Understanding and Overcoming Depression—Part 3

 

Treatment Recommendations for Depression:

Thankfully, there is hope!  Depression is among the most treatable of illnesses.  Almost all patients gain some relief when receiving proper care.

 

But tragically, less than 50% of Americans with depression ever seek treatment, due to embarrassment or avoidance.

 

If you suspect clinical depression in yourself or someone you care about, please consider these recommendations.

 

1.  See your medical doctor - to rule out medical conditions that generate depression (such as thyroid, hormones, vitamin deficiency, blood sugar, heart health, endometriosis, lupus, fibromyalgia, and tumors).  Be “cleared” medically.  Always request complete and specific blood labs, to rule out these conditions.

 

2.  Seriously consider a counselor - A competent counselor can help you look at life from the whole perspective of body, mind, and spirit.  This may be the single, most important step you take. 

 

Consider that your objective thinking gauge may be off-kilter for awhile.  There will be strong pessimistic and negative thinking.  Depression does that.  

 

Also consider your losses, and go through the grieving process, in order to adjust to them, rather than ignore them.  “You can’t heal what you don’t feel.”

 

3.  Don’t isolate – let your friends and family and church help out. “No man is an island,” and when we try to be, it spells disaster.  Stay connected!
 

4.  Balance your life.  Ensure the essentials, such as sufficient sleep, good nutrition, exercise, rest, play, and time with friends.  Put these essentials into your daily schedule, and even commission others to help you follow through.  Do some constructive and pleasurable activity every day.


People who follow this “behavioral” advice—they help change their own brain chemistry!

 

5. Delay big, important decisions until you know you are feeling better.  And then when you proceed—proceed only if the people who “know you the best and love you the most” generally agree with your major decision.  Therefore any decision that even seems to be important, run that by others who care and who are wise.

 

6.  Seriously cutback on stress, by taking time off, saying “no” to all non-essential requests, and delegating many of your responsibilities for awhile.

 

7.  Do not “self-medicate” with a reliance on alcohol, street drugs, excessive food, spending, sex, or obsessions.  This unhealthy relief only causes deeper depression later!


8.  Consider herbal and natural treatments, supported by research, through a qualified specialist.

 

9.  What about Medications?  I believe that we can greatly benefit from medications (properly used and carefully monitored)!  Antidepressants are NOT sedatives, “uppers,” nor are they physiologically addictive.  

 

Usually counseling and the other treatment recommendations are enough to significantly help alleviate mild to moderate levels of depression.  However, antidepressants may be prescribed by a family doctor or psychiatrist for those suffering with moderate to severe depression, in order to correct imbalances in the levels of chemicals in the brain.

 

These medications are NOT sedatives or “uppers.”  They are not habit-forming or addictive.  They do not make non-depressed people feel good or “high.”

 

Antidepressants usually require 3-4 weeks to begin an improvement.  If there is no improvement or there are bad side effects, the doctor will consider another antidepressant.  Some people need to try 2 or more medications to find the very best one, so be patient.  The biggest reason prescribed medications fail to help is that mentally suffering people don’t comply or don’t take them as prescribed.  

 

When there is an improvement in your mood, the doctor will recommend continuing the medication for a total of 9 to 12 months in order to prevent relapse.  If a person has had 2 or more bouts with severe depression in their lifetime, longer-term medication will be suggested to decrease the risk of future episodes.

 

Three Med Precautions:

(1) Do not mix prescribed meds, over-the-counters, and herbal remedies together without consulting a doctor.  

(2) Children and adolescents should be closely monitored due to a higher risk (of increased depression or suicidal thoughts) prompted by new medication. 

(3) Medication as a substitute for counseling is almost never recommended.  Both meds and counseling are recommended for an optimal improvement rate and better long-term outcome.  With a counselor you can learn and sort through the essential issues of life, so that your long-term welfare is better ensured. For those suffering with higher levels of depression, medications address the immediate biological component of depression, leveling the playing ground, allowing you enough motivation and energy to work towards healing.  Then, a Counselor and perhaps a support group will help you tackle important issues, so that your long-term recovery is more successful!

 

Rarely used procedures, but nevertheless sometimes effective for highly resistant depression:  

(1) Electroconvulsive Therapy (ECT), (2) Vagus Nerve Stimulation (VNS), and (3) Transcranial Magnetic Stimulation (TMS).

 

In addition to all the treatment options we now have, more recent, promising treatments to inquire about and further explore include: 

(1) blocking the stress chemicals that damage the nerve cells during stress, (2) the hormone DHEA, (3) administering IV-ketamine, and (4) deep stimulation to area 25 within the brain.

