Depression is Real

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No, it is not something you can ‘snap out of’. Depression is a chronic, medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms as well.

Do you constantly feel miserable without knowing why? Do you have headaches, neck and back pain? Are you always tired? Do you have food cravings or loss of appetite? Do you feel worthless? These are symptoms of depression which is a long term illness that needs to be addressed.


Depression goes by many names including major depression, major depressive disorder and clinical depression. It affects how you feel, think and behave, and can lead to a variety of emotional and physical problems. You may have trouble doing normal, daily activities, and depression may make you feel worthless, as if life isn’t worth living.

Depression symptoms may be so severe that it’s obvious something is wrong. Other people feel generally miserable or unhappy without really knowing why. Depression affects each person in different ways, so symptoms caused by depression vary from person to person. Inherited traits, age, gender and cultural background all play a role in how depression may affect you.


Going beyond a bout of the blues, depression isn’t a weakness, nor is it something that you can simply ‘snap out of’. Depression is a chronic illness that usually requires long term treatment, like diabetes or high blood pressure. On the bright side a majority of people with depression feel better with medication, psychological counselling or other treatment.

What are the symptoms of depression?

1 Feelings of sadness or unhappiness
2 Irritability or frustration, even over small matters
3 Loss of interest or pleasure in normal activities
4 Reduced sex drive
5 Insomnia or excessive sleeping
6 Changes in appetite — decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
7 Agitation or restlessness — pacing, hand-wringing or an inability to sit still
8 Irritability or angry outbursts
9 Slowed thinking, speaking or body movements
10 Indecisiveness, distractibility and decreased concentration
11 Fatigue, tiredness and loss of energy — even small tasks seem to require a lot of effort
12 Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
13 Trouble thinking, concentrating, making decisions and remembering things
14 Frequent thoughts of death, dying or suicide
15 Crying spells for no apparent reason
16 Inexplicable physical problems such as back pain or headaches


Types of depression
Make sure you understand what type of depression you have so that you can learn more about your specific situation and its treatments as there are several other conditions with symptoms that can include depression. It’s important to get an accurate diagnosis so you can get the appropriate treatment for your particular condition. Your doctor evaluation will help determine if your symptoms of depression are caused by one of the following conditions:

Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It’s a type of stress-related mental illness that may affect your feelings, thoughts and behavior.

Bipolar disorder. This type of depression is characterised by mood swings that range from highs to lows. It’s sometimes difficult to distinguish between bipolar disorder and depression, but it’s important to get an accurate diagnosis so that you can get the proper treatment and medications.

Cyclothymia. Cyclothymia (si-klo-THI-me-uh), also called cyclothymic disorder, is a milder form of bipolar disorder.
Dysthymia. Dysthymia (dis-THI-me-uh) is a less severe but more chronic form of depression. While it’s usually not disabling, dysthymia can prevent you from functioning normally in your daily routine and from living life to its fullest.

Postpartum depression. This is a common type of depression that occurs in new mothers. It often occurs between two weeks and six months after delivery.
Psychotic depression. This is severe depression accompanied by psychotic symptoms, such as delusions or hallucinations.

Seasonal affective disorder. This type of depression is related to changes in seasons and diminished exposure to sunlight.


Medication
A number of antidepressant medications are available to treat depression. There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring chemicals in your brain to change your mood.


Types of antidepressants include:
Selective serotonin reuptake inhibitors (SSRIs). Many doctors start depression treatment by prescribing an SSRI. These medications are safer and generally cause fewer bothersome side effects than do other types of antidepressants. SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). The most common side effects include decreased sexual desire and delayed orgasm. Other side effects may go away as your body adjusts to the medication. They can include digestive problems, jitteriness, restlessness, headache and insomnia.


Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications include duloxetine (Cymbalta), venlafaxine (Effexor XR) and desvenlafaxine (Pristiq). Side effects are similar to those caused by SSRIs. These medications can cause increased sweating, dry mouth, fast heart rate and constipation.


Norepinephrine and dopamine reuptake inhibitors (NDRIs). Bupropion (Wellbutrin) falls into this category. It’s one of the few antidepressants that doesn’t cause sexual side effects. At high doses, bupropion may increase your risk of having seizures.


Atypical antidepressants. These medications are called atypical because they don’t fit neatly into another antidepressant category. They include trazodone (Oleptro) and mirtazapine (Remeron). Both of these antidepressants are sedating and are usually taken in the evening. In some cases, one of these medications is added to other antidepressants to help with sleep. The newest medication in this class of drugs is vilazodone (Viibryd). Vilazodone has a low risk of sexual side effects. The most common side effects associated with vilazodone are diarrhea, nausea, vomiting and insomnia.


