Depression Remission Rather Than Cure
Research suggests that chronic depression is an illness to manage rather than cure. Based on my personal and professional experience, that makes sense to me. I think of chronic depression as something that can go into repeated temporary remissions.
It is not uncommon for people to require a fair bit of trial and error to find their best strategies for managing their own chronic depression. The goal is to find whatever methods work for you, so the impact of depressive symptoms is kept to a minimum.
I hope that my sharing the progress I have made in managing my depression is helpful to you.
If you are dealing with depression and you need support, please do not hesitate to contact me. If Im not the right fit for you as your therapist, I will help you find someone who is.
Make Depression Urges Work For You
OK, so at the end of a long, depressed day, youve exhausted yourself by practicing all the skills above. Youre fed, hydrated, and you even took a mental health walk even though you hated it. Nice job, buddy! Now all you want to do is collapse into a gray, fatigued heap until you have to do it again.
The last skill I want to suggest is a bit of emotional jiu-jitsu. Don’t fight your depression urgesmake them nice. Channel the low, tired energy of your depression into a healthy activity. Do you have the urge to isolate and cry for two days? Great! Sounds like a wonderful opportunity to clean your living room, get cozy, and watch a marathon of your favorite tearjerker movies.
You have no appetite and only want ice cream? That makes sense! Drag yourself to the grocery store and get a reasonably balanced frozen meal that doesnt sound horrible . Then, work with your depression urge by picking out the nicest flavor of ice cream that youve never tried before. Its not depression, its gastronomy!
Youve done enough hard work for the day. Now, make your life easier by redirecting your depression urges towards activities that could even turn out to be a little bit fun, if were dreaming big.
Chronic Illness And Mental Health: Recognizing And Treating Depression
Chronic illnesses such as cancer, heart disease, or diabetes may make you more likely to have or develop a mental health condition.
It is common to feel sad or discouraged after having a heart attack, receiving a cancer diagnosis, or when trying to manage a chronic condition such as pain. You may be facing new limits on what you can do and may feel stressed or concerned about treatment outcomes and the future. It may be hard to adapt to a new reality and to cope with the changes and ongoing treatment that come with the diagnosis. Favorite activities, such as hiking or gardening, may be harder to do.
Temporary feelings of sadness are expected, but if these and other symptoms last longer than a couple of weeks, you may have depression. Depression affects your ability to carry on with daily life and to enjoy family, friends, work, and leisure. The health effects of depression go beyond mood: Depression is a serious medical illness with many symptoms, including physical ones. Some symptoms of depression include:
Remember: Depression is treatableeven if you have another medical illness or condition. For more information, visit the National Institute of Mental Health depression webpage. If you need help starting the conversation, check out NIMHs Tips for Talking With Your Health Care Provider.
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Tips To Help Cope With Chronic Pain And Depression
Depression plays a significant role in chronic paintaking just a few steps to get ahead of it can help patients appreciably by giving them more control over their personal situation.
For some people, the stress and depression resulting from chronic pain can become consuming, and have the potential to significantly worsen and prolong the pain. Increased pain can, in turn, lead to increased stress and depression, creating a cycle of depression and pain that can be difficult to break.
Tip : Eat A Healthy Depression
What you eat has a direct impact on the way you feel. Reduce your intake of foods that can adversely affect your brain and mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones .
Dont skip meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours.
Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these feel-good foods quickly lead to a crash in mood and energy. Aim to cut out as much of these foods as possible.
Boost your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To get more, take a B-complex vitamin supplement or eat more citrus fruit, leafy greens, beans, chicken, and eggs.
Boost your mood with foods rich in omega-3 fatty acids.Omega-3 fatty acids play an essential role in stabilizing mood. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, sardines, tuna, and some cold-water fish oil supplements.
Read Also: How To Cheer A Depressed Person
S To Proactively Address Depression
Following are several steps to help proactively prevent or manage both the chronic pain and associated depression that may develop:
Early diagnosis of depression associated with pain.Many physicians are not necessarily trained to assess for depression during the course of treating pain. Talking to a physician about symptoms of depression, while still in the acute pain phase of pain, can alert a physician to the need to consider treatment of both conditions.
While one patient may demonstrate a full recovery from the initial episode of pain, a patient who is more prone to or shows signs of depression and stress, or who has a history of clinical depression may be more vulnerable to developing a chronic pain problem that persists beyond the initial acute pain complaint.
