Masters sprinter suffering clinical depression seeks our advice
We often celebrate comebacks by athletes who endured major injury or disease. But that’s not all we have to deal with. A masters sprinter has written me seeking advice on how to deal with clinical depression, especially the medications prescribed to deal with it. I have no wisdom on this subject. But y’all may have some advice. The sprinter in question is aware that the stigma attached to depression is lessening but still prefers to go nameless. Can anyone help?
I’ve also posted this note on the Forum, which has a longer shelf life. Here is the athlete’s question:
For reasons that don’t concern us here particularly, but principally work and family-related, I have been diagnosed as suffering from clinical depression. My physician, who is well-disposed towards people in sport, has prescribed 20mg of Citalopram (also known as Celexa) daily.
I am a sprinter in my 50’s, and this is my first encounter with medication like this. The drug appears to have a number of unpleasant side-effects (nausea, headaches, sleeplessness, for example), at least in the initial stages, and for about 1 in 10 users.
Research on the internet suggests that may be a low figure. I would be interested to hear from any other Masters with first-hand experience of this particular medication, especially how it affected regular training?
14 Responses
Dr. Sad Sprinter,
If work and family problems are causing depression, the cure may more effectively target your stressors rather than your brain chemistry.
Many people with these situation-based issues do very well on herbal products. (Full disclosure, I sell herbal products.)
These are more gentle and can be taken until no longer needed and stopped immediately. Your drug may require a “step-down” period where you slowly ween yourself off the drug.
I have no particular problem with drugs, but before resorting to something this strong, it might be worth your while to consider the less potent, but safer herbal approaches.
No need to replace your knee if you only need a massage, right?
Sorry for my bad English.
10 years ago I became depressed (burn out etc. after being a workaholic). Since then I am from time to time more or less depressed. But in 2001 I started to do sports (walking, jogging) after 30 years of “no sports”. And I consulted a psychiatrist. For many years I have taken “Zoloft” regularly. In the beginning I started with another one, I don’t remember the name, but it was not good for me and my doctor changed to “Zoloft”. “Zoloft” for me has no side-effects, except a little bit for the libido. 8 years ago I started with masters T&F. To do T&F was and is very helpful for me. But “Zoloft” was (and from time to time is) also helpful. For me it was good: it was (and from time to time is) like crutches. And affected in no way my regular training (multievents). I suggest also the lecture of Andrew Solomon’s “The Noonday Demon: An Atlas for Depressions” see: http://www.noondaydemon.com
Take care!
Hello,
I am a psychiatrist and 800 m runner. Thank you for asking this question! Full disclosure: I do NOT own any drug company stock! 😉
Depression is a huge public health problem, profoundly affecting quality of life–and even mortality–for millions of people. It is very common in those of us in the Masters age group. The risk of suicide is especially significant in older men. And depression is VERY TREATABLE. It is great that you talked with your physician about it.
The herbal medicine St. John’s Wort acts in a way very similar to the SSRI medications such as Celexa, Prozac, Zoloft, etc. Data supports use of St. John’s Wort as effective for mild-moderate depression only. (Note that herbals vary in safety: natural doesn’t necessarily mean safe! Small doses of foxglove–digitalis-can kill. Some other herbals appear very safe.)
The best treatment for clinical depression is a combination of medication and psychotherapy. Some folks with mild depression can do well with just psychotherapies, especially specific types like interpersonal or cognitive therapy. (I do lots of psychotherapy.)
However, if you have four or five of the following symptoms, or significant trouble functioning, medication should definitely be considered and can make a huge difference. Symptoms of depression may include increased or decreased sleep; fatigue; poor concentration or memory; loss of interest and motivation; feelings of guilt, self-recrimination or hopelessness; changes in appetite and weight; restlessness or feeling slowed down; anxiety; and suicidal thoughts or actions. There can be other symptoms in severe depressions, as well, such as delusions or hallucinations; these require slightly different medication regimens. Note that if you have lots of up and down mood swings or any history of mania, you should consult with a psychiatrist before taking antidepressants.
I have used SSRI medications and other antidepressants with lots and lots of people and many people tolerate them just fine, especially if people start low and go up slowly.
