Depression and depressive episodes affect people of all ages and ethnicities. A depressive episode consists of a combination of signs and symptoms of depression for two weeks or longer that negatively affect a person’s overall functioning. People with depression experience at least one major depressive episode and do not also have a medical condition such as bipolar. disease or hypothyroidism. Common symptoms include depressed mood, decreased interest in normal activities, insomnia or hypersomnia, and feelings of lightness. And they are quite evident in an otherwise healthy and genial old man, my patient, who complained only of insomnia. It quickly became clear that depression was the real problem, and the insomnia was just a symptom of depression. Thankfully, depression has been found to be treatable with the nonpharmacological strategies below, and its insomnia cured.
When a depressive episode is confirmed, steps must be taken immediately to prevent death and, if necessary, begin pharmaceutical treatment. Although most people with a major depressive episode do not want to die, some do. Pharmaceutical therapies combined with counseling and emotional support are immediately effective, and in extreme cases, involuntary facilitation is necessary for mental healing. I will never forget the teenager I cared for in the emergency room with a self-inflicted and ultimately fatal gunshot wound to the head. If only we had obtained it, it could not be prevented.
It is important to recognize that depression can be caused by an underlying mental or physical illness. Some underlying problems that can mimic depression include thyroid disorders, new diabetes, dementia, and heart disease. One of my recent patients had chronic fatigue syndrome, poor mood, and weight gain. Innocent blood test identified hypothyroidism, and after treatment, his poor mind was resolved, and he was once again happy and energetic as usual.
For the mild control of depression, where there is no risk of suicide, nonpharmacological therapy can be particularly effective. Cognitive therapy is the most researched, and appears to be helpful in both treating depression and preventing relapses. This is my major counseling method used when seeing patients in the clinic. For example, one elderly female patient had family problems, making things depressing. Cognitive therapy involves changing some of your own false beliefs about personal motivations, which results in a paradigm shift that ultimately cures depression.
Self-treatment is usually beneficial. One effective technique that I have personally recommended for years is similar to that given by Drs. Paul Meier and Francis Minirth. This program involves regular meditation, socializing with supportive people, and showing gratitude. Actively work to solve personal problems. Finally, eat healthy, exercise and get enough sleep. These self-treatments, along with pharmaceutical therapy in more severe cases, often dramatically improve depressive episodes.
Depression is usually mild, but it can be serious, so preventing death is always the first step. Proper diagnosis and treatment through health care is essential. Make sure the depression is not due to underlying physical or mental health issues. Finally, recognize that the treatment at work at home is frequent and it almost always helps. Meditation, active problem solving, gratitude, and a healthy lifestyle will greatly improve the mild to moderate depressive episodes. .
REFERENCES
National Institutes of Health. Sadness [accessed 12/12/2012]
