Our Guide to Dealing with Depression
Almost anyone you know will use the words “I’m depressed” to describe the way they are feeling from time to time. Feeling ‘blue’ or feeling down’ is not the same as suffering from a clinical depression. Depression becomes an illness when symptoms are severe, last for several weeks, and begin to interfere with one’s work and social life.
Types of Depression
There are several types of depression: major depression, seasonal affective disorder (SAD), postpartum depression, situational depression, bipolar disorder, and premenstrual dysphoric disorder (PMDD).
Major depression, also known as major depressive disorder, is diagnosed when you are feeling depressed most of the time throughout the day, most days of the week. Symptoms would include a depressed mood and a loss of interest in activities, along with at least three other symptoms of depression.
Seasonal Affective Disorder (SAD)
SAD is a type of major depression that occurs during the winter months when days the days grow shorter and there is less sunlight. This type of depression typically goes away during the spring and summer months. Light therapy can benefit people that suffer from SAD.
Women who experience major depression in the weeks and months following childbirth suffer may be suffering from postpartum depression. It’s important to distinguish between ‘baby blues’ and postpartum depression.
Anywhere from 50 – 85% of new moms experience ‘baby blues’ – this phenomenon following childbirth that lasts anywhere from a few hours to two weeks. It usually resolves untreated as the mother adjusts to the changes in her routine, hormonal fluctuations and less sleep.
Postpartum depression generally develops within three months of giving birth and can last for years if left untreated. This condition is often accompanied by anxiety, sleep and eating disturbances, feelings of guilt and shame and thoughts of harm towards one’s self or the baby.
Stressful life events, such as the death of a loved one or a divorce, can cause a depressed mood to develop. This type of depression is also known as ‘stress response syndrome’ and it responds well to cognitive behaviour therapy. Seeking help to process difficult life events can help you to process the event, manage self-care and help you to heal from the trauma and/or loss.
A person suffering from bipolar disorder, formerly known as manic depression, experience severe shifts in mood and energy making it difficult to function. This condition usually emerges in late adolescence or early adulthood. People often live with this condition for years without having it properly diagnosed or treated.
Premenstrual Dysphoric Disorder (PMDD)
Most women experience some sort of premenstrual syndrome (PMS) the week before their period, signs and symptoms may include: bloating, food cravings, cramps, moodiness, etc. Women suffering from PMDD experience symptoms that are more severe and debilitating; they often interfere with daily activities, work, school and relationships.
PMDD can cause monthly episodes of hopelessness, anxiety, intense anger and conflict, loss of sleep and feeling ‘out of control’.
What Causes Depression
There is no one cause of depression. Depression usually results from a combination of recent events and personal factors. There may also be a genetic link since people with a family history of depression are more likely to experience it.
The following factors may make you more prone to experience clinical depression:
- Specific, distressing life events: the death of a loved one, loss of job, divorce, etc.
- A biochemical imbalance in the brain
- Personality – tendency to worry, low self-esteem, negative or pessimistic thought patterns, perfectionists, self-critics, etc.
- A family history of depression
- History of trauma or abuse
- Having had one episode of major depression increases the risk of having another
- Chronic pain or illness
- Drug and alcohol use
What Are Some Symptoms of Depression
Depressive illness can change the way a person thinks and behaves, and how his/her body functions. When a person is depressed, it affects both the body and the mind. It disrupts some of the body’s most basic systems, making the person feel unwell.
- Feeling worthless, helpless or hopeless
- Sleeping more or less than usual
- Increased alcohol and drug use
- Withdrawing from family and friends
- Avoiding work, school and/or social situations
- Increased physical health complaints, especially fatigue or pain
- Negative thoughts – “I’m a failure”, “Nothing good ever happens to me”, “Life’s not worth living”, “It’s all my fault”
- Eating more or less than usual
- Difficulty concentrating or making decisions
- Decreased sex drive
- Overwhelming feelings of sadness or grief
- Thoughts of death or suicide
Depression Diagnosis & Treatment
An accurate diagnosis of depression should only be made by a qualified mental health professional or physician. Psychologists, psychiatrists and family physicians are able to diagnose after a complete evaluation of symptoms, screening, assessment and history.
Depression is the most treatable of mental illnesses. Most people who suffer from depression are helped by the treatment they get, which usually includes psychological therapy and/or medication. The most effective treatment of clinical depression is a combination of Cognitive Behavioural Therapy (CBT) and medication.
