Tag: depression

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The Mental Health Consequences of New Year’s Resolutions

The year 2024 is coming to an end. Through everything, we have made it here! This is the time of year when we start reviewing how the year has gone and we start looking towards the new year. There are things we want to change or things we want to have stay the same. Many of us make resolutions to achieve these things. But are New Year’s Resolutions always the best answer? 

Why We Make Resolutions

Usually, we’re inspired to make these changes in our lives for some reason or another. Maybe we want to get healthier in some way or change habits we feel are holding us back. For some of us, we want to set some kind of goal in a skill we already have. For others, they want to gain a new skill. 

We make resolutions because we want to better ourselves in some way. But we also make them so that we can look back on the year and note if we’ve made positive progress towards something. It’s important to many people to feel as if they’ve done something good for themselves or pushed to become a better version of themselves. 

However, we also put a lot of pressure on ourselves because of the social importance of New Year’s Day. 

Why Many of us Fail 

That pressure we put on ourselves is a big contributing factor! We focus less on why we made the goal or resolution in the first place and more on how we’ll feel at the end of the year if we fail. This just sets us up for failure because we’re being motivated by fear and shame instead of something positive. 

Another reason is that many of us set vague resolutions and not measurable goals. What does “get healthier” really mean? This is so difficult to measure and understand that it can seem as if we’ve made no progress towards this goal, even if we have! It’s important to set specific goals because of this. The seeming lack of progress can be really disheartening for someone who is working hard towards something. 

Negative Mental Health Consequences of Resolutions

When we “fail” at fulfilling our New Year’s resolutions, it can feel as if we’re just stuck. Some of us can feel as if we’ll never achieve anything, never fix a bad habit, or never realize our dreams. This is incredibly difficult to deal with, especially year after year, and it can lead to anxiety and depression in some people. These negative feelings and thoughts can be really detrimental to many people. 

If we’ve failed at these same resolutions before, the anticipatory failure can also contribute to greater anxiety and depression. It can be something we dread every year and yet we still set the same goals and approach them in the same way. This generally isn’t good for most people’s mental health and it’s why many of us feel so badly by mid-March. 

There’s also an issue with the “new year, new me” approach. This encourages us to make so many changes all at once that it becomes overwhelming. This isn’t a sustainable or long-term way of approaching making positive changes in our lives. Small, incremental changes make for much better and long-lasting effects in our lives. 

Is it Possible to Set and Achieve Resolutions?

Of course! Not only is it possible in general, but it’s also possible to approach them in a healthier way that can contribute to better mental health, not worse. In next week’s blog post, we’ll be discussing how to go about setting New Year’s Goals as opposed to New Year’s Resolutions. Not that you need to set goals around a specific time! 

That’s another important thing to remember. Sometimes the best time to start working towards a new goal is June 27th, May 18th, or even December 3rd. The point is that the best time to start working towards goals is the time that you’re ready to. Trying to push yourself to set and achieve goals based on a certain day of the year is just setting yourself up for trying to achieve something you may not be mentally ready for, which sets you up for failure. 

Resources:

https://centerstone.org/our-resources/health-wellness/how-new-years-resolutions-impact-mental-health/

https://www.choosingtherapy.com/new-years-resolutions

https://www.columbiapsychiatry.org/news/are-your-new-years-resolutions-faltering

https://www.everydayhealth.com/emotional-health/why-not-to-make-a-new-years-resolution

https://www.mentalhealthfirstaid.org/2020/01/realistic-new-years-resolutions-for-your-mental-health/

https://www.nami.org/people/mental-health-resolutions-for-the-new-year/

https://www.psychiatry.org/news-room/apa-blogs/americans-top-5-new-years-resolutions

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The Mental Health Benefits of Counseling

Almost every week, we mention how speaking to a therapist or counselor can be of benefit for addressing a variety of needs. However, this is the first time we’ll be addressing the benefits of counseling more closely. Of course it can be used to address specific mental health disorders but it also has more far reaching benefits than just helping people to cope with mental illness.

What is Therapy?

Therapy, or counseling, often refers to talk-therapy or talk-psychotherapy. This is a form of treatment which involves speaking to a trained professional about a problem you’re having. The professional then uses evidence based practices to help you build skills to then address whatever concern brought you to therapy.

