While the majority of individuals with depression have a full remission of the disorder with effective treatment,only about a third (35.3%) of those suffering from severe depression seek treatment from a mental health professional. Too many people resist treatment because they believe depression isn't serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.
Accept Your Diagnosis. Many people (particularly men) have difficulty accepting that they are depressed. They may feel ashamed or weak, or otherwise believe that if they just "push through" they can handle it themselves. This is not a terribly useful or productive approach for people to take as it tends to set them up to sabotage their therapies. Such patients may "forget" to take medications on schedule, or decline to tell anyone who cares for them what they are dealing with.
These negative thoughts and feelings tend to focus your attention on things you do not like about yourself or your life situation. These thoughts also tend to make your problems seem worse than they really are. As well as concentrating on your negative features and experiences, when you are depressed, you tend to underestimate your positive characteristics and your ability to solve problems. A number of strategies may help you achieve a more balanced view of things:
A. Krill oil is extracted from the bodies of Antarctic krill — tiny shrimp-like shellfish — and can be taken in capsules. Like fatty fish and fish oil supplements, krill oil capsules contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Consuming these fatty acids (and alpha-linolenic acid, or ALA, which is derived from plants and converted in the body to DHA and EPA) is associated with a reduced risk for cardiovascular disease.
Thus far in this document, we've described therapies that are generally best prescribed and monitored by clinical professionals. However, it is also possible to take a self-help approach to the treatment of depression under certain circumstances. Self-help approaches emphasize what people can do for themselves rather than what professionals can offer.
Some symptoms of depression as described above are normal after any kind of loss including the onset of a disability or severe illness. If you have had these symptoms for a long time it may be helpful to talk with a mental health professional. It is also helpful to talk to someone if you have other symptoms such as feeling guilty or worthless, or if sadness interferes with the ability to do important life tasks (take medication; go to therapies, work or school).
You may know Botox (botulinum toxin) for its wrinkle-reduction prowess. But a bit of research is being conducted into using it to treat depression. Doctors observed that people who had Botox injections into their forehead seemed to have a better mood after the injection — and not just because they felt more attractive. So, researchers in the U.S. and Germany pooled the results of three clinical trials with a total of 134 people who were treated in that way — with Botox — for depression. More than 80 of them got Botox shots in addition to their usual antidepressant medication. People with depression tended to see substantially greater improvement in their depression symptoms 6 weeks after treatment than people who got a fake (placebo) injection.
Stressful life events play a part in the onset or relapse of depression. Ongoing conflicts with others can take their toll on our well-being, as can other social and environmental stressors such as financial difficulties, retirement, unemployment, childbirth, loneliness, or loss of someone or something important. In vulnerable people, these unpleasant life events may be enough to cause or worsen a depressive illness.
For patients who are unable to switch from an older SSRI to either a newer SSRI or to another class of antidepressants either because of lack of tolerance or lack of therapeutic response, the doctor may consider adding another medication to the SSRI. For example, some doctors have reported success by adding bupropion to SSRIs to improve sexual function.
Problem-focused coping leads to lower level of depression. Focusing on the problem allows for the subjects to view the situation in an objective way, evaluating the severity of the threat in an unbiased way, thus it lowers the probability of having depressive responses. On the other hand, emotion-focused coping promotes depressed mood in stressful situations. The person has been contaminated with too much irrelevant information and loses focus on the options for resolving the problem. They fail to consider the potential consequences and choose the option that minimizes stress and maximizes well-being.
People living with high-functioning anxiety and depression usually do not fit the stereotype of either disorder. In fact, many appear to be overachievers. The anxiety can serve as an energizer, driving the person towards achieving his or her goals. It’s later, when in private, that the symptoms of depression tend to emerge. Feelings of self-doubt and self-criticism, fatigue, helplessness or guilt, moodiness, and a desire to avoid interaction with others become intensified. Because the stereotypical image of depression or anxiety doesn’t match up with what people living with high-functioning anxiety and depression “look like,” it is hard to spot, even for sufferers to recognize in themselves. However, the symptoms of high-functioning anxiety and depression are the same as for non-high functioning anxiety and depression. The main difference is the ability to suppress or diminish the appearance of disruptions in life activities.
The side effects of tricyclic antidepressants are often worse than the side effects of SSRIs and SNRIs. As a result, more people tend to stop taking tricyclic antidepressants: Studies found that about 15 out of 100 people did so, compared with around 10 out of 100 people who were taking SSRIs. Taking an overdose of tricyclic antidepressants is also more likely to lead to severe side effects than taking an overdose of the other antidepressants.
Persistent depressive disorder, formerly referred to as dysthymia, is a less severe but usually more long-lasting type of depression (dysphoric) compared to major depression. It involves long-term (chronic) symptoms that do not disable but prevent the affected person from functioning at "full steam" or from feeling good. Sometimes, people with persistent depressive disorder also experience episodes of major depression. Double-depression is the name for this combination of the two types of depression.
It's also common for people who are having a difficult time with an anxiety disorder to feel depressed as a result of the way anxiety is interfering with their lives. It's my experience that most patients who experience this will find that their depression lifts naturally as a result of doing better with anxiety, and no special treatment for the depression is necessary.
Life events and changes that may precipitate depressed mood include (but are not limited to): childbirth, menopause, financial difficulties, unemployment, stress (such as from work, education, family, living conditions etc.), a medical diagnosis (cancer, HIV, etc.), bullying, loss of a loved one, natural disasters, social isolation, rape, relationship troubles, jealousy, separation, and catastrophic injury. Adolescents may be especially prone to experiencing depressed mood following social rejection, peer pressure, or bullying.
