What If My Depression Never Goes Away

Depression: What You Need To Know As You Age

If youre one of the more than 14.8 million American adults who experiences major depression, you may feel so bad that you cant get out of bed, be around the people you love or participate in activities that you usually enjoy. Actually, there are more than 50 different symptoms of major depression, ranging from the well-knowncrying and sadnessto those you might never associate with depression, such as anger, workaholism and back pain.

Depression is a disease that affects every aspect of a persons life, not just mood, says Johns Hopkins expert Andrew Angelino, M.D., Chair of Psychiatry at Howard County General Hospital. The World Health Organization predicts that by 2020, depression will be the second-leading cause of disability in the world, just behind cardiovascular disease.

People who are depressed are far more likely to have other chronic medical conditions, including cardiovascular disease, back problems, arthritis, diabetes, and high blood pressure, and to have worse outcomes. Untreated depression can even affect your immune response to some vaccines.

Depression is not just debilitating it can be deadly. An estimated one out of five people with depression will attempt suicide at some point.

Symptoms And Causes Of Depression

Symptoms of depression can be very different from person to person. However, as a general rule, if you are depressed you feel hopeless, sad and lacking interest in things that used to make you feel happy.

Depression symptoms are bad enough to interfere with work, social life and family life, and can persist for weeks or months.

Doctors describe depression in one of three ways, depending on how serious it is:

• mild depression it has some impact on daily life
• moderate depression it has a significant impact on your daily life
• severe depression this makes it nearly impossible to get through your life day to day

A few people with severe depression may have symptoms of psychotic depression.

Below is a list of depression symptoms it’s unlikely that one person would have all of them.

Personal Factors That Can Lead To Depression

Personal factors that can lead to a risk of depression include:

• family history depression can run in families and some people will be at an increased genetic risk. However, this doesnt mean that a person will automatically experience depression if a parent or close relative has had the condition.
• personality some people may be more at risk because of their personality, particularly if they tend to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative
• serious medical conditions these can trigger depression in two ways. Serious conditions can bring about depression directly or can contribute to depression through the associated stress and worry, especially if it involves long-term management of a condition or chronic pain
• drug and alcohol use can both lead to and result from depression. Many people with depression also have drug and alcohol problems.

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Commit To A Simple Routine

Sometimes, severe depression makes it hard to get out of bed. Entire days may pass before you take a shower or interact with another person.

All humans benefit from structure. It keeps us grounded and sane. Regardless of the severity of your symptoms, a simple routine can help you stay focused. It can give you a small sense of purpose as you move throughout your day.

The key to this routine is making it both uncomplicated and manageable. For example, you may commit to brushing your teeth, eating breakfast, and washing your face each morning. Aim to follow this routine regardless of your emotions that day. The more you can build the habit, the more second-nature self-care becomes.

Finally, dont beat up on yourself if you cant commit to the routine one day. You are human! Although most of us have heard the cliche that it takes 21 days to form a habit, research shows that it can actually take anywhere between 18-254 days!

In other words, be kind to yourself if you start slipping. The self-loathing will only make it that much harder to try again.

What Is Major Depressive Disorder

Major depressive disorder is a serious mental illness that affects how people feel, think, and go about their everyday tasks. The condition can also impact a persons sleep habits, appetite, and ability to enjoy life.

Major depressive disorder isnt something that eventually passes.

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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.

It’s Ok To Have Emotions

For a long time, I suppressed uncomfortable emotions like sadness, thinking that would mean the depression would go away.

But it turns out when we suppress one emotion, we also suppress our ability to feel all other emotions, like joy.

It meant that for a long time I’d avoid things that moved me deeply â like music â in case they made me too emotional.

Now I know emotions exist to tell us important things about ourselves and the situation we’re in, for example, what we need, what we value, what we love.

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How To Tell If You Have Clinical Depression

Clinical depression affects people in different ways.

The symptoms of clinical depression can be complex and vary from person-to-person.

Generally, if you have clinical depression:

• you feel sad, hopeless and lose interest in things you used to enjoy
• you experience these symptoms for at least 2 weeks
• the symptoms are serious enough to interfere with work, social life or family

There are many other symptoms of clinical depression and you’re unlikely to have them all.

