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.
How Is Depression And Anxiety Treated
If you broke your leg, you wouldn’t just struggle on without help. You’d get in seen to. Mental health is as important as physical health and can be treated successfully. There are several treatments available often a combination of treatments is needed.
If your symptoms are mild, your GP may take a ‘wait and see’ approach. They may give you some advice on how to cope with symptoms then see if symptoms improve within a few weeks.
Theres something called ‘talking therapies’ now, which can really help people who are feeling low, anxious or out of sorts.
Talking treatments allow you to talk to a trained professional who can help you manage your thoughts and feelings and the effect they have on your mood and behaviour.
Examples of talking treatments include cognitive behavioural therapy and counselling. They may be one-on-one sessions or in a group environment.
If you are considering talking treatments, be sure to mention any cultural, language or religious needs you have or any hearing or sight problems, so they can be addressed when arranging therapy for you. Talking treatments are effective and available for free on the NHS.
The Risk Of Suicide Is Real
What to do in a crisis situation
If you believe your loved one is at an immediate risk for suicide, do NOT leave them alone.
In the U.S., dial 911 or call the National Suicide Prevention Lifeline at 1-800-273-TALK.
In other countries, call your countrys emergency services number or visit IASP to find a suicide prevention helpline.
It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain theyre feeling.
Since suicide is a very real danger when someone is depressed, its important to know the warning signs:
- Talking about suicide, dying, or harming oneself a preoccupation with death
- Expressing feelings of hopelessness or self-hate
- Acting in dangerous or self-destructive ways
- Getting affairs in order and saying goodbye
- Seeking out pills, weapons, or other lethal objects
- A sudden sense of calm after depression
If you think a friend or family member might be considering suicide, dont wait, talk to them about your concerns. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a persons life, so speak up if youre concerned and seek professional help immediately!
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Habits That Can Make Your Depression Worse
There are a number of risk factors associated with developing major depressive disorder, including temperament, environmental factors , genetics, and other mental health and medical disorders.1 Most of these triggers of depression are out of the realm of control for the depressed patient. There are, however, some habits within the realm of control that can worsen symptoms of depression.
Depression is a serious medical condition that can be treated with counseling, medication, or a combination of the two, but people struggling with depression can also make lifestyle changes to help alleviate symptoms. It helps to look at choices and habits that can contribute to depressive symptoms to understand how to make healthy choices during the treatment process.
How You Can Help
It might seem small, but just doing things together, being there and staying connected can be a big help.
Depression and anxiety are so common that its highly likely that at some point youll know someone who might be experiencing it. It might be someone in your whnau, a team-mate or someone from your community. People with depression and anxiety are more likely to get through with help and support than on their own.Being depressed and anxious can be a really lonely experience. Sometimes the most important thing is having supportive people around or checking in. Having a coffee, watching television, phoning or texting to say Hi can help a lot. When youre feeling down, knowing that people are thinking of you can really lift your spirits.Often when people are feeling bad they dont want to go out and do anything. Everything feels just too hard. So encouraging them to do something with you is a great support. It could be something small like watching funny video clips, listening to music, going for a walk or window-shopping. Think about something you both like to do. There are different things you can do, depending on who youre trying to help:
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Ways To Turn Around Your Mild Depression Before It Gets Worse
When you’re feeling low, it can be tempting to go to the dark place in your mindworrying that you won’t feel like yourself again and shouldn’t even bother trying to lift your spirits. Yet there are plenty of things you can do to stop a mild case of depression in its tracks, says Helen Odessky, PsyD, a Chicago-based psychologist and author of Stop Anxiety from Stopping You. Here, Odessky and other mental health specialists share the tactics that can help you turn around your mild depressionbefore it gets worse.
They May Start Needing More From You
A depressed person legitimately cant function like a mentally health person. There will be things they will no longer be able to do as much of, as often, or at all. Pestering or shaming them about it will only hurt, not help. If theyve been keeping their depression private, it will be that much harder to deal with others getting irritated with them because they cant perform at the level thats expected of mentally healthy people.
