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Dealing With Depression During or After Divorce or a Breakup
Theodora Blanchfield
Other than the death of a loved one or a major illness, divorce is one of the biggest life stressors you may face. It's a complicated decision, both legally and emotionally, and it's not uncommon for depression and divorce to occur together.
Depression after divorce is common because it's a major loss that can bring with it immense grief. Sometimes, a traumatic event like divorce may exacerbate a preexisting mental health condition or lead to the development of a new one. What are the signs you should look out for, and how can you prepare for them as you navigate this difficult time?
Common Stressors from Divorce
During a divorce, you're attempting to live your everyday life on top of juggling all of the divorce-related stressors. It can be emotionally and mentally draining for anyone, so it's not surprising if you're wondering whether what you're feeling right now is from divorce, depression, or both.
Common stressors during this time can include needing to start over, deciding whether to keep your marital home or move, losing the life and lifestyle you know, paying high lawyer fees, and managing your children's reactions if you're a parent. And then, of course, there's the stress of the unknown. You may wonder if the divorce settlement agreement will be just, if you'll get the assets you want and need, and if your employment status will need to change (e.g., if you need to go back to work after you've been a stay-at-home parent). You may also wonder how divorce will affect your kids and other relationships in your life, like mutual friends.
Recognizing Symptoms of Depression during or after Divorce
If you're also managing symptoms of depression, these stressors can be even more difficult to manage. It can be hard to distinguish whether you're experiencing expected stress and/or depression, especially since the two often coexist. However, there are some specific symptoms of depression that aren't caused by everyday stress. These symptoms can include fatigue, feelings of worthlessness or hopelessness, weight loss or gain, and thoughts of death or suicide.
While you might feel that this isn't the right time to seek treatment, remember that depression can also impact decision-making capacity, and it's critical to be able to think clearly and advocate for yourself while you're dealing with a life decision as complicated as divorce. When symptoms from depression and divorce start impacting your life—if you have trouble making it to work or keeping up with your responsibilities, for example—it may be time to seek treatment.
Treatment Options
One of the best ways you can advocate for yourself if you're experiencing depression during your divorce is to seek care. Your first line of treatment will likely be either talk therapy or medication. You may want to talk to your primary care provider and see if they have a referral to a therapist. If you're prescribed medication, don't be discouraged if the first pharmacological treatment you try isn't the one for you—less than 30% of people find the right one on the first try.
However, if you've tried two or more medications and are still experiencing symptoms of depression, you're not out of solutions. Another option to consider is transcranial magnetic stimulation (TMS), a treatment that uses magnetic pulses to gently stimulate areas of the brain. TMS is non-invasive, and its treatments are short (about 20 minutes), creating minimal disruption to your already full routine.
It's common to experience depression during or after divorce, but you don't have to feel this way. If you're not feeling better after medication and therapy, then consider looking into other treatments, such as TMS. But above all, be sure to give yourself grace while going through this hard time, and as much time as you can when making a big decision.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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