Dr. Guterson: with the Super Bowl coming up this Sunday, I once heard a story about a guy who was with his buddies watching the Super Bowl. He was having a great time and then suddenly his wife called him in a state of desperation - she was out in the middle of somewhere with a flat tire. What advice would you give her husband? Answer: well, some questions are easy and some are more perplexing. This one is in the easy category: He should get off his derrière and go help his wife - and never breathe a word about what a ‘martyr’ he is.
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"Ramblings on the Psych Ward"
Dr. Guterson - It’s that dreary time of year and I’m falling into a depression once again. Does light therapy actually work? A: Absolutely! Although, like everything, one has to be careful. Light therapy has become a standard treatment for winter depression. Research has shown that light therapy can be as effective as antidepressants. The extra light can alter those neurotransmitters which are important for mood, like serotonin and dopamine. Also, getting outdoors (dress appropriately!) for a nice refreshing walk can be a big plus. There are lots of factors that need to be considered with light therapy: the type of light box, how many minutes per day and what time(s) per day to sit near the light box, how far away to sit from the light box. And one thing to be very careful of - light therapy could trigger a manic episode in those with Bipolar disorder. For all these details you need to follow the directives of your psychiatrist. Finally, try singing “Here Comes The Sun” while you’re in the midst of your light therapy. That always works.
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Dear Dr. Guterson: Everyone keeps talking about Prozac. What are your thoughts? Thanks for asking! When I think of Prozac, I first and foremost think of Carly Simon singing the theme song from the famous James Bond movie, ‘The Spy Who Loved Me’: “Nobody does it better Makes me feel sad for the rest Nobody does it half as good as you Baby, you’re the best!” Yes, in my mind, Prozac is ‘the best’. In my experience, I have seen Prozac time and time again provide the most robust turnaround for those suffering from Depression. And in high doses, Prozac is also very effective for Anxiety and Obsessive Compulsive Disorders. But - a few caveats are in order here. First of all, people who are feeling depressed should not necessarily run to swallow Prozac. The diagnosis of Depression must be done carefully and responsibly. Some people may do fine with effective talk therapy and consistent life style changes (diet, exercise, sleep). Next, know that Prozac is not like taking a Tylenol. It’s not that you swallow a Prozac and suddenly, voila!, you feel better. All antidepressants take time to reach their full effect, oftentimes 4-6 weeks. There are side effects with all medications. With Prozac, sexual side effects, like delayed orgasm and decreased libido, occur a significant minority of times. And know that Prozac has one of the longest half lives of almost any medication. This means that if someone suddenly stopped their Prozac, it would take about 4-6 weeks before it leaves one’s system. That explains why some psychiatrists might be reluctant to give it - because if it doesn’t work, if it makes things worse, it will remain in a patient’s body for a long time. But, yes, when used correctly and judiciously, Carly Simon has it right - Prozac is the best. (And I do not work for any pharmaceutical companies). In fact, there are some people who will suggest that we should put Prozac in the water. Finally, there are some great books about Prozac. ‘Listening to Prozac’ and ‘Prozac Nation’ (which was made into a movie) are a couple of them. Wishing you the very best, Dr. John Yaakov Guterson
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