 

The National Institute of Mental Health regarding Men:

 

menanddepression.nimh.nih.gov

 

The NIMH recommends the following for alleviating depression in men:  regular mild exercise, a schedule of enjoyable pleasant events, setting realistic goals, trimming down to a reasonable amount of responsibility, breaking larger tasks into very doable smaller ones, allowing others to help fill in, being patient even with gradual change in the depression, when feeling incapacitated: do something constructive every day, being with others, confiding in others, and letting family and friends help.


 

Adapted from "Courageous Living: Coping with Depression" (DVD)
Chris Thurman, Ph.D., from American Association for Christian Counselors.


This DVD covers symptoms, causes, and how God has made it possible to have victory over depression.  God will make a way for His children to do well with this struggle.  Often, a particular stressor or let down triggers the onslaught of the full force of depression.


Symptoms:

    A – Affect.  Your mood will change.  Sad, blue, discouraged, painful.

    B – Behavior.  Behavior changes, seen in low energy, changed appetite,  sleep, and activity.

    C – Cognition.  Trouble concentrating and keeping your mind on a task.
           Negative thinking about yourself, life, and your future.


Causes:

  • Loss:  A loved one, friendship, job, dream and expectation, pet, living location. 

  • Stress.  We can take just so much for so long, which leads to a depletion.

  • Body chemistry.  Biochemical and hormonal imbalances.

  • Faulty thinking.  We all have inner dialogue, self-talk, but what are we saying, and is it true?  Irrational, distorted, negative thinking as a habit begins to take over.

Six ways we distort reality, which worsens depression:

  • Magnification.  Any discouragement can be magnified by us, and it can be larger in us than it actually is, and we become depleted quickly.  See it in its proper size, in a larger perspective.

  • Polarization.  Black and white.  All or nothing thinking, about self, life, others, future.

  • Personalization.  We take events personally, as if done because of us or to us, rather than the event being more about the other person or happenstance.

  • Overgeneralization.  Making bleak predictions about the future based on a single event.  Since this happened, it’ll always be that way—that’s what I’m in for.  Fatalistic thinking, can lead to destructive self-fulfilling prophesies.  Blocks change and making any impact in life’s course.  Get’s us “off the hook.”

  • Selective abstraction.  Focusing on negative details so that we miss the bigger picture.  The tree becomes the forest.  So, every circumstance is toxified by that which is “stuck in the craw.”  

  • Emotional reasoning.  “I feel this, so it is absolutely true.”  However, emotions are not factual.

All these are distortions which increase depression, and they do not take into consideration the broader picture, and more importantly, they do not allow God’s input and reality to be part of the experience.  It is an established fact that these distortions will lead to and increase your depression.  However, we can become skilled in defeating these distortions.  People do it all the time with good success.

We must not be alone in this illness.  The Church, supportive group, counselor, and doctors are all vital to overcoming depression.


For example, Jeremiah 19:11 says:  “I know the plans I have for you, declares the Lord.  Plans to prosper you and not to harm you.  Plans to give you a hope and a future.”  That is a tremendous source of encouragement.  His plans are indeed good for you.  He came to heal and set you free.  He has a bright future for you, not hopelessness.  Our real hope is in God, His plans and power on our behalf.  We go to Him for this, and partner with Him.  Our dilemmas do not intimidate or overpower Him.  He will use many resources in our lives, for His purposes, as we come to Him, allow others in, and overcome depression by His wisdom and power.

 

How Do I Help a Hurting Friend (suffering depression)? (Rod Wilson)

 

Your first response should be compassion, even when it’s frustrating.  Become educated about depression.  Pray specifically, alone and with other Believers.  Assure the loved one that you will always be there and not abandon them (although you’ll need normal breaks).  Bring a sense of hope (We don’t see all the answers right now, but we will.  God will help us.).  Do your part (but not the professional’s part) to stimulate realistic/healthy/undistorted thinking.  Remember, healthy balance is needed in all the areas—of body, mind, spirit, relationships, and environment (stress).
 

Helping Those Who Hurt (Norm Wright)
 

First, faithfully pray for him/her, and for you to have patience, understanding, and hope.  Second, Let your spouse know these things, expressing such assurances as: “I care for you, I’m available to help you, I want to be with you, I don’t understand it all but I’m trying, I’m here for you, you mean a lot to me, I love you, you’d do the same for me, we’re in this together.”  Third, make sure you understand depression’s signs/symptoms, causes, and solutions.  Fourth, do your part to help your spouse connect with multiple sources, because the more aid the better.  Fourth, once you’ve done these steps, you’ll know how you can gently do your part to encourage what is helpful to your spouse.  Also, collect helpful phone numbers (of doctors, family, friends, emergency resources) to call upon whenever needed.

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© 2015 by Jack Merenda, Psy.D., Inc.