Major Depression: Reasons Why People Avoid Treatment

If you feel depressed and are trying to deal with it on your own, see if any of these reasons ring true to you. If they do, then follow the expertsâ advice to get the help you need.

If I give it time, Iâll snap out of it. Although a case of the blues passes with time, clinical depression may linger indefinitely if not treated, says Erik Nelson, MD. People canât just snap out of being depressed. Sometimes depression has a biological cause. And like other medical conditions, it often requires treatment to control or heal it.

Waiting for depression to simply pass can be harmful for a number of reasons. For one, depression that goes untreated may become more severe, Nelson says. The longer the delay in treatment, the more difficult it may be to control, and the more likely it is to recur when treatment is stopped. There also is growing evidence that untreated depression can contribute to or worsen other medical problems. âHeart disease is the one that has been most linked to depression, but research also suggests a link between depression and metabolic issues such as obesity, diabetes, and diseases such as Alzheimerâs and cancer,â Nelson says.

Expert advice: Donât allow depression to linger. Speak to your doctor. If you find it difficult to seek treatment for a mental disorder, remember that treatment for it may help prevent serious health conditions like heart disease.

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What Are The Signs And Symptoms Of Depression

Common symptoms of depression include:

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of irritability, frustration or restlessness
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies or activities
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early morning awakening, or oversleeping
• Changes in appetite or unplanned weight changes
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and that do not ease even with treatment
• Suicide attempts or thoughts of death or suicide

If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK . You also can text the Crisis Text Line or use the Lifeline Chat on the National Suicide Prevention Lifeline website.

Who Is At Risk For Depression

Depression can affect anyone, no matter their age, gender or circumstances. About 16 million Americans experience depression each year.

Women may experience depression more often than men. And your genetics or other health conditions can increase the likelihood that youll have at least one depressive episode in your lifetime.

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What To Do About It

Some people do experience symptoms of depression in waves or intermittent episodes. This means you could experience days, even weeks, of relief and then notice your symptoms suddenly come back or intensify.

In other words, worsening depression is sometimes just the nature of depression but that doesnt mean its permanent, or that treatment wont help.

Professional support is the best way to improve symptoms of depression. If your symptoms fail to ease within a few days or continue to get worse, its best to talk to your therapist or doctor as soon as possible.

If youre already taking medication or working with a therapist, they can help you get guidance on next steps.

It never hurts to schedule an appointment as soon as you start to feel worse. You can always cancel later if you begin to feel better, but that way youll have the appointment if you need it and wont have to worry about availability.

Get A Consultation With A Teaching Hospital

Before my husband begged me to have a consultation at Johns Hopkins Mood Disorders Center, I had been to six psychiatrists. One of my blogs, in fact, is called The Psychiatric Guide to Annapolis. Let me just say that there are a lot of people who shouldnt be practicing medicine, like one I dubbed Pharma King, who received generous kickbacks from a pharmaceutical company.

The reason I trust teaching hospitals like Johns Hopkins, is that they never stop researching, and they are not afraid to use the older drugs like lithium that have proven track records but arent lucrative. Kay Redfield Jamison, a professor of psychiatry at Johns Hopkins, wrote an excellent op-ed piece in the New York Times just after the death of Robin Williams called Depression Can Be Treated, But It Takes Competence. She writes:

“Many different professionals treat depression, including family practitioners, internists and gynecologists, as well as psychiatrists, psychologists, nurses and social workers. This results in wildly different levels of competence. Many who treat depression are not well trained in the distinction among types of depression. There is no common standard for education about diagnosis. Go to a teaching hospital. You wont regret it.

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Does Depression Look The Same In Everyone

Depression can affect people differently, depending on their age.

Children with depression may be anxious, cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.

Older children and teens with depression may get into trouble at school, sulk, be easily frustrated feel restless, or have low self-esteem. They also may have other disorders, such as anxiety and eating disorders, attention-deficit hyperactivity disorder, or substance use disorder. Older children and teens are more likely to experience excessive sleepiness and increased appetite . In adolescence, females begin to experience depression more often than males, likely due to the biological, life cycle, and hormonal factors unique to women.

