Why You Might Be Depressed, Too
There is a growing belief that the same imbalances in brain chemistry that are responsible for depression also cause OCD. The good news is that many of the same medications used for OCD often show tremendous success in treating depression, as well. Certain other therapies can also help to alleviate both depression and OCD.
It may also be that OCD can cause depression for the very same reasons any illness does: It can be isolating, frustrating, debilitating (even disabling), and very unpleasant. Few of those who are not affected by it may be able to understand its symptoms and the torment it causes. OCD, while it afflicts a great many people, still does not affect the majority of the population. Therefore, sufferers often feel very much alone. OCD can also make one feel like a prisoner of its demands.
It is not uncommon for people who feel overwhelmed by frequent or constant anxiety to feel hopeless, even to the point of experiencing active or passive suicidal thoughts. You might find yourself thinking, So what if I die? Anything has got to be better than this. Luckily, depression — whether biochemical or circumstantial — can be treated. (If your depression feels serious or overwhelming, please skip ahead to the section “Depression, Large, and Small.”)
The way we think has a definite bearing on the way we feel. If you keep thinking, I'm a failure, I'm nothing, my life is worthless, you'll come to believe it. People who are generally happy tend to have as many external problems as those who are miserable. The difference is outlook. You can actually learn to respond differently to life's challenges.
Medication is one way to go, and it has proven very helpful against depression, as well as OCD. However, if you can't tolerate medication, or if you fear it, there are other options, also. Cognitive behavioral therapy, either alone or in conjunction with medication, can be quite helpful.
You may remember that CBT helps patients to change compulsive actions gradually while at the same time helping them to examine their negative thinking patterns (such as, “There's danger everywhere you look”). Cognitive therapy techniques can also be used against depression.
What's the best way to treat depression?
There's no one answer for everyone, of course, but therapy in conjunction with regular medication seems to be quite successful in a large number of cases. Several medications and therapies work well against both OCD and depression.
Just as cognitive therapy helps you to look at and understand how your thoughts influence your beliefs, so can it help you to realize the ways in which they can influence your feelings. (For example, if your thoughts, from morning till night, run along the lines of, I'm a loser; I haven't gotten anywhere and I never will, you will almost certainly feel worse overall than the person whose thoughts generally lean toward such sentiments as, I feel so lucky to have a supportive family and a job I enjoy for the most part.) A cognitive therapist can help you to recognize your entrenched, negative thought patterns and encourage you to find positive ideas where you couldn't before.
In addition to CBT, there's interpersonal therapy (generally a short-term treatment that focuses on the patient's interactions with others). There are other types of “talk” therapy, as well. Medication along with, or before beginning, any type of psychotherapy, is believed to increase its chances of success.
An Older Therapy, Re-Examined
In 2006, Kitty Dukakis, wife of former Massachusetts governor and one-time Democratic presidential candidate Michael Dukakis, co-wrote a book with medical author Larry Tye about electroconvulsive therapy. Tye wrote about it from a historical perspective, and Dukakis, from a personal one. Dukakis said her treatment-resistant depression responded positively to ECT.
In some cases, electroconvulsive therapy (ECT) — formerly known as “electroshock therapy” or by the less formal name, “shock treatment” — may be an option. ECT uses electrodes to deliver a brief (approximately 30-second) burst of electricity into strategic centers of the brain and is generally done over several sessions for a relatively short period. ECT has shown some promise in the treatment of depression, particularly serious or dangerous depression, or in cases in which medication is not a good choice.
ECT, once used widely for the treatment of an array of mental illnesses, fell out of popular favor in the later part of the twentieth century, as it was considered dangerous and unpleasant, or even barbaric. Then, as now, it was known to cause memory damage. Significant improvements over time have made ECT far less traumatic than it once was. However, while sometimes useful for intractable depression, ECT is not believed to have much, if any, effect on OCD.