Following a diagnosis of clinical depression, a variety of treatment options will be suggested based on the severity of depression. Fortunately, treatment for depression is very effective. One or a combination of the following therapies may be prescribed:

Medications

Often called, antidepressants, treat but do not cure, depression. Antidepressants help balance the chemicals (neurotransmitters) in the brain that affect mood and emotions. These neurotransmitters (serotonin, norepinephrine, and dopamine) are affected by certain medications. Balancing the benefits (What is my end goal?) to side effects (Is it worth it to reach the end goal?) is a decision between patient and doctor. It is hard to predict what side effects a patient will experience if any. Common side effects are weight gain, insomnia, sexual problems, dry mouth or tremors. Medications often take up to a month to take full effect. So patience is involved. Take the medications as prescribed by your doctor and do not stop without approval. It is common to try different antidepressants before finding the right one.

Being educated on the medications available will help in having a productive conversation with a doctor and help in making an informed decision. Ask someone that is taking a prescribed antidepressant about their experience. Talk with other professionals and inquire through professional organizations via the internet. Refer to the Further Readings/Videos located on the sidebar of this blog to get started.

Medications may treat the symptoms of depression, but they do not address the underlying cause. Although, depression can be genetic there can be a different underlying factor. Personal conflicts (family or friends), death of a loved one, serious illness, and substance abuse can also contribute to depression. The following is a small synopsis of various forms of psychotherapy that is used in conjunction with medication(s).

Psychotherapy

Psychotherapy, “talk therapy,” is usually used in combination with medication. Since medication does not cure depression or a chemical imbalance may not be to blame, psychotherapy is very effective. Psychotherapy involves talking with a psychiatrist, psychologist or licensed mental health provider in an individual, family or group setting. The patient learns to deal with their thoughts, emotions, behavior, and feelings. Trust, and a good working relationship between therapist and patient is essential for a productive, positive experience. The patient must be comfortable talking about intimate feelings and be able to open up and be honest. Initial consultations are encouraged before settling in on a permanent relationship with a therapist. This also allows both the patient and therapist to get a feel for each other’s comfort level. More importantly, it allows the patient to see how the therapist works. Feeling a “connection” is key to a successful relationship and treatment outcome.

There are a wide variety of psychotherapy treatment options and finding the most beneficial type depends on your particular illness and preference. Consider educating yourself on each option through internet research. Many therapists have their own websites that may provide insight as to how they work; helping you narrow down candidates. Researching and becoming knowledgeable in all aspects of therapy will aid in a treatment plan and success. A synopsis follows of each kind of psychotherapy.

• Cognitive Behavioral Therapy (CBT) – This therapy involves the patient identifying and recognizing negative, unhealthy behavior and changing those thinking patterns into healthy ones. This involves identifying thoughts and how they influence behavior. Once identified, the patient learns how to shift these negative and unhealthy thoughts into ones that will bring about positive behavior and feelings. CBT involves a lot of problem-solving and solution-based therapy.
• Interpersonal Therapy (IPT) – This therapy involves the patient learning to understand their interpersonal relationships and learning healthy ways to communicate and relate to others.
• Psychodynamic Therapy – This therapy involves uncovering and dealing with childhood experiences and inappropriate repetitive thoughts and feelings that affect current behavior. These thoughts and feelings are that of the “unconscious” (outside a person’s awareness). The patient looks at the unconscious, repressed feelings and learns how to cope with those feelings and change them to function in the current world.
• Psychoanalytic Therapy – This therapy is similar to psychodynamic therapy except this type of treatment is more long-term. It usually involves the patient saying anything that comes to mind and dream analysis. The therapist then utilizes the information gathered and develops a therapy plan that will facilitate positive behavioral and thought process change.
• Humanistic Therapy – This therapy is based on the belief that all people are naturally good and can successfully solve their own problems. Humanistic therapy focuses on the “here-and-now” rather than dwelling on the past. The relationship between patient and therapist is equal. The therapist is empathetic, warm, understanding and non-judgemental. The therapist provides guidance toward healthy behavior. The patient learns to recognize they are good, powerful and creative and learns to successfully solve their own problems.
• Holistic Therapy – This therapy involves mixing various elements of different talk therapy, specific to individual treatment needs.

