Feeling depressed sucks, but there is hope…
Frequency and Presentation:
It is estimated that depression affects approximately 16% of the US population.
Depression can feel like seeing life through dark sunglasses, making it hard to find any joy in daily life. You might feel withdrawn and desire to isolate more and more. Depression can look like prolonged sadness, loneliness, irritability, lack of motivation, sleep issues, frustration, anger, resentment, and can lead a person to isolate and pull away from connecting with others; inadvertently worsening the feelings of depression. Life then, can become a self fulfilling prophesy–you feel depressed and then you don’t take any action and because you don’t take action, you continue to feel depressed.
Sometimes it can feel so apparent that something needs to change, but actually taking that first step of asking for help feels like the hardest part.
In my experience, depression, and more generally speaking mood related issues, also manifest differently based on an individual’s identity, background, socialization, and environmental factors that are experienced as being “out of one’s control,” making it difficult to identify mood concerns as depression. One example of this was found in a recent study published by the Journal of the American Medical Association which found that when men are depressed they may experience symptoms that are different than what is included in the current diagnostic criteria. Although men were likely to experience many traditional depression symptoms, men were much more likely to report symptoms of anger attacks/aggression, irritability, substance abuse, and risk-taking behaviors over symptoms such as withdrawal from friends, sleep problems, and feelings of complaintiveness. (JAMA Psychiatry)
Depression may manifest as a major impairment or in a more mild form which prevents you from actively working toward your goals and living with more intention. If left untreated, depression can be quite damaging to your sense of self, perceived competence, and your ability to maintain satisfying relationships.
Therapy for depression includes constructing a plan to relieve symptoms which also involves developing a deeper understanding of how to feel empowered within the contextual factors that contribute to what you’re experiencing. A holistic, 6-part approach has been known to be effective when treating depression:
- Brain Food– evaluating your diet and making changes to help support your mood and overall functioning can help to improve moods. I often collaborate with other providers such as your primary care physician and nutritionist in order to help you make improvements in a healthy and responsible way.
- Action-putting into place a plan that is doable. Setting achievable goals and following through with them is part of managing depression. Through therapy, we will also help you to put outside supports in place and create a sense of community for yourself.
- Exercise– studies have shown that just 35 minutes of working out even in the form of a simple brisk walk, can be just as impactful as medications for depression so it’s worth giving it a try. In therapy, you will be able to make a plan that works for your lifestyle so you can make realistic progress.
- Exposure to light-bright light stimulates the brain’s production of serotonin, which is crucial to our well-being. Serotonin is a neurotransmitter with widespread effects on mood and behavior. (The Depression Cure)
- Sleep-is critical to our overall well-being and worth working on to improve. Here are a few tips to help you make some adjustments (list adapted from the book The Depression Cure, by Dr. Stephen Ilardi):
- Set the scene for sleep. What does your bedroom look and feel like? Is it peaceful and conducive to rest? If not, what small improvements can you make to help set the scene? Studies show that cooler temperatures and a dark room facilitates higher quality sleep.
- Anytime you’ve been lying awake for fifteen minutes, get up, leave the bedroom, and do something relaxing until you feel drowsy enough to return to bed.
- Avoid getting into bed anytime you aren’t drowsy.
- Anything you do to increase your drowsiness should be done somewhere other than the bedroom.
- You can make an exception in the case of sex.
- Avoid sleeping anywhere other than your own bed (i.e.- sofa, guest room, recliner).
- Also helpful: get up at the same time every day, avoid napping, avoid bright light at night, avoid caffeine and other stimulants, avoid alcohol at night, if possible, keep the same bedtime every night, avoid taking your problems to bed with you (try a brain dump in a journal before getting to bed for example), don’t try to fall asleep.
- Cultivate healthy, reciprocal connections/ let go of toxicity-connection heals and combats loneliness. All of us are born to connect. When we don’t feel meaningfully connected to others, we inevitably suffer. The late researcher, Dr. John Cacioppo developed the following acronym to help people with the process of cultivating connection. He believed it was important to EASE your way back into social connections…
- The first E stands for “extend yourself,” but extend yourself safely. Do a little bit at a time.
- The A is “have an action plan.” Recognize that it’s hard for you. Most people don’t need to like you, and most people won’t. So deal with that, it’s not a judgment of you, there’s lots of things going on. Ask [other people] about themselves, get them talking about their interests.
- The S is “seek collectives.” People like similar others, people who have similar interests, activities, values. That makes it easier to find a synergy.
- And finally when you do those things, “Expect” the best. The reason for that is to try to counteract this hyper-vigilance for social threat.
Therapy can be instrumental in making important shifts when it comes to managing depression. In my practice, I work with folks to help them honor what their depression may be trying to communicate and set a realistic plan to create a healthy routine and connection. Together we’ll work to help you gain a sense of stability while creating a more sustainable path forward. Treatment will take into consideration your history, past coping mechanisms, overall health and wellness, and your current support system and aim to strengthen these areas. Therapy is a unique type of service in that it requires you to be active both inside and outside of the therapy office. With that said, therapy requires a commitment to the process and a willingness to try something new and different.
Lisa A. Martin, PhD1; Harold W. Neighbors, PhD2; Derek M. Griffith, PhD3,4
JAMA Psychiatry. 2013;70(10):1100-1106. doi:10.1001/jamapsychiatry.2013.1985
The Depression Cure by Stephen Ilardi
**This post is meant to provide general educational information regarding the management of depression; it does not take the place of therapy or medical advice from your doctor.