Lifting the Clouds of Depression

Bad Days Blow Over

Bad days can ruin a perfectly good mood! We’ve all had bad days when everything seems to go wrong, and we just want to give up. Whether it’s losing your job, health issues, kids out of control, divorce, car wreck, or natural disasters, there’s no doubt about it…life can be hard sometimes! Stress can build up and wear us down to the point of exhaustion. Unexpected tragedies can send us reeling. And we’ve all laid in bed in the morning wondering if we can possibly face another day.

It’s healthy to feel sad when we lose something or someone. When our boundaries are crossed, anger is the natural response. It’s okay to be afraid when our well-being is threatened. These are all warning emotions to help us improve negative situations. They give us a clear signal to take notice and ACT. Usually, we can do something to make it better. The guy in the photo above can rebuild his house (hopefully he has fire insurance). We can usually get medical help for that health diagnosis. We can apply for a better job than the last one. Like the movie, “What About Bob?”, we can “take a vacation from our problems”, so we don’t lose it.¹ The point is that hard challenges come and go. They’re temporary and can usually be helped and improved or just endured at the very least. Our good mood can be restored when the fires from a bad day blow over.

With Depression, Bad Days Are Forever

We can usually mentally survive just about any kind of difficulty, as long as we see an end in sight. But for those who suffer from depression, also known as major depressive disorder or clinical depression, it feels like there is no end in sight. The bad days feel like they will last forever, every minute of every hour, day after day that never ends. Depressive disorder is more than just feeling sad or going through a rough patch. While sadness and grief come and go in temporary waves, mood and pleasure decrease continuously with depression. Feelings of worthlessness and self-loathing are common. These thoughts can lead to wanting to end one’s life due to feeling worthless and undeserving to live or even cope.²

Depression is a serious medical condition marked by extreme sadness or despair that lasts for at least two weeks and interferes with the activities of daily life. Usually, depression develops over a long period of time, leading to a downward spiral of feeling sad and hopeless. Specific types of depression include perinatal depression, psychotic depression, seasonal affective disorder, bipolar disorder, and persistent depressive disorder. Common symptoms of depression include:³

• 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
• Decreased energy, fatigue, or being “slowed down”
• 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 that do not ease even with treatment
• Suicide attempts or thoughts of death or suicide.

Do I Have Major Depression Disorder?

Are you going through a temporarily rough time in your life or does clinical depression seem more like the case? 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. 3 If you think you may have depression, talk to your medical or mental health professional. You can also take this preliminary QUIZ, 4 which includes some of the questions a professional would ask to make a correct diagnosis.

Depression is one of the most common mental disorders. About 21 million U.S. adults (8.4%) had at least one major depressive episode in 2020. It affects people of all ages and all racial, ethnic, and socioeconomic backgrounds.⁵ Research shows that depression is caused by a combination of genetic, biological, environmental, and psychological factors.³ It does not have one specific cause and can happen for many different reasons. Some of the major contributors to depression include: ^5,6

• Mood disorders, such as depression, tend to run in families.
• Medical conditions. People who have a history of physical illness, sleep disturbances, medical illness, chronic pain, anxiety, and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) and medications can mimic depressive disorder. Drug and alcohol misuse. Adults with a substance use disorder are at significantly higher risk for experiencing a major depressive episode. Alcohol use can worsen depressive symptoms.
• When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress, which may lead to depression.
• Life circumstances. Marital status, relationship changes, financial standing, and living conditions influence whether a person develops depression.
• Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
• Some personalities are more apt to experience depression, including those who tend to hold in worries and stress, have low self-esteem, are perfectionists, and are sensitive to criticism.

