Tips For Living Well With Major Depressive Disorder
Living with major depression can feel lonely. People may be fearful or ashamed of being labeled with a serious mental illness, causing them to suffer in silence, rather than get help. In fact, most people with major depression never seek the right treatment. But those struggling with this illness are not alone. Its one of the most common and most treatable mental health disorders. With early, continuous treatment, people can gain control of their symptoms, feel better, and get back to enjoying their lives.
What Causes Depression Relapses
Depression relapses can happen at any time, even if youre already receiving treatment or are on medication for depression. Its like any other condition if you have it once, you may be predisposed to it and are more likely to experience it again.
Sometimes people will experience relapses caused by specific triggers, even when the treatment would have otherwise worked. Possible triggers include:
- ruminating on negative experiences, mistakes, and painful memories
- stressful life events, such as an upcoming exam or company layoff
- changes to the family structure, such as divorce or having a child move away to college
- hormonal changes, such as puberty, pregnancy, or menopause
But the most common cause of relapses isnt maintaining treatment after a depressive episode.
Most people benefit from sticking to their treatment plan, even if theyre not currently experiencing depressive symptoms. This includes coping mechanisms learned in therapy to manage depression.
If youre experiencing symptoms of depression relapse, get treatment as soon as possible.
Treatment can include a combination of different types of psychotherapies and medications. This includes:
Medications your doctor may prescribe include:
What Are The Signs And Symptoms
Major depression symptoms vary from person to person. To receive a diagnosis of major depressive disorder, some of these signs and symptoms must be present for at least two weeks. Anyone who has questions should consult their doctor.
- Continued feelings of sadness, hopelessness, pessimism, emptiness
- Fatigue, lack of energy
- Insomnia or other sleep issues such as waking up very early or sleeping too much
- Anxiety, irritability, restlessness
- Lack of interest or joy in hobbies and activities
- Changes in appetite, leading to weight loss or weight gain
- Moving, talking, or thinking more slowly
- Trouble concentrating, thinking clearly, or making decisions
- Vague aches and pains, such as headaches, joint pain, back pain, or digestive problems
- Thoughts of death or suicide, or suicide attempts
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What You Can Do: Daily Habits Make A Difference
These healthy lifestyle habits, along with professional treatment, can help you manage the symptoms of major depression:
Treatment Works. SAMHSA Can Help You Find It.
Effective treatments for major depressive disorder are available in your area. The earlier that you begin treatment, the greater likelihood of a better outcome. For confidential and anonymous help finding a specialty program near you, visit SAMHSAs Early Serious Mental Illness Treatment Locator.
If you, or someone you know, need help to stop using substances whether the problem is methamphetamine, alcohol or another drug call SAMHSAs National Helpline at or TTY: , or text your zip code to 435748 , or use the SAMHSAs Behavioral Health Treatment Services Locator to get help.
Pay Attention To Sleep Hygiene
Depression and sleep are closely linked. Almost everyone going through a depressive episode experiences sleep disturbances. The relationship is bidirectional, meaning poor sleep can cause depression and depression can lead to poor sleep.
If you are trying to bounce back from depression, pay attention to sleep hygiene. This includes sticking to a regular bedtime, avoiding alcohol and caffeine late in the evening, ensuring your bedroom is cool, dark, and quiet, and switching off all electronic devices 2 hours before bedtime.
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Causes Of Manic Depression/bipolar Disorder
The exact causes of bipolar disorder are not known. A number of different factors likely play a role, including:
- Genetics: Research suggests that bipolar disorder tends to be influenced by genetics. Studies have found having a family member with bipolar disorder increases the likelihood of a person also developing the condition.
- Brain function: Differences in brain chemistry and structure may also play a role. Imbalances in neurotransmitters such as serotonin, dopamine, and norepinephrine increase the risk of having the condition.
- Environmental factors: Certain environmental factors, including stress, can contribute to mood episodes in bipolar disorder, although why this happens is not known. Other environmental triggers may include sleep problems, injury, and substance use.
Factors That Rule Out A Depressive Episode
If a person is meeting symptom criteria for a major depressive episode, there are still some factors that would either rule out a major depressive episode or would lead to a different diagnosis.
- The symptoms must not be caused by a substance such as an illegal drug or a medication.
- The symptoms can’t be caused by a medical condition, such as thyroid disorder, lupus, or a vitamin deficiency.
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Practice Mindfulness And Meditation
Mindfulness is living in the moment and appreciating it. Rather than rushing through your daily routine, stop for a moment to appreciate the small joys of life, such as your childs laughter or the taste and texture of your food.
Meditation exercises like deep breathing or activities like yoga and tai-chi can help relax tense muscles and relieve stress.