CBT helps the client to become aware of thought distortions which are causing psychological distress, and of behavioural patterns which are reinforcing it, and to correct them. A psychologist will make every effort to understand experiences from the client’s point of view; the client and psychologist work collaboratively exploring the client’s thoughts, assumptions and inferences.
Negative Thinking and Depression
The psychologist helps the client learn to test these presumptions by checking them against reality and against other assumptions. Throughout this process of learning, exploring and testing, the client acquires coping strategies as well as improved skills of awareness, introspection and evaluation. This enables them to manage the process on their own in the future, reducing the likelihood of experiencing a relapse.
Negative thinking in depression can result from biological sources, modelling from parents or other sources. The depressed person experiences negative thoughts as being beyond their control. The psychologist provides techniques to give the client a greater degree of control over negative thinking by correcting cognitive distortions.
This type of thinking also interferes with recovery and makes the person more vulnerable to depression in the future. It is important to recognize unhelpful thoughts and replace them with more realistic thoughts.
Cognitive Behaviour Therapy (CBT) Can Help
As well as helping people manage negative thoughts, CBT also involves looking at behaviour. This includes helping people find new ways of going about their everyday life. This can include the way a person may react to certain people or situations and/or how a person might plan their day.
Learning these techniques and incorporating new activities into daily life (e.g. exercise, self-care, increasing social supports) can help recovery and prevent relapse. Some of the specific ways we help include the following:
- Change your negative thoughts and feelings
- Identify ways to manage your illness and stay well
- Encourage you to get involved in activities
- Speed your recovery
- Prevent depression from recurring
Antidepressants and Depression
Antidepressants are medications that can help to restore chemical imbalances in the brain by allowing the nerves of the brain communicate more effectively. By targeting certain brain chemicals (serotonin, norepinephrine, dopamine), antidepressants help to regulate mood and to reduce the symptoms of depression that keep you from managing daily routines and enjoying life.
When deciding which antidepressant to prescribe, your doctor will take into consideration your depression symptoms, overall health, and any other medications you may be taking. Some antidepressant medications can cause unpleasant side effects: dry mouth, nausea, weight gain, decreased libido.
Most side effects decrease after a week or two, if the side effects do not decrease ask your doctor to try another medication. If you are experiencing unpleasant side effects it is important to decrease your medication dosage slowly under the supervision of a physician.
Self-Help Techniques and Depression
There is a wide range of self-help techniques and therapies that can help to manage depression and prevent relapse. They are most effective when used in conjunction with psychological treatment and/or medication. It can be good to know that there are things you can do for yourself to feel better.
Fighting Depression with Exercise
Regular exercise may increase the levels of serotonin in the brain. Serotonin is a neurotransmitter involved in regulating mood, sleep, libido, appetite and other functions. Exercise can also increase the level of endorphins in the brain which have ‘mood-lifting’ properties.
Regular exercise increases energy, improves sleep, distracts from worries and negative thought patterns. Group exercise provides social support and reduces feelings of loneliness. Mild to moderate exercise can be helpful for depression; a brisk walk three to four times per week is beneficial.
Yoga and Depression
Yoga is an ancient exercise philosophy that provides a gentle form of exercise and stress management. It consists of postures known as asanas that are held for a short period of time and are synchronized with your breathing. Yoga is very helpful for reducing stress and anxiety, which are often precursors to depression. Studies have shown that yoga breathing exercises are beneficial for depression.
Meditation and Depression
Mindfulness meditation is a form of self-awareness training. Mindfulness is about being in the present moment, without making a judgment. It allows us to experience our body and feelings in each moment with acceptance.
Mindfulness meditation can help to stop getting caught up in thinking about the past or worrying about the future. Practicing meditation on a regular basis can change the way our brain and nervous system function; it decreases stress and improves mood.
Untreated clinical depression is a serious problem. Many people who are seriously depressed wait too long to seek treatment or they may not seek treatment at all. They may not realize that they have a treatable illness, or they may be concerned about getting help because of the negative attitudes held by society towards this type of illness.
Untreated depression increases the chance of developing a drug or alcohol addiction, it can ruin relationships, create problems at work, make it difficult to overcome serious illnesses and even result in suicide. Without proper treatment untreated clinical depression can last for weeks, months, or years.