Coping with Depression

Things you can do to speed recovery and keep it from returning

By R J Ignelzi

Look around at the people in your office, the grocery store or your church or synagogue. Even though they may not be weeping or cowering alone in a corner, there’s a good chance that at least a few of them are suffering from depression.

The World Health Organization estimates that about 350 million people worldwide have some form of depression, while approximately one in 10 American adults report being clinically depressed, says the U.S. Centers for Disease Control and Prevention.

Depression is all around us. However, many of us fail to recognize depression in ourselves or a loved one because the mental illness often is disguised as a physical symptom or a seemingly minor change of mood or energy.

“Depression can manifest itself in different ways in different people. A sad mood is the most common manifestation of depression, but there are some other signs in other people,” said psychiatrist Dr. Michael Plopper, chief medical officer of Sharp HealthCare Behavioral Health Services, which encompasses the psychiatric services at both Sharp Mesa Vista Hospital and Sharp Grossmont Hospital.

To be accurately diagnosed with depression, “you need a constellation of at least five symptoms which have lasted at least two weeks,” said psychologist Jerry Gold, director of Behavioral Health Services at Scripps Health. These symptoms can include being sad, sleeping too much or too little, withdrawal from pleasurable activities, anger and irritability or physical symptoms like a stomach ache or headache.

Depression can happen to anyone, at any age, of any race or ethnic group. It can be triggered by chemical imbalances in the brain, hormonal changes, medications or things going on in your life.

If you think you may be depressed, discuss your concerns with your physician who may suggest professional counseling or prescribe antidepressant medications. The good news is that depression is a highly treatable illness. No matter what your depression symptoms or if you’re taking medications and/or undergoing psychotherapy, there are things you can do to help you cope with depression, speed recovery and help prevent depression from returning.

• Don’t wait too long to get evaluated or treated. There is research showing the longer one waits, the greater the impairment can be down the road, according to the National Institute of Mental Health, part of the National Institutes of Health. Try to see a professional as soon as possible. Note: Medicare now covers annual depression screenings.

• Stick to your treatment plan. Attend every psychotherapy appointment, even if you don’t feel like going. Take your medications as prescribed even if you don’t think they’re helping you. Talk to your doctor before stopping or skipping medications because you may experience withdrawal-like symptoms if you stop too suddenly.

• Set up a routine. Depression can deplete motivation for even the most mundane tasks.

“Break up your day into hourly schedules. Try and create manageable chores which can be accomplished,” said Thomas Manheim, a clinical psychologist specializing in the treatment of anxiety and depression in Del Mar/Solana Beach. These can be simple things like walking the dog, going to the grocery store or cleaning out a cupboard.

• Get some exercise. Physical activity helps reduce depression symptoms. When you’re depressed, exercising may be the last thing you feel like doing. But studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue.

Research suggests that physical activity triggers new cell growth in the brain, increases mood-enhancing neurotransmitters and endorphins, reduces stress, and relieves muscle tension — all things that can have a positive effect on depression, Manheim said.

Consider walking, jogging, swimming, gardening or taking up another activity you enjoy. To gain the most benefits, aim for at least 30 minutes of exercise per day. It’s OK to start small, since even short 10-minute bursts of activity can have a positive effect on your mood.

• Get some sunlight. Expose yourself to a little sunlight every day. Lack of sunlight can make depression worse. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal or people-watch on a park bench.

• Avoid alcohol and illegal drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat.

• Get plenty of sleep. Sleeping well is important for both your physical and mental well-being. If you’re having trouble sleeping, talk to your doctor about what you can do.

• Eat a healthy, nutritious diet. What you eat has a direct impact on the way you feel. Aim for a balanced diet of protein, complex carbohydrates, fruits and vegetables.

Don’t skip meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours. Minimize sugar and refined carbs. You may crave sugary snacks, baked goods or comfort foods such as pasta or french fries. But these “feel-good” foods quickly lead to a crash in mood and energy.

• Keep stress in check. Not only does stress prolong and worsen depression, but it can also trigger it. Figure out all the things in your life that stress you out such as work overload, unsupportive relationships or health problems. Once you’ve identified your stressors, you can make a plan to minimize their impact.

• Write it down. “Finding words to describe your depression is another way to take your life back,” said Manheim, who encourages journaling — writing down your inner emotions and negative thoughts.

• Express yourself creatively. Let your creative juice flow through music, art, writing or cooking.