Hi Jacques, it is nice to hear from you again... although, I am sorry you have been struggling again lately.  I used to be awful about complying with my pdocs' instructions for taking the psychotropics properly.  I kept thinking that I could go off them once I started feeling better.  It would takes a couple of months for things to deteriorate and by then, I would have "forgotten" that I needed to take certain meds to avoid the mood disorders.  <sigh>  I've finally accepted that I need to take my meds properly and continuously if I want to function and thrive in the here and now.  Good news... It's working!

My treatment plan has been reduced to just medication. Wellbutrin and Cipralex to battle the depression and lithium(-carbonate) to counter the mood swings. My blood work seems to be a little off on almost everything tested, so I also have to take vitamin and other supplements. As soon as we have that under control, we will continue to look at other treatment options.

Excellent post Josie... covers all the important aspects necessary to successfully manage this debilitating disorder.  It doesn't have to win!  But it isn't going to just magically get better.  It takes a multi-pronged, persistent approach... at least it certainly has for me.

• Taking three medications... Wellbutrin 300mg for depression, Prozac 40mg for anxiety, Seroquel  50mg  as a sleep aid.
• Seeing a therapist once or twice a month... while she is not a CBT therapist, she has been key in helping me apply these principles to my everyday life.
• Continuing to work through the CBT program on the various Evolution Health sites.  I have gone through the lessons in order (doing the homework is essential!) and now visit various ones depending on what issues or symptoms are poking up needing attention as  I still "forget" what I've learned so have to go over these things again and again.... they are gradually becoming more automatic.
• Have begun exploring the Healthy Living sister site and am determined to follow through on eating better and exercising more.
• I don't have much real life support but find great encouragement from the Evolution Health forums.

Life IS good! :)

Members,

In order for things to get better, you are going to have to take action. The first step toward recovery is to seek appropriate treatment. Appropriate treatment for depression is medication, psychotherapy or both. No matter what type of treatment you choose, you will be asked to "get active" in your treatment. Medications only work if you take them as directed and let your doctor know how things are going. Psychotherapy only works if you're willing to do some hard work.

Healthy living habits may also help you to overcome depression. Exercise, a proper and balanced diet, moderate use of caffeine and alcohol, and learning how to reduce stress are important. In order to make these kinds of changes, you will need to do some work.

The help and support of family and friends can be an important part of recovery. Friends and family can also play an active role in the treatment process. However, if you want support and help, you have to be willing to ask for it.

Medication and Therapy Compliance

Treatments for MDD work well. However, treatments for MDD do not work right away. It usually takes 4 to 8 weeks before people notice that things are getting better.

If your doctor prescribes medication, take it as prescribed. It's important for you to let your doctor know if you have any problems or side effects. It's also important to let your doctor know if the medication is working. If the medication is not working after 4 to 8 weeks, don't give up. Talk to your doctor again. There are likely other options including increasing the dose or switching medications. If the medication seems to be working, make sure to tell your doctor that too.

Your doctor needs to know what is going well and what is going not so well. Communication between you and your doctor is extremely important. Keeping detailed records of your symptoms and sharing that information with your can help you get the best results possible.

If you are involved in psychotherapy you'll be asked to do a lot of work. For example, in CBT and CBASP you'll be asked to set goals for treatment and you'll be asked to do "homework" that helps you to work toward your goals. You'll be asked to keep detailed records of your symptoms, to record what you are doing and feeling, and to record what you're thinking about when you feel depressed. You'll be asked to share all of this with your therapist.

Treatment for MDD is hard work. However, the only way for you to recover and get back to your life is to get active.