Mental Health........

Depression: Dealing Day to Day

Though depression can be an extremely difficult disease to handle, there are strategies that help. Some methods of managing it effectively are explored below.

1. Seeking early treatment
   If you have feelings of unhappiness that are persistent and interfere with your activities and relationships, you are probably suffering from depression. Early treatment is key to the quickest possible recovery.
   
   
2. Taking all medications as prescribed by your doctor
   Work with your doctor to decide which medications to try and then make sure to take them faithfully. If you are feeling better, don't stop taking antidepressants without getting the go-ahead from your doctor.
   
   
3. Attending all scheduled therapy sessions
   Therapy can be a very effective tool in managing depression. Working with a psychiatrist, psychologist or clinical social worker in regular therapy can help depressed individuals find better ways to cope, solve problems and set realistic goals, as well as manage suicide risk if there is any. Skipping therapy sessions can extend or negatively affect treatment for depression.
   
   
4. Eating a well-balanced diet
   A healthful diet is an essential part of managing depression. It is composed of foods that provide a variety of nutrients, including vitamins and minerals. Foods that should be part of any sound diet include:
   
   
   • Vegetables
   • Whole grains
   • Fruits
   • Dairy products
   • Beans
   • Lean meats
   • Poultry and fish
   • Nuts and seeds
   
   You can work with your doctor and/or dietitian to create a meal plan that is well balanced and that offers a variety of food choices.
   
   
5. Avoiding illegal drugs and alcohol
   Although moderate alcohol consumption may offer some health benefits, people who abuse alcohol have an increased risk of depression. The same is true for individuals who abuse illegal or prescription drugs. If you have depression, it is best to avoid these substances, which can worsen symptoms and inhibit the effects of antidepressant medications.
   
   
6. Exercising regularly
   Regular physical activity has been shown to have antidepressant effects in people with mild to moderate depression, who are encouraged to exercise for 30 minutes a day on most days of the week. If you are new to exercise, it is best to begin gradually by exercising for just a few minutes at a time, and work your way up to 30 minutes or more a day. Aerobic activity (also called cardio) is typically most effective at relieving symptoms of depression. Examples of aerobic exercise include walking, running, biking, dancing, in-line skating, swimming and playing basketball. (Consult with your doctor before beginning a new fitness routine.)
   
   
7. Getting plenty of rest
   Changes in sleep patterns are common among people with depression. They may sleep too much (hypersomnia) or not enough (insomnia). It is common for depressed individuals to awaken early in the morning and have difficulty falling back asleep.
   
   Sometimes these problems can be allayed with a few simple strategies, such as avoiding beverages with caffeine before bedtime, refraining from napping during the day and using earplugs to block out background noise. Getting the recommended amount of sleep can help alleviate feelings of depression.
   
   
8. Employing positive coping methods
   It is common to feel hopeless during a depressive episode. But you can help take control of your condition by identifying and using positive coping methods. In other words, when you start to feel sad, you can do something that provides solace. While this may not always ease the pain, and it's certainly not a cure, it can help stem the sadness on some occasions. Positive coping methods include:
   
   
   • Writing in a journal
   • Talking to a friend or family member
   • Exercising
   • Engaging in a hobby, such as cooking, drawing or gardening
   
   
9. Sharing your feeling with others
   Sharing your feelings with others, such as friends, family members and your doctor and/or therapist, can help you identify and work through any emotional challenges you may be experiencing. Having a reliable network of social supports can help combat the feelings of isolation that often accompany depression.

Depression: Fast Facts

• Depression affects about 9.9 million American adults each year.
  
  
• Depression affects women nearly twice as often as men.
  
  
• As many as one out of every five women will develop depression in her lifetime.
  
  
• Women between the ages of 18 and 45 account for the majority of all cases of depression.
  
  
• Anyone can develop depression, regardless of their age, race or social class.
  
  
• Many people with depression do not even realize that they are depressed and initially see their primary care doctor to treat what they believe is a physical disorder.
  
  
• Depression cannot be prevented. However, more than 80 percent of people who have it can be treated successfully with psychotherapy, medical therapy or a combination of both.
  
  
• Although a depressive episode can last from a few weeks to many years, most episodes last between six and nine months.
  
  
• Selective serotonin reuptake inhibitors (SSRIs) are generally the first antidepressant medication prescribed for depression.
  
  
• The risk of depression may be as high as 25 percent in first-degree relatives (parents, children and siblings) of patients with a history of depression.
  
  
• About one third of depressed individuals also suffer from some form of substance abuse or dependence.
  
  
• As many as 15 percent of patients with depression eventually commit suicide.
  
  
• About 5 to 10 percent of people who have had a major depressive episode will eventually have a manic episode (characterized by an elevated mood and excessive energy and optimism) and develop bipolar disorder.
  
  
• Depression is commonly associated with other conditions, including eating disorders, anxiety disorders, obsessive-compulsive disorder and borderline personality disorder.
  
  
• Depression is one of the leading causes of disability in the United States and internationally.

Depression: Key Q&A

How can I tell if I'm depressed or just sad?
Depression is different from occasionally feeling blue. If feelings of unhappiness are persistent and debilitating, interfering with your activities and relationships, you may be clinically depressed.

What is the most common symptom of depression?
Although depression has many symptoms, perhaps the most common is altered mood. If you are suffering from depression, you may experience profound sadness, anxiety, anger, irritability or apathy (lack of emotion). You may also be pessimistic, discouraged, extremely sensitive or subject to crying spells.

How common is depression among women?
Women are nearly twice as likely to develop depression as men. As many as one out of every five women will experience depression during her lifetime, with females between the ages of 18 and 45 accounting for the majority of all cases of depression.

What causes depression in women?
Depression is likely caused by an imbalance in neurotransmitters, the brain chemicals responsible for regulating mood. Many mental health professionals believe that the hormonal changes that commonly occur during the different phases of a woman's life may lead to a depressive episode. These phases include menstruation, miscarriage, pregnancy, childbirth, premenopause and menopause.

Anger and Depression

By:
Peggy Elam

Question :

Quite often I feel very depressed and alone in the decisions I make. I get really angry every day at things that don't mean anything. Many people have told me that my anger gets out of hand and I should go to counseling. I've wondered a few times whether I suffer from depression or some other mental disorder. What do you think?

--Sara

Answer :

It's true that depression and anger have often been linked in the psychological literature. Some refer to depression as "anger turned inward." I've seen the feelings you've described in others. Many depressed individuals alternate between feeling angry at themselves and getting angry at other people.

People who are not necessarily depressed but are in some sort of emotional pain also may lash out verbally at others. It's the emotional equivalent of the wounded animal that strikes out at the person who's trying to help it.

I can't give you a diagnosis -- saying whether you might suffer from depression or some other psychological or emotional problem -- without learning more from you and doing a complete assessment. But it sounds to me like you might benefit from consulting a psychologist or some other licensed mental health professional.

You may be able to get a referral for a qualified therapist from a friend or family member, or ask your physician who he or she would recommend. You don't have to commit to counseling right off the bat (unless, of course, you want to). Consider first meeting two or three times with a therapist -- giving yourself and the therapist enough time to get to know each other -- to discuss what's going on with you and whether and how counseling might help. Then you can decide what course of action you want to take.