Electroconvulsive Therapy (ECT) – This therapy involves controlled electrical stimulation to the brain, under general anesthesia. The electrical stimulation causes a brief seizure in the brain. This stimulation causes a change in brain chemistry that reverses symptoms of depression. ECT is used when depression medications do not work in severe cases of depression. Oftentimes, medications are taken in combination with ECT. According to the Mayo Clinic, in the United States, ECT treatments are generally given two to three times weekly for three to four weeks depending upon the severity of depression and the patient’s response. Mayo Clinic

LIFESTYLE CHANGES

Lifestyle Changes As Treatment Option: There are self-help strategies that one can implement in their daily lives that will help alleviate depression symptoms. Dependent upon the severity of depression, or used in combination with other treatments, changes in daily routine, nutrition, and thought processes can help one control depression symptoms. These lifestyle changes do require a commitment. Oftentimes, it is an “in-the-moment” decision to commit that makes these lifestyle changes so difficult. Sapped of energy, wanting comfort food, or wanting to be alone make lifestyle changes particularly challenging on a daily basis. The benefits of succumbing to your committed, positive lifestyle change far outweigh giving in to your first reflex response. Lifestyle changes include:

Nutrition – Essential to feeling happy, calm and motivated are proper levels of neurotransmitters (serotonin, norepinephrine, and dopamine) in your brain. For the brain to get these proper levels of neurotransmitters your body needs to be supplied with the proper nutrients, minerals, vitamins, and antioxidants (from a whole food source, preferably). Consider the following self-help nutritional strategies:

1. Omega-3 Fatty Acids: Evidence suggests foods with Omega-3 fatty acids help stabilize mood, increase memory, and lower fatigue. Found in seafood (tuna, salmon, sardines, herring), walnuts, leafy greens (watercress, spinach, mustard greens).
2. Folic Acid (B9): Folic Acid helps the body create new nerve cells and supports serotonin regulation. Remember, serotonin (a neurotransmitter) passes messages between the nerve cells and helps the brain manage a variety of functions such as mood and regulating social behavior. A deficiency in folic acid causes fatigue and lowers levels of serotonin. Folic acid can be found in spinach, black-eyed peas, asparagus, Brussel sprouts, and avocado.
3. B12: Low levels of B12 can cause short term fatigue, slowed reasoning and is associated with depression. B12 plays an important role in regulating depression. B12 can be found in Rainbow Trout, Sockeye Salmon, Swiss Cheese, Mozzarella Cheese, and Tuna.
4. Vitamin D: Studies show that low levels of Vitamin D are associated with depressive symptoms. Low levels of Vitamin D are attributed to indoor lifestyles, limited sun exposure and a low intake of foods rich in this vitamin. Foods rich in Vitamin D include Cod Liver Oil, Salmon, Swordfish, Oysters, Shrimp, and Milk.
5. Vitamin B6: Helps in the production of neurotransmitters. Neurotransmitters help regulate brain function which influences our emotions. B6 helps regulate a healthy mood. Foods such as chickpeas, salmon, yellowfin tuna, chicken breast, fortified breakfast cereals, all contain Vitamin B6.
6. Magnesium: Helps in the production of serotonin, our major contributor for happiness! Foods that include magnesium are almonds, cashews, peanuts, tofu, whole grains, and legumes.
7. Iron: Supports energy level. Since fatigue is one of the major symptoms of depression, maintaining a proper level of iron will help ease fatigue. Also, iron deficiency is associated with mood changes and apathy which can lead to depression. Foods that are high in iron include fortified oatmeal, soybeans, beef ribeye, dark meat turkey, shellfish, spinach and pumpkin seeds.

Keep in mind, comfort food is just that, for comfort. It does nothing to alleviate depression symptoms long term. In fact, it can make you feel worse, after the fact. Initially, comfort food will raise your serotonin levels, but soon after your mood energy will crash. Many people with depression crave carbohydrates or comfort foods (cupcakes, ice cream) because it soothes them, but it can also lead to weight gain (which can make you feel more depressed), diabetes, and other major health problems. Controlling comfort food intake and substituting it with healthy snacks is a better lifestyle choice.

Alcohol is a known depressant of the central nervous system. Alcohol is a depressant that can cause your problems to seem worse than they really are and make you feel even more depressed. Alcohol lowers serotonin and norepinephrine levels – our brain’s happy regulators! Avoid alcohol!

Evaluate Your Thought Process – The way we think about ourselves, others, our past experiences, and our emotional reasoning plays a large role in how we behave and feel. Analyzing your thought process during a particular situation can help you rationalize your feelings in a positive, healthy way. Unfortunately, negative thoughts are a symptom of depression. Depression makes it difficult to think positively. Learning and practicing positive thinking is a self-help strategy that both depressed and non-depressed people need to work on daily. Unfortunately, those with depression need to place a more conscious effort into it. Cognitive Behavioral Therapy helps one to learn to replace negative thoughts with positive thoughts. So how do we replace negative thoughts with positive ones? Consider the following suggestions: investigate with further reading and, if available, ask for support from family and/or friends to help you recognize negative thought. Consider professional Cognitive Behavioral Therapy. For those who are motivated, have mild depression and are in the early stages of depression, Cognitive Behavioral Therapy can actually be self-taught. For more severe cases of depression, or if you find yourself unable to completely commit to self-help, use self-help in combination with medications or consider bibliotherapy in combination with professional help and/or medications.