In the long run, mindfulness and meditation help to change how your brain responds to stress and anxiety and makes it less likely that youll have a depression episode.
A Lack Of Standardization
Quantitative scales help researchers measure and organize symptoms, as well as designate a cutoff point for whats considered severe depression for the purpose of a specific study. However, methodologies vary between studies and researchers, meaning there isnt a single definition of severe depression across the board.
A lack of standardization means that if a persons depression symptoms are assessed with different scales by different providers, the diagnosis may not be consistent. Some providers dont use them in clinical practice unless a patient is taking medications, whereas others use them regularly.
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How Can I Find Help
If you think you may have depression, start by making an appointment to see your health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses webpage if you are unsure of where to start.
Indulge In Your Favorite Things
When youre not in a depressive episode, what types of things make you happy? Whether its watching a comedy, reading a good book, or anything else, try to engage in activities that you know you enjoy. This can be hard, since part of a depressive episode can include not wanting to do things you usually enjoy. But if you go ahead and do them anyway, you may still get some of that enjoyment, which makes this a great coping skill for depression.
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Track Triggers And Symptoms
Keeping track of moods and symptoms might help a person understand what triggers a depressive episode. Spotting the signs of depression early on may help them avoid a full-blown depressive episode.
Use a diary to log important events, changes to daily routines, and moods. Rate moods on a scale of 1 to 10 to help identify which events or activities cause specific responses. See a doctor if symptoms persist for 14 days or more.
How Remission Is Handled
Your doctor or therapist may recommend changing your medication once symptoms have stopped. Or, they may advise staying the course to avoid depression symptoms recurring.
Remission may mark the end of your time receiving specific clinical treatments for depression. This decision is largely up to your discretion and the clinical professional.
Consider talking with your doctor and therapist to make sure youre on the same page about your depression treatment plan and what markers youll both use to determine recovery.
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Paying Attention To Nutrition
Become more self-aware about providing your body with the proper nutrition and hydration it needs, Weiss suggests. If your body lacks certain nutrients, this could potentially be feeding your depressive feelings.
You could start by limiting sugar intake and increasing consumption of fresh fruits and vegetables when possible.
Bipolar Disorder Vs Major Depression
You may have heard of people who were first diagnosed with depression but later diagnosed with bipolar disorder, and this can be confusing. How can you tell the difference? Keep in mind that the hallmark of bipolar disorder is the presence of episodes of mania or hypomania. These are not present in major depression.
Another common question that’s asked is “Can depression turn into bipolar disorder?” The answer to that question is no, depression doesn’t transition into bipolar disorder later on.
However, it is possible for someone to be diagnosed while they are in the depressive phase, which may result in a diagnosis of depression. At the time, they may not recall or be asked about symptoms of mania or hypomania that would lead to a bipolar diagnosis. Later on, with more careful questioning, or with the occurrence of a manic or hypomanic episode, the diagnosis of bipolar may become clear.
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Depressive Episode Meaning: Times Of Acute Depression
The American Psychiatric Association defines a depressive episode as a period in ones life of at least two weeks, during which they exhibit the requisite symptoms ofmajor depressive disorder. The symptoms of MDD are diverse, and include the following:
- A sense of worthlessness.
The APAs Diagnostic and Statistical Manuals fifth edition states that a depressive episode must include a number of the above and other symptoms in order to meet the requirements for an official depressive episode diagnosis.
An official MDD diagnosis can be given even after a single depressive episode has been recorded, in which case it would be considered a single-episode instance of MDD. An MDD diagnosis could also include more than one depressive episode, in which case it would be considered a recurrent episode case of MDD.
What Are The Different Types Of Depression
You might have heard a number of terms used to describe depression. In this section, we explain what some of these terms mean.
What is clinical depression?
Clinical depression is a common term, but it is not a formal diagnosis. People sometimes say clinical diagnosis to just mean they have been diagnosed by a doctor.
What is a depressive episode?
Your doctor might say that you are going through a ‘depressive episode’. This is the formal name that doctors give depression when they make a diagnosis. They may say that you are going through a ‘mild’, ‘moderate’ or ‘severe’ episode.
What is recurrent depressive disorder?
If you have had repeated episodes of depression, your doctor might say that you have recurrent depressive disorder. They may say that your current episode is ‘mild’, ‘moderate’ or ‘severe’.
What is reactive depression?
If your doctor thinks that your episode of depression was caused by particular stressful events in your life, they may say that it is reactive. For example, divorce, job or money worries. This is sometimes separated from an adjustment disorder, where you may struggle with some symptoms of depression because of adapting to a major change in your life. Such as separation from people, retirement or migrating to a new area.
What is a severe depressive episode with psychotic symptoms?
You can find more information about Psychosis by clicking here.
