This blog seemed to get lost; so here it is again.

How many forms of depression are there?  Too many!  

• Atypical Depression
• Bipolar Disorder
• Clinical Depression
• Double or Dysthymia Depression
• Major Depression
• Persistent Depressive Disorder
• Postpartum Depression
• Premenstrual Dysphoric Disorder (PMDD)
• Psychotic Depression
• Seasonal Affective Disorder (SAD)
• Situational Depression
• And more 

But, for this Blog, let’s just look at General or Clinical (also, sometimes defined as Major) Depression. 

Just about everyone suffers from a certain amount of depression, sometime during their life; a death in the family, loss of a love, losing one’s job or pet… there can be numerous issues to cause depression. It only starts becoming a problem, however, if it starts lasting for periods of time of more than two weeks or so, without the person “snapping out of it,” so to speak.  When left untreated, depression can last weeks, months, years or an entire lifetime. 

What symptoms does Clinical or General Depression have?  Many… and they can overlap into other forms of depression, making diagnosis difficult; especially, if the patient has other medical issues already. 

1. Appetite changes
2. Difficulty concentrating
3. Drug or alcohol abuse
4. Fatigue
5. Feelings of guilt
6. Feelings of helplessness
7. Feelings of hopelessness
8. Feelings of worthlessness
9. Insomnia
10. Isolating oneself from friends
11. Loss of interest in usual activities
12. Low self-esteem (can be different than worthlessness)
13. Missing work
14. No interest in pleasurable activities, including sex
15. Oversleeping
16. Poor memory
17. Slow movements
18. Slow speech
19. Thoughts of suicide
20. Trembling, twitching, or shaking
21. Unsafe sexual practices
22. Weight gain or loss
23. And, again, more! 

No one person has any particular symptom; or, have all symptoms… as depression varies from patient to patient. And, it is difficult, sometimes, to tell the difference between depression and an anxiety disorder; which, often, have many of the same symptoms as well. This is why, it is best to leave ‘diagnosis’  and ‘treatment’ to the professionals. 

But, other than the obvious, of seeing your doctor, what can be done to treat depression? Generally speaking, meds are prescribed to help ‘elevate’ mood and help relieve other symptoms. In severe cases, especially, where the patient might become a danger to themselves or others, Electroconvulsive therapy (ECT) may be necessary. This, literally, ‘resets’ or ‘reboots’ the brain; and helps to, quickly, balance the brain chemicals. 

Repetitive Transcranial Magnetic Stimulation (rTMS) may, also, be used to treat Clinical Depression; in which, certain areas of the brain are stimulated with a special kind of magnet to increase activity. This helps to control ones mood. 

Psychotherapy (or, ‘Talk Therapy’), generally, follows either treatment, if medications after ECT or rTMS are unsuccessful. On its own, psychotherapy may be enough to resolve some severe depression by relieving anxiety and resolving guilt; but, mostly, it is used with different medications. Talk Therapy can get down to “the root of the depression”; such as teaching the patient ‘how’ to cope with a loss. With mild forms of depression, Talk Therapy may be all that is necessary, in fact. 

Of course, there are other methods for medically treating depression; but are there any ‘natural’ ways to treat it… like “home remedies?” There ARE things one can do to help themselves or a family member with the use of a doctor. Understanding, (on the part of friends or family) is the first way to help someone suffering from depression. One may not be able to understand the problem, but they can understand that the person with the depression cannot cope with a certain aspect of life or health and needs the emotional support of their friends or family. Getting angry at someone who cannot control their emotions, is not going to help them; nor, is just telling the person to “it’s time to move on” with their life. 

This is, especially, true with it comes to grieving. Everyone ‘grieves’ in their own way. Sometimes, it takes days to accept and cope with a loss, sometimes it takes a lifetime! But, when it takes more than a couple of weeks to keep that loss from interfering with every day function, this is where Clinical Depression comes in.  Sure, one is going to be sad for weeks, months or years after suffering from a loss; but the person/patient needs to realize that “life does go on” for the surviving family or friends; and, they need to learn to cope via meds, brain manipulation or other ways, such as Diet, Nutrition, Cranial Electrotherapy Stimulation, Exercise or other means. 

Sometimes, a ‘lifestyle’ change can, aid with depression symptoms. But, what equates to a ‘lifestyle’ change?  In some people it could be moving to a new house or town. With others, it could be loss of weight, new clothing, meeting new people, getting a pet, joining a club… many things can constitute a, so-called, ‘lifestyle’ change! Is there anything else one can do?

Regular exercise, for example, can be as effective in treating depression as medication can; and, if the patient is already taking meds of some sort, exercise can help to lower the daily dosage; and thus, eliminate some of the negative side effects the medication might have.  Exercise can boost endorphins and other brain chemicals; and trigger the growth of new brain cells while, sometimes, ‘re-routing’ affected nerves.  And, one doesn’t have to be an athlete to do exercise! Just a brisk walk for half hour to an hour per day can greatly reduce symptoms.  But, technically speaking, if one can exercise ‘aerobically’ (meaning, getting the heart rate up for an extended time) for an hour or more, the body and brain will be greatly improved.  If the patient ‘physically’ feels (and looks) better, their depression is going to, naturally, reduce. Best of all, you don’t have to train for a marathon in order to reap the benefits. What if the patient is incapable of walking?  Then, there are other means of physical therapy or even Whole Body Vibration to exercise the ‘Core’ muscles.  As long as the patient can just stand (or, even sit on some machines) for 10 or more minutes, they can greatly reduce their depressive symptoms… just like working out for an hour at the gym!

