100 million people suffer from depression, the leading cause of disability in the world.  Despite the statistics, depression, anxiety and other mental illnesses still have a stigma that cause many people to avoid treatment.

My story

I battle everyday.  I'm sorry to report it has been years.  What I realized after several years is that this is a war for me.  It is no longer about heartbreak.  Love or hate.  Anger or blame.  But, sadly it started there. 

It's depression that won't go away.  It's almost like a friend to me.  So ordinary and comfortable, I truly don't know how to leave it.  Like a new replacement for my former spouse, it is comfortable and available. 

It is the ground that stops me from falling - but it distorts the fact that it is this very ground that I wish to avoid.   After falling to the ground,  it's like, ya, I'm down, I survived, but I'm hurt and in pain here.  Then there it is, my depression-the ground, letting me know he was there to catch me.  Like I should be thankful-  I know it sounds weird; but, somehow I fall for it and fall and fall into a deeper, painful state of depression.  It scares me to think one day I may not get up from the ground.  It scares me.

Fear

Know why depression scares people?  'Cause depression is awful.  It's the wretched, discontented, hob child of mental illness.  Some people don't realize how bad it feels to be depressed.   It kills, it debilitates, it appears silently in the eyes of so many people. 

On the outside, the onlooker may not know we are depressed.  We smile and when others ask how we are, we say "fine".  But, we feel the depression like pain.  Pain, depletion, blank, emptiness-  We are missing something so real, some of us would cut our own bodies to find it.  We act in ways, even we can not understand.  And when we can not find what we need, when we can not find ourselves, our life, our meaning, we turn deeper into our depression. 

We numb our quest with drugs and alcohol so that we do not have to feel this demon inside our body that lives with us, stealing every part of who we are, what we need, what we seek.  Sadly, this demon distorts our perception of our life, keeps us in such a darkness, that no matter what good things happen, we can't see or feel anything but the overwhelming miserable emotions.

We may remark a bit to those who ask, but rarely get into the details, which often is nothing we can even pinpoint as a reason to feel so damned awful.  That's a big part of the problem.  Our family get's less and less supportive as the disease overtakes us.  At some point, we understand their frustration, since the demon inside begins to show in everything we do or say.  We can understand that our loved ones don't want to be around a miserable and depressed person.  They have a chance to expel the demon from their life as it has overtaken us and we begin to identify it as part of us.  The sad truth is that we make those around us sad and frustrated.  As awful as it sounds, we can understand that if we had a chance to expel our depression and unremittent sadness, we too would begin to distance ourselves from it.  But, we can not simply choose to abandon it or decide to "not be depressed".

Somehow, many may think it's a decision to be depressed despite the fact that to be diagnosed with depression or any other mental illness, it has to be a medical problem.  No different from any other life threatening medical condition-  Perhaps the misconception is since there is limited diagnostic testing; therefore, many feel the disease is something someone can control or just get over, like a bad day or occasional sadness.  But, for many people who suffer from depression and mental illness, it is simply not something you can "just get over".  After awhile, many don't know if life is worth living.  If you have ever felt like this, been depressed, miserable, hopeless you would not be alone.


For immediate help call 1-800-273-8255 National Suicide Prevention Hotline

Free and confidential support


Worldwide Threat

According to the Centers for Disease Control (CDC), every year 1 million of us report attempting to commit suicide in the United States. 800,000 people die every year through-out the world due to suicide, according to the World Health Organization (WHO).  That's almost 2 million of us that had suicide on our mind last year and almost half succeeding.  That's scary.  Worse is all of the people who fear the admission of feeling suicidal.  How many of us are really out there?  

We should be scared.  Suicide was the second leading cause of death in ages 18-34 last year.  It's a real threat to our lives, our family and friends.  Suicide and depression are deadly.  Take it seriously and get help.  Help each other.  The most deadly thing you can do is to ignore it or let others tell you to just get over it. Fight until the depression is defeated.  Fight like it is a matter of life or death.  Because it is.

Simple to get.  Complicated to treat.

While it's so simple to fall into depression, the diagnosis, treatment and therapy 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.

What are the most common types of depression?

Major Depressive Disorder - Mental health disorder having episodes of psychological depression.  Very common and can be lifelong. 3 million cases per year in the U.S. - Symptoms include: Loss of interest, low self-esteem, pain of unknown cause, low energy, low mood, changes in appetite.