One of the main benefits of counseling is that there is no one size fits all approach. There are so many different forms of therapy. For example, cognitive behavioral therapy (CBT) is one of the most well-known forms. And many people often think of psychodynamic or psychoanalytic therapy when they first imagine therapy (you know, Freud and a couch). 

However, there is also ACT, DBT, EMDR, ERT, and many, many more. Many of these forms of therapy were developed to target specific mental disorders or problems that people may be having. Motivational Interviewing (MI), for example, was developed for addressing substance use disorder. 

What Does Therapy Help With?

There are many benefits of counseling to consider. Of course, it can help with mental illness, such as depression or anxiety disorders. However, it can also help with things like coping with grief or loss, dealing with stress, handling transitions, and other issues people may be facing. 

Therapy can also help with working on self-esteem, problem solving skills, self-confidence, and coping with rough patches in your life. Most people who go to therapy only do so for a short period of time, usually to help resolve a current issue such as the death of a loved one. 

People also seek out therapy to help with communication skills, relationship problems, and for help addressing conflicts they may be facing in life. 

How Do I Find a Therapist?

Word of mouth is an excellent way of finding a therapist. Ask around and see if you can get recommendations from doctors or people you know who have gone to therapy. Your insurance provider is also a great resource for finding a therapist as that will be the easiest way to insure that the cost of your sessions will be covered. 

We have a large list of clinicians here that are also an option for those looking into the benefits of counseling and considering getting counseling themselves. 

Resources:

https://www.avila.edu/2022/12/13/5-benefits-of-working-with-a-mental-health-counselor/

https://www.coe.edu/student-life/health-wellness/mental-health-counseling/potential-benefits-counseling

https://www.harmonyridgerecovery.com/10-benefits-of-mental-health-counseling

https://www.healthline.com/health/benefits-of-therapy

https://www.mhanational.org/therapy

https://positivepsychology.com/counseling-process

https://online.sbu.edu/news/5-ways-mental-health-counseling-builds-stronger-communities

https://www.verywellhealth.com/benefits-of-therapy-5219732

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The Importance of Work-Life Balance

A lot of people struggle with having proper balance between their lives and their work. It can be easy, especially in our always on the go, keep pushing for more, and goals/financially motivated society to feel like work is allowed to take over our lives. But a work-life balance is important. There are a lot of potential negative consequences that can happen when we don’t prioritize our lives outside of work more than or at least as much as our lives at work. 

What IS a Work-Life Balance, Anyways?

Simply put, work-life balance is when you’re able to balance your work priorities and obligations with the things you both need and want to do outside of work. It means meeting your deadlines or work goals while also investing time in yourself, getting things done at home, and spending time with the ones you love. 

This is going to look different for everyone! We all have our own hierarchy for what matters most to us. This can also change over our lives. What we prioritize at 25 is likely going to look different for when we’re 35. So this is definitely something to assess over time to make sure your work-life still aligns with your needs, values, and goals. 

Consequences of Being Out of Balance

Stress, to put it simply, can be one of the most immediate consequences of not having a good work-life balance. Stress can then go on to affect us in other ways. 

Like:

  • Irritability
  • Depression
  • Aches and pains, like headaches
  • Stomach problems
  • Relationship issues
  • Productivity problems
  • More likely to become ill 
  • Blood pressure and other heart problems
  • Exacerbate chronic health conditions
  • Trouble sleeping
  • Problems with eating (too much or too little)
  • Overspending or risky behavior to cope with stress
  • Substance use (like drinking more than usual) to cope with stress
  • Burnout

And that’s not even an exhaustive list! However, it’s clear to see how having a poor work-life balance can affect you not just at home, but at work, too. Looking at the list, it makes it clear how counterproductive it is to focus solely on work at the expense of your mental and physical health. It’ll only affect your work poorly, too!

What Can I Do?

Working on achieving a better work-life balance is going to depend pretty heavily on your specific goals and priorities. However, the first step will be the same for everyone. Step back and really consider how you spend your time every day and every week. Are you happy with it? What areas do you wish you could spend more time in? Is it hobbies, family, or something else? Once you have answers to these questions, it’s easy to see where to tweak things to bring things more in balance with what you personally are looking for in life.

