|Attachment Theory David Schnarch Couples CE Comments Anxiety Mindfulness Gender Issues Etienne Wenger Community of Excellence William Doherty The Future of Psychotherapy Brain Science Clinical Excellence Attachment Wendy Behary Mary Jo Barrett Linda Bacon Narcissistic Clients Ethics Couples Therapy Challenging Cases Future of Psychotherapy Trauma Symposium 2012 Diets Alan Sroufe Mind/Body Men in Therapy Great Attachment Debate Clinical Mastery|
|Clinicians Digest Mar/Apr 2008 - Page 3|
How can therapists who treat moderate to severely depressed clients know when to think beyond psychosocial events and serotonin? In his 2000 book, The Antidepressant Survival Guide, psychiatrist Robert Hedaya, professor of psychiatry at Georgetown University, presents separate checklists to help determine whether a depression might be caused by malfunctioning thyroid or adrenal glands. Among the dozens of possible indicators: weak muscles (especially in the upper arms and thighs), unexplained weight fluctuation, dry skin, hair loss, swelling in the hands or feet, puffiness below the eyes, irregular menstrual periods, a craving for salty foods, excessive tiredness, dizziness or light-headedness when standing, an increased tendency to bruise, or darkening of the skin around elbows, knuckles, palms, knees, or nipples.
Not all therapists pay sufficient attention to possible biological causes of depression. Belfort's article serves as a reminder that therapists should make sure that they refer to psychiatrists who consider thyroid and adrenal problems before handing out an antidepressant prescription. The simple blood tests may head off months of anguish and deterioration.