Tricyclic antidepressants. These antidepressants have been used for years and are generally as effective as newer medications. But because they tend to have more numerous and more-severe side effects, a tricyclic antidepressant generally isn’t prescribed unless you’ve tried an SSRI first without an improvement in your depression. Side effects can include dry mouth, blurred vision, constipation, urinary retention, fast heartbeat and confusion. Tricyclic antidepressants are also known to cause weight gain.


Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate) and phenelzine (Nardil) — are usually prescribed as a last resort, when other medications haven’t worked. That’s because MAOIs can have serious harmful side effects. They require a strict diet because of dangerous (or even deadly) interactions with foods, such as certain cheeses, pickles and wines, and some medications including decongestants. Selegiline (Emsam) is a newer MAOI that you stick on your skin as a patch rather than swallowing. It may cause fewer side effects than other MAOIs. These medications can’t be combined with SSRIs.


Other medication strategies. Your doctor may suggest other medications to treat your depression. These may include stimulants, mood-stabilising medications, anti-anxiety medications or antipsychotic medications. In some cases, your doctor may recommend combining two or more antidepressants or other medications for better effect. This strategy is known as augmentation.


Psychotherapy
Psychological counselling is another key depression treatment. Psychotherapy is a general term for a way of treating depression by talking about your condition and related issues with a mental health provider. Psychotherapy is also known as therapy, talk therapy, counselling or psychosocial therapy.


Through these talk sessions, you learn about the causes of depression so that you can better understand it. You also learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life. Psychotherapy can help you regain a sense of happiness and control in your life and help ease depression symptoms such as hopelessness and anger. It may also help you adjust to a crisis or other current difficulty.


There are several types of psychotherapy that are effective for depression. Cognitive behavioral therapy is one of the most commonly used therapies. This type of therapy helps you identify negative beliefs and behaviors and replace them with healthy, positive ones. It’s based on the idea that your own thoughts — not other people or situations — determine how you feel or behave. Even if an unwanted situation doesn’t change, you can change the way you think and behave in a positive way. Interpersonal therapy and psychodynamic psychotherapy are other types of counseling commonly used to treat depression.


Alternative medicine
Herbal remedies and supplements include:

St. John’s wort. Known scientifically as Hypericum perforatum, this is a herb that’s been used for centuries to treat a variety of ailments, including depression. It’s classified as a dietary supplement and a popular treatment in Europe for mild or moderate depression. But, it can interfere with other depression medicines, as well as some drugs used to treat people with heart disease, seizures, cancer and organ transplant.


SAMe. Pronounced ‘sammy’, this is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosylmethionine. It’s classified as a dietary supplement and the side effects are usually minimal, but SAMe can trigger mania in people with bipolar disorder.
Omega-3 fatty acids. Eating a diet rich in omega-3s or taking omega-3 supplements may help ease depression, especially when used in addition to standard depression treatments. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods.


Folate. Low levels of folate, a B vitamin, may cause a slowed response to some antidepressants. Taking folate supplements (folic acid) may be helpful when used in addition to antidepressants.


Always seek the advice of your doctor when using alternatuve medication. You can’t always be sure of what you’re getting and if it’s safe. Also, be aware that some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions.

Mind body connections
The connection between mind and body has been studied for centuries. Complementary and alternative medicine practitioners believe the mind and body must be in harmony for you to stay healthy.


Mind body techniques that may be tried to ease depression symptoms include:
Acupuncture
Yoga
Meditation
Guided imagery
Massage therapy


As with dietary supplements, take care in using these techniques. Although they may pose less of a risk, relying solely on these therapies is not enough to treat depression.

Coping with and treating depression
1 Stick to your treatment plan. Don’t skip psychotherapy sessions or appointments, even if you don’t feel like going. Even if you’re feeling well, resist any temptation to skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms.


2 Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan.


3 Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so that you know what to do if your symptoms get worse.


4 Get exercise. Physical activity reduces depression symptoms. Consider walking, jogging, swimming, gardening or taking up another activity you enjoy.


5 Avoid alcohol and illegal drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat.


6 Get plenty of sleep. Sleeping well is important for both your physical and mental well-being. If you’re having trouble sleeping, talk to your doctor about what you can do.


7 Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.


8 Write it down. Keeping a scrapbook or journal can improve mood by allowing you to express pain, anger, fear or other emotions.


9 Join a support group. Connecting with others facing similar challenges can help you cope. Local support groups for depression are available in many communities, and support groups for depression are also offered online.


10 Don’t become isolated. Try to participate in social activities, and get together with family or friends regularly.


11 Take care of yourself. Eat a healthy diet, exercise regularly and get plenty of sleep.


12 Learn ways to relax and manage your stress. Examples include meditation, yoga and tai chi.


13 Structure your time. Plan your day and activities. You may find it helpful to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organised.


14 Don’t make important decisions when you’re down. Avoid decision making when you’re feeling very depressed, since you may not be thinking clearly.

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