Despite the popularity of social media platforms and the rapidity with which they’ve inserted themselves into nearly all facets of our lives, there’s a remarkable lack of clear data about how they affect us personally: our behaviors, our social relationships, and our mental health. In many cases, the information that’s available isn’t pretty. Studies have linked the use of social media to depression, anxiety, poorer sleep quality, lower self-esteem, inattention, and hyperactivity — often in teens and adolescents.
There is a danger that, in some people, antidepressant treatment will cause an increase, rather than a decrease, in depression. In fact, the U.S. Food and Drug Administration (FDA) requires that all depression medications include a warning label about the increased risk of suicide in children and young adults. The suicide risk is particularly great during the first month to two months of treatment.
Anxiety disorders are the most common type of mental disorder. 50-60% of migraine patients will suffer from an anxiety disorder. Most anxiety disorders involve chronic worry or fear and avoiding things that trigger these feelings. In panic disorder, the patient has recurrent, unexpected feelings of intense fear or terror that seem to come from out of the blue. The heart starts beating rapidly and breathing becomes strained. Other symptoms may involve sweating, fear of dying, or losing control. Although attacks don’t last very long and are not dangerous, many people develop significant anxiety between attacks and come to fear normal body sensations.
While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics.
The key to living with depression is ensuring you’re receiving adequate treatment for it (usually most people benefit from both psychotherapy and medication), and that you are an active participant in your treatment plan on a daily basis. This requires a lot of effort and hard work for most people, but it can be done. Establishing new, healthier routines are important in many people’s management of this condition. Getting regular emotional support — for instance, through an online support group — can also be extremely beneficial.
Social abuse, such as bullying, are defined as actions of singling out and causing harm on vulnerable individuals. In order to capture a day-to-day observation of the relationship between the damaging effects of social abuse, the victim’s mental health and depressive mood, a study was conducted on whether individuals would have a higher level of depressed mood when exposed to daily acts of negative behavior. The result concluded that being exposed daily to abusive behaviors such as bullying has a positive relationship to depressed mood on the same day.
Nurture yourself with good nutrition. Depression can affect appetite. One person may not feel like eating at all, but another might overeat. If depression has affected your eating, you'll need to be extra mindful of getting the right nourishment. Proper nutrition can influence a person's mood and energy. So eat plenty of fruits and vegetables and get regular meals (even if you don't feel hungry, try to eat something light, like a piece of fruit, to keep you going).
As of today, there is no laboratory test, blood test, or X-ray that can diagnose a mental disorder. Even the powerful CT, MRI, SPECT, and PET scans, which can help diagnose other neurological disorders such as stroke or brain tumors, cannot detect the subtle and complex brain changes in psychiatric illness. However, these techniques are currently useful ruling out the presence of a number of physical disorders and in research on mental health and perhaps in the future they will be useful for the diagnosis of depression, as well.
A recent report from the Centers for Disease Control and Prevention (CDC) showed an increase in suicide among people not previously diagnosed with a mental disorder, but there is a link between mental illness and suicide. Depression and other mental health conditions such as bipolar disorder, anxiety disorders, and schizophrenia are associated with an elevated risk for suicidal behavior. Among the symptoms associated with major depression are recurrent thoughts of death and suicidal ideation with or without specific plans for committing suicide. (2)
Selegiline inhibits MAOb at lower doses and both forms at higher doses. Because it does not inhibit MAOa, it does not require dietary restrictions at lower doses. Lower doses of oral selegiline (Eldepryl) appear to lack antidepressant properties and are usually prescribed to treat Parkinson disease. Higher doses are used to treat major depressive disorder, and the selegiline transdermal patch is FDA approved for this indication. Selegiline is sometimes used off-label to treat attention-deficit/hyperactivity disorder.
Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. He or she just needs to be a good listener—someone who’ll listen attentively without being distracted or judging you.
Depression can increase the risks for developing coronary artery disease and asthma, contracting the human immunodeficiency virus (HIV) and many other medical illnesses. Other complications of depression include its tendency to increase the morbidity (illness/negative health effects) and mortality (death) from these and many other medical conditions.
Depression is a disorder of the brain. There are a variety of causes, including genetic, biological, environmental, and psychological factors. Depression can happen at any age, but it often begins in teens and young adults. It is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter. Depression is one part of bipolar disorder.
Remember, antidepressants aren’t a cure. Medication may treat some symptoms of depression, but can’t change the underlying issues and situations in your life that are making you depressed. That’s where exercise, therapy, mindfulness meditation, social support and other lifestyle changes come in. These non-drug treatments can produce lasting changes and long-term relief.
There are a lot of different medications for depression. But it's difficult to predict how well a particular medication will help an individual. Because of this, doctors often first suggest taking a drug that they consider to be effective and relatively well tolerated. If it doesn't help as much as expected, it's possible to switch to a different medication. Sometimes a number of different drugs have to be tried out before you find one that works.
Much work remains to help determine the best treatment options for different types of patients. We also need to better understand the impact that treating depression and anxiety has on headache. Remember, it is extremely important to obtain best treatment for each disorder: the depression or anxiety and the headache disorder. Safe and effective drug and behavioral therapies are available, so talk with your provider about any symptoms that you have.
Doctors at NIMH are dedicated to mental health research, including clinical trials of possible new treatments as well as studies to understand the causes and effects of depression. The studies take place at the NIH Clinical Center in Bethesda, Maryland and require regular visits. After the initial phone interview, you will come to an appointment at the clinic and meet with one of our clinicians. Find NIMH studies currently recruiting participants with depression by visiting Join a Research Study: Depression.