Bibliotherapy, the use of books as a treatment tool for mental and psychological disorders can be used to treat mild to moderate depression and anxiety. Often it is used in conjunction with other therapy. The patient needs to have a positive attitude towards this therapy, especially if not used in conjunction with any other therapy. Positive attitudes are required with any self-help programs which one decides to use, thus this bibliotherapy is actually not that different than other self-help therapies (i.e. working on nutrition, exercise, etc.). An excellent self-help book, Feeling Good: The New Mood Therapy, authored by psychiatrist David Burns, provides the reader with the tools needed to help oneself turn moods around. You can also purchase a handbook to use in conjunction with the Feeling Good book. The handbook contains a depression checklist, exercises that will help you get through every day problems, a daily mood log, and more. To purchase either or both of these books, click here. Dr. Burns also has a very resourceful website which can be found here.

Reduce Stress – Stress has a direct effect on mood. Stress is a normal part of life, but it is how we handle the stress that affects our mood and behavior. The inability to cope with stress can affect your sleeping routine, relationships, productivity, and daily routines. These are all the same symptoms of depression, thus, increasing depression. Learning coping strategies in stressful situations can control stressful symptoms which will ultimately reduce the chances of it creeping into your depression. To reduce stress, try to figure out what stresses you and get rid of that stressor. Meditation, yoga, deep breathing exercises, and physical activity, can help control feelings of stress.

Socialization – As difficult as it is to socialize during a severe bout of depression, staying social is the best medicine. If you feel hesitant being around friends, try taking a class in something you have a great interest in. Discover a new hobby and join a local Meetup group where you can exchange ideas in small groups, share favorite outdoor activities and discover new interests that are available in your area. Meetup.com is a great place to make a new circle of friends that share the same interests as you. Think about joining a local museum and make a habit of visiting it monthly. Many museums offer classes, small/large events, and volunteer opportunities. Making a commitment to get out daily and conversing will help boost your mood, as hard as it is to initially get out the door.

Lifestyle Change Miscellaneous Suggestions– Do not underestimate these suggestions simply because I have not elaborated on them. These ideas are proven to help with depression symptoms!

1. Get Active! Try and exercise at least 30 minutes per day. Exercise is an all natural treatment for depression and releases our “feel good” chemicals in the body, endorphins! Not only are endorphins released, but other proteins are released that contribute to cell growth and new cell connections. Obviously, improvement in brain function improves the ability to feel better! Start exercising in a 5 minute increment. Gradually increase your exercise activity and soon you will find yourself doing 10, 15 and 30. Eventually, you will begin to feel better after a few weeks of routine exercise. The key to obtaining a realistic exercise goal of 30 minutes is to do something you enjoy – walk around a park, bicycle, swim, dance, shoot hoops, rollerblade, hit a tennis ball against a wall. Doing something you enjoy will keep you motivated, especially once you begin to reap the benefits of your physical activity.
2. Help Others – Helping others always makes a person feel good. Consider volunteering at a nursing home, hospital, or helping a neighbor in need. Look in Care.com and offer your companionship services for free reduced fees. Working at an animal shelter or fostering dogs or cats can be a two-way street. An animal in need will receive the love and attention needed and vice-versa! You also may get the added benefit of walking, should you foster a dog.
3. To-Do Box – Recently, I bought a small, pretty box from Joanne Fabrics. I didn’t know what I was going to use it for until one day I realized how much my depression symptoms, such as constant fatigue and lack of motivation, prevented me from doing anything but sleep, eat, watch t.v., and work on this blog. So I made a list of the things in life I used to enjoy. I bought some pretty scrap paper and cut out different shapes (hearts, flower, circle, etc) and wrote one of my most favorite activities on each one. I also included some not-so-enjoyable activities (like grocery shopping, cleaning, laundry, bills). If, my mid-day (if I was even awake), I haven’t done anything but sleep or do absolutely nothing, I open the box and blindly choose one task. I close the box, place that task on top and I make it stare at me until I have completed it. It actually works. 75% of the time. That is much more productive than sleeping or not doing anything productive for 18+ hours a day.