Depression

Major depression is when a person has five or more symptoms of depression for at least 2 weeks:

  • Agitation, restlessness, and irritability
  • Dramatic change in appetite, often with weight gain or loss
  • Extreme difficulty concentrating
  • Fatigue and lack of energy
  • Feelings of hopelessness and helplessness
  • Feelings of worthlessness, self-hate, and inappropriate guilt
  • Inactivity and withdrawal from usual activities, a loss of interest or pleasure in activities that were once enjoyed (such as sex)
  • Thoughts of death or suicide
  • Trouble sleeping or excessive sleeping

Before diagnosing depression, the health care provider should rule out medical conditions that can cause symptoms of depression.  Many researchers believe it is caused by chemical imbalances in the brain, which may be hereditary or caused by events in a person’s life.

Some types of depression seem to run in families, but depression can also occur in people who have no family history of the illness. Stressful life changes or events can trigger depression in some people. Usually, a combination of factors is involved.

— Adapted from Google Health

Andrew Koenig, best known as Walter Koenig’s son and for his role on Growing Pains, recently killed himself.    Without telling his family or friends, Andrew Koenig had sold or given away all of his possessions and terminated his 14-year lease on his apartment.  He may have seen this as preparing for his death.

Depression is hard. One of the symptoms of depression is that you really, really believe nothing can ever get better and that you don’t matter anyway.  When you really believe nothing can ever get better it’s damn hard to take action to make things better!

How did I get help?  Initially I was discussing how I hated my life and myself with a friend who I did not realize was in therapy for depression.  He urged me to call his therapist’s office.  After my first therapist moved, I called an employee help line provided by my employer’s health insurance, who arranged a referral to a new therapist.

My official diagnosis is atypical depression, because I am “mood reactive” — meaning my mood will improve if something positive happens.  Yes, I have done therapy. Usually it’s been helpful.  I have used antidepressants.  My first SSRI just gave me headaches, but the second one worked.  (This is not abnormal.)  I have found other self-help techniques that work for me, like:

  • Exercise, even if it’s just walking around the block.
  • Getting enough sleep and keeping a regular sleep schedule (treating my sleep apnea really helped there).
  • Dealing with underlying medical problems. My example: identifying and treating my vitamin deficiencies and asthma.
  • Eating what my body wants.
  • Support system. This includes my family and friends. I have several friends who have themselves dealt with depression (or bipolar disorder) that make for a knowledgeable support group.
  • Containing the worry by a) writing down each problem; b) decide what is the worst that could happen; c) figure out how I’ll cope with it.  This actually prevents me from ruminating too much.
  • Checking my perceptions.  Part of depression is that one’s emotions and perceptions are out of sync with the rest of the world.  If I’m worried about being fired, I try to think logically about how people are treating me at work, my interactions with my boss, and so forth.  If no one has mentioned a performance problem, AND I’ve gotten several compliments on my work in the last week?  It might be my perceptions are just that wee bit off.
  • Focus on small accomplishments.  Maybe you’re writing things down, maybe you’re using Outlook Tasks or Google Tasks, but track what you need to do and that you get it done. This is a reminder that you are getting things done even though you don’t feel like it.
  • Relaxation and stress reduction: for me, this is mostly stretching, reading, hot baths, laughter, and time with loved ones.

Currently I am not on antidepressants, I’m not in therapy, and I’m not experiencing symptoms.  I don’t know how long this will last.  A lot of what I’m doing with the above self-help is about prevention.  I know that for me, a lot of stress on little sleep will induce depressive symptoms.  So I avoid it.

“The only thing I want to say is if you’re one of those people who feel that you can’t handle it anymore, if you can learn anything from this it’s that there are people out there who really care,” Walter Koenig said. “You may not think so, and ultimately it may not be enough, but there are people that really, really care.

“Before you make that final decision, check it out again; talk to somebody,” Koenig said.

ABC News


More:

Google Health: Depression

Mayo Clinic: Depression: Lifestyle and Home Remedies

Mayo Clinic: Depression: Treatments and Drugs

National Suicide Prevention Hotline

Depressed? Employed? You Can Cope

26 thoughts on “Depression

  1. I’ve had a couple of bad bouts with depression myself. Containing worry was especially important for me. I started telling myself to worry about things on an “as needed” basis and that seemed to help.

    • One technique I’ve read about is to make a “worry list” and schedule 15 minutes a day to worry. If you start to worry at another time, add the worry to the list and remind yourself you’ll worry during your worry time.

      It didn’t work for me, but you reminded me of it ;)

  2. Thanks for this.

    Have been on kind of an emotional roller coaster these last few days. I’m doing OK with it all (really), but this post made me feel like, somehow, I have friends I don’t even know? That people get it? Does that make sense?

    Life is beautiful. May I add meditation as something that has helped me immensely in dealing with depression? It is not that meditation necessarily helps directly with depression, but it helps me accept everything, including any physical, mental or emotional issues I might be struggling with.

    Sometimes, it is the resistance to what is that is the most painful. Consistent meditation facilitates acceptance (for me) and helps me see the fleeting beauty of even the aspects of life that I “don’t like”.

