Feeling Down, Depressed, Hopeless?

If you are feeling down or sad most days of the week, it might be a sign of depression.

Possible causes of depression:

• Stress

• Chemical changes in your brain

• Certain medical conditions

• Genetics

• Changes in hormones

Symptoms of depression:

• Hopelessness

• Feeling down and sad

• Loss of interest in things you have enjoyed

• Decreased energy

• Difficulty in concentration

• Irritability

• Fatigue

• Lack of motivation

Depression can be:

• Mild

• Moderate

• Severe

Depression can:

• Interfere with your ability to:
  • Function in life
  • Care for yourself
  • Manage your responsibilities
• Affect relationships with your family and friends

It is important for you to understand the significance of depression and when to get help. We encourage you to discuss these symptoms with your healthcare provider (physician, nurse practitioner or physician assistant). Depression can be treated, and the earlier the better.

Treatment options may include:

• Counseling

• Exercise

• Relaxation techniques

• Alternative therapies

• Medication

The best option is different for everyone. A decision for depression treatment is a shared decision between you and your healthcare provider.

This page provides resources to help you be a partner in making decisions about possible treatment.

The information on this website is not meant to be a substitute for your relationship with your provider. If you have thoughts of harming yourself, you need to contact your healthcare provider (physician, nurse practitioner, physician assistant) right away to discuss these feelings.

The National Suicide Prevention Hotline, 1-800-273-8255, is free and available 24 hours a day, 7 days a week. More information can be found here.

Educating Yourself

Educating yourself is one of the most important things you can do. The National Alliance on Mental Illness is a non-profit organization that offers education regarding depression and other mental illnesses. This organization has state and local chapters that can offer support groups and provide you and your family with resources.

Counseling

Counseling, which is often called talk therapy or psychotherapy, is recommended for all types of depression. A counselor may be a psychologist, medical social worker, or a licensed professional counselor.

The University of Michigan depression tool kit provides information on different types of therapy.

Behavioral Activation

Brief behavioral activation can be used alone or in combination with other treatment options. The goal of brief behavioral activation is to increase the frequency of events that are pleasurable. 

Worksheets can help you schedule pleasurable daily events which help you to be active in your own care. If needed, a therapist or healthcare provider can assist you with determining goals.

Here is more information about behavioral activation and a step-by-step guide.

Exercise

Exercise has been shown to improve depressed mood and potentially even prevent depression. Exercise can be as beneficial as antidepressant medications.
As little as 30 minutes of moderate activity 3-5 times per week can show this benefit.

Possible activities include:

• Walking or running
• Cycling
• Swimming
• Dancing
• Sports
• Gardening    

Get Out and Get Moving

The Centers for Disease Control and Prevention (CDC) discusses physical activity and its benefits.

Medication

Treatment with medication is often a first line treatment but needs to be a shared decision made between you and your healthcare provider. Although medications are an important part of treatment for moderate and severe depression, the focus of this website is to review additional options for treatment of depression.

Mindfulness Activities

Meditation: Relaxation techniques and mindfulness can help depression. The main idea with mediation is to stay in the present moment.

There are many ways to accomplish this:

• Deep breathing exercises
• Guided imagery
• Progressive relaxation
• These are all techniques you can learn yourself or work with a counselor

Mindfulness is most helpful when combined with psychological and cognitive –behavioral therapies. Check out this website for more information about the practice.

Yoga

Yoga involves both the mind and body and can help depression. Yoga is a meditative practice, which has been used for centuries.  There are a variety of yoga styles. The type of yoga style is a choice of the individual. Not only does yoga help mental health, there are physical health benefits as well. Explore this website for more information on improving depression and anxiety with yoga.

Acupuncture

Acupuncture is an ancient form of traditional Chinese medicine. It involves the use of needles to stimulate points on the body to correct energy imbalance. This traditional Chinese belief is that many disease states are a result of imbalance in our energy fields. Check out this short video discussing acupuncture.

Need help finding the right provider trained in complementary therapies? Here is a more general site that discusses complementary therapies and how to choose a provider.

Light Therapy

Seasonal affective disorder is a type of depression that occurs in people that are sensitive to reduced sun exposure, especially during the winter months in northern climates.

For many years, light therapy has been shown to help seasonal affective disorder. A light box is used to provide ultra violet light during seasons that have little sunlight.

Typically a light box of 10,000 lux for 30 minutes every morning is helpful for seasonal affective disorder. More information can be found here.

Supplements and Herbs

Can vitamins and herbs help depression?

Many herbs and vitamin supplements have not been fully researched for the treatment of depression. There has been research showing that some herbs can actually worsen certain medical conditions or can be harmful if taken with other medications. It is very important to discuss with your healthcare provider before taking any vitamin or herb.

The National Institute of Heath follows the studies for complementary and alternative therapies. There is information both for consumers and healthcare providers on their website. Here is a resource for complementary treatments that have been studied for depression.

Research

Many individuals also want to know about the research related to depression and treatment. The National Institute of Mental Health (NIMH) is a governmental agency focused on research for mental illness as well as education for the public. There are many resources at this website including information about depression and other illnesses that effect mood.

There are links that will take you to the research studies about depression that have been done or are in the process of being done. The NIMH also contains studies about other mental illnesses. This link will take you to information about the studies and also information regarding treatments for depression.

A special thanks to the Anna Mae (Berg) Spaniolo Endowed Faculty Practice Enrichment Award.