Conquering Chronic Depression

Depression, Featured Article, Mental Health & Sleep Center
on April 10, 2014
chronic depression

It’s perfectly normal to feel blue from time to time. For most of us, this mindset is fleeting and passes within a few days. But for the estimated 10 percent of adult Americans who suffer from chronic depression, it’s not as easy to rebound from gloomy moods. It is what some describe as feeling “hopeless and helpless,” “living in a black hole,” or ”having a constant sense of impending doom and gloom.”

Depression is a serious mental illness affecting one’s thoughts, feelings and mood that is generally caused by a combination of genetic, biological, environmental and psychological factors. Interestingly enough, depression doesn’t always manifest as sadness—some chronically depressed people may just feel empty and apathetic, losing their passion for life. Men, in particular, could be restless or even angry and aggressive. By interfering with their concentration and ability to work, sleep, study and eat, not only does it wreak havoc with their quality of life, it can cause concern for those who care about them.

And it’s not just mental—depression can take its toll on a person physical health, too. According to a study published in the American Heart Journal in 2005, researchers found that people with depression are more likely to have other medical conditions, such as heart disease. What’s more, depressed subjects are less apt to follow therapy for these and additional problems, adding to their disease burden. In another article from the 2005 Archives of Internal Medicine, some diabetes patients in the study were neither adherent to their medication, nor motivated to improve their diet and exercise regimens. They even neglected to check their blood sugar on a regular basis.

“Depression may be common,” contends Teresa Tran, a specialist pharmacist in the Express Scripts Neuroscience Therapeutic Resource Center, “but it can be serious. If left untreated, it can eventually lead to thoughts of death or suicide.”

What should you do if you suspect that you are depressed? First off, “Talk to someone and let your doctor know if you are experiencing symptoms,” Tran says. “There are medical conditions that mimic depression, such as low blood sugar, thyroid issues and side effects of certain medications. Your doctor will be able to determine if treatment is needed.”

If therapy is called for, there are numerous reasons why that advice should not be ignored. “Early treatment may help to keep the depression from becoming more severe or chronic, “ she explains, “and the risk of suicide increases when depression is left alone and the symptoms reoccur.”

Tran explains that major depressive disorders usually come in episodes lasting 6 to 12 months. In between those, most people feel better and are asymptomatic. “On the other hand, about one out of four people with depression will still have trouble getting through their day and there’s a greater chance of having another episode. Without treatment, after two episodes, a third episode could occur. And after three, the possibility of having a fourth is 90 percent.”

The good news is that unlike other mental conditions, if depression is properly treated, thoughts of suicide and those sad, anxious, hopeless and pessimistic feelings will soon disappear, as well as symptoms related to headaches, stomach problems and chronic pain. “Your energy will be increased and your circulation and concentration improved. You’ll sleep better and take a greater interest in pleasurable activities.”

For some, lifestyle changes can be as effective as medication in improving symptoms of depression. Harvard Health Publication reports that the effects of exercise on depression can last longer than those of antidepressants. Regular exercise, for example, has been known to boost serotonin, endorphins and other feel-good chemicals in the brain, similar to the way in which antidepressants work. Studies dating published in the Archives of Internal Medicine conclude that exercise can improve mood in people suffering from mild to moderate depression, and may even serve to help those suffering from severe depression. Even a simple 30 minute brisk walk can have a highly beneficial effect on mood and outlook.

In addition to regular exercise, it is also important to eat small, well-balanced meals throughout the day. For sustained energy and minimized mood swings, choose protein and complex carbohydrates. Any form of refined sugar –including corn syrup and alcohol—are very quickly assimilated by the body. This can cause a “rollercoaster effect” – an instant spark of energy followed by a sudden drop of blood sugar that can lead to fatigue and weakness, and therefore helplessness. In addition, alternative and complementary treatments that include vitamin and herbal supplements, acupuncture, and relaxation techniques—such as biofeedback, meditation, yoga, or tai chi—are also recommended.

If your doctor has determined that taking antidepressant drugs is the best course of treatment for you, Tran suggests a few important tips to keep in mind:

• There is usually a lag of two to three weeks before medications begin to relieve symptoms of depression. It may take up to six weeks to see the full benefit. So don’t be discouraged if you don’t immediately notice an improvement in symptoms.

• Discuss symptoms that have not improved with your doctor. A different dose or medication may be needed.

• Antidepressant medication generally should be taken for at least six to nine months after a first episode of depression. The duration may be longer for subsequent episodes. Talk with your healthcare provider about the length of treatment since early discontinuation increases the risk of depression recurrence.

• When antidepressants are discontinued, they should be tapered over two to four weeks to minimize side effects associated with abrupt cessation of therapy.

For those who are living under the oppressive grip of chronic depression, liberation may seem impossible. But with the proper treatment approach, they can rediscover a happy, healthy life and move on to be better than before.