For example, if you feel like you bring work home with you a lot, either literally (finishing paperwork, emailing, etc) or mentally (worrying about projects, thinking about responsibilities, etc) then it may be time to consider setting some boundaries around work when you’re at home. If it’s simply not possible to not bring physical work home with you, set yourself a time limit for how much you’ll spend on it each day. This can help you balance out how you spend the rest of your day.

Do you feel overwhelmed with what you have to do at home? Enlist help from those who live with you, if possible. Splitting up chores so it doesn’t all fall on one or two people who also have busy work lives can really help with alleviating the feelings of “work never ends”, even if it isn’t your job that seems to be following you around. 

If you feel comfortable and safe to, talk to your boss or co-workers. You may be surprised to know that others at work also feel the same way you do. Working together to come up with a better workplace culture that can support a healthier work-life balance for everyone can be more effective than trying to tackle it alone. 

If even after working on getting your life more balanced you still feel like you’re struggling with stress, overwhelm, depression, or other negative feelings then consider reaching out to a therapist. 

Resources:

https://www.camh.ca/en/camh-news-and-stories/achieving-work-life-balance

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/work-life-balance

https://mhanational.org/4mind4body-work-life-balance

https://www.mhanational.org/work-life-balance

https://oaksintcare.org/how-work-life-balance-impacts-mental-health/

https://www.webmd.com/balance/balancing-work-and-family

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Cancer and Mental Health

October is Breast Cancer Awareness Month, which is arguably one of the most discussed cancers in the media. There is a large push to get those assigned female at birth to check themselves regularly for lumps or anything that may feel out of the ordinary. Regular breast screenings are incredibly important to your overall health as early detection of cancer is critical for the best outcomes with treatment. However, one thing that is often not discussed is how cancer and mental health can intersect. 

Cancer and Mental Health

Receiving a cancer diagnosis of any kind can be absolutely life changing and devastating. This is not only true for the patient themselves but also for their loved ones. Many of the treatments can be difficult on the body and certain cancers carry with them lower chances of survival, especially if caught late. 

Some of the most common concerns with cancer and mental health are anxiety and depression, with social isolation as a result of cancer being a risk factor for worsening mental health. 

Many cancer patients experience fear, uncertainty, anger, and disbelief after a cancer diagnosis. There can be a sense of “why me” or “did I do something to deserve this?” This can be especially true for cancers such as lung cancer, which are often related to smoking. However, it is important to understand that no one deserves to get cancer and that doctors are still unsure as to why some people develop it while others don’t. 

Because of the serious nature of a cancer diagnosis, it can be difficult to talk to others about it. This can help contribute to isolation and loneliness. Sometimes cancer patients avoid talking about it out of fear of making others uncomfortable and sometimes it’s because they themselves don’t want to talk about it. It can be helpful to broach the topic with those closest to you just to get their support, if you’re comfortable with it. 

All the feelings someone could have around a cancer diagnosis are perfectly normal. There is nothing inherently wrong with feeling anxious, sad, angry, or any other negative emotion as a result of a diagnosis of this kind. However, when those feelings start to make life more difficult or are getting in the way of quality of life, it’s time to reach out for more support. 

When to Reach Out

Some mental health disorders can be difficult to distinguish from symptoms of cancer or side effects from treatment. For example, depression. Sadness from a cancer diagnosis is perfectly normal and those feelings will wax and wane over time. Depression, however, is much more serious and could require treatment for the best outcomes. 

  • Signs to look out for:
    • Fatigue
    • Changes in appetite
    • Weight loss or gain
    • Changes in sleep patterns
    • Irritability
    • Feeling hopeless
    • Feeling worthless
    • Extreme levels of guilt (out of proportion)

If you feel you may want to harm yourself or are thinking of killing yourself, reach out to your care team ASAP to get help with these feelings. There are many options available for help. 

The standard treatments for depression are something we’ve covered in our blog post about major depressive disorder. However, it is important to know that when it comes to cancer and mental health, one needs to consider the specific ways in which depression can impact treatment and quality of life and how cancer can contribute to MDD. 

Taking care of mental health is associated with better mental health outcomes, possibly because of the likelihood of adhering to treatment and being open to learning more about the diagnosis and what can be done. Being more proactively involved in your treatment plan can make a difference for long-term outcomes. 

