depression being conveyed, man in dark clouds, early morning on top of mountain range

Depression: Understanding its Presence

Depression is not “all in your head.” While depression is medically characterized as a chemical imbalance in the brain, it affects your body as well as your thoughts and your feelings, in fact your whole life.  

Depression is more than moodiness. While everyone has their down days, clinical depression goes beyond a blue mood or feeling sad.

Depression is characterized by the darkness of despair, misery, hopelessness and dejection. Such feelings persisting for at least two weeks, combined with poor concentration, lack of energy, meet criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder. You may also notice an Inability to fall or stay asleep and/or lack of appetite or eating more than normal.

Depression has been called the common cold of mental illness. One in six people in the U. S. will suffer a major depression during their lifetime. For more detail on prevalence see the NIH website.

Many factors contribute to depression

Depression is often the result of prolonged stress. Constantly released stress hormones such as cortisol and epinephrine eventually overwhelm the “feel good” hormones like oxytocin, serotonin, and dopamine, leaving you at risk for depression. This is why antidepressant medication may be helpful.

Recent studies indicate that genetics play a role with some people having a built-in predisposition toward negativity which fuels depression. A low tolerance for stress may also makes you more susceptible to the effects of a negative environment or traumatic experiences.

Chronic illness and chronic pain put one a risk for depression, increasing the release of stress hormones and making a positive outlook more difficult to maintain.

Depression is part of grief that naturally arises when you experience loss of any kind. Stuffing grief rather than allowing yourself to feel the pain of loss, sets you up for a clinical depression.

Depression is one characteristic of post-traumatic stress, and it can show up long after the traumatic experiences are over.

Depression may seem to come out of the blue with no obvious cause.

Ignoring depression can be dangerous

A low-grade depression, like a low-grade infection, can sap your energy, rob you of pleasure and decrease your ability to function.

A severe depression, like a severe infection, can be life threatening.  Emotional numbness may leave you going through the motions, feeling life is not worth living or that your family and friends would be better off without you. Hopelessness and despair often lead to thoughts of suicide as a way to escape the pain.

Depression can be treated

The good news is that depression is one of the most treatable mental illnesses. Most people will recover fully with proper treatment and depression sometimes lifts spontaneously. The usual treatments for depression include antidepressant medications (SSRIs) and/or psychotherapy. A combination of medication and therapy provide the best outcome for recovering from depression.

Primary care physicians are the first line of defense in prescribing antidepressant medication. More complicated cases require the skills of a psychiatrist.

Cognitive behavioral therapy focuses on changing the automatic negative thoughts and irrational beliefs that feed the sense of hopelessness and helplessness associated with depression. Therapy is also helpful in dealing with difficult life situations or working through past traumas.  

Mindfulness practices such as meditation and focusing on the present moment may create a sense of peace that helps to lift depression.

Spiritual resources are valuable in overcoming depression. Faith in a loving God or a beneficent universe go a long way to create a sense of wellbeing.

Maintaining wellness

Having experienced a major depression puts one at higher risk for another. The following are a few of the practices that help to prevent a recurrence.

Social connections with family, friends, coworkers and neighbors are critical to maintaining mental and physical wellness. Recent studies have shown loneliness to be as detrimental to health as a two-pack a day cigarette habit. Find a community to be a part of.

Regular exercise provides a boost in mood as well as promoting physical fitness, as does a healthy diet with a focus on protein and fresh fruits and vegetables.

Practicing gratitude and self-compassion help maintain a positive attitude. The idea is to focus on what you have rather than what you are missing and be as kind to yourself as you are to your best friend.

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