Life hands us all ups and downs. But depression is more than just feeling low because something didn’t go your way. It’s persistent, ongoing — and recurs. Depression takes many forms and may be brought on by any of a number of causes. For instance, seasonal affective disorder (SAD) is triggered by a lack of sunlight and can be responsive to light therapy; reactive depression may occur in response to a traumatic event or illness; certain types of depression seem to have a genetic link. Among those who suffer from it, depression varies in severity as well as in symptoms, which span a wide range, from insomnia to excessive sleep, from overeating to lack of appetite, and which may also include feelings of guilt, worthlessness and/or helplessness; feelings of hopelessness and/or pessimism; irritability; restlessness; loss of interest in activities or hobbies that were once pleasurable; persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment; and persistent feelings of sadness, anxiousness and/or “emptiness.”
An Imbalance in Brain Chemicals
No matter how severe or what the symptoms, all forms of depression share a common trait: imbalances of brain chemicals, known as neurotransmitters — especially serotonin (which, in addition to affecting your mood, is tied to sleep, appetite and overall metabolism) and dopamine (which is associated with feelings of reward and pleasure).
Many of the more recent antidepressant medications are targeted at raising your brain’s levels of one of these compounds. Medication is one effective course of treatment, but it’s not the only one — and depending on your situation, your mental health care provider may recommend other approaches or a combination of several.
Talk About It
Among the proven therapies for depression are ones that help you share your feelings with others — either with a trained therapist or in a structured group setting. “Talking about your feelings to someone who can understand you can make a huge difference in your treatment process,” says Michael McKee, PhD, a clinical psychologist at the Cleveland Clinic’s Department of Psychiatry and Psychology.
Cognitive behavioral therapy (“talk” therapy): This one-on-one communication between you and a therapist is a form of psychotherapy used to help you express and resolve issues in a way that helps you change negative thought patterns and build a positive mental outlook. Multiple studies have found that if you are working with an experienced therapist, cognitive behavioral therapy can be as successful in treating depression as medication.
Group therapy: For some, dealing with an “expert” — a therapist — can be anxiety-producing or antagonizing. If this is the case for you, your doctor may recommend that you attend one or more group therapy sessions. Sharing similar stories, noticing patterns in your and others’ thinking and making connections with others in a social setting can be beneficial and, for some, provide similar results to working one-on-one with a therapist.
Syncing Mind and Body
Mind-body therapies are a group of techniques that are designed to improve the mind’s ability to affect bodily functions and symptoms. Some mind-body therapies are thousands of years old; some are relatively recent developments, but all are focused on improving the pathways between your mind’s conscious thoughts and your body’s involuntary reactions — and ultimately, give you control over both. According to researchers at the Chinese University of Hong Kong, China, an increasing number of studies have shown that mind-body training has a positive impact on different mental and physical conditions, including depression. Among the many practices grouped under mind-body therapy:
Yoga: The Chinese University researchers noted that in one study, depressed patients who underwent 20 sessions of yoga experienced a significantly elevated mood and a greater sense of psychological well-being than they had previously. Another study helps explain why this might be so: Researchers from the Boston University School of Medicine found that yoga boosts levels of a brain chemical known as gamma-aminobutyric acid (or GABA), which is associated with controlling both depression and anxiety.
Meditation: While there are many forms of meditation, one in particular — mindfulness meditation, which teaches you to recognize thoughts and feelings as they’re happening and then consciously decide to let them pass — was found in a 2009 pilot study to successfully reduce symptoms of depression. In mindfulness meditation, the goal is not so much to clear your mind of thoughts and feelings but to acknowledge and be conscious of them — and allow yourself to let go of them and bring your attention back to the present. Mindfulness meditation begins with your focusing on your breathing and using the breath as an anchor to the present moment. As thoughts and feelings arise, you acknowledge them and then return your concentration to your breathing.
Biofeedback/neurofeedback: Biofeedback — in which you measure your physical state in real time in an effort to raise self-awareness and, through that awareness, become conscious of how your body reacts to different stimuli — takes many forms and is used for many conditions. For depression, the treatment relies on monitoring your brain waves — which are actually electrical signals — on an electroencephalograph (EEG) as you go through certain tasks or think about certain things. The goal is to become aware of how you feel when you experience different thought processes, identify the brain wave patterns associated with positive feelings and become able to enhance them. It should be noted that this is not electroshock therapy, in which the brain receives a jolt of electricity to change its brain wave patterns.
Focus on the Positive
As you work with a mental health practitioner to achieve an improvement in your mental outlook, there are some activities you can do on your own. Dr. McKee offers three ideas to help you build and strengthen a positive outlook on life:
Count a blessing. Allow yourself a moment to appreciate one specific person in your life. Think of the happiness and meaning this person brings to your life. Chances are you will experience a feel-good moment.
Engage in self-praise. Take a few note cards and on each one write one good thing about yourself. Examples might be, “I’m good at throwing a football” or “I have beautiful hair.” Keep these cards where you can access them easily, and review them over and over again.
Get out and see people. A number of studies, Dr. McKee says, “show that isolation is bad for mental and physical health — and many show that social interaction can improve both.” Depression, he continues, can lead people to isolate themselves, which in turn can worsen symptoms. Having lunch with a good friend, seeing a movie with your sister or attending a social function can help break this cycle and give you the feeling of being liked and cared for — which in turn will improve your mood and help enable you to take other positive steps toward recovery.