How Does Cancer Contribute to Depression?

There are many things about a cancer diagnosis that can impact the likelihood of developing depression. One of the major things is the sense of loneliness and feeling like there’s no one you can open to. It’s incredibly isolating to feel as if you have to hide large parts of yourself from loved ones. 

Other factors include:

  • Body image (self conscious because of bodily changes)
  • Guilt (“Did I do something for this to happen?”)
  • Change in daily activities and plans
  • Change in energy levels
  • Pain
  • The fear of dying
  • Anxiety and panic due to uncertainty and fear
  • Fear of cancer coming back after treatment
  • Fear of what will happen to family
  • Anxiety over medical costs
  • Not being able to work
  • The need for others to help care for them (loss of independence)
  • Long hospital stays

It is worth mentioning that these things can also contribute to worsening mental health of the loved ones of a cancer patient. If someone in your life has been diagnosed with cancer and you feel as if you may be becoming depressed, reach out to someone for more support. 

What Can Help Support Mental Health?

There are many different things someone can do to help support or improve their mental health after a cancer diagnosis. With cancer and mental health support, it’s important that your cancer care team is part of some of these choices. Depending on your health and needs, some options may not be suitable, so get guidance from your care team before making any major changes. 

Somethings you can do:

  • Support groups
  • Therapy
  • Medication
  • Mindfulness practices like
    • Meditation
    • Journaling
    • Yoga
    • Breathing exercises
  • Eating balanced, nutritious meals
  • Light exercise, if possible (check with your care team)
  • Seeking out social support from loved ones
  • Pastoral counseling, for those who are spiritual, can be very helpful
  • Spending time with pets/animals
  • Keeping to your normal routine within reasonable limitations

It can also be helpful to ask the care team where you go for appointments or treatment about what options they have at the facility to help support cancer and mental health together. It could be that there are options you’re not even aware of that are there!

Things to ask about:

  • Therapy dogs at the facility you attend for treatment
  • Counselors at the facility you attend
  • Social workers who can connect you to counselors, especially those who specialize in the mental health needs of cancer patients

Cancer can be a life changing diagnosis, especially if caught in the later stages. However, people are living longer and with higher quality of life even with advanced cancer than they ever have before. While all feelings around cancer are valid, you don’t have to suffer with poor mental health, too. Make sure to seek out help, whether you’re the patient or a loved one. When it comes to cancer and mental health, you have options to take care of yourself and support the best quality of life for yourself. 

Resources:

https://www.cancer.gov/about-cancer/coping/feelings

https://www.cancer.org/cancer/survivorship/coping/support-service-animals.html

https://www.cancer.org/cancer/managing-cancer/side-effects/emotional-mood-changes.html

https://www.macmillan.org.uk/cancer-information-and-support/treatment/coping-with-treatment/cancer-and-your-emotions

https://www.mhanational.org/cancer-and-mental-health

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Staying Ahead of SAD and the Winter Blues

In a previous blog post we’ve talked about major depression with a seasonal pattern, better known as SAD. That post was specifically meant to bring awareness to the summer pattern, as it’s less well known. However, this post is for the more common pattern of SAD, which is typically experienced in the fall and winter. This post will also touch on the winter blues, which while similar, is not the same as seasonal depression!

Depression or the Winter Blues?

A lot of people use these terms interchangeably, but technically there is a difference. For most people, the coming of winter signals the end of a lot of things. We don’t spend as much time out of the house doing things, we find ourselves sleeping more, and often we find ourselves eating more. It doesn’t help that winter is packed with a lot of stressful holidays that can be very difficult for some people. All of this can contribute to just generally feeling a bit more down during the winter than usual. Generally, this doesn’t really get in the way of functioning or enjoyment of life.

Seasonal depression, however, is different. A depression diagnosis implies, to some extent, an impact on functioning and enjoyment of life. It goes beyond just a little extra down to feeling quite sad, maybe hopeless, and having a more difficult time enjoying usual activities. That difficulty finding enjoyment with usual activities can also come across as having difficulty concentrating on things like reading, watching TV, or other activities that were not difficult for the person to do before. 

Often with winter pattern depression, we see people eat much more than usual, especially high carbohydrates foods. They often sleep much more than normal which gets in the way of doing other activities. 

