Is Rehab for Depression?
I’ve spent a lot of time writing about rehab, about various types of programs for getting past alcoholism. But what about depression? You know people who take Zoloft, Prozac, etc. for depression; and those who see a therapist for it. You may also be aware of inpatient programs—rehab—for very severe depression.
Let’s take a look at circumstances in which rehab may be the best option for depression, and what would happen from there.
First, we should look at some of the strains of this awful condition. Now, you know I’m not Mr. Label, and I don’t think that things fall into neat categories. The tags here ae just to help guide you a little.
Major Depression- This is what a lot of people think of as “depression.” It can be defined as “inability to enjoy life” for six months or longer. I’ve suffered it and I’ve seen it—it’s not a depression that is caused by anything specific, which means it won’t go away due to one or two improvements or stimuli. I’ve had friends who were just mired, just in a consistent state of depression. My research has told me that this involves very low levels of serotonin.
Atypical Depression- This is rare, but involves swinging into a more positive mindset due to good news, good circumstances, something we probably don’t find into Major Depression. But these improvements don’t last.
Dysthymia- A milder depression, but one that lasts a long time, generally more than two years.
Bipolar Disorder—You hear a lot about this one, and people tend to think of it in terms of the swings, and may not realize it’s a form of depression. The one pole is depression and the other is great bursts of energy and somewhat grandiose plans or goals.
Inpatient Treatment
Inpatient treatment means, of course, staying at a facility, with some degree of 24-hour attention. Admission is voluntary, which means you’re not in a locked facility, which may be the case after a suicide attempt. In residential treatment, you will generally talk with a therapist daily, as well as participating in group therapy sessions. You may be prescribed medicine as well. Sometimes, acupuncture, meditation, and yoga are included.
When is it Time?
The question is, which of the above strains of depression, and in what magnitudes, warrant a trip to rehab? Each type of depression above could send a person to rehab, but only at their most severe. You probably have an intuition that medication and other forms of help would come first, and that’s correct. Except in very rare circumstances, no one would go straight into inpatient care. That would probably involve a flare-up of very acute depression, probably accompanied by a harmful act of some kind.
Most depression sufferers are able to at least find improvement over time, even if this means increasing one’s medications.
A good candidate for rehab is a person with something similar to major depression or a severe case of bi-polar disorder, who has tried therapy or medication and still isn’t seeing results. While going through these methods, one might have a slide back into worse symptoms, perhaps caused by a trigger of many kinds.
One sign that rehab is necessary is debilitating depression. By this I mean the kind of crushing funk characterized by never wanting to get up in the morning, skipping work or other commitments, finding life meaningless, partaking in activities that had formerly been enjoyable and finding no pleasure, not caring about what happens to you.
The other one is the fabled symptom of feeling the need to hurt yourself or others. You may realize you’re crossing into this territory if your depression includes bouts of rage.
Why wouldn’t you?
I would generally say that as a matter of principle, it makes limited sense to pursue a treatment that could be considered overkill, or at least one that isn’t necessary. Going the route of assuming a need or wanting to think of yourself as someone who needs more care than you really do may not be useful. A mindset like that may keep you from doing the hard work you need to do to rise out of depression.
Some people are very quick to be hard on themselves, and depression will certainly provide an environment for a mindset like that. The other thing, of course, is being able to take time off of work, paying for the treatment, etc. Now, erring on the side of caution is a good idea, but you don’t want to err too much and to be too cautious and get into a spiral of dependency.
There’s no doubt that the holistic nature of inpatient programs is beneficial. It allows you to take a step back from things and get rest, relaxation, and a chance for introspection that you need. However, even this isn’t guaranteed to have long-lasting effects. Further, one may have a hard time implementing the things you learn in this setting.
I have a friend here in Cincinnati who went through an inpatient program, and she didn’t have the easiest time following up on it. She found that, having been through outpatient therapy sessions in the past, she got contradictory messages from the therapist she saw in the inpatient program. Here you are, placing yourself into this intensive environment, with a new person coming in and attempting to make large changes right away. It can be good for injecting some new energy into a person with a hard time getting out of bed, and the medication you’re prescribed may be crucial, but not all rapports you build with the therapist will be equal.
I have seen therapists, but never underwent inpatient care. My sense is that intuition tells a lot of the story. If you are struggling and feeling mired in a worse slump than you’re used to, you may consider rehab, yet have some success with a vacation, upturns in your situation that may naturally occur, etc.
A sense of helplessness, of an extreme escalation, something that feels very different from what you’ve previously undergone, will probably precede your trip to rehab for depression.
Photo Credit Jonathan Mayer on FLickr
