How much of anxiety and depression is “nature vs. nurture”?  Everyone becomes anxious and depressed at some period of life for many reasons and issues.  However, anxiety and depression become problematic when they interfere with daily functioning are prolonged over time and seriously affect work, play, intimate time and life in general. 

These disorders are biologically inherited and involve complex pathways in the brain that predispose patients to neurotransmitter excesses or depletions.  Medications do help in restoring this balance.  Those who are genetically vulnerable to anxiety and or depression will find that life’s stresses affect them in different ways compared to those without the disorder.  In addition, our family experience, how we view ourselves, past conflicts and traumas, current family stressors, our inability to heal as well as our diet and exercise--- all contribute to our mood.  Those more vulnerable may experience such factors in more severe ways than those who do not necessarily have this genetic predisposition.

Do I have to take medications forever?  This depends on the individual circumstances and issues and the degree of severity on the impact on one’s life.  Some episodes are short lived while other people’s anxiety and or depression can wax and wane and relapse over time.  Some people require ongoing preventive treatment with medications while others can stop medications after some months when they feel they are in recovery. 

What role does therapy play in addition to medications? Medications alone are never the one answer.  Depression and anxiety are intimately related to what is going on in our inner life.  This means that individual and group therapy will help identify the origins of our need to heal, offer an ability to heal and help repair our sense of Self.  We have to take responsibility of our recovery over time through many modalities including our own self-help and practice of what is learned in therapy.  There are no magic answers and no one clinician can be the end all and be all of treatment. 

How can I personally empower myself when my issues are plaguing me, even though I feel better with medications?  Therapy is one aspect. However we must strive to enrich our lives.  This means we need to rediscover who we are what are interests are and reclaim a purpose for being on the planet.  We need to divide our time between work, family, recreation, creativity and spirituality (in the way we view spirituality or not). If we lack this capacity because we did not learn this balance from the past then it can be learned and it is never too late.  In essence we can nurture and parent ourselves and move forward from the point where we did not receive, achieve or attain.  The more selflessness we develop for community and as a whole the more we can let go and feel freer to expand ourselves outside of our own focus.

© 2007 - 2010 Rama Pemmaraju Rao, M.D.

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