From Forever to Never

Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better. Between 80% and 90% of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.² The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts.⁵ After an assessment rules out medical and other possible causes, a patient-centered treatment plan can include any or a combination of the following:⁵

1. Wellness Techniques

Physical and mental health strongly rely on each other for overall wellness. One affects the other. Strengthening and nurturing our bodies can also do the same for our mental health. Here are the three pillars of physical health, which can help prevent and even reverse depression:

• Although experts are not sure how exercise acts as an antidepressant, scientific studies have well established that regular exercise can effectively decrease the symptoms of depression. Clear reductions in depression can result even after 10 consecutive days of walking on a treadmill for 30 minutes. The benefits are long-lasting with many maintaining positive gains at a 12-month follow-up. ⁷ Learn more about how to get started.⁸ 
• Healthy Eating. Diet is such an important component of mental health that it has inspired an entire field of medicine called nutritional psychiatry. What we eat matters for our mental health, especially because it can be linked to depression. One study found that the following diet decreased the risk of depression: high in fruits, vegetables, whole grains, fish, olive oil, low-fat dairy, and antioxidants, with a low amount of animal fats, processed meats, sugars, and flours.⁹ Learn more about this way of healthy eating called the Mediterranean diet.¹⁰ 
• Depression and sleep are closely connected in a bidirectional relationship – poor sleep can contribute to depression and having depression usually includes poor sleep. About 75% of adults with depression have insomnia. Some of the ways to improve sleep while feeling depressed are to keep a regular sleep/wake time, keep naps to under 20 minutes, get some sunshine, and exercise. Read more about tips for better sleep with depression.11

• Bright Light Therapy (BLT). This uses a light box to expose a person to full spectrum light and helps to regulate a specific type of depression called seasonal affective disorder (SAD). Yet a growing body of research shows it can be used to treat non-seasonal depression too.¹² Growing evidence suggests that immediate improvement in depressed mood may be detectable after only one light session.¹³
  
• Religious beliefs and practices may help people to cope better with stressful life circumstances, give meaning and hope, and provide a supportive community. In at least 444 studies between 1962 and 2011, over 60% report less depression and faster remission from depression in those who are more religious/spiritual, or a reduction in depression severity in response to a religious/spiritual intervention.¹⁵

2. Psychotherapy

In many cases, significant improvement can be made in 10 to 15 sessions with the help of a licensed mental health professional. Depending on the severity of the depression, treatment can take a few weeks or much longer. Two of the most common evidence-based therapies for depression are cognitive behavioral therapy and interpersonal therapy.¹⁶

• Cognitive Behavioral Therapy (CBT) is a type of therapy in which patients learn to identify and manage negative thought and behavior patterns that can contribute to their depression. CBT helps patients identify unhelpful or negative thinking, change inaccurate beliefs, change behaviors that might make depression worse, and interact with others in more positive ways.
• Interpersonal Therapy (IPT) is a form of therapy in which patients learn to improve their relationships with others by better expressing their emotions and solving problems in healthier ways. IPT helps patients resolve or adapt to troubling life events, build social skills, and organize their relationships to increase support for coping with depressive symptoms and life stressors.

3. Medication

Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants may be prescribed to help modify one’s brain chemistry. Antidepressants may produce some improvement within the first week or two of use, yet full benefits may not be seen for two to three months. Psychiatrists usually recommend that patients continue to take medication for six or more months after the symptoms have improved. Generally, antidepressant medications have no stimulating effect on people not experiencing depression.² Like all drugs, depression medication may cause side effects. Careful consideration and monitoring with your mental health professional will help to find the best medication and dosage for you. Learn more about the common types of medication used to treat depression. ¹⁷

4. Brain Stimulation

For people who suffer from severe depression or psychosis, brain stimulation can be beneficial. It involves activating or inhibiting the brain directly with electricity or magnetic waves by trained medical professionals. Electroconvulsive Therapy (ECT) is the longest studied brain stimulation therapy for depressive disorder with psychosis. Other experimental methods include Repetitive Transcranial Magnetic Stimulation (rTMS), Vagus Nerve Stimulation (VNS), Magnetic Seizure Therapy (MST), and Deep Brain Stimulation (DBS).