- Muscle tender points
- Sleep disturbance and fatigue
In many stress-related back pain cases, patients complain of the pain “moving around” or becoming noticeably worse either just before, during, or just after a stressful event or experience.
Chronic pain can also be exacerbated by things such as physical de-conditioning due to lack of exercise and a persons thoughts about the pain. An appropriate exercise program and practicing distraction, guided imagery, and other cognitive techniques, are all effective coping techniques that can help prevent the pain from worsening.
Recognizing how stress affects pain provides the ability to lessen pain without pain medications some level of empowerment over chronic pain.
Tips For Living With Depression
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Everything feels more challenging when you’re dealing with depression. Going to work, socializing with friends, or even just getting out of bed can feel like a struggle.
But there are some things you can do to cope with your symptoms and improve your quality of life. Here are eight tips for living with depression.
This video has been medically reviewed by Daniel B. Block, MD.
Also Check: How To Live A Happy Life With Depression
Things People With Chronic Pain Should Do When Theyre Depressed
- Eliminate the use of alcohol and other drugs
- Exercise or engage in some form of physical activity every day, such as walking, or whatever is possible given your physical limitations
- Eat a proper, well-balanced diet also, use a good multivitamin daily
- Obtain an adequate amount of sleep if sleep is a problem discuss this with your doctor/therapist
- Reach out for emotional support from friends and family
- Focus on the positive aspects of your life
- Pace yourself, modify your schedule and set realistic goals
- Eliminate or reduce unnecessary tasks so that your schedule is more manageable
- Reduce or eliminate the use of nicotine, caffeine, and sugar
- Consult with a physician if you are experiencing any medical problems
- Seek early intervention which may modify the severity of your depression
Focus All Your Energy Into Basic Self
When you feel like youve been drained of your life force, the last thing you want to do is cook, clean, or shower. These things feel menial and meaningless, so why bother? But hunger, dehydration, and feeling smelly never improved anyones mood.
If youre depressed, then youre already scraping the bottom of your energy barrel just by getting through the day. You need to be strategic about how you spend your limited physical and emotional energy. For the time being, dramatically lower your expectations for yourself to the bare minimum. Focus your will on basic life tasks.
If you get out of bed, put on a fresh pair of pajamas, make yourself a bowl of cereal, and drink a glass of water, youre doing great, sweetie! If you brush your teeth, shower, and go to work, thats an absolute A-plus. Good job!
For extra credit, use that last gasp of energy to keep your depression den from getting too deplorable. Set a timer for five minutes and use that time to tidy up your living spacemaybe throw out old takeout containers and put your favorite sweatpants in the wash. Race the clock to see how much you can do in five minutes. My mother-in-law calls this method the Tornado Clean Up, and its genius: an oddly satisfying game and a healthy activity all in one.
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What Chronic Conditions Trigger Depression
Although any illness can trigger depressed feelings, the risk of chronic illness and depression gets higher with the severity of the illness and the level of life disruption it causes. The risk of depression is generally 10-25% for women and 5-12% for men. However, people with a chronic illness face a much higher risk — between 25-33%. Risk is especially high in someone who has a history of depression.
Depression caused by chronic disease often makes the condition worse, especially if the illness causes pain and fatigue or it limits a person’s ability to interact with others. Depression can intensify pain, as well as fatigue and sluggishness. The combination of chronic illness and depression might lead you to isolate yourself, which is likely to make the depression even worse.
Research on chronic illnesses and depression indicates that depression rates are high among patients with chronic conditions:
- Chronic pain syndrome: 30%-54% experience depression
How Can Cognitive Behavioural Therapy Help With Depression
Cognitive Behavioural Therapy or CBT is one of the most effective psychological treatments for depression. CBT uses cognitive and behavioural strategies to help target the thoughts, feelings and behaviours associated with depression. All of our online programs use CBT strategies.
Click below to see if our online CBT program can help you tackle your depression to improve the way you feel.
Cognitive strategies to help with depression
People who are depressed generally have a negative thinking style. They often think of themselves as worthless and that the world is bad or unfair, and they have little hope that their lives will improve in the future.
When something bad happens, people with depression often blame themselves, but when good things happen, they tell themselves they are just lucky. They are also less likely to recognise and appreciate positive events when they happen, and instead are more tuned into the bad things in their lives and brood over those events.
The cognitive strategies in CBT can help people identify and correct this biased way of thinking. These strategies identify and challenge sometimes hidden assumptions and beliefs, and can reframe the way they think about life.