This is why its always best to be understanding with those in your life, both work and personal. You dont know if someone isnt just slacking off, but is struggling with a real health problem.
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Suicidal Thoughts: An Emergency
For people who are severely depressed, suicide is a real threat. Each year, about 30,000 people in the U.S. take their own lives, although the true number may be higher. Some suicides go unrecognized because they’re classified as accidents, drug overdoses, or shootings. Among people whose depression remains untreated, up to 15% will kill themselves.
What are the warning signs of suicide? According to the National Suicide Prevention Lifeline, they include:
- Talking about wanting to die or wanting to kill yourself
- Looking for a way to kill yourself, such as searching online for methods or buying a gun
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing use of alcohol or drugs
- Acting anxious or agitated behaving recklessly
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
They May Often Seem Exhausted Or Complain About Always Being Tired
A prevalent side effect of depression is constant exhaustion. Not everyone with the disorder struggles with it, but its extremely common. For those who experience this symptom with their depression, its often one of the hardest side effects to cope with.
Also, if someone is living with an undiagnosed depression disorder, the cause of their exhaustion can be baffling. They can get plenty of sleep each night and still wake up every morning feeling like they only slept a few hours. Worse, they may blame themselves, believing it to be laziness or some other personal fault thats causing their low energy levels.
This is also a symptom thats difficult to conceal for those who have been diagnosed with depression but are attempting to keep it from their peers, as it often affects their workload and personal relationships.
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Bad Days In Depression: What Do They Feel Like
Having a bad day now and then isnt a sign of depression. But when you live with depression, a bad day can mean some of your symptoms intensify, or they impact your routine more than usual.
Its natural to feel discouraged or disheartened when this happens. You may feel like youre taking a step backward or that nothing works for your depression.
Untreated depression could be one reason you may feel your symptoms are intensifying.
If youre treating your depression, other factors can contribute to your bad days. For example, your antidepressants may have stopped working, or youre living with symptoms of other conditions.
In any case, the first step to getting through difficult days may be remembering that theyre not permanent. Identifying what works for each symptom when it intensifies can also help.
Depression can sometimes manifest as a feeling of hopelessness. You might have a hard time figuring out whats the point in moving on? But this is depression talking to you. This feeling can be managed.
You may also feel lonely, especially on a bad day.
Hopelessness and loneliness may feel like a profound sense of emptiness and lack of purpose.
Its possible to regain purpose when you have depression, though, and you can also manage these symptoms.
Here are some tips:
Change Your Medication Or Therapy Routine
Its important to be open and honest with your therapist or doctor about what is working and what isnt. You may need more than just therapy, or more than medication, or even a different medication entirely.
Certain types of therapy can be very beneficial in helping to treat depression. Cognitive behavioral therapy is one effective form that many therapists utilize.
Other types of therapy used to treat depression may include:
- Interpersonal therapy
- Selective serotonin & norepinephrine inhibitors
- Tetracyclic antidepressant
- Monoamine oxidase inhibitors
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Feel Better One Small Step At A Time
There is no health without mental health.
In the past decade, depression rates have escalated, and roughly one in five Americans will suffer from major depression at some point in their lives.
While there is no quick fix or one-size-fits-all for overcoming depression, the following tips can help you manage depression so it does not manage you.
1. Beware of rumination. The word “ruminate” derives from the Latin meaning for chewing cud, a less than appetizing process in which cattle grind up, swallow, then regurgitate and rechew their feed. In the human realm, ruminators analyze an issue at length . Many ruminators remain in a depressive rut because their negative outlook hinders their problem-solving ability.
- Remind yourself that rumination does not increase psychological insight.
- Take small actions toward problem-solving.
- Reframe negative perceptions of events and high expectations of others.