    • I’m glad it helped. There’s a reason I make mental note of friends and acquaintances who I know have dealt with depression — because they do understand.

      I’m glad meditation works for you. It helps me to be in the moment, too, but sometimes I prefer distraction ;)

  3. My Mother is going through this, I live with her, she is menopausal and very heavy set and does not want to even think about exercise.

    I have a 3 year old, a type1 diabetic 5 year old and no car..how can I find the time to help? What should I do? Sometimes I feel the same way too.. I have always had depression but I am sooo busy I don’t even know what I can do for my Mom..

    • It may be the best thing you can do is encourage her to get professional help. This may also be a situation where you need to “put on your own oxygen mask” first, and make sure you’re getting what you need.

  4. I’ve had to deal with depression since I was a teenager dealing with my father’s death, and it’s never really gotten easier. I’ve done therapy, taken meds, all the standard stuff over the years. I’m currently managing things on my own and feel ok…the thing that helps me most is to move. Exercise really clears my head and cheers me up. I think that some people just have different set points of happiness than others..but if you seriously start feeling suicidal and depression halts your day to day life, therapy is essential. Help is there. That’s just harder said than done for some people and they just don’t see a way to re-emerge from the depths of their sorrow.

    • I’m glad you’ve been able to get to a point where you are doing well. And yes, therapy is very good — many of my self-help techniques were learned in therapy. Just because I’m not currently in therapy doesn’t mean I haven’t learned from it.

  5. The problem with support systems is that you can’t really build one once you’re already depressed, because if there is one thing I keep being told about how to make friends it is that everybody hates depressed people (so don’t be depressed). You have to have the support network in place already, and in light of that advice about what a horrible friend you are if you’re depressed I don’t see how you’re supposed to rely on your friends without feeling like a horrible imposing burden whom they would be better off without. This is a problem I have. Plus it takes time to get to know people well enough to know they won’t be complete jerks if you do try to rely on them.

      • Thanks for your concern. I’ve done therapy in the past but didn’t find a therapist I found effective. Fortunately I am depressed at a much more manageable level nowadays (SSRIs may have something to do with it, although I got kind of forced off them in a completely inadvisable way) so it doesn’t matter so much.

  6. Thank you for posting this.

    I want to make a point about medication.

    Some people (like me, apparently) need long-term (possibly life-long) medication for depression, even when they do therapy and use the self-help treatments you describe. If a person needs them only temporarily that’s great; if a person needs them longer-term, that doesn’t mean they are failing in self-care.

    I’ve had various kinds of depression over the years. A couple of years ago I tapered off all my medications to see how I would be able to handle life without them. The depression came back. I had lots of self-therapy tools, and although they prevented me from falling into catastrophic thinking, they were not sufficient to allow me to access joy. I went back on the meds and I’m glad I did.

    Also, in reply to meerkat: You’re absolutely right. You can’t build a support system when you’re depressed. And even if you have a support system built, if you’re actively depressed, you should not rely solely on friends. It’s important to get professional help. If that feels like a daunting task, then call a crisis hotline. They will be able to direct you to help.

    • Thanks, Stef. This is a good point about medication. I was trying to avoid too many tangents in a long post, but: I stopped taking medication (Wellbutrin) because I was starting to have hypomanic symptoms. Once I was off the meds I had no symptoms of hypomania or depression.

      This was also when I started treatment for vitamin B12 deficiency. Vitamin B12 is essential for the neurological (nerves/brain) system, so this may have had an effect as well.

      I have since had depressive symptoms in time of stress or lack of sleep. Since then I’ve managed with self-care, but I don’t assume I will always be able to do so. Several of my self-care practices were learned in therapy, too; not going to therapy NOW doesn’t mean I didn’t benefit from it.

  7. Thanks for this post- hopefully people might be able to identify symptoms or at least reach out for help. I first was diagnosed with depression when I was 15, and have continued to do therapy off and on, as well as changing up different medications (I’m 28 now).

  8. Hi. Friend of Stef’s here (though I actually found you through a comment you left on Seanan McGuire’s journal, but anyway).

    I self-identify as a “recovering depressive,” in a fashion almost exactly analogous to being a recovering alcoholic. It will be part of my life for the rest of my life; some days are better than others, and I get through them one at a time.

    Andrew Koenig was only a year older than I am, so I followed the story very closely, and was heartbroken (albeit unsurprised) by the final chapter. To hear of Michael Blosil’s death this morning only salted the wound. And I’ve been off my meds for a couple of weeks (not entirely by choice), so these stories are landing on already fragile nerves.

    We are diminished by their losses…but if even one person listens to Walter’s impassioned plea, then there can yet be hope.

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  11. Depressed for 20 years, here. I’m a “lifer”. :) And although I do believe that I will suffer from some degree of depression (even if it is just a tiny degree) for the rest of my life – and that I will be on meds for the rest of my life – I do know what happiness feels like and I enjoy my better moments. It was nice to read your post. I feel good when people I follow online speak out about mental illness, none of is is truly alone.

  12. It also goes to show how depression affects the memory, that I thought this post was from today – I seriously thought Andrew Koenig passed away a few weeks ago.

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