DEPRESSION AND HOW TO OVERCOME IT
When Depression strikes, there's a lot you can do to lift yourself out of the gloom
A good many of us suffer from depression at any one time. Of these a surprising majority don't receive the care they deserve - and that's truly tragic, given that each of us has a significant chance of becoming depressed at some point in our lives, and that there's a range of treatments that work.
When you're feeling unhappy, it can be hard to judge if things are bad and you need help. Ironically, it can be easier when the depression is severe. People with severe depression say it's the blackest feeling they've ever had - they are unable to move, find motivation, or feel hope or anything positive about themselves. It can be difficult to explain this feeling to family or friends because, outwardly, their lives seem good. And if there is no obvious reason for being depressed, that can lead to incredible guilt.
But if your feelings aren't that bad, how do you know if you need help? Luckily there are ways to assess yourself. And taking that step can, in itself, be therapeutic. Researchers have shown that just understanding depression helps alleviate its symptoms.
Here's one set of questions you can ask yourself.
For at least the last two weeks, have you :
- Been feeling unusually sad?
- Lost interest in things you used to enjoy?
- Felt tired and had less energy?
- Lost self-confidence and don't feel good about yourself?
- Felt unnecessarily guilty?
- Been eating more or less and therefore either putting on or losing weight?
- Sleeping too little or too much?
- Not been moving around much or been feeling anxious or restless?
- Wished you were dead?
- Found it difficult to concentrate?
You don't have to have everything on this ten-point list. Far from it. Very roughly, if you've been experiencing most of these things for the past two weeks you do have depression that's probably severe and requires attention from a professional. Just over half is moderate depression, while just under half is characterized as a case of mild depression.
Anxiety, by the way, is a common traveling companion to depression-agitation builds alongside the blackness. There is no evidence that tranquillizers do much to help depression-or indeed anxiety. However, help for depression often relieves anxiety.
Let me tell you one thing : anyone with serious depression needs to see someone who knows what they are doing. Beyond that, let us run through a few different treatments that work at different levels and have a fair amount of evidence behind them.
The ones at the top of the list, with the best evidence backing them up, are antidepressant medications, cognitive behaviour therapy ( CBT ), interpersonal therapy and exercise.
Anti-depressents are very effective and totally must be used in severe cases of depression. The newer kinds - the so called selective serotonin re-uptake inhibitors (SSRIs) such as fluoxetine - can initially make people more agitated, so new users may need careful monitoring. SSRIs, with the possible exception of fluoxetine, should not be given to children or adolescents unless under expert supervision.
Despite its negative public image, electro - convulsive therapy ( ECT, commonly called " shock treatment ") is an effective treatment for severe depression. ECT puts an electrical current across the skull, yet no one is sure why it works.
Forget those scenes from old black-and-white horror movies - the process is much more sophisticated these days, and for a person who may be suicidal or who really has trouble with the medications, ECT can be life-saving and lift the gloom dramatically.
Despite the fact that it can cause temporary memory loss, ECT is probably under-used given how effective it can be as a short-term treatment.
Cognitive behaviour therapy ( CBT ) is a psychological technique that aims to adjust how you think. Trials suggest it is at least as good as medication. If you suffer from depression and think everything's hopeless, that you're a terrible person and life's never going to be any better, then CBT teaches you how to develop a more realistic attitude.
The good news is that CBT treatment is available to anyone. Psychologists, psychiatrists, trained counselors and some GPs can provide CBT. Psycological counselling can help sort out the problems which has led to depression and helps the patient think more rationally. Another Psychotherapy that works is called Interpersonal Therapy and involves working through answers to your problems with another person.
A lot of evidence backs up physical exercise as an anti-depressant, particularly in the elderly. However, that advice public-health bodies give about doing little bits of exercise frequently won't help cure depression. It's got to be moderately intensive and progressive. In other words, you've got to sweat a bit, whether it be with weights or aerobic exercises.
Present mindfulness, i.e. being fully aware of the present and not paying any attention to the past or future helps aliviate depression. The simplist of tasks being done in the present moment, like eating, walking, doing the dishes or so, will keep the mind engaged in the present moment and hence prevents stress due to past or future thoughts.
Other therapies with a good track record include bibliotherapy - essentially using reliable self-help books, particularly as a CBT exercise. For the elderly, researchers are studying reminiscence therapy, which is exactly what it says it is - talking and reflecting on things from the past.
Experts in the field, though, worry that unhappiness has been turned into a medical condition and is treated needlessly with drugs and psychotherapy, when being unhappy from time to time is simply part of normal life. For this reason, assessing the severity and duration of your symptoms is an important first step.
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