When to See a Professional

If your depressed mood lasts for more than two weeks or is seriously interfering with your ability to function at work, with your family, and in your social life, consult with a mental health professional as soon as possible. Call the suicide hotline at 800-273-8255 or call 911 if you experience thoughts about suicide, hurting yourself, or hurting others. Never stop taking your medications or start an alternative therapy without approval and supervision.

Mind Spa recommends our mental health treatment for individuals with depression. Our licensed therapists and medical professionals are dedicated to providing patients with safe and effective mental health treatment that teaches them how to properly heal their symptoms. Contact Mind Spa today for personalized treatment options (720) 822-3838.

References

(1) Oz, F., Goodman, M., Castro-Neves, O., T. P. (1991). What about Bob? [Film]. USA.

(2) American Psychiatric Association. (n.d.). What is depression? https://www.psychiatry.org/patients-families/depression/what-is-depression

(3) National Institute of Mental Health. (n.d.). Depression. https://www.nimh.nih.gov/health/publications/depression

(4) Patient. (n.d.). Quiz: Am I depressed? https://patient.info/news-and-features/quiz-am-i-

depressed

(5) National Alliance on Mental Illness. (2017, August). Depression. https://www.nami.org/About-

Mental-Illness/Mental-Health-Conditions/Depression

(6) Medicine Net. (2021, October 1). What are 4 major causes of depression?

https://www.medicinenet.com/what_are_4_major_causes_of_depression/article.htm

(7) Craft, L. L., & Perna, F. M. (2004). The benefits of exercise for the clinically depressed.

Primary care companion to the Journal of clinical psychiatry, 6(3), 104–111. https://doi.org/10.4088/pcc.v06n0301

(8) Mayo Clinic. (n.d.). Depression and anxiety: Exercise eases symptoms.

https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495

(9) Harvard Health Publishing. (2020, January 29). Diet and depression.

https://www.health.harvard.edu/blog/diet-and-depression-2018022213309

(10) Harvard T.H. Chan School of Public Health. (n.d.). Diet review: Mediterranean diet.

(11) Newsom, R, Dimitriu, A., (2021, May 19). Depression and sleep.

https://www.sleepfoundation.org/mental-health/depression-and-sleep

(12) Oldham, M. A., & Ciraulo, D. A. (2014). Bright light therapy for depression: a review of its

effects on chronobiology and the autonomic nervous system. Chronobiology

international, 31(3), 305–319. https://doi.org/10.3109/07420528.2013.833935

(13) Reeves, G. M., Nijjar, G. V., Langenberg, P., Johnson, M. A., Khabazghazvini, B., Sleemi, A.,

Vaswani, D., Lapidus, M., Manalai, P., Tariq, M., Acharya, M., Cabassa, J., Snitker, S., &

Postolache, T. T. (2012). Improvement in depression scores after 1 hour of light therapy

treatment in patients with seasonal affective disorder. The Journal of nervous and mental

disease, 200(1), 51–55. https://doi.org/10.1097/NMD.0b013e31823e56ca

(14) Watt, A., Lener, M. S. (2021, October 28). How does light therapy treat depression?

https://www.healthline.com/health/depression/light-therapy#method

(15) Bonelli, R., Dew, R. E., Koenig, H. G., Rosmarin, D. H., & Vasegh, S. (2012). Religious and

spiritual factors in depression: review and integration of the research. Depression research and

treatment (2012), 962860. https://doi.org/10.1155/2012/962860

(16) American Psychological Association. (2016, October 1). Overcoming depression: How

psychologists help with depressive disorders. https://www.apa.org/topics/depression/overcoming

(17) Food and Drug Administration. Depression medicines. https://www.fda.gov/consumers/free-

publications-women/depression-medicines

(18) National Institute of Mental Health. (n.d.). Brain stimulation therapies.

https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies