It's normal to feel sad and depressed at times. It's natural to experience these feelings as life goes on. But does this sadness, this heaviness in your heart, this feeling of not wanting to do anything seem to have taken over your entire life for weeks or months? Do you no longer feel like doing the things you used to enjoy? Do you start each day feeling bored and alone? Well, this could be you. Let's talk openly about this condition, which is depression.
What exactly is depression?
The first thing to understand is that depression is not a mental illness or a made-up condition. It is a real medical condition that needs to be treated, just like diabetes or high blood pressure. It is related to changes in the chemicals (neurotransmitters) in our brain that control mood, thoughts, and behavior.
Many people are ashamed to talk about this, afraid of "what people will think." Some suffer alone, saying they "need to be strong." Others turn to alcohol and drugs to escape the pain in their hearts. However, none of these are the right solutions. The most important thing is to accurately identify the illness and seek the right treatment.
How do you know for sure if this is depression?
If you think you may be experiencing symptoms of depression, please see a qualified medical professional. In many cases, your primary care doctor can diagnose and begin treatment for this condition.
Your doctor will ask you about your symptoms and whether anyone in your family has had these conditions. They may also ask you to fill out a questionnaire. They may also do some tests to see if there are other physical conditions that could be causing your symptoms. For example:
- Underactive Thyroid
- Some vitamin and nutrient deficiencies
- Reactions to other medications or drugs/alcohol
Important: If your symptoms are very severe, or if you have thoughts of ending your life or harming yourself or others, see a psychiatrist immediately without hesitation.
What are the effective treatments for depression?
The good news is that depression is a very treatable condition. There are several treatment options. The best results are usually achieved when one or more treatments are used together. The two main treatment options are:
1. Medication
2. Psychotherapy or talking therapy
Let's look at these two separately.
Medication
Medications used to treat depression work primarily by restoring the balance of chemicals in the brain that control mood. There are several types of these medications. Your doctor will determine the medication and dosage that is best for you.
| Drug category | A simple explanation |
|---|---|
| SSRIs and SNRIs | These are the most commonly used medications with few side effects. They regulate the activity of chemical messengers in the brain called serotonin and norepinephrine. For example: Fluoxetine, Sertraline, Venlafaxine. |
| Tricyclic antidepressants (TCAs) | These are a slightly older class of drugs. They have more side effects than SSRIs. But they can be more effective for some people. For example: Amitriptyline. |
| MAOIs | These are also effective medications. However, they are not widely used anymore because they require avoiding certain foods (e.g. fermented cheese) and other medications when taking them. |
| Other Medications | Sometimes, in addition to antidepressants, other medications, such as atypical antipsychotics, may be added. There are also newer treatments, such as Ketamine. |
Be sure to remember these things about medication:
* It can take several weeks (perhaps 4-8) for the full effects of the medication to be felt. So don't stop taking the medication just because there is no difference in the first few weeks.
* It may take some time to find the right medication for you. If one medication doesn't work, you can talk to your doctor about switching to another.
* Never stop taking your medication suddenly without your doctor's advice. Doing so may cause uncomfortable symptoms to return.
* It is very important for parents and doctors to be aware of this, as negative thoughts may increase, especially in children and young people during the first weeks of starting medication.
Psychotherapy
This is like psychotherapy. It involves talking to a trained counselor or therapist, understanding your thoughts, feelings, and behaviors, and learning to manage them.
- Cognitive Behavioral Therapy (CBT): Helps you identify negative, irrational thoughts and replace them with more realistic and positive thoughts.
- Interpersonal Therapy: Understands how your relationships with family and friends affect your mood and helps you resolve those issues.
It's important to find someone you feel comfortable with, so you can talk about what's on your mind without any fear or hesitation. This treatment can last from a few weeks to several months.
Lifestyle changes bring great relief!
Along with medication and psychotherapy, simple things you can add to your daily routine can provide great relief from the symptoms of depression.
- Exercise: Getting at least 30 minutes of exercise every day, such as walking, running, or swimming, increases blood flow to the brain and improves mood. According to some studies, regular exercise can be as effective as some medications.
- Sleep: Good sleep is essential for mental health. Get into the habit of going to bed and waking up at the same time every day. Avoid using your phone or watching TV before bed and do something relaxing, like reading a book.
- Diet: Eat a balanced diet. Reduce sweets and fast foods as much as possible. Include more fruits, vegetables, and greens in your diet.
- Social connections: Don't isolate yourself, talk to a trusted friend or family member about what's on your mind.
- Hobbies: Take up something you used to enjoy. Draw, listen to music, garden. Even something small can bring you joy.
- Nature and sunlight: Getting a little bit of sunlight each day not only provides vitamin D, but also improves mood.
Other treatments
There are other specific treatments for severe depression that does not respond well to medication and psychotherapy.
- ECT (Electroconvulsive Therapy):This is a very safe and effective treatment performed under anesthesia. It is used to provide rapid relief to those with severe depression and suicidal thoughts.
- rTMS (Repetitive Transcranial Magnetic Stimulation): This involves stimulating specific areas of the brain using magnetic waves.
- VNS and DBS: These are surgical treatments that are still in the research stage.
Take-Home Message
- Depression is not your fault or a weakness. It is a real illness that needs treatment.
- You don't have to suffer alone. Ask for help. As a first step, see a trusted doctor .
- There are effective treatments. Medication, psychotherapy, and lifestyle changes can help you recover.
- Never stop taking antidepressants without medical advice.
- There are people who love you and care about you. Talk to them. Remember that you are not alone on this journey.
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