People will also socially isolate. Poor weather and a lack of outdoor activities makes social isolation much easier in the winter than other times of year. It’s not unusual to not want to go out when it’s cold and uncomfortable out. However, for people with SAD, this is often hiding the bigger issue in that the isolation is being fueled by depression. 

What can we do? Winter blues.

The general idea of trying to stay on top of the winter blues is pretty similar to SAD. Self-care is one of the biggest things that can contribute to feeling better during the winter months. Now, depending on if you’re experiencing the winter blues or seasonal depression, some aspects of this self-care could look quite different. But the general idea is very similar. 

For the winter blues, especially, it’s important to keep as normal a routine as possible. A lot of the general down feeling we get from winter comes from the disruption in our routines and activities we love. If you like being active, try finding a way to make outdoor activities more comfortable for you in the winter or find a new indoor activity to try instead. Try continuing with your regular socializing and keep yourself to a consistent sleep schedule. It can be hard to want to stay awake until your normal sleep time of 10pm if it gets dark at 4pm. For many of us, our brains are partially wired to associate sunset with getting ready for bed!

General mindfulness can also be very helpful. The self-awareness and insight that comes from practicing mindfulness can help us stay ahead of these kinds of feelings. Often we can stop a cycle from progressing further if we notice it in the beginning stages. Mindfulness can help with that!

Of course enjoy all those holiday specialities you love. There’s no reason not to eat your favorite dessert but also make sure to keep eating balanced, nutritious meals. When we feel better physically, it can help boost how we feel mentally, too!

Get out and enjoy some vitamin D! We get it from the sun and while there’s less of it available in the winter, we can still get it by having short periods of time outside. Don’t just take a supplement without doctor’s guidance, though. Not everyone needs to supplement vitamin D!

What about for SAD?

For seasonal depression, all of those tips above are great. They may be difficult to keep up with, as major depressive disorder can be pretty disruptive to people’s lives sometimes, but it’s important to try. Something that could help is to also coordinate with your care team to start an antidepressant (or increase the dose) temporarily a few weeks before your symptoms usually begin. With SAD, it can help to have that little bit of extra help, chemically, to get through the worst of the symptoms. This has been found to be a pretty effective treatment for SAD. Towards the end of when your usual symptoms are present, you can discontinue the medication or go back down to your normal dose (again, all with your care team’s guidance). 

Something else that can help is therapy. Cognitive behavioral therapy (CBT) is one of the most well known forms of therapy these days. Most importantly, there is a form of it that has been specially designed for seasonal depression. CBT-SAD has been shown to be an effective treatment for SAD, both winter and summer, and can make a big difference for how people experience these seasons. 

What else should we know?

We know a lot more about how the winter tends to affect people than the summer. And to an extent, it is socially normal and expected that winter will bring with it some form of feeling down. However, if you’re struggling with keeping up with your daily routines and you feel you need help, reach out to a doctor or a therapist. Even if you just need to talk to someone during the winter, it can really help. 

Winter can be dark and dreary, but we don’t have to feel that way all the time ourselves. 

Resources:

https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

https://mentalhealthcommission.ca/blog-posts/34590-seven-ways-to-cope-with-the-winter-blues

https://newsinhealth.nih.gov/2013/01/beat-winter-blues

https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder

https://www.nhsinform.scot/illnesses-and-conditions/mental-health/seasonal-affective-disorder-sad

https://www.verywellmind.com/how-to-beat-the-winter-blues-5087998

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Summer Isn’t the Best Time For Everyone: Summer SAD

In our previous post, we discussed the mental health benefits of summer. While there are many benefits of summer for the majority of people, some people experience more mental health difficulties during summer. Most people have heard of SAD, seasonal affective disorder, and the assumption is that it always affects people during the winter. However, some people have SAD in the summer. 

Seasonal affective disorder is more formally known as major depressive disorder with a seasonal pattern. This means that the symptoms of depression come at predictable times seasonally. For the majority of people with SAD, symptoms start in the fall, get more severe during winter, and then resolve by the beginning of spring. However, about 10% of those with SAD experience symptoms starting in late spring which get more severe during summer and then resolve by early fall. 

Major Depression or SAD?