Nutrition. Even without depression, proper nutrition is important for both your physical and mental health; and small, well-balanced meals throughout the day can keep the depression patients energy up and minimize mood swings. Sure, we all have our ‘comfort foods;’ but when they are just sugary food items, they will only provide a quick ‘boost’ to the system. Eating complex carbohydrates is a much better choice; as one will still get a ‘boost,’ but not have the ‘sugar crash’ which later comes!  Supplements, such as SAMe, St. John’s Wort, and Zinc have been proven effective in treating depression; and many other vitamins and minerals, also, seem to help – for a list of vitamins and supplements, check the internet or talk to a nutritionist. But, vitamins, such as B-Complex (I like B-100’s for my patients) when taken with a good Omega 3 supplement, have also been proven to help.  One needs to realize, however, these are NOT mood altering substances, but ‘mood enhancing!’  Luckily, they only seem to enhance a good mood, rather than a bad! 

Sleep. Sleep, or the lack of it, has an immense effect on depression and mood.  Depression symptoms, such as sadness, fatigue, irritability, and anger, often, become worse with the lack of sleep.  Taking Melatonin, Valerian, Kava or even drinking a little decaffeinated Chamomile Tea at bedtime can often help with sleep.  Next, a device safe to use daily, to help with sleep, might also, come in handy; especially, as it helps not only in sleep, but depression, stress and anxiety as well.  That device, is a Cranial Electrotherapy Stimulation machine (or CES as it is known). This FDA approved, prescription only, home use device sends a micro-current through the brain and helps to induce sleep. Many people use it an hour or so before bedtime; while others (although, not recommended), use it at bedtime and fall asleep with it on! 

Social support. Of course, it is important to keep in touch with your doctor when taking meds.  If seeing a psychologist or psychiatrist as well, it is important to keep up that interaction; especially, if ‘Talk Therapy’ is being used.  But, it’s best to be able to talk to more than just a doctor.  A strong social network of friends, also helps to reduce isolation; which is a key issue for depression.  The biggest mistake Clinical Depression patients make, is severing ties with regular friends and family. If one doesn’t have much in the way of friends or family, then perhaps finding a group of people with similar interests or hobbies might be in order; even, if it happens to be a “Grief Group.”  Remember the old saying, “misery love company?” Well, it’s true. Grief groups allow the depression patients to have some social interaction and SUPPORT by people who TRULY understand what the patient may be going through; and, meetings (either online or in person) allow the person to have more ‘Talk Therapy,’ so to speak. Many patients start looking forward to their interaction with others in this group, in fact. 

What’s another way? Join a club, go to a senior center, build something, go dancing with someone, take lessons of some sort.  Again, not only is there some physical and mental exercise involved, but more social interaction and a chance to make new friends.  And, even volunteering at a school or somewhere is a way to get social support and help others while stimulating the brain, getting a certain amount of exercise and helping yourself. I have known patients who have joined groups to “read” to the blind or to children. Not only does it help the people getting the service, but helps to give the depression patients a positive feeling of “worth” as well!

Stress and anxiety reduction.  Again, make changes in your life to help manage and reduce stress.  Hate getting bills in the mail (even if there is no problem in paying them) because it causes too much stress and anxiety just seeing them?  Arrange an ‘Auto-Pay’ program to make your payments for you.  Hate getting telemarketing calls? Use an answering machine or Caller ID to screen your calls!  Stress exacerbates depression; so, it stands to reason, that if one can start eliminating issues which cause stress, depression symptoms may reduce as well.  Of course, doctors may have medications to help with stress and anxiety; but, many of those have negative side effects, and can even CAUSE depression to use! 

Lastly, getting “Toxic People” out of one life can seriously impact good mental health. Unfortunately, many people feel that a unsupportive relationship or working with highly toxic people is better than not having a relationship or job at all!  This is, certainly, not the case; especially, when those relationships are, at least, part of the depression issue.  Again, this tends to fall under the category of “A Lifestyle Change!”  Getting rid of or limiting exposure to  toxic people in one’s life, even if they are family members, can greatly impact ones depression.  Of course, some people may see this as a way to increase “guilt” feelings; which is why, it is important to speak to a therapist and, perhaps, have some Talk Therapy to go with that Lifestyle change! 

The main thing to remember is, rarely, when one feels like they have ‘hit absolute the bottom,’ do things get worse!  And, no matter what the issue, time does tend to heal all wounds!  If you are dealing with issues you don’t feel you can handle by yourself anymore, get help!  There are plenty of agencies that can help – some, even for free – in which therapy, support and even meds can be obtained until the depressive issue is over.