases, any major stress triggers in your life have be faced if true recovery is going to occur.
If alternative medicine is to be considered, I would counsel a visit to your GP first. It is probably wiser to consider yoga, reflexology, massage and acupuncture as part of a holistic approach containing all the therapies already mentioned above. Be careful about mixing herbal therapies with antidepressants, especially St John's Wort.
I feel it's time Irish women took charge of their own destinies and stopped allowing the confusion so often surrounding this area to get in the way of getting the help they so often desperately need.
Proper information, a good family doctor and a holistic acceptance of whatever therapy is necessary for a full recovery could transform the lives of many.
Dr Harry Barry is a GP in Drogheda, who has written a book titled Flagging The Problem: A New Approach To Mental Health (Liberties Press, €19.99)