Therapy for Depression

Depression has become a very common term in recent years.  It can be hard to determine if you are clinically depressed, versus just sad.  Hopefully this will give you some understanding of what depression is, where it comes from, and how you can improve your condition.

What is Depression:

Depression is mood disorder where you are more than just sad about your recent circumstances.  It is when you find that you are down or maybe even hopeless, for a longer stretch of time, and your circumstances might improve but your mood does not.  A way to distinguish this from a sad emotion is that it is much more chronic and begins to interfere with your life.

Signs of Depression:

Having 3 or more of these symptoms for more than a couple of weeks might suggest you are struggling with depression.

• Depressed Mood
• Decreased energy and motivation
• Significant increase or decrease in appetite or weight
• Decreased enjoyment in things you would normally enjoy
• Trouble getting out of bed, going to work, school, etc.
• Isolating, not wanting to spend time with others
• Heavy feelings of guilt or shame
• Feeling hopeless or helpless
• Thoughts of not wanting to be alive
• Thoughts of suicide

What is the difference between depression and feeling sadness or grief?

Sadness is a normal primary emotion we all have.  We all experience sadness and grief when we have losses, or when we've been hurt.  However, our primary emotions tend to wave up and down, so we might get waves of sadness, but are also able to experience other emotions as well.  We would feel the sadness often resulting from an occurrence.  Depression often feels more like a stuck state of being.  It feels more like a fog, everything is more difficult to see, enjoy, appreciate, etc.  People often say they feel more "blah," apathetic, indifferent about things, rather than sad.

What causes depression?

Of course it had been demonstrated that for some people a chemical imbalance in the brain is a major cause of depression.  Therefore, anti-depressant  medications have been very helpful in shifting that imbalance to improve mood.  However, it often is more complicated than that.

One thing that complicates the issue is what causes the chemical imbalance?  There are many different reasons and theories about why people's brain chemicals change.  I won't go into them all here, but to name a few, of course genetics can play a role, as well as nutrition and overall health, stress, illness, hormones, and injuries.   That is why taking good care of your health is critical in preventing and recovering from depression.

Our focus in therapy is on coping and recovery, prevention, as well as on the emotional causes of depression.  We find that many people are not comfortable with feeling or expressing their emotions.  They also are often afraid of their emotions, or don't understand them.  All of this can lead to avoiding our true feelings.  For example, if we suffer a great loss, we might be too overwhelmed by the sadness and grief, and worry that we will not recover if we allow ourselves to experience the feelings.  Therefore we stuff them away inside, do anything to avoid them, and maybe only express more reactive emotions such as anger.  We just keep telling ourselves to "get over it."

When our true emotions are avoided or interrupted, we can become stuck in a state of depression and anxiety. Therapy can help you understand your emotions, and give you a safe environment to explore them and work through difficult emotions so you can move through them and truly be able to move forward.

What you can try at home:

• SLEEP:  Sleep has the biggest impact on your mental health and your overall health.  Establishing a healthy sleep routine, going to bed and getting up at the same time daily, and getting at least 7-8 hours of quality sleep is the first and most critical step toward mental health.  Some things that help with better quality sleep are keeping the room very dark while you sleep, wearing quality blue blocking glasses continuously starting a couple hours before bed, getting exercise in the day, and getting enough magnesium in your diet or using supplements, just to name a few.
• Exercise, exercise, exercise: yes you are hearing it again, that exercise is vital for recovering from and preventing depression.  Studies continue to prove that exercise can be just as effective as some anti-depressants, such as Prozac.  The most helpful forms of exercise seem to be moderate aerobic activity for about 20 minutes, and some light weight training.
• Take a walk outside: research has proven this to be effective as well, it's no wonder we all feel happier in the warmer months in the Midwest.
• Study what types of foods help depression: there is good information out there about what type of diets and food actually improve brain health and serotonin levels.
• Practice relaxation and meditative exercises:  focusing your mind on calming your body and on positive thoughts can shift your mood as well your physiology.
• Seek out cultural experiences: some studies show as well that mood can improve from cultural experiences such as performances, museums, music, etc.
• Engage in social activities you are comfortable with: this might be family gatherings, or time with close friends.
• Ask for support: lean on your friends and family for support, talk about how you're feeling.
• Seek physical touch: being touched in a soothing and comforting way can be very healing and improve positive feelings.  This might be gentle touch from your partner, or could be a professional massage if you do not have someone to provide this for you.
• Notice what you are focusing your thoughts on: focusing on negative thoughts will increase negative feelings, just as focusing on positive thoughts can improve mood and feelings.
• If you can, allow yourself to feel emotions you might be avoiding: again you might be depressed as a result of avoiding your feelings.  If you give yourself some time and space to feel sadness, grief, or even anger, you might find your mood is able to shift and you can feel some relief.  This might be easier with support, such as a friend or a therapist.
• Talk to your doctor: if you feel you might need medication, or if you have taken medication for some time and no longer feel the benefits.

When therapy is recommended:

• You need help putting the above suggestions into action.
• You have tried many of the suggestions above and don't experience any improvement.
• You're mood seems to only improve slightly, or for a short time, and then goes down again.
• You are taking anti-depressants but feel you still need more improvement or support.
• You are tempted to hurt yourself, or are doing self-harm such as cutting.
• You feel like you don't want to be alive, or feel suicidal.
• You are struggling to attend to your daily responsibilities.

You should go to a hospital, or the nearest Emergency Room if:

• You feel suicidal and you might want to act on it.
• You are not able to do your daily activities.
• You are not able to care for yourself such as shower, shave, eat, drink, etc.