When people with depression are able to reframe their thoughts, they are able to recover from failures more effectively and recognise and take credit for the good things in their lives. Having these skills has been shown to reduce relapse and a recurrence of depression.
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Assess The Parts Instead Of Generalizing The Whole
Depression can tinge recollections with difficult emotions. You may find yourself focusing on things that are unhelpful or perceived as difficult.
Try to stop this overgeneralization. Push yourself to recognize the good. If it helps, write down what was meaningful about the event or day. You can track what you achieved that day, and which activities were enjoyable.
Seeing the weight youre giving to one thing may help you direct your thoughts away from the whole and to the individual pieces that were helpful.
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This negative bidirectional relationship between depression and chronic illness can worsen some conditions and impact our ability to fight them and manage our day-to-day emotions as we cope, Saxena says.
Symptoms of depression can be insomnia, back aches, headaches, migraines, appetite changes, GI issues, and heart issues, she explains. Depression leads to higher cortisol levels in the body, which makes the body more prone to these issues.
That rise in cortisol weakens the body’s ability to fight off other illnesses, like colds or the flu, says Saxena. It also leads to an increase in blood pressure and heart rate, which both impact heart health and sleep, as well as headaches and migraines.
Experiencing both depression and an illness at the same time can be debilitating, she says. The mental anguish that comes with a chronic illness is bad enough, and with depression on top of that, one can exacerbate the other. That’s why it is really important to have a support system and a therapist or counselor that you can speak to regularly to help you manage and cope.
Talk about it with a health care provider, because you do not need to suffer with this alone, Saxena adds. There are groups, therapies, and interventions that can help you both feel better mentally, as well as learn ways to cope long term and learn how to live with a chronic illness. The power comes from people, so allow people into your world and share what is going on.
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Radically Open Dialectical Behavior Therapy
Radically open dialectical behavior therapy is a newer type of therapy thats shown promise for chronic or treatment-resistant mental health conditions.
Dialectical behavior therapy is at the base of RO-DBT. This is a type of psychosocial therapy that helps you cope with difficult emotions.
RO-DBT is considered for people who overcontrol or attempt to cope by self-controlling. Overcontrol has been linked with social isolation and other relationship problems, perfectionist tendencies, and suppressed emotions.
Though this therapy may help some people with PDD, it is new and may have limited accessibility.
First-line treatments for PDD usually combine medication and therapy.
The medications for PDD are the same as those that treat other forms of depression. These include:
- serotonin-norepinephrine reuptake inhibitors , such as venlafaxine or duloxetine
- atypical antidepressants, like bupropion
- tricyclic antidepressants , including amitriptyline
Most doctors will likely start by prescribing an SSRI since most people tolerate them well, but its not uncommon for people to try several medications before finding one that works for them.
Its not always easy to find the right med that relieves symptoms without causing too many side effects. Treating chronic depression may also involve some maintenance, which means tweaking the treatment over time.
While it can be a frustrating back and forth of trial and error, there are treatments out there that will help you.
How Is Depression Treated
Depression is among the most treatable of mental disorders. Between 80% and 90% percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.
Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem or a vitamin deficiency . The evaluation will identify specific symptoms and explore medical and family histories as well as cultural and environmental factors with the goal of arriving at a diagnosis and planning a course of action.
Recommended Reading: What It Feels Like To Have Depression
Do The Opposite Of What The Depression Voice Suggests
If you believe an event wont be fun or worth your time, say to yourself, You might be right, but itll be better than just sitting here another night. You may soon see the automatic thought isnt always helpful.
Things People With Chronic Pain Should Avoid When Theyre Depressed
- Isolating behavior
- Making long-term commitments or important decisions, unless absolutely necessary
- Over-committing to activities which are stressful or overwhelming
- Assuming that things are hopeless theyre not!
- Engaging in emotional reasoning
- Assuming responsibility for events which are outside of your control
- Avoiding treatment as a way of coping so you dont have to change
Seek Support From Online Support Groups
Online support groups are a wonderful way to connect with others, no matter what else is going on in your life. Not only can you find helpful advice and encouragement in an online support group, but you can also give those gifts to someone else in need.
Friends and family members may mean well, but they dont always understand what youre going through. Other people with chronic illness, or chronic warriors, as they sometimes refer to themselves, do understand.
Even if someone doesnt share your health condition, they know what its like to live with a long-term illness that affects their quality of life every day. Connecting with someone who understands that can go a long way.