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While some of us go through difficult times without trouble, many face a low period that we are unable to get through without help.   Help may include talking with a family physician, psychiatrist or therapist. Medical doctors can prescribe medication if your symptoms suggest the need. But, how do you know if your symptom(s) warrant help and/or prescription medication?  

Depression is a mood disorder. It causes unremittent sadness, loneliness and/or unhappiness that is serious enough to affect your ability to manage your everyday life. It may also include symptoms such as anxiety, isolation, unexplained moodiness, frustration, anger, despair, lethargy, sleep disturbances or issues, loss of interest, low energy, poor eating habits and concentration problems.

Unlike spouts of occasional sadness, anxiety or loneliness - depression is unlikely to just "go away" on it's own.  You need to be proactive.  The intervention may vary based on your type and severity of depression and may seem different than other medical illnesses, but you need ways to combat it before it worsens. So what intervention is available? 

The diagnosis, treatment and therapy for depression can be extremely complicated.  There are numerous types of depression that once diagnosed must be treated with the correct medications, therapy or counseling and on-going medical intervention.  Since there are so many variables and very little diagnostic testing for the medical condition, it's important that the patient, physician and therapist work closely together for the most effective treatment possible.

Anyone suffering from depression with thoughts of suicide should seek help immediately. The National Suicide Prevention Hotline is 1-800-273-8255.

What are the most common types of depression?

Major Depressive Disorder

Psychotic Depression 

Bipolar Depression

Cyclothymic Disorder

Dysthymic Disorder

Seasonal Affective Disorder 

Depression is best treated with some type of medical intervention. The most common forms of treatment include medication prescribed by medical doctors, such as SSRIs, SNRIs, MAOIs, A-typical antidepressants and Tricyclic antidepressants.

While the use of anti-depressants helps many people, some do not respond well to such treatments or may be hesitant to talk with a professional about his/her problems for fear of medication side-effects or stigma. Regardless of the reasons, if you suffer from depression, some intervention is necessary.

Alternative therapy

There are numerous therapy options available to help you improve your emotional well-being. Many have found success in alternatives to medication or in addition to their current treatment. These include: transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), talk or music therapy with counselors, therapists or psychologists, doctor approved exercise program and yoga or meditation.

We have more detailed information regarding the various depressive disorders, medications and alternative therapies in our 2019 DMK article, "Depression. Real, Simple. Miserable."  We also listed some details regarding some common therapies used in addition or as alternatives to medication below.

Psychodynamic Therapy -

The most common form of therapy for the treatment of depression; also referred to as talk therapy where you speak with a therapist about your problems, emotions and work to understand your behaviors and mood as related to unresolved circumstances or issues.

Cognitive Behavioral Therapy -

A psycho-social intervention whereas a therapist or doctor employs methods to reduce unhelpful cognitive distortions (thoughts or beliefs) and aims to improve coping strategies and personal development as a way to solve problems and treat depression, anxiety and other mental health conditions.

Interpersonal Therapy -

A short term focused treatment dealing with interpersonal or personality issues as they relate to depression. It is known to be as effective for mild to moderate depression as some ant-depressants.  Commonly recommended for adolescents and children suffering from depression.

Music Therapy -

The American Music Therapy Association, an association to advance public awareness to promote music therapy, defines this therapy as a clinical and evidence based use of music intervention implemented within a therapeutic based relationship, to accomplish goals, promote wellness, alleviate of pain, express emotions and improve communication. The therapist must be a credentialed professional who has completed a music therapy program.

I don't feel like myself, but I don't really feel depressed either?

Why not just get a medication to help you?  One reason is that the problem you suffer with may not be clinical depression that warrants a prescription.  It may be a situation in your life that with counseling or therapy may start you on your way to feeling better.  Only a licensed medical doctor can prescribe medication following a diagnosis of your condition/illness.  A counselor, therapist and psychologist can not prescribe medications.  They can help you find ways to cope and deal with your problems and/or refer you to a physician who can diagnose and treat your illness with medication.

It's important to know that your life situation or problems can be the source of depression that requires medication.  But, depression can occur with or without contributing problems or issues in your life.   Regardless, some professional guidance is likely to help.