What is dysthymia?
What is cyclothymia?
What is postnatal depression?
What is manic depression?
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When Does Low Mood Become Depression
We all have times when our mood is low, and we’re feeling sad or miserable about life. Usually these feelings pass in due course.
But if the feelings are interfering with your life and don’t go away after a couple of weeks, or if they come back over and over again for a few days at a time, it could be a sign that you’re experiencing depression. See our page on for more information.
I Pay Attention To How I Talk To Myself
A therapist once referred to the ânegative tapeâ playing in my head, and she couldnât have described it better. For years I didnât notice how much guilt, shame, and cognitive distortions impacted how I talked to myself. Throughout the day I had a running inner monologue that told me I wasnât lovable, didnât do enough, and should have tried harder â regardless of how well I had done or how much I was loved.
The first step in changing how I talk to myself was becoming aware. I began to notice how often I put myself down, or scrutinized my behavior. Once I even kept a tally of how many times Iâd criticized myself in one day. I started saying to myself, Amy, you are doing it again. Step away from the negative messages. Change the channel.
I began to realize that I had a choice: I could tell myself something new. I now make a concerted effort to replace the negative messages with affirming statements. I tell myself that I did a good job, that I am a good friend, and â most importantly â that I love who I am.
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Keep A Gratitude Journal
When youre going through a depressive episode, its common to be consumed by negative thoughts. One of the ways to get out of a depressive episode is to redirect your mind to positive thoughts.
Writing a gratitude journal helps you appreciate all that is good and beautiful in your life. Start with something simple like writing down three good things that happened that day or three people youre grateful to have in your life. This will help to replace negative thoughts and emotions with positive ones.
When Can Remission Begin
Theres not a consensus among medical professionals regarding the timeframe of when remission begins.
A 2008 analysis classified remission as 3 weeks or more of reduction in depressive symptoms. Others, like the International Classification of Diseases, 10th Revision, defined in remission as free from depressive symptoms for several months.
Because theres no standard timeframe for the remission of depression, talking with a healthcare professional can be beneficial. Consider asking questions about how they discern remission status and how it may affect your treatment plan.
Keep in mind that the period in remission is not the same as recovery from depression. Theres no medical on how long you should be in full remission before being considered in recovery.
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Bipolar Disorder Vs Manic Depression
A critical point in distinguishing bipolar disorder from major depressive disorder is whether the person has had a manic episode. For someone to be diagnosed with bipolar disorder, they must have had a manic episode lasting for at least one week or a hypomanic episode lasting for at least four days.
Whats A Major Depressive Episode
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition , a major depressive episode is characterized as having 5 or more depressive symptoms that last for more than 2 consecutive weeks.
The symptoms must be severe enough to disrupt daily functioning at home, work, or at social events. These depressive symptoms include:
- disinterest in most activities and hobbies
- slow movements and delayed speech responses
- drastic changes in appetite
- sleeping too much or too little
- intrusive feelings of worthlessness or guilt
The HAM-D is one measure that can assess the severity of remission in depression. However, clinicians tend to use the DSM-5 for rating and diagnosing depression remission.
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Deterrence And Patient Education
Patient education has a profound impact on the overall outcome of major depressive disorder. Since MDD is one of the most common psychiatric disorders causing disability worldwide and people in different parts of the world are hesitant to discuss and seek treatment for depression due to the stigma associated with mental illness, educating patients is very crucial for their better understanding of the mental illness and better compliance with the mental health treatment. Family education also plays an important role in the successful treatment of MDD.
Keep Your Mind Occupied
One way to keep sadness at bay is to involve yourself in fun activities. Think of your hobbies and things you love to do, preferably involving other people. Depression can make you lose interest in those things, but the passion is always there.
Activities like painting, cooking, listening to music, playing a musical instrument, working in the garden, or journaling lead to the release of dopamine and other pleasure chemicals in the brain, which can lift your mood during a depression episode.
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Physical Effects Of Depression
Depression can appear physically via symptoms felt in the body. Examples of physical effects of depression include sleep disturbance, appetite changes, poor concentration or memory, and a loss of interest in sex. Some people with depression may also feel chronic pain, experience gastrointestinal issues, or have a higher level of fatigue.
I Start From Where I Am
Self-care isnât all fancy spas or relaxing vacations. While I love getting massages or walking by the ocean, in reality I need to take better care of myself where I usually am â at home, in the car, at work, or out with family and friends.
As frustrating as it can be, mental illness is part of my life, so I needed to develop coping skills that I could use throughout the day. Making this perspective shift â from looking outside for self-care to also looking inside âhelped me cultivate skills and self-awareness that I can use to cope with depression and anxiety in my everyday surroundings.
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