The existence of a predictable pattern is what makes it distinctly different from major depressive disorder (MDD). MDD often does not have a specific pattern of onset of symptoms. Not only must the symptoms be seasonal but this pattern needs to exist for a minimum of 2 years in order for someone to be diagnosed with SAD as opposed to MDD or another mood disorder. 

SAD is well researched, but the majority of research is for the winter pattern. There is little research about summer pattern SAD, which means we don’t know nearly as much about it. What we do know, is that it shares many of the same symptoms of winter pattern SAD, with a few exceptions. Instead of eating more than usual (especially carbohydrates) as is common in winter pattern SAD, summer pattern usually comes with decreased appetite. This means that people often lose weight as opposed to gaining weight. Summer pattern SAD also comes with more irritability and insomnia, as opposed to hypersomnia (oversleeping) common in winter depression. 

There are also some studies that suggest potential triggers for summer pattern SAD. One potential trigger is pollen. Summer depression seems to be more common in those who have seasonal allergies triggered by pollen, which is more common in the spring and summer. Another trigger could be the heat and especially high humidity. Summer pattern SAD seems to be more common in countries that experience high humidity, which suggests this link. There also could be a link between more sunlight and longer days. It’s possible that in those who experience summer SAD that they’re more sensitive to circadian rhythm changes due to the sun. This could be what causes the insomnia many people with summer pattern SAD experience. 

Treatment Options

Unlike with winter SAD, we don’t really have specialized treatments for summer pattern SAD. We do know that SSRIs and SNRIs are effective treatments for summer SAD, especially when started 4-6 weeks before the usual onset of symptoms and then discontinued at the end of summer. There is a form of CBT that has been developed specifically for those with seasonal pattern depression called CBT-SAD and that has been effective for treating summer depression, as well. Other suggestions have been to stay out of the heat and sun as much as possible (no more than 30 minutes to an hour), being in air conditioned spaces if possible, and to keep one’s bedroom dark. Going to bed right after sunset and sleeping in a dark room can help offset some of the disturbances the longer days can cause to sleep patterns.

Another suggestion is to try and maintain a normal routine as much as possible. This helps with avoiding the isolation that can come from depression symptoms. Exercise and maintaining a nutritious diet can also help with relieving the severity of symptoms. 

While we may not know as much about summer pattern depression as we do about winter, we do know that it exists. If you’re one of those people who experience seasonal depression in the summer, you’re not alone. And there are effective treatment options out there. Hopefully over time, more research will be done on this form of depression and we’ll know even more about it and how best to treat it. 

Resources:

https://health.clevelandclinic.org/summer-depression

https://www.healthcentral.com/condition/depression/summer-seasonal-affective-disorder?legacy=psycom

https://www.healthline.com/health-news/seasonal-affective-disorder-can-affect-you-in-the-summer-too#Ways-to-combat-summer-SAD-symptoms

https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder

Could Summer Depression Be Seasonal Affective Disorder?

https://www.smithsonianmag.com/science-nature/people-get-seasonal-depression-summer-too-180955673

https://www.verywellmind.com/summer-depression-symptoms-risk-factors-diagnosis-treatment-and-coping-4768191

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All About MDD: Major Depression Disorder

May was Mental Health Awareness Month and in honor of that, we shared information on our socials during May about various mental health topics. This series of blog posts is an expansion on those social media posts. Our last post was about compassion fatigue and why self-care and mental health is so important as a clinician. This post is about major depression disorder, more commonly just referred to  as depression. 

MDD is one of the most common mental health disorders in the world and one of the leading causes of disability globally. 3.8% of the global population and 29% of Americans experience depression at least once in their lives. 18% of Americans are currently experiencing depression. This disorder has been most commonly associated in adults in the past but more recently has been acknowledged in children. Depression is also proportionally higher in the LGBTQIA+ population than the general population.

While women and people assigned female at birth are 50% more likely to be treated for depression than men and people assigned male at birth, it’s unclear if this is due to genetic differences (meaning that depression is more common in one group or the other biologically) or societal differences. Men and people assigned male at birth are less likely to seek treatment for mental health disorders, primarily due to societal stigma, which may be skewing data in this area. 

