Getting Over the Blues

Aydrian L. Thomas, M.D.

 

Depression affects more than 20 million individuals nationwide.  They come from all walks of life, and are not limited to any religion, occupation or economic status.  The impact of this disease is widespread in terms of lost productivity in the workforce, increased healthcare costs and consequent dependence on alcohol and other substances.  Staggering statistics like these serve to under gird the seriousness of this condition.  But what exactly is depression?

 

The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) defines depression as a collection of five or more of the following symptoms:

1. depressed (sad or empty) feelings most of the day, nearly every day
2. diminished interest or enjoyment in most activities most of the day, nearly every day
3. significant change in appetite resulting in weight loss or weight gain
4. sleeping too much or difficulty sleeping
5. feeling that you are moving in slow motion or are hyperactive
6. fatigue
7. feelings of worthlessness
8. excessive guilt or irrational guilt
9. trouble concentrating or making decisions
10. recurring thoughts of death ranging from wishing you were dead to planning suicide in detail

 

Depressed individuals, aside from having the abovementioned features, will notice that the depression interferes with their work, their relationships or other areas of their lives.  Symptoms must be present and impactful for at least 2 weeks to meet criteria for a major depressive episode. If this describes you, there are measures you can take.

 

Open the lines of communication.  Depression is a naturally isolative disease.  It makes you feel alone, and often alienates you from others.  Couple this with the stigma society places on illness of this type, and you have a dangerous combination.  Your best move is to tell someone you trust—regardless of whether you think they will understand—exactly how you feel.  If there is no one who fits description in your life, talk to a counselor or spiritual advisor.  When it comes to depression, silence can be deadly.

 

Conversely, if you notice a loved one showing signs of depression, don’t alienate them.  All too often, depressed individuals are dismissed as lazy, unmotivated, unspiritual or weak.  And all too often the same loved ones lament the fact that they ignored the warning signs until it was too late.  Even if you don’t understand how they feel, let them know that you are there. Acknowledge their struggle, and resist the temptation to impose your opinion of how they “should” feel.

 

Learn your enemy.  You may have noticed that depression is referred to as a “disease” or “illness”.  From a treatment standpoint it is, and it should be treated no differently than hypertension or diabetes.  Timely diagnosis and appropriate treatment are essential to managing depression as with other diseases.  The notable difference between depression and other illness is that it affects the mind.  As a result, it is easy to get lulled into thinking you can just snap out of it. Keep in mind, you wouldn’t snap out of a stroke or heart attack.  Depression is no different.

 

Beyond seeking professional help, it is also important to learn the intricacies of this disease.  Learn the features, signs and symptoms, the warning signs that things may be getting worse, and the effect it may have on your thoughts and decisions.  Depression colors the way you look at even the simplest of issues.  It is important to know when the disease is talking.

 

Exercise.  Like the miracle tonics of yesteryear, exercise is a cure for whatever ails you.  Studies have shown regular, aerobic exercise to be an effective adjunct to medication and counseling in the treatment of depression.  Perhaps it’s the endorphin rush that follows that brisk 3-mile walk, or the sunlight exposure, or the improved blood flow to the nervous system; whatever the reason, exercise is a proven way to help lift the veil of depression.  So walk, run, swim and dance your blues away!

 

Take care of yourself.  Depression creates such demotivation that the sufferer can find herself ignoring the essentials of self-care.  Resist the urge to lie in bed all day.  Try to avoid the (almost ubiquitous) comfort foods.  The elation from comfort eating is only momentary, but the consequences can last a long time.  Keep your appointments even if you do not feel like going.  The momentum you generate may be just enough to keep you from sinking deeper into despondency.

 

Keep hope alive.  Depression is treatable, and in many cases the treatment can be completed in a matter of months.  Don’t lose hope in feeling better.  Remind yourself how you felt during your happiest moments, and cling tenaciously to possibility that you will feel good once again.

 

 

 

Dr. Aydrian Thomas is board certified by the American Board of Family Medicine.  He is a family physician practicing in York, South Carolina.