- Let go of unhealthy or unattainable goals and develop multiple sources of social supports.
2. Focus on what youre doing right. As rough as your life is right now, you havent fallen off the edge, and this is not just by chance. Key is to remember that humans are remarkably resilient and capable. Because depression can cloud your judgment, it can be tempting to overemphasize the negative aspects of situations, while discounting the positives.
Mixed Anxiety & Depression Explained
Depression and anxiety have similar causes and some people can experience symptoms of both conditions at the same time. If youve been experiencing both low mood and persistent worry, tension, and unease, click below to learn more about the relationship between anxiety and depression.
How To Deal With Depression
There are a range of ways to deal with depression, and often they are best used in conjunction with each other. The primary medical options are Cognitive Behavioural Therapy , antidepressant medication, and in some severe cases, Electroconvulsive Therapy .
Education and coping strategies are also important when learning to manage your depression.
ECT is an effective form of treatment for depression, especially if:
- There are medical contraindications to medication.
- There is a need for rapid improvement because of suicidal intent or refusal to eat.
- The person has experienced treatment failure following CBT, several medications, or combined medication and CBT treatment trials.
- The person has had a previous positive response to ECT.
- Somatic symptoms are prominent.
- Psychotic symptoms are present.
What is CBT?
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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.
Tips For Preventing A Relapse
These prevention strategies can help to stop depression from returning:
Keeping up with treatment: Finishing the full course of a prescribed medication can significantly reduce the risk of relapse, especially during the critical 6 months after treatment begins.
Mindfulness based therapies: Mindfulness can help a person understand any negative thought patterns and find ways of dealing with them. One study shows that practicing mindfulness three times a week may reduce depression relapse by up to 50% within a year.
Educating friends and family: Telling friends and family what warning signs to look out for might help catch an episode early.
Prepare for a relapse: It may help to make a plan so that, if warning signs do appear, the individual can act upon them quickly. A doctor can help with this.
When worrying symptoms come back during treatment, it might mean that current treatment is not working as it should.
A doctor may recommend changing the treatment style or increasing the medication dosage.
Treatments that can help include:
Talking therapies: Interpersonal therapy , cognitive behavioral therapy , or both may reduce the risk of depression returning.
Medication: or mood stabilizers can help some people. Following the doctors recommendations for taking these drugs can help reduce the risk of a relapse.
Electroconvulsive therapy: In some cases, a doctor may recommend
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Consider Practicing Meditation And Yoga
Mindfulness meditation and yoga have been shown to reduce symptoms of depression and anxiety.
Both of these practices may help you feel grounded and focus on the present moment, which could help you avoid negative thoughts that fuel your emotions.
If youre having a difficult moment dealing with intense emotions, consider this exercise:
- Find a quiet place and sit up in a comfortable position.
- With eyes closed, focus on the rhythm of your breath.
- Place both of your hands on your belly and feel how it lifts as you breathe in and flattens as you breathe out.
- As you breathe in through your nose, count until 5.
- Hold your breath for 5 seconds.
- Breathe out through your mouth as you count until 5.
- Repeat the breathing in, holding, and breathing out cycle for as long as it feels comfortable.
How Is Depression Diagnosed
To be diagnosed with depression, an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad.
If you think you may have depression, talk to your health care provider. Primary care providers routinely diagnose and treat depression and refer individuals to mental health professionals, such as psychologists or psychiatrists.
During the visit, your provider may ask when your symptoms began, how long they last, how often they occur, and if they keep you from going out or doing your usual activities. It may help to make some notes about your symptoms before your visit. Certain medications and some medical conditions, such as viruses or a thyroid disorder, can cause the same depression symptoms. Your provider can rule out these possibilities by doing a physical exam, interview, and lab tests.
Read NIMHs Tips for Talking With Your Health Care Provider to help prepare for and get the most out of your visit. For additional resources, visit the Agency for Healthcare Research and Quality website.