Psychotic Depression - Also known as major depressive disorder with psychotic features, it's thought to occur in roughly 20% of those who have major depressive disorder.  The symptoms include the same as MDD, as well as, racing thoughts, delusions and hallucinations.  While some people have psychotic symptoms (seeing, hearing and thinking things that aren't real) inline with typical depressive themes (guilt, low self-worth, shame), known as major depressive disorder with mood-congruent psychotic features, others do not, resulting in a diagnosis of major depressive disorder with mood-incongruent psychotic features.  Some may experience a combination of both. 

Bipolar Depression - A serious mental disorder characterized by extreme mood swings.  Also known as manic depression - More than 3 million cases in the U.S. - Symptoms include: Disruptions in normal mood or psychomotor activity, mania to include rapid speech, dysphoria and irritability and depression to include low energy, tiredness, poor eye contact, negative outlook, and low self esteem.

Cyclothymic Disorder -  Mood swings between mild depression and hypomania.  This disorder tends to be chronic but the mood swings are milder than bipolar depression.  The symptoms of depression never reach major depressive disorder and the hypomania is a milder form of mania as seen in bipolar depression.  A diagnosis is made usually after two years of these symptoms that have occurred at least half the time over the course of those years.

Dysthymic Disorder - Mild, long term depression.  This is a common disorder of on-going mild depression that has intermittent remission.  This disorder is commonly unreported and therefor undiagnosed.  The triggers of psychosocial elements manifest the disorder.  It appears to have genetic susceptibility and is commonly underrecognized and undiagnosed.  Symptoms include: sadness, lethargy, low self-esteem, pain of unknown cause, low mood and loss on interest.  Often this depression is difficult to effectively treat.  On-going therapy and medical intervention is often recommended.

Seasonal Affective Disorder - Mood disorder characterized by depression that occurs at the same time every year.  A common form of depression where the individual has depression type symptoms only during specific seasons but normal mental health during other seasons.  Winter is the most common season for this disorder.  Symptoms include: prolonged sleeping, overeating and lethargy.  Suspected reasons have included: low sunlight exposure (vitamin D deficiency), low serotonin, increased production of Melatonin and/or personality traits. 

Fighting Depression and Suicide

Many people don't like to discuss  the "S" word.  Even if suicide has been on our mind, once we feel better, we never want to think, talk or ever visit such drastic hopelessness again.  

For me,  I'm like a depression magnet.  Once I realize I'm slipping in to a deeper state of depression I think, "How do I get out?"  Like hanging off the edge of a cliff I start to realize that I'm not just uncomfortable anymore, I'm holding onto something that without help I will eventually need to let go.  So, I do.  My emotions, hope and brain chemicals fall with me.  My mild on-going depression suddenly turns into a major depression.

I never really care anymore how I got there.  I've gone through the rigors of every mistake I made, every turn I took.  I've tried the drugs to prevent it and the counseling to talk it out.  I've had the pity party, the pissed-off party and the pathetic weight loss party (after the pathetic weight gain fling, of course).   I have found that despite prevention or the negative reaction, my depression always comes back.

It doesn't help to blame someone else or myself.  When I'm down, I just want out, but still I walk closer and closer to a deeper depression. Then I feel something, tell me, take a step back.  Then another step back, away from the darkness, away from the edge.  I reach out because I don't want to die.  I want to live!

For many of us, we aren't suicidal because we don't respect life.  W simply want to kill the demon inside; we want to be happy, healthy and normal again.  But, we feel so hopeless and powerless, eventually we don't feel we have the strength to live.  We feel so dead inside, we want give up the shell of a person left on the outside.

It may seem to others that those of us who go through this are looking for attention or enjoy looking like crap, feeling worse than crap and watching as everyone else lives a happy life.  I personally feel positively pathetic when I see the effects depression has had on my life.  Somehow my life just never gets past go.  It's mild depression, major depression, then mild and so on.

While everything in life seems so darned uncomfortable, when things get tough, depression feels comfortable.  My grey sweatshirt, messy bun and tennis shoes welcome me with open arms and I them.  My quiet introvert wakes up and she feels tired, slow and fat.

