Dear Alice,
Over the past year that I spent abroad, my cyclic depressions
turned into a general depression, which has more or less left me
incapable of doing anything. Along with the depression, I deal
with bulimia, which expresses itself in my finest moments of
despair. While abroad, I recognized that the depression I was
feeling was no longer normal and asked my parents to please
arrange some counseling for me upon my return home. So, for the
months of July and August, I went to a therapist twice a week. I
have not followed up with therapy back in New York, but feel that
I must do something. Actually, I did do something, I went to the
university's shrink, who promptly wrote me a prescription for
something called Zoloft. What can you tell me about this drug?
In the meantime, I skip 2 - 3 classes a week and couldn't keep the
small job I got to help cover the cost of therapy, which I see in
the future. I constantly feel paralyzed, trapped, as if there is
"no way out." I can't go on like this. Suicide is not an option
for me, NEVER, but THIS ain't living.
—Signed,
Extremely unhappy
Dear Extremely unhappy,
It's understandable that you were prescribed an antidepressant drug
at your university's health services. This drug can help you with
daily activities, and lift your spirits enough to have the energy
to work through some of the depression. It is important for you to
also see a therapist for talking through some of your problems
while you're on Zoloft. One counselor must have referred you
to the psychiatrist who wrote the prescription. If you remember
and liked that person, you need to make an appointment to see
him/her, as well as go for your med checks. Otherwise, if you are at Columbia., make an
appointment at Counseling and Psychological Services (CPS) with any therapist there to complement your drug
therapy (x4-2878).
It may also be important for you to look at the
possible relationship between the bulimia and the depression, and
to discuss both with your therapist. The underlying causes may be
similar, or quite different, but it's a relationship worth
exploring with a professional (many researchers actually link
bulimia's causation solely with depression). If you are a
Columbia student, seeing a professional
at Health Services at Columbia is free if you have paid the health service fee; and, if you need more intensive
treatment, your therapist at CPS can refer you to someone in the
community who would be
covered by your insurance policy, be it the student medical
insurance plan or otherwise.
Here's some basic information on Zoloft, but you also need to feel
secure in being able to ask the psychiatrist who prescribed it for
you to give you more information at your next scheduled
appointment. Zoloft is a type of antidepressant called a selective
serotonin re-uptake inhibitor, or S.S.R.I. It works by altering the
action of the neurotransmitter serotonin. It is believed that
moods, feelings, levels of vitality, and sleep depend — at least
to some degree — on your serotonin levels. Serotonin is associated
with a calming, and somewhat sedative, effect on people. Drugs such as
Zoloft or Prozac interfere with your body's re-absorption of
serotonin, which makes it more available to brain cells and likely
reduces anxiety and depression. (This is an
extremely simplified version of a complex medical science.) Of the
most notable possible side effects of Zoloft are edginess, nausea,
insomnia, weight gain, and sexual difficulties (both in orgasming, and for men, in maintaining erections). These side effects
are considered much less threatening than the side effects of the
earlier antidepressants, which included confusion or blood
pressure problems.
Alice encourages you to follow through on your work in fighting
this depression and your eating disorder. Don't stop until you get
the help that you need!
- Alice
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Depression, bulimia, and Zoloft
