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Everyone experiences depression to one degree or another but some experience it as a fleeting emotion after an adverse event, while others deal with it on a daily basis. It's essentially an imbalance of the brain that some cannot overcome without assistance. Those who are depressed often have a difficult time coming to terms with their emotions, and if you're "down in the dumps," you may find yourself feeling the same way. Understanding what depression is, how it affects you, your life and those around you is crucial to maintaining a quality of life while not letting it completely overwhelm you.
The symptoms of depression are varied, and not everyone is going to experience all of those symptoms. It’s possible to receive a diagnosis of depression while only manifesting a portion of the symptoms. The core of depression boils down to not feeling good about life. Feeling happy is difficult, if not downright impossible, for a depressed person, and thoughts of “Why bother doing anything at all?” are frequently at the surface. Many people also experience anxiety on top of depression and find it hard to let go of thoughts that are nonproductive. Additional symptoms of depression include thoughts of suicide and/or suicide attempts; loss of interest activities that would normally give pleasure; changes in appetite, either a decrease or increase; oversleeping or battling insomnia; a persistent feeling of sadness or emptiness; self-loathing, guilt, feelings of being worthless, helpless; difficulty with memory, concentration, or an inability to make decisions.
Whether a depressed person will attempt to take his or her own life depends on the level of depression from which the person suffers. Everyone has a unique experience when suffering from depression, and in some cases, a person may feel his or her days are dull and gray with nothing to look forward to, but will not attempt to end his or her life. While this person is suffering from depression, he or she is not in a state of mind that drives them to do something drastic about it apart from suffer with the condition. Depression might prevent a person from seeking proper treatment to improve the quality of life, but not take drastic action. Either way the condition is serious, and whether the person is a suicide risk or not, help should be sought immediately.
Diagnosis can take place in the office of a physician or therapist. Physicians are trained to recognize the signs of clinical depression and are usually the first line of defense when it comes to getting treatment. From there, depending on the severity of the patient’s symptoms, the physician may opt to treat in the office or refer the patient to a psychiatrist for more in-depth treatment. No two cases are alike, and some people do fine with a physician’s treatment while others need to get more aggressive with therapy.
When you ask for help from a physician or therapist, the first thing you will likely do is fill out a questionnaire. On it are questions that you answer using your own judgment. You choose the number that best describes the intensity of the feeling about which you are asked and return the completed document to the physician. The sum total of the answers determines how severe your depression is and helps to guide the physician in your diagnosis. It is important to answer the questions honestly in order to get the help that’s needed. No judgment is being applied, just the desire to treat and help you feel better.
Once the physician has determined the severity of the depression, he or she makes the decision of which antidepressant is the most appropriate for you. There are several drugs available for treatment although most of them work in a similar manner.
A majority of the time, depression is caused by the overproduction or lack of serotonin. Serotonin is a natural neurotransmitter, helping regulate signals between neurons in the brain. It affects memory, sexual desire, sleep, appetite and digestion, and moods and behavior. Too much or not enough serotonin typically results in depression. If there’s too much, the brain can’t absorb it all through its receptors, and if there’s not enough to take in, the regulation can’t happen. At this point, there are two choices: Live with the condition and try to deal with the symptoms on your own, or take action and go see a medical professional for help.
Most medications on the market that treat depression are known as selective serotonin reuptake inhibitors, or SSRIs. Another form is known as selective serotonin and norepinephrine inhibitors, or SNRIs. Also used are monoamine oxidase inhibitors, or MAOIs. Some people respond well to an SSRI such as Prozac or Lexapro, while others need something a bit more refined in its action such as Cymbalta or Effexor. Older drugs such as Elavil, Imipramine and Pamelor may be appropriate for treatment as well.
All medications, even though they are classified as an SSRI or MAOI, work different from one another. Each has a unique action that addresses the issue at hand. The goal of medication is to control or reduce the symptoms to a point of near non-existence. Someone who has depression with anxiety is more likely to be prescribed Prozac, while someone who has multiple symptoms may be prescribed Zoloft.
Sometimes mood stabilizers are used alongside the main antidepressant in order achieve better results. It’s not unusual for someone to be on an antidepressant yet not feel better. The root cause is being treated, but there is another issue going on that requires additional medication. Lithium, Seroquel or Abilify have the ability to increase the overall effect of the antidepressant.
Once the medication issues are sorted out, therapy may be employed as additional treatment. Sometimes known as “the talking cure,” therapy is used to bring issues to the forefront and determine if there are triggers or self-sabotages that are causing the issue. You may find that expressing your emotions and feelings to a neutral party can be beneficial in that it gives voice to the problem. Said neutral party listens and helps you, the patient, to overcome the problem at hand. The therapist works to give you tools that you can employ in the fight against returning to depression in the event you move off medication.
The physiology of the brain is still not well understood. It is entirely possible for you to feel normal and great on the medication, causing the physician to take you off treatment because it’s not needed any more. But it also possible that you’ll return to a depressed state in the future. Or, it may be that you never have to go back on medication as the depression was a one-time issue that you’ve overcome successfully. There are those who have to spend their entire lives on medication because their brain chemistry never comes around.
How you experience depression is a highly individual thing. What you experience is not going to be the same as someone else. There are commonalities to be sure, but you may have a short-term brush with the issue while someone else has spent their entire life with depression and needs to stay on medication for their own safety. No one can say for sure how long the problem can persist due to the unpredictable nature of the brain. The hope is that the treatment is only needed for a short period of time, but reality may dash that hope.
It’s possible to make simple life changes to address the symptoms of depression. Exercise, while easy to revile, is an excellent activity to alleviate the symptoms. It affects the brain chemistry by releasing endorphins that include dopamine, norepinephrine and serotonin. This may seem counterintuitive to the idea that the brain has too much of these neurotransmitters, but exercise helps the body self-regulate more efficiently than doing nothing at all. Engaging in physical activity burns off adrenaline and stressors, key components in anxiety. It also increases oxygen flow to the brain, resulting in a domino effect of positive neural activity that helps to alleviate the causes of depression.
Healthy diet choices also helps to increase energy levels, something that is sapped by depression. Reducing carbohydrates and eating foods that create a slow, sustained energy burn keeps you moving, and keeps the mind from dipping into the well of depression.
If you feel you are depressed and are ready for a change, start with your physician for assistance. You and your physician are best equipped to deal with the problem at hand, and the two of you working as a team has the best potential for a positive outcome. Your physician can help you with diagnosis, medication and help you decide what your next steps should be. At the very least, you gain the help of a trained professional who can keep an eye on your progress and guide you on the path towards wellness.
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