The problem with depression is like any other illness.  It won't go away just because you want it to.  You need to be proactive.  The intervention may vary based on your type and severity of depression and may be different than other illnesses, but you need ways to combat it.   So what intervention is available? 

Top ways to beat depression

Medication

There are many possibilities.  Listed below are examples of name brand drugs in multiple categories. There are more options and generic drugs not listed.  Ask your medical doctor for more information1

Most Common

SSRIs (Selective Serotonin Reuptake Inhibitors) increase levels of serotonin in the brain. eg. Lexapro, Prozac, Paxil, Luvox, Vilazodone, Sarafem

SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors) increase levels of both Serotonin and Norepinephrine in the brain. eg. Cymbalta, Effexor, Pristiq, Fetzima

Powerful

MAOIs (Monoamine Oxidase Inhibitor) block the actions of monoamine oxidase enzymes which increase the concentration of the three neurotransmitters  dopamine, serotonin and norepinephrine in the brain.  eg. Zelapar, Marplan, Parnate, Nardil, Emsam and Eldepryl

Different

A-typical antidepressants act in an a-typical way in comparison to other antidepressants and each other.  eg. Wellbutrin, Remeron, Trintellex, Trazodone and Nefazodone

Original Antidepressants

Tricyclic Antidepressants are named after their chemical structure which contains three rings of atoms.  They increase levels of norepinephrine and serotonin while blocking acetylcholine  They now have a black box warning for potentially causing suicidal thoughts or causing people to commit suicide.  eg. Elavil, Anafranil, Sinequan, Surmontil, Norparmin

TMS

Transcranial magnetic stimulation is an FDA cleared treatment is a noninvasive procedure that uses magnetic pulses to stimulate nerve cells in the parts of the brain responsible for depression and obsessive compulsive behavior disorder.  It can used as a singular treatment or along with medications and therapy.  It's often used when other forms of treatment haven't worked.  There are different ways the procedure is performed and is said to be painless.  It's often performed in sessions lasting 4 weeks or more and provides remission for many months.  

ECT

Electroconvulsive therapy is a procedure used to treat some mental health conditions including major depression.  The procedure requires the patient to be under general anesthesia and is performed by triggering a brief seizure when small electric currents are delivered through the brain.   The procedure has changed a great deal from when it was first offered, but it still has side effects.  It's usually used when all other forms of treatment have failed.

Therapy

Group therapy

This gives you an opportunity to work out your depression among your peers.  You'll hear from others who feel like you or sometimes worse and some that can give you good insight into how they cope on a daily basis.  You can share and know that your sharing helps others.  Helping others is always a great way to feel better!  People you meet can provide the best support from people who truly understand.

Counselors, psychologists and therapists

Find someone for which you make a good connection.  Don't settle.  If your therapist isn't really helping after a few months, move on to find someone that forms a better connection.  You should be comfortable discussing all of your feelings and emotions.  She should be able to provide you an opportunity to explore methods and options that can get you moving in the right direction.  These professionals will not be able to prescribe medication.

Psychiatrists

Some depression and mental health disorders can be treated by your family doctor. However, if you seek prescriptions and medical intervention from a trained mental health physician, you will need a psychiatrist. 

Make sure to give the medication time to work.   Report any side effects immediately to your psychiatrist so that your dosage or medication can be altered to fit your specific need or reaction.  If after several months you still feel lousy, make sure you talk to your doctors and therapists to develop a plan and alter your medication and therapy.

Yoga, Meditation and Mindfulness

Yoga, medication and mindfulness are great alternatives when medical intervention has failed to provide complete remission from your illness.  Each or all can also be added in the beginning of your depression therapy in addition to other forms of treatment or as an on-going way to combat the return of depression and anxiety after the cessation of treatment. 

Speak with your doctor before beginning any physical activity.  Yoga, meditation and mindfulness may help you center your thoughts and feelings, improve sleep and reduce stress.  They are extremely beneficial to improve mind, body and soul which can be a center logic for your emotions.  

Exercise

There is a lot to be said for blood flow and aerobic activity.  Get your heart beating and you literally fight heartbreak.   There's big science behind it that relates to endorphins and neurotransmitters in your brain, but the long and short of it is that when you're done working out, you just feel better physically and mentally. 

Regardless of your current weight or shape, talk with your doctor and get your new plan to get fit, approved. Then get out there and get moving.  Preferably in nature, outside if you can; walk in a park, in a gym, in your subdivision or in the mall.  Run, jog, walk, skip anywhere that you can get a workout in around three to five times a week.  Just do this!

Support

Enough can't be said about having support from family, friends or support groups.  If you know someone who is suffering from depression, be patient, be honest and work together to fight back.  Don't let the depression take someone you love.  Don't just think that suicide is the only way your loved one can be lost.  Depression can destroy relationships, finances, careers, health and cause you to see a distorted aspect of the person you love.  Don't ignore their symptoms.  Together, be proactive to solve problems, seek treatment and ongoing therapy.

If you're depressed and feel alienated from your family, don't give up.  Let them know you understand they don't want to see you so miserable and that you would like to work together towards depression treatment.  Listen to their fears, feelings and concerns, too.  Sometimes helping others can be helpful in dealing with your own problems.  If you don't feel you have anyone to talk to at home, reach out to local support groups through hospitals or churches near you.

Bad stuff

Ok.  You're fighting for your life.  Are you surprised I might tell you not to worry so much about eating right?  Unless you suffer from obesity, disease associated with overeating or food addiction, don't stress over a short-term change in your diet.  Aim your eating habits at 80/20 (80% good and 20% bad).  Try to keep mostly good stuff in your fridge like celery which is supposed to burn more calories to digest than the calories of the vegetable itself.  Ok.  Add some ranch or blue cheese dressing! 

Keep working out, but allow yourself that 20% junk food.  If you notice the bulge, cut back. Too much focus on perfect diet, perfect body, perfect life makes life dull, boring and "perfectly awful".  That isn't what humans are-  We are imperfect and happier to seek more than perfection.  So, keep some of your mess, eat a Twinkie® and workout after dinner.  That's life and some days, it's just enough to make it worth living.

Super bad stuff, off limits

Ok. This rule is weird since I just told you to live a little.  But, don't do super bad stuff.  It makes it worse.  No long-term damage stuff.  So, while you have some 20% high fat-calories or whatever, it's still not so bad (again barring any health problems that suggest otherwise). 

But, street drugs, abused prescription drugs, heavy drinking, ciggys, e-cigs or something that can literally kill you, should be avoided.  Stay away from anything that you feel would lead to addiction or results in long-term damage to your body. This includes overeating or failing to stick with the 80/20 rule.

When you're depressed, you'll have a harder time quitting these things and the damage is so significant in the short-term that they are a serious threat.  Wouldn't it suck to fight back from an awful depression to end up with lung cancer? 

Angels  

Angels are all around us.  They appear to us in thought, prayer and through inspiration. But, don't always expect your angel to appear in the mystical sense of the meaning.  Your belief system should begin with you.  Pick up the phone, go for a walk, seek your angel and ask for help.   It doesn't make you weak, it makes you a survivor.  


For immediate help call 1-800-273-8255 National Suicide Prevention Hotline

Free and confidential support


Who is your angel?

Do you have an angel?  Is there something, someone or somewhere when things get really bad?  If you feel depressed, please talk with someone who can help.  Your angel can help you when you think you might just keep walking to the edge.  Many of us have been on that edge and you don't belong there, none of us do.  You want to live.  Don't let depression distort your life image anymore.

Words to live by....

Look, it's hard to get through this crap.  You know I've been fighting for years and know every part of this depression stuff.  It has been better since I learned about depression and ways that I can fight it!   I am a fighter and that despite bad days, I will always fight back because it's my life and I want it back

You should want yours too.  So fight.  One day, I believe, we will have the life we want.  That belief has given me greater perspective and slowly my major depressive symptoms have been lessened over the years.  You and I will get better.  But, if you have days or nights you want to give up, remember whose life it is.  It's your life.  Don't let that demon have it.  Life isn't about what it has been, it's about what it can be.  There is life after depression, until then, fight for a better future.  Fight with me!  

For immediate help call 1-800-273-8255 National Suicide Prevention Hotline

Free and confidential support

-OurDMK.com

1DMK, it's contributors and writers of this article are not doctors or pharmaceutical engineers, as always, talk with your doctor regarding all options for the treatment of depression and the pharmacology of medications used in that treatment.



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