Starting a medication can change your mood and feelings but won't necessarily improve your overall problem if the issues are more than a psychiatric/physical problem.   Psychiatric medications aren't magic pills.  They may help you feel better and more motivated to address the issues that induced symptoms that lead to depression and the need for a prescription.  Medication, therapy and alternative treatments may help you cope with your life changing problems that otherwise would leave you too emotionally overwhelmed or depressed to manage.

If your depression is rooted with life problems, you should seek prescription medication as a tool rather than a solution.  Once you feel better, it may be easy to accept the situation you're in, when in fact, your depression was telling you something is wrong with your life and needs your attention.  It doesn't mean that you need to feed your sad emotions.  Rather, find a reasonable solution to change your situation.   Medication can help boost your mood, concentration and energy in order to improve your strategic thinking, but often counseling or group therapy is advised.

Identifying the primary cause

There are many reasons you may be suffering from sadness, depression, anxiety or other emotional issues.  Numerous issues such as stress, grief or substance abuse can make everyday strife into exacerbate a major depressive disorder.  Also, major depression can continue constantly, during specific times of a woman's menstrual cycle or intermittently for unknown reasons .  Prescription medication for anxiety, depression or mood disorder is often prescribed.  Sometimes, the primary cause is an underlying issue such as thyroid, hormones or pain induced condition that needs medical intervention in addition to the possible treatment of depression or other mood disorder.  Some medications used to treat depression are also prescribed for the treatment of pain, anxiety, psychosis and sleep disorders.

Though a clinical diagnosis can be made in addition to recognizing a life changing event that has induced the medical problem, sometimes the problem can be treated with therapy by a licensed mental health professional with alternative means to avoid prescription medication.  Regardless the treatment, it helps to uncover the primary cause of your sadness and find coping skills to deal with it effectively and continuously until you begin to feel better.  

Types of problems that induce depression:

  1. divorce or loss of some kind
  2. low self-esteem
  3. family disagreements
  4. career issues
  5. money problems
  6. weight management issues
  7. relationship issues
  8. stress, anxiety or grief from loss
  9. poor health
  10. periods of isolation
  11. pain or other physical problem

Speak with peers or professionals

Sometimes, you may think you are sad about one thing, when in fact, there are numerous issues that need attention in order to get past your depression or anxiety.  This is why a trained therapist may make it easier in helping you uncover the underlying issues that lead to your sadness or feelings of hopelessness.

Thinking about daily issues grouped with the primary cause of your current state-of-mind can make anyone confused and frustrated.  It can cause you to feel hopeless and lost, inevitably feeding your hopeless emotions.  Sometimes the best way to unravel such feelings and get to the bottom of your underlying emotions is to talk with peers or therapists.  Your peers could be trusted friends, family or a local group therapy where you can share your situation and empathize with others in similar, yet unique situations like yours.  Mental health professionals can also refer you to peer counseling and/or individual and family therapists.  These professionals may include psychiatrists, psychologists, therapists & counselors.  Make sure you seek the help from a professional who has experience in the type of situation or problem for which are suffering.

Coping and problem solving skills

As you proceed through the identification phase of what is making you miserable, you will want to develop, learn and implement problem solving skills and coping mechanisms.  Your therapist or counselor will be able to offer you some ideas that would be specifically based on your circumstances and personality.  Your problem solving skills will be based on the problem itself and may include an actual plan in order to set goals that will help you reach milestones in your therapy. 

You can develop your skills and action plan with or without the intervention of a counselor or therapist; however, it is helpful to have such support during this phase of your recovery.  Both your problem solving and coping skills may include talk or music therapy, writing, meditation, physical fitness, social activities or a hobby. It's important to find positive ways to address the negative thoughts and situations that occur on a regular basis in addition to unexpected issues that may arise. 

Diet and exercise

Enough can not be said about the benefits of eating nutritiously and maintaining a regular fitness program.  It shouldn't be a surprise that what we put in our bodies will actually affect how we feel.  Some of us may be affected more than others.  Foods that are high in soy, additives, preservatives, pesticides, sodium, sugar or carbohydrates can cause us to have negative effects both immediately following consumption of these foods, as well as, cumulatively throughout our lifetime.

The chemical response in our brain to high sugary content foods can induce a dopamine high that can consequently result in a drop soon thereafter.  It causes us to want more poor food choices which can cause us to overeat.  This cycle commonly leads to obesity, depression, anxiety, increased cortisol (stress hormone), poor sleep and other issues that do not help with improving our mental or physical health.

