14 The Costco Connection JANUARY 2018
CONSUMERCONNECTION
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AMANDA HOROWITZ
Amanda Horowitz is a writer,
businesswoman and owner
of Fight Back! She is the
daughter of Fight Back’s
founder, David Horowitz.
Fight Back! has received
multiple Emmy Awards
and awards from more than
;;; government and citizen
groups and has helped to
draft over ;; pieces of
consumer-related legislation
in the United States.
Horowitz can be contacted
at
Amanda@fightback.com.
Please include “Consumer
Connection” in the subject
line. She will select questions
to answer in this column
but regrets that unpublished
questions cannot be answered
individually.
MORE IN ARCHIVES
At costcoconnection.com,
search “Consumer Connection.”
Please note that Amanda Horowitz
and Fight Back! are not licensed
professionals in any field. If you are
seeking professional advice, you should
consult with your own licensed
professional. Amanda Horowitz and
Fight Back! do not assume any liability
or responsibility for the interpretation,
application, or accuracy of any
information provided.
DEPRESSION IS ONE of the leading causes of
disease or injury worldwide, according to the
Centers for Disease Control and Prevention
( cdc.gov). It can cause troubles at home, at work,
with money and in relationships. It can lead to
self-harm or death. Symptoms include loss of
interest in activities, feelings of hopelessness
and changes in sleep or appetite. If you have
been experiencing these symptoms for more
than two weeks, medical experts say that you
could have depression.
Depression is a medical illness. As a consumer, you need to know the resources available: how to get the best care, your insurance
benefits, the doctor-patient relationship,
choosing a therapist, paying for therapy, drug
options and psychiatric hospitals. Here’s a look
to help you and your family members navigate
this difficult situation.
Getting help. While licensed psychologists,
counselors, social workers and psychiatric
nurse practitioners all treat depression, seeing
a psychiatrist is recommended if you have
depression symptoms along with thoughts of
self-harm. Psychiatrists’ medical training
includes four years of medical school and four
years in a psychiatric residency. They are
trained to prescribe and manage psychotropic
medications. The American Psychiatric
Association has a physician locator at psychia
try.org. Click “Patients & Families,” then “Find
a Psychiatrist.”
If you live in an area with a lack of mental
health providers or lack of access to mental
health services, some mental health experts rec-
ommend consulting with a primary care physi-
cian as a good first step. In certain states, clinical
psychologists can legally prescribe medication
for mental health treatment. There is debate
about this among medical health professionals.
Discuss treatment options with your physician. According to Dr. Philip R. Muskin, a professor of psychiatry at Columbia University,
research indicates psychotherapy with psychotropic medication is the most effective overall
treatment for depression. However, individual
treatment plans vary. Art, music, group or
equine therapy or self-help groups may be part of
a treatment plan. Treatment could include tests
by other physicians that screen for illnesses that
could mimic depression symptoms.
Medication. Some psychotropic medications
could make your symptoms worse at the begin-
ning of treatment; you could have uncomfort-
able side effects or an increase in thoughts of
self-harm. Tell your physician immediately if
symptoms occur. If you have been treated with
medication before, one way to potentially get
clues about how your body may respond to a new
medication is to ask your physician to adminis-
ter a genetic test.
Treatment-resistant depression. When de-
pression is unresponsive to other forms of ther-
apy, brain stimulation therapy, such as repeti-
tive transcranial magnetic stimulation or
electroconvulsive therapy, or pharmacotherapy
using ketamine may be suggested. Be aware that
while the Food and Drug Administration has
approved ketamine as an anesthetic, it is not
approved for treating depression. Physicians
may choose to use it unapproved (“off label”)
when they judge it is medically appropriate.
Consider the available data on ketamine and the
potential risks associated with the drug before
using it.
Costs. Check with your health insurance
coverage provider for access to mental health
benefits (also called behavioral health benefits).
Check your plan for providers in your area. Note
that not all providers accept insurance.
A provider may charge patients on a sliding
scale to assist those with financial challenges.
Patient-assistance programs and discount drug
cards may make medication affordable for some
individuals. Physicians sometimes can provide
free samples of certain medications.
If you are in crisis. In these cases, don’t hesi-
tate to call ;;; or go to the local emergency room.
Also, the National Suicide Prevention Lifeline is
available for support ;;/;/;;; at ;-;;;-;;;-
TALK (;;;;). If necessary, an inpatient hospital
stay can provide a safe space to formulate a treat-
ment plan.
Residential care facilities and clinics offer
mental health services. Ask a trusted mental
health provider for a referral. Programs and
cost vary. C
More than the blues
How to get the depression help you need
• For current or former service members:
mentalhealth.gov/get-help/veterans.
• American Society of Addiction Medicine:
asam.org/resources.
• National Alliance on Mental Illness: nami.org.
• Mental Health America:
mentalhealthamerica.net.
• U.S. Department of Health and Human
Services: MentalHealth.gov.
• National Institute of Mental Health:
nimh.nih.gov.
• Substance Abuse and Mental Health Services
National Helpline: 1-800-662-HELP (4357;
SAMHSA.gov.
ADDITIONAL RESOURCES
