Myths
Myth #1 -- YOU'LL GET AN ACCURATE DIAGNOSIS Almost half the people in the U.S. with clinical depression don't get diagnosed properly, says Wayne Katon, M.D., of the University of Washington Medical School in Seattle. In part, that's because many clinicians use a test developed in the 1950s called the Hamilton Depression Rating Scale ("Ham-D"), which was designed to measure antidepressant effectiveness, not to diagnose depression, says Andrew G. Ryder, Ph.D., of Concordia University in Montreal. The test overlooks some symptoms that indicate depression (such as sleeping too much) and highlights others that aren't always relevant (such as weight los). When trying to diagnose or rule out depression, nothing is more important than detailed conversations with your doctor. Myth #2 -- MEN AND WOMEN HAVE THE SAME RISK FOR DEPRESSION In fact, women are twice as likely as men to experience major depression. Scientists think hormones, an increased tendency to ruminate, and a possible heightened response to stress could all contribute to making women more vulnerable. Myth #3 -- ETHNICITY HAS NO BEARING ON DEPRESSION Differences in the way people from various cultures express depression can result in a missed diagnosis or the wrong medication being prescribed. For instance, "having nerves' in most Caucasian-American cultures means you 're anxious or stressed out; in Latino culture, it can mean you're depressed," says Carolyn Kaufman, Psy.D., of Columbus State Community College in Columbus, OH. So a Latina woman could walk away from her doctor with a prescription for an anti-anxiety medication when what she really needs is an antidepressant. The shocker: Doctors from the same ethnic backgrounds as their patients aren't always better at figuring out what's what. What to do? Make sure your physician can repeat back to you, in different words, what it is that she thinks you're feeling. Myth #4 -- ETHNICITY SHOULDN'T AFFECT YOUR PRESCRIPTION Most drugs are tested on white men. But about 40 percent of African-Americans and Asian-Americans actually metabolize drugs more slowly than Caucasians do, as a result of a genetic difference in liver enzymes, according to research conducted by L. DiAnne Bradford, Ph.D. of Morehouse School of Medicine in Atlanta. The impact: They wind up with more of the drug in their bodies, which increases side effects (insomnia, diminished libido, and scores of others) without increasing benefits Myth #5 -- DEPRESSION IS GENETIC Scientists think that both your genes and your environment affect your mood. No one has found a gene that's directly responsible for depression, but you can inherit one type of gene that can make you more vulnerable to depression after stressful events. So, while you may be able to blame you family for many things, it's not all their fault if you are depressed. Myth #6 -- ANTIDEPRESSANTS MAKE YOU FAT Most antidepressants do carry about a 30-percent chance that you'll gain weight, says Thomas L. Schwartz, M.D., of State University of New York Upstate Medical University. But one-Wellbutrin XL (buproprion)-may cause you to shed a few pounds. Other antidepressants raise serotonin, the chemical that regulates appetite, and may make you feel famished. Even if you eat less, the serotonin might make you store more fat and sugar. But buproprion raises levels of nonrepinephrine and dopamine, not serotonin, thus avoiding appetite issues. Myth #7 -- DEPRESSION IS ALL IN YOUR HEAD Physical illness can trigger depression. One pathway may have to do with cytokines, a natural part of the body's immune response to illness. In fact, when some patients are treated with a certain type of cytokine, they become depressed or even suicidal. In addition, "a mood disorder can potentially affect the body's ability to fight an illness," says David Spiegel, M.D., of Stanford University School of Medicine. Stress can lead to arterial spasms and heart attacks, even if your arteries are clear. Depression is also associated with a poorer prognosis for diseases including stroke, epilepsy, and diabetes. Bottom line: Get treatment for both your physical illness and your depression. Myth #8 -- PILLS ARE THE ANSWER IF YOU HAVE A DOWN DAY HERE AND THERE Placebos have been found to work as well as antidepressants in people with minor depression, meaning you can get through the day but have a low mood for a couple of weeks and don't enjoy certain activities the way you used to. Yet drug makers have been expanding the definitions of mood disorders so much that even health people who have the occasional bad day (and who doesn't?) think they should reach for a pill, according to Ray Moynihan and Alan Cassels, authors of Selling Sickness. Don't buy the hype: Sometimes, counseling or meditation is just what you need to feel like yourself again. |