20 minutes of physical fitness, three times a week and a healthy diet to include lots of whole grains, fresh fruits and vegetables, reduced red meat can be a great start to a new healthy lifestyle.  As always, check with your primary care or specialty physician before starting any new diet and exercise regimen.  

Do something positive before negative takes over your life

The only mistake you can make is not do anything about your negative feelings, depression, anxiety or dire circumstance.  Without effective means of dealing with or treating the problem, it is common to turn to damaging or addictive behavior that may include drinking or illegal use of drugs in an attempt to self-medicate.  The longer you wait to effectively deal with your situation, the worse it will get and higher likelihood of substance abuse or life damaging behavior.  Life damaging behavior can affect your future, family, career and overall personal happiness and achievements.  In some ways, it can be as damaging as addiction.  In this way, the depression itself becomes a comfortable low that which many people begin to cling, ultimately destroying their lives and fullest potential.

Living low

At first, you notice your life is dim, but as it gets darker and depression worse, it is very common to fall into the traps like substance abuse, suicide ideology, and/or risky behavior originating from a mental health condition or disorder like depression or anxiety.  The mental illness can also originate from some event, loss or tragedy. 

Without a professional to help decipher or uncover the multi-tiers of issues that are primary causes and effects of your problems, the problems will continue to erode your life.  Your life becomes so clouded by suffering that, in the darkness, you reach for anything that can numb your pain.  It is so very confusing and complicated; alcohol or drugs seem so easy to buy and take. Substance abuse then continues the cycle as it causes the depression and possible feelings of suicide to worsen. This is why it so important to get help as early as possible.

It won't happen to me or my family

If you think you are someone who would never fall into a mental illness trap, know that it's an illness that often gets ignored due to the stigma mental health disorders have in our society.  Ironically, American's have a high prevalence of mental health disorders.   According to the National Institute of Mental Health, mental illnesses are common in the United States.  As of 2017, they noted the prevalence of any mental illness (which includes Anxiety, Depression, MDD, PTSD and other mental, behavioral and emotional disorders) was 46.6 million adults age 18 and older. 

Mental health vs. Coronary Heart Disease

For comparison, John Hopkins Medicine estimates 15 million U.S. Adults have coronary heart disease.  According to the Centers for Disease Control and Prevention (CDC), heart disease (coronary heart disease being the most common type) is the leading cause for death for both men and women.  Suicide, one deadly effect of mental illness is the 10th leading cause of death in the United States.  

However, our society supports a greater level of awareness of the risks associated with coronary heart disease and prevention thereof.  Perhaps this is because the topic of CHD is often openly discussed and considered a physical problem, whereas many people incorrectly view mental illness as an illness of choice. 

Ironically, to be classified an illness that requires psychiatric treatment, it is considered a medical condition based on biological and chemical dysfunction of the body.  Not a choice, a medical condition more prevalent than coronary heart disease, it should be taken seriously, one reason being that suicide (a potential deadly result of mental illness) is also a top ten killer of Americans (in addition to medical conditions like Heart Disease, Cancer, Stroke, Alzheimer's and Diabetes) according to 2017 data from the CDC and Medical News Today.

Fight the stigma of Mental Health Disorders

However, many people still live in denial and feel too uncomfortable bringing up their concerns or problems to their doctors.  One in five adults have some diagnosed mental health disorder.  Imagine how many people have undiagnosed mental health disorders around the world, in our country, in your community?  In addition to the stigma, disorders like Anxiety, PTSD or MDD that breed hopelessness, prevent many from believing they can be helped with treatment.

However, improvement following treatment for MDD is quite high according to an article on WebMD, What's Stopping You From Seeing a Doctor About Depression?, that suggests as many as 70% of people with MDD can improve and in some cases in a span of weeks.  Other disorders and conditions are also quite treatable with the right therapy, doctor(s) and medications. 

The first step is to realize you are suffering from a problem that typical coping strategies can't help and to then seek the right professional(s) for assistance.  You may or may not need prescription medication, but unrelenting mental health problems are unlikely to resolve without some form of intervention.  

Consider the DMK Counselor Directory for listings of mental health providers (therapists, counselors, psychologists) in your area.

Anyone suffering from depression with thoughts of suicide should seek help immediately. The National Suicide Prevention Hotline is 1-800-273-8255.


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