There is some data that suggests that depression could be genetic, with people who have at least one biological relative with depression being at higher risk than those who don’t. Those who have experienced trauma or stress as children are also more likely to develop depression as adults. Substance use (alcohol, drugs) has also been linked to higher rates of depression. Some physical illnesses, such as diabetes, are also associated with higher risk for developing depression.

Symptoms of Depression

In order to be diagnosed with depression, an individual must have five or more of the following symptoms:

  • Sadness, hopelessness, emptiness
  • Fatigue
  • Feeling restless or lethargic
  • Sleep issues (sleeping too much or too little)
  • Appetite changes which can contribute to weight gain or loss
  • Anxiety or irritability
  • Difficulty concentrating
  • Feeling guilty, ashamed, or like a burden
  • Social isolation
  • Lack of pleasure in doing things (anhedonia)
  • Thoughts of dying or attempting suicide

Some people may only have five of the symptoms while others could have many more. The important part is that these symptoms must be present most days for at least two weeks for the person to qualify for a depression diagnosis. Other possibilities must also be ruled out, such as vitamin deficiencies or a physical illness.

Most people go to their primary physician first at the onset of symptoms, especially for sleep disturbances and fatigue. This could be because of lack of education about mental health disorders such as depression or because of the stigma that is attached to depression. Physicians can help but usually their understanding of psychiatric treatments are limited in comparison to psychiatrists.

The majority of people experience major depression disorder once with many experiencing recurring episodes of depression. The more episodes of major depression disorder someone experiences, the more likely it is that the depression will be more chronic in nature. With proper treatment, most people start to feel better within a few weeks to three months. For most, MDD can go into remission in about 6 to 9 months. Without treatment, however, symptoms can last months or years and could be more severe than for those who are getting medication and/or therapy for their depression. This is one of the many reasons early diagnosis and treatment are so important. It can help avoid someone’s life being so impacted by depression that they become disabled or attempt (/complete) suicide. 

An important thing to note is that depression and grief are not the same thing. Grief, which can come with sadness, is a natural response to loss. However, they can co-occur, which can prolong symptoms of grief and make them more severe. Accurate diagnosis is crucial in this area in order to make sure someone gets the proper treatment most likely to help them. 

Treatment Options for Major Depression Disorder

Major depression disorder is very treatable in most people and there are a variety of of treatment approaches that are available:

  • Treatments include a variety of medications that can be tried (SSRIs, SNRIs, TCAs, MAOIs, etc)
  • Various forms of talk therapy are also available for treating MDD (CBT, family therapy, interpersonal therapy, etc)
  • For treatment resistant depression, brain stimulation therapies exist that can help severe MDD (ECT, rTMS, VNS)
  • Esketamine is a newer, FDA approved treatment for MDD that has not responded to other forms of treatment.
  • A combination approach is usually the most effective way of treating MDD (therapy plus medication, for example)

When trying medications it is important to remember that it can take at least 6-8 weeks to feel the full benefits of a medication. If side effects are intolerable, discuss with your doctor before discontinuing treatment. 

Along with these traditional treatments, a variety of self-care activities can be done in conjunction (not instead of) to help alleviate symptoms more quickly or avoid a recurrence of a depressive episode:

  • Regular exercise
  • Eating nutritious and balanced meals
  • Mindfulness, such as journaling or meditation
  • Spending more time in nature
  • Remaining connected with your social circle and confiding in trusted people
  • Setting realistic goals 
  • Break down tasks into smaller steps
  • Avoid using substances such as alcohol and drugs not prescribed to you

Self-care is incredibly important when treating depression, especially in those who have recurrent depressive episodes. While it can be difficult to get into a self-care routine while depressed, it can be crucial to helping shorten the depressive episode. It’s especially important for staving off future episodes. 

Ending mental health stigma is an important step in ensuring that people are more likely to seek help for their depression sooner rather than later, which can help with achieving the ideal prognoses. The more we discuss mental health and educate others about it, the more likely people are to seek help in a timely manner and get back to being able to live their lives more fully again.

Resources:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/major-depression

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Depression

https://www.ncbi.nlm.nih.gov/books/NBK559078

https://www.nimh.nih.gov/health/topics/depression

https://www.psychiatry.org/patients-families/depression/what-is-depression

https://www.samhsa.gov/mental-health/depression

https://www.who.int/news-room/fact-sheets/detail/depression

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