Tuesday, September 24, 2013


                           Feelings of sadness

                                           Lack of energy
                                            Feelings of emptiness
                                                           Hard time sleeping
Sleeping too much

               Drop in attention span

                           Can't hold a conversation

                                     Hard time concentrating

                                             Can't make easy decisions  
                                                            Cry at the drop of a hat

                          All of these are symptoms of depression.

Are you thinking something along the lines of "I've felt all those before" or "That's me right now. Am I depressed?"

You probably were at the time. You might be now. But don't worry, you probably don't need meds or therapy. Feeling depressed and actually being diagnosed with Major Depressive Disorder (MDD) are two very different things.

Everyone gets sad at one point or another. Everyone has a hard time sleeping at times. Everyone has burn-outs. That's part of life. Stress happens. Life changes happen. Those things will affect you.

Sometimes when depressive feelings hit, the cause is fairly obvious to pinpoint. Sometimes, though, it's not always so easy. I mean, let's say you just got a promotion and pay raise at work, you're a newlywed, you won a brand new car, you're going to graduate a semester early...and you're feeling depressed.

Wha? What's causing this?


There are two types of stress: Eustress (yoo-stress) and distress. Eustress is known as positive stress, or rather, stressful events that are perceived by the person to be beneficial to their lives. This could include any of the things listed in the above paragraph. Distress is what we commonly refer to as stress: negative life events that have absolutely no perceived positive benefits whatsoever.

But even too much eustress can turn into distress. Take the above list, for example. All of the things listed are good things, but
  • With promotions come training for new/added responsibility, and you're expected to perform.
  • Being a newlywed can be loads of fun, but with the ups also come the downs.
  • Yay for a new car! But now you have one more vehicle to insure, register, gas up, and maintain.
  • Yeah, you'll graduate early if you get that last fee paid/processed in time. You forgot all about it because of all the other good things going on.
Very quickly, eustress can turn into distress.

Distress can lead to depressive symptoms.

That's not necessarily a bad thing. Depressed feelings and symptoms are part of the body's coping mechanisms. I mean, imagine for a moment that you had no way of releasing that negative energy/stress...

...yeah. Not a good thing.

But MDD happens when those natural coping mechanisms don't turn off when you're done using them...or they turn on randomly and you don't know why.

We've all had a hard time getting out of bed at one point or another, but what if it took you an hour to get out
of bed every day? It's not because you're tired, but because you don't see the point.

We've all gotten sick of something we usually enjoy at times, but what if it were practically everything you usually enjoy, and for longer than what most would consider normal?

We've all lost focus in class or during a conversation. Daydreaming happens, too. Usually, we can just bite the bullet and make ourselves focus. But what if you just can't concentrate or hold up your end of a conversation no matter what you try? What if you just don't really care to try because, again, what's the point?

From what is known about the cause, (as I mentioned before) it's usually some sort of stressful event or situation. But it's what the stress does to your brain that's interesting. Your brain has a chemical in it called serotonin that's in charge of regulating things like mood, appetite, sleep, and memory. When you get stressed, that chemical level in your brain decreases (hence the lack of appetite when you're just feeling down). MDD happens when the stressful moment has passed but the serotonin levels in your brain do not return to normal.

If you do have MDD, be it on the mild or severe side of the scale, what are your options for treating it?

This means going to a bar and drinking away your sorrows.

Don't do that. It doesn't work and only increases your chances of familiarizing yourself with Alcoholics Anonymous later down the road.

Prescription medication
This is usually the most popular form of treatment, mainly because it's the only one most people know about. (Ever seen a commercial advertising counseling for depression?) They take anywhere from 6-8 weeks for actual change to be noticed. If you have severe MDD, this can help to regulate the serotonin while you undergo therapy or taking care of yourself. However, just like anxiety, medications can only get you so far.

A 1-year study was done many years ago that involved 4041 people. All were diagnosed with MDD and all were given antidepressant medication.
  • During the first step of the medication process (this took a little over a month), 1010 people responded, 1212 people dropped out because it was't working, and the rest just stayed to see if something would wok later on. 
  • Continuing on over the subsequent months only resulted in lower response rates and higher dropout. (i.e. more people felt that it wasn't really working and therefore, stopped participating in the study.)
  • By the end of the 1-year study, only 80 people (of the original 4041) were actually remitted...that's only 2% of all those that started the study.
Of course, there are always other variables involved in each person's condition, environment, lifestyle, etc. that are affecting their remission potential. But just like anxiety, why do we as a society believe that giving everyone the same type of medication for a condition that was most likely caused by different things is actually going to work?

Answer: In many cases, we're used to treating the symptoms of a problem instead of the cause.

Is medication going to change that fact that you just lost a dear loved one, had a baby, became empty-nesters, etc., and you're having trouble coping? Not really. The medication may be able to help regulate your serotonin levels so that you can develop coping skills, but medication alone won't solve the problem for you.

There are two types of therapy out there that are used in treating MDD: Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT)
  • As I mentioned in my anxiety posts, CBT works with you to basically re-write your thinking process. No worries. I'm not talking about brainwashing here. It helps you to recognize what triggers your depression so that you can develop coping skills to use in the moment that it happens. Those triggers and skills may be different for everyone, which is why CBT is the latest and greatest therapy out there to help with your individual situation; it caters to you instead of just your symptoms.
  • IPT is one of the newest types of therapy out there. It mainly focuses on relationship skills and overall functioning in your life. Depending on the trigger of your depression, it can assess your (1) social role transitions, (2) conflict levels, (3) level of grief related to relationship loss, and (4) skill deficits. Because it's so new, therapists have a hard time recommending it because there haven't been as many studies on it as there have on CBT. But so far, it looks very promising.

Taking care of yourself
Recently, many studies have come out showing the importance of taking care of yourself. In addition, some of these same studies have shown that doing so can help to control and even eliminate mild-moderate cases of many disorders, including depression.

Go outside. Take a walk in the sunshine. Go for a run. Don't run? Jog. Work out. Stay hydrated. Stop eating junk food all the time. Re-discover fruits and vegetables. Get enough sleep. Leave work at work. When you're home, be home as much as you can. Appropriately balance your work-social life. Have a social life. Keep your priorities straight. Set realistic goals. Be okay with not being able to do everything when you want to. Laugh at yourself more. Be okay with a B+ on an exam. If you can't control it, don't worry about it.


Random side note: Many people have also heard of Postpartum Depression, Post-Traumatic Stress Disorder (PTSD), or other specially-named depression-based things. Truth be told, while trauma and postpartum events can trigger depression, specific disorders like the two mentioned don't actually exist. Now, before anyone/everyone starts disagreeing, let me explain. 
For a disorder to have it's own name, it has to have its own symptoms. In my Anxiety posts, you probably noticed that OCD, Panic, and GAD have individual symptom sets that distinguish them from each other. In depression, no matter what the cause, the symptoms are the same. Therefore, while terms like PTSD and Postpartum Depression are used to indicate the source of the symptoms, technically, it all falls under Major Depressive Disorder. 
Other random side note: If you read my posts about anxiety, you probably noticed a lot of stressful reasons for anxiety to make itself at home in your mind. Therefore, it's not surprising that depression and anxiety are often found together, although they don't always have to be.

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