Younger adults with depression are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, and substance use disorders.

Middle-aged adults with depression may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning awakening. They also may more frequently report having gastrointestinal symptoms such as diarrhea or constipation.

Electroconvulsive Therapy Electric Shock Treatment

If you have severe depression and other treatments, like medication, haven’t worked, ECT might be recommended for you.

When receiving ECT, you will be given an anaesthetic and medication that relaxes your muscles to begin with. Electrodes will be placed on your head that give an electrical “shock” to your brain.

ECT is given over a series of sessions, normally twice a week for three to six weeks.

ECT can cause side effects including nausea, headaches, aches in the muscles and memory problems.

Most people find that ECT is good for relieving severe depression, but the beneficial effects tend to wear off when several months have passed.

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How Can I Take Care Of Myself

Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you dont feel like doing them, they can improve your mood. Other things that may help:

• Try to get some physical activity. Just 30 minutes a day of walking can boost mood.
• Try to maintain a regular bedtime and wake-up time.
• Eat regular, healthy meals.
• Do what you can as you can. Decide what must get done and what can wait.
• Try to connect with other people, and talk with people you trust about how you are feeling.
• Postpone important life decisions until you feel better.
• Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.

Different Types Of Depression

There are different types of depression, and there are some conditions where depression is a symptom. These conditions include:

• Bipolar disorder people with bipolar disorder, which is also known as “manic depression”, experience times of depression, where the symptoms are similar to clinical depression. They also go through phases when they have excessively high moods . Bouts of mania can include harmful behaviour like unsafe sex, spending sprees and gambling.
• Seasonal affective disorder is also called “winter depression”. It’s depression that is related to weather, usually winter, so it happens seasonally.
• Postnatal depression happens to some women after they’ve had a baby. It’s treated similarly to other types of depression, with antidepressant medication and talking therapy.

Learn more about how depression is diagnosed here.

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Treatments Might Take A While To Work

Depression is a long-term illness, and it wont go away overnight. Antidepressant medications can take anywhere from 2-6 weeks to kick in, and sometimes longer to reach their full effect. Therapy is generally considered more effective than medication, and many people feel better after just a few sessions. But its still hard to predict how long it will take to see long-term results. You never know when youll have a major breakthrough.

Its also possible for a treatment to stop working after a while, or not work as well as it used to. You might have to switch medications, change your dosage, or take several medications at once. Try telling your doctor or therapist that you feel stuckthey can help you find new things to try.

Other Causes Of Depression

There are a number of things that can lead to developing depression.

• Stressful events big changes in your life, like bereavement, the end of a relationship or the loss of a job, can be difficult to deal with. When these things happen, it’s important to keep seeing friends and family instead of trying to deal with problems alone this increases your risk of developing depression.
• Giving birth pregnancy and birth can make some people vulnerable to depression. Postnatal depression can happen as the result of physical changes, hormonal changes, and the responsibility of taking care of a new baby.
• Loneliness your risk of depression gets higher if you aren’t in contact or spending time with family and friends.
• Personality some personality traits can put you at a higher risk of developing depression. These include low-self esteem or a habit of criticising yourself too much. These personality traits can come from your genes, which you get from your parents, or they can be as a result of experiences in your early life.
• Family history it’s more likely for someone to develop depression if a family member, like a sibling or parent, has experienced it before.

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Load Up On Vitamin D And Vitamin B

I was relieved that Dr. Weiss included blood tests to check vitamin D and vitamin B-12 levels, as well, because deficiencies in both of those vitamins can cause severe depression. They are included in my list of 10 Nutritional Deficiencies That Can Cause Depression. According to a 2009 study published in the Archives of Internal Medicine, as many as three-quarters of U.S. teens and adults are deficient in vitamin D. Last year Canadian researchers performed a systematic review and analysis of 14 studies that revealed a close association between vitamin D levels and depression. Researchers found that low levels of vitamin D corresponded to depression and increased odds for depression. In another 2009 study, more than a quarter of severely depressed older women were deficient in B-12. I take each of those vitamins in liquid form so that they absorb quickly and efficiently.