Many of the listed side effects will not occur in each individual, and if they do, they often go away, or can be managed. For example, I recommend that patients take these medications just before eating, to avoid heartburn or stomach irritation. If one medication causes an intolerable side effect, another one will often be much better. For example, if Celexa is sedating, it can be moved to evening to help sleep. If it is still sedating, Lexapro or Zoloft may be just fine. Celexa (citalopram) has many years of successful use in Europe and North America. If a person cannot tolerate an SSRI, he or she may do really well with bupropion (Wellbutrin), which does not tend to cause weight gain or sexual dysfunction, for example. There are many other options. It is always a risk-benefit decision. I have many people who are very grateful for medications, however.
If there are other symptoms such as panic attacks, generalized anxiety, obsessive-compulsive disorder, etc., the SSRI’s are definitely the class of medications to start with.
These are general principles; of course, you should always speak with your own physician. If you try a medication and things aren’t going well, talk with your doc! If that doesn’t work, consider a psychiatry consultation.
I hope my answer is helpful for many people. My office number is 802.654.7265 if you have other general questions I might be able to help with. Best of luck and keep running! Exercise helps mood, too!
Sue Deppe, MD
WOW!! What splendid advice. So glad the forum is available. I have a fellow vaulter friend quite a bit older than me who could not leave his house for 15 years because of depression. He won nationals a few years ago and it was a joy to see. Now you can’t shut the guy up (or me) because he loves his life so much and I couldn’t be happier for him. All the best to this person and thanks to those of you helping. Bubba
Bubba,
I am sad that your friend lost fifteen years of his life. But how wonderful it must be to see him now! Watching someone get better is one of the great joys of the work I do.
Yea for the friends who are there for us all during the rough times and the illnesses we face! Thanks for the support.
Sue
Pino,
Thank you for sharing your experience. Glad it is going well!
Sue
Sue;
I’d suggest investing in drug stocks. Our aging population makes it a no-brainer.
Sue mentions interpersonal therapy. It’s highly successful in treating depression and in some clinical studies has been shown to be as effective as medication (though as Sue says combination therapy is sometimes the best).
An excellent book on the therapy is Dr. Gregory Hinrichsen’s “Interpersonal Psychotherapy for Depressed Older Adults”, available on Amazon. The book is especially relevant since it focuses on treating depression in older people.
An interesting piece on a new way of treating depression by sleep deprivation:
http://opinionator.blogs.nytimes.com/2010/04/07/in-sleepless-nights-a-hope-for-treating-depression/
My dear daughter suffered from depression in High School. At first I resisted puting her on meds but finally gave in. I believe miracles are reserved for the hand of God, but this came close. She went from a D student that never left the house to an A- student with a “normal” social life in less than 6 months. She’s graduating from UCLA in June with a degree in Psychology and plans on helping others in similar circumstances for her career.
Don’t give up! Lots of help out there!!
I am a sprinter and licensed psychologist. First, it is very important to address your depression medically and psychologically. Sometimes it can be seasonal. The winter months interfere with training, especially in the northwest where i live. Disruptions in training can be frustrating and lead to injuries and discouragement. Step back, assess your situation, talk to a therapist, and look at your family history. The good news is depression is very treatable, and you can learn to manage it and continue to train and compete. Fee free to call 360-679-3310.
hi. I am from New Zealand, and have been sprinting since I was 20 (NOW AGED 55). Beginning in 2002 I suffered a total burnout and depression,My job at the time was a policeman with 26 Years service.My brain simply would not switch off of police work.I was prescribed all manner of drugs, yours included.While they did work to some extent,they all have nasty side effects,from panic attacks to muscle spasms,nausea, libido loss, skin allergies. My advice is for you to stop sprint training (FOR NOW) as this puts a lot of stress on ones body.To maintain general fitness join a walking group.Walking with friend is a great way to recovery from depression, you will surprised how many people have had depression and have recovered.Now everything takes time.It is now 8 years and I am back to competitive sprinting and work
part time instructing school children.Now back to you,if your drugs are causing too many side effects try different ones until you find one more suitable.
When you are well one the way to recovery wean yourself off the drugs.Personally I do not believe you can compete properly while on psychiatric drugs.
Best of luck,if I can do it so can you!
Jeff Barnfield.
I suffer from PTSD, the meds I take help out greatly! They haven’t produced any negative effect with me, however I’ve have been on different trail basic meds from the the day I was diagnosed and that was back in 2004. I will say that other than some prolong bouts of abnormal growth of hair on my hands, I finally found one that work for me for very Quickly. The hair thing was a joke, with these new Meds. I can joke with other people and not feel like I just lost a whole lot of friends or think that people are not like me. I hope you find the right combination that work’s for you. DON’T GIVE UP!!!
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