Depression 101
Depression. This one word brings up many different thoughts and images for people. You might say “that story made me depressed” or “I was so depressed when we broke up.” Or you think about the person who has been in their pajamas for 5 days without a shower. But, what exactly is depression?
Symptoms of Depression
When we talk about depression, we usually discuss having multiple symptoms over at least a 2-week period. Some of these symptoms are:
Having a low mood most of the day, nearly every day
Loss of interest or joy in activities
Significant weight gain or weight loss with no lifestyle changes or changes in appetite
Sleeping too much or not enough
Feeling low energy/fatigue
Increase in things like fidgeting or pacing OR severely slowed speech and movements
Feeling excessively worthless or guilty
Difficulty concentrating, focusing, or making decisions
Frequent thoughts of death or suicide
What Depression is NOT:
Being lazy
Being weak
A choice someone makes
Something you necessarily just “snap” out of
Something only women have
Feeling a little sad for a day or 2
Specifically caused by any one negative event
Risk factors for depression (does not necessarily mean causation)
Low levels of certain chemicals (neurotransmitters) in the brain
Environmental stressors- Frequent exposure to trauma, violence, neglect, abuse, or other intense stressors
Genetics- Depression can often be traced through family trees
Certain medical conditions such a thyroid problems, hormonal issues, chronic pain, or cancer, amongst many others
Substance abuse
Poor nutrition- If we are not feeding the body properly, it can’t make the chemicals we need to hold off depression
If you suspect that you or your loved one are struggling with depression, the first line of defense is to always speak with your doctor. Your doctor can first make sure there are no underlying medical conditions causing your symptoms. I always encourage my clients to have a complete physical done with bloodwork to make sure no stones are left unturned. If your doctor cannot find any medical reasons for your depression, they might next encourage you to make some of the following lifestyle changes.
Lifestyle changes that can help with symptoms of depression
Exercise- Exercising starts a physical chain of reactions in your body that can improve symptoms of depression. Exercise has been found to increase the amount of endorphins, a feel good chemical. Exercise has also been found to support new cell growth in the hippocampus part of the brain, which plays a role in having a better mood. Exercise also helps us to relieve stress, which also plays a role in depression.
Changing Diet- When you fuel your body with junk, you’re going to feel like junk. You have to provide your body with the right amount of vitamins, minerals, and building blocks to make the chemicals you need to feel good.
Supplements- Many studies have found that those with depression also have lower levels of vitamin B and D, magnesium, omega 3’s, folate, zinc, and iron, and amino acids. Your doctor can perform blood work that can identify if one of these levels is low and recommend a supplement to meet your needs. However, the best source of vitamins and minerals is through your diet and nature.
Sleep Routines- Getting an appropriate amount of sunlight, following a bedtime routine, and avoiding electronics 2 hours before bed sets your circadian rhythm up, which helps you sleep better. I’ll talk more about sleep specifics in a later blog because it is so important to our mental health.
If these lifestyle changes do not improve your depressive symptoms, your doctor may recommend one or more of the following treatments.
Medical Treatments for depression
Medications- Your doctor might also suspect a chemical imbalance leading to depression and prescribe an antidepressant. Antidepressants have been around for many years now and have found to be very effective in the treatment of depression. Currently, 1 in 10 Americans are prescribed antidepressants making them the 3rd most commonly prescribed class of medications. As with most mediations, there are the risk of side effects and these certainly need to be considered when weighing your treatment options.There have been many improvements in antidepressants over the years so even if you’ve not had great success in the past, an antidepressant may be worth trying again.
ECT (electroconvulsive therapy)- In the 1930’s, it was discovered that inducing a seizure in the brain could lead to a decrease in mental health symptoms in clients. Seizures are induced by connecting electrodes to a client’s skull and running electric current through them. The most famous depiction of this procedure was in the 1975 film One Flew Over the Cuckoo's Nest. The treatment has been refined and improved since this film was created, but the basic principle remains. ECT is now done under anesthesia and in a surgical room. Often, doctors prescribe more than 1 treatment episode over the span of a few weeks. Many clients start their ECT treatments while admitted to the hospital but continue treatments once discharged by coming back to the hospital periodically. There are certainly side effects to this treatment and it is not used until after many failed attempts at other treatments.
TMS (transcranial magnetic stimulation)- TMS is a newer treatment for depression that also works on electrical impulses in the brain. However, instead of a current being applied through electrodes attached to the skull, a metal coil above your head creates a magnetic field that creates the impulses that go through your brain. This treatment is much gentler than ECT and can be done on an outpatient basis through a series of treatments over time. You must also show that several antidepressants have not worked to be approved for TMS.
Vagus Nerve Stimulation- This treatment is also newer in the medical world. In this treatment, a pacemaker-like device is implanted in your chest and attached to a wire threaded through your vagus nerve. The implanted device sends an electric signal through the vagus nerve, which helps to regulate mood. There is an entire theory we’ll discuss later about the vagus nerve’s role in mental health that has made a huge difference in how we understand it.
Alternative or Complementary Treatments For Depression
Acupuncture- Acupuncture involved placing tiny needles in specific points of the body to correct imbalances and improve the body’s functioning.
Yoga/Meditation/Breathing Exercises- Yoga (which includes meditation and breathing exercises) has been scientifically proven to influence mental health. I wrote a whole blog about this topic if you’d like to read more here.
Reflexology- This treatment applies pressure on certain points of the feet that correlate to certain parts of the body and is believed to help with symptoms of depression.
Herbal remedies- Despite research to support it, St. John’s wort has been used for many years to treat depression. People also report ginkgo biloba helps to improve memory and brain functioning.
Massage- On top of the other physical benefits of massage, it has been found that massage can reduce the amount of cortisol, our stress hormone, in your body. When you decrease the cortisol in the body, you can help to improve your overall health, including mental health.
Talk Therapy
Of course, I can’t talk about treating depression without mentioning talk therapy. Therapy provides so many benefits, from a relationship with another human, coping skills, insight into negative thoughts and behavior patterns, and a safe place to feel all the feels. If you ask 10 therapists, you are likely to get 10 different answers on the best form of talk therapy. But, no one approach works for every client so just because CBT or EMDR worked for your friend, doesn’t necessarily mean it will work for you. If you’d like to learn more about how I treat depression, you can read here or reach out to me here to schedule your consultation so we can talk a little bit more. You can also research therapists in your area using a site like Psychology Today or Therapy Den and connect with them through their profiles.
If you are feeling severely depressed and are having thoughts of hurting yourself, please call the National Suicide Prevention Hotline at 1-800-273-8255, 911, or go to your nearest emergency room.
Until Next Time,
Amber