Recognizing & Treating Depression

Linda Ciotola, M. Ed.,CHES, TEP

Sources: National Institutes of Mental Health; Blue Cross/Blue Shield (Vitality); American Counseling Association; Wellness Networking Group

According to the National Institutes of Mental Health, depression affects about 19 million Americans. The effects are far-reaching, impacting not only personal well-being, but family interactions, work place performance, and even financial security.

The following symptom check-list is provided by Blue Cross/Blue Shield:

Depressive mood: do you suffer from feelings of gloom, helplessness or pessimism for days at a time?

Sleep disturbance: do you have trouble falling asleep at night or trouble staying asleep – waking up in the middle of the night or too early in the morning? Are you sleeping too much?

Chronic fatigue: Do you frequently feel tired or lack energy?

Isolation: Have you stopped meeting friends for lunch? Increasing isolation and diminished interest or pleasure in activities are major signs of depression.

Change in appetite: Are you eating far less than usual – or far more? Severe and continuing appetite disturbance is often an indication of depression.

Inability to concentrate: If you can’t seem to focus on even routine tasks, it’s probably time to get some help.

Dependence on mood-altering substances: If you depend on alcohol or other drugs to make it through the day, you may be suffering from depression. Often the substance abuse causes symptoms like those of clinical depression, but are in fact due wholly to the drug use.

Feelings of guilt or worthlessness
Frequent thoughts of death or suicide
A number of treatment options are available and needs may differ depending upon severity. For mild depression, exercise is a first line treatment because of its neurotransmitter elevation effect. Outdoor exercise with sun exposure can be particularly helpful for those suffering with Seasonal Affective Disorder (SAD). Full spectrum lighting at home and work may also help. Avoidance of alcohol is essential for anyone prone to depression because it is a chemical depressant. Optimal nutrition is also key. Keep blood sugar stable with well-balanced, evenly spaced meals containing lean protein, whole grains, fruits and vegetables and healthy fats like nuts, seeds, olive oil. Supplementation with amino acids, essential fatty acids, vitamins, minerals, and/or herbs may also help. Contact a health practitioner familiar with these rather than trying to self-medicate.

Music is a proven mood stabilizer. Combining movement with music in a manner synchronizing the movement with the beats per minute of the music (entrainment) elevates mood-enhancing brain waves. Try walking to your favorite upbeat music; take an exercise class choreographed to music, or just dance. Listen to upbeat music often.

For moderate depression, counseling is a proven treatment, especially when added to the interventions mentioned above. A number of treatment modalities are available as well as specialists in categories such as marriage and family. Options beyond traditional “talk therapy” include experiential and expressive arts therapies, EMDR (see October issue), and dialectical behavior therapy (DBT) which combines psychoeducation with mindfulness training. If your thinking patterns are making you depressed, cognitive behavioral therapy may be the treatment of choice. Interview practitioners to determine a good match.

For more severe depression, medication may be essential in addition to psychotherapy and all the aforementioned treatments. A psychiatrist familiar with mood disorders can prescribe medication best matched to your symptoms. In very severe cases, hospitalization may be necessary. Never stop taking medication without medical supervision.

Like addictions, mood disorders like depression do tend to run in families. So, there may be a genetic pre-disposition to depression which can be triggered by environmental factors such as stress, loss, or trauma. Recent research has shown that acupuncture, regular yoga practice, and meditation help raise the genetic set-point for mood.

If you know that you have a dip in mood during the holiday season, speaking with a professional counselor can help you through this difficult time. In addition, life coach and counselor Sue Waldman, MA, LPC, CEC makes the following suggestions:
The DO’s of managing holiday blues:

Do follow these basics for good health:

Do eat right
Do exercise regularly
Do get plenty of rest
Do pray and meditate
Do set realistic goals:
Do organize your time
Do make lists
Do prioritize
Do make a budget and follow it
Do rethink how you view and approach the holidays
Do write down everything that you are grateful for
Do focus on the present and think positively
Do forget about what is suppose to happen and adjust your expectations
Do let go of the past and create new or different ways to celebrate
Do allow yourself to feel sad, lonely or melancholy – these are normal feelings, particularly at holiday times
Do something for someone else
Do volunteer your time to a good cause
Do enjoy activities that are free
Do spend time with people who care about you
Do spend time with new people or a different set of friends or family
Do contact someone with whom you have lost touch
Do give yourself a break – plan to prepare (or buy) one special meal, purchase one special gift, and take in one special event. The rest can be ordinary, but will seem special because of the time of year and the people you’re with.
Do treat yourself as a special holiday guest
The DON’TS of managing holiday blues

Don’t drink alcohol
Don’t overindulge in holiday foods, especially those that are high in sugar and fat
Don’t have unrealistic expectations of yourself or others
Don’t dwell on the past
Don’t focus on what you don’t have
Don’t spend money you don’t have
Don’t ignore your health
Don’t accept the role of victim
Don’t long for what once was
Don’t convince yourself that there is no hope
Please pass this on to anyone who you believe needs some extra support during the holidays.

Special Note: Since 54% of Hispanic men with depression do not recognize they have it or fear treatment, the NIMH has launched a public education campaign to encourage Hispanic men who are depressed to seek help. Spanish-language materials are available through the Real Men, Real Depression campaign. For information and materials, visit Often, men’s depressive symptoms reveal themselves through anger and/or irritability. Treatment is essential to help them and to protect those close to them.

Editor’s Note: If you or someone you know is suffering with depression, please seek help.

* Linda Ciotola and her colleague Karen Carnabucci have co-authored the book Healing Eating Disorders with Psychodrama and Other Action Methods – Beyond the Silence and the Fury Click here to order.