Banishing the
Darkness of Depression

 

Due to advances in medication, depression is now more treatable than
many physical illnesses. However, only one out of three seriously
depressed people ever seeks help! Although counseling can teach thinking
and people skills that improve mood, the need for medication should be
addressed first. The more of the following conditions that are present, the
greater the need for antidepressants:

• Other physical problems or medication reactions have been ruled
  out. A complete thyroid battery should be done if a person has
  gained weight, feels exhausted or is sensitive to cold.

• Routine activities are becoming increasingly difficult: problems
  concentrating, making decisions, working, sleeping, or carrying out
  daily tasks.

• Suicidal thoughts are causing problems.

• Concentration and energy are not sufficient to counsel on past
  trauma or recent loss.

• A family history of depression is present.

• More than one previous episode of significant depression has
  occurred.

• Medication has been helpful in the past and has not caused
  prolonged side effects.

• Interest in or ability for self-examination is lacking.

• Therapy to change thinking, behavior, or interaction patterns has not
  helped.

CHANGING THE CHEMISTRY OF DEPRESSION

Since the 1950s, nonaddictive antidepressants have helped 60–75% of
people with depression find relief. Any side effects usually disappear or
become tolerable after a couple of weeks. These medications act directly
on various neurotransmitters:

• Dopamine—linked to pleasure and self-stimulation.

• Norepinephrine—enables the nervous system to respond to incoming
  stimuli.

• Serotonin—balances the action of dopamine and norepinephrine.

• MAO (monoamine oxidase)—an enzyme that breaks down adrenaline
  and serotonin.

The variety of options is steadily growing: tricyclics (TCAs), MAO inhibitors
(MAOIs), selective serotonin reuptake inhibitors (SSRIs), and other
“designer” antidepressants that target very specific neurotransmitters with
fewer and fewer side effects:


  Antidepressants                  Used for                     Side Effects


























Other options besides medication may be needed or preferred:

• Electroconvulsive therapy (ECT) can stabilize the “beat” of the brain
  when people are immobilized by depression. This is similar to a pulse
  of electricity resetting the rhythm of a heart that has stopped beating.
  Ninety percent of people who don’t respond to medication improve
  with ECT.

• Saint John’s wort is an herb with as many as 50 active chemicals. It
  may slightly increase the flow of serotonin and dopamine and
  suppress MAO and interlukin-6 (an immune cell found in excess in
  some depressed people). The proper amount (300–600 mg. 3
  times/day) may relieve depression with fewer side effects than
  medication. This may not be the best option if a person is sun-
  sensitive, at risk for cataracts, or needs rapid results.

TAME YOUR TEMPERAMENT

People who are introspective and underreactive can be prone to brooding
and feeling empty. If stagnation is allowed to continue, it can lead to serious
problems. Understanding your temperament and modifying your habits can
help manage low periods without antidepressants or boost the power of any
medication you are taking:

1. Recognize and reframe your mood: When you are brooding or
   feeling empty, tell yourself that your body is signaling the need for
   outside stimulation. Reattribute any thoughts of hopelessness,
   helplessness, and regret to sluggish body chemistry.
   

2. Postpone worry and apathy: Set limits on how long and when you
   allow yourself to ruminate or vegetate. Do not permit more than two
   separate hours a day. If you feel a mood coming on, tell yourself it
   will have to wait till your “down time.”
   

3. Modify ruminations: Say worries out loud, pinch your nose, write,
   sing, or speak them in pig Latin. Avoid thought-stopping methods
   that hinder needed stimulation.
   

4. Get a light: Spend time outdoors, especially in the early morning.
   Replace fluorescent fixtures with full-spectrum bulbs that have the
   same rays as the sun.  This resets production of melatonin, which
   causes hibernationlike states that mimic depression.
   

5. Sleep deprivation can be the fastest way to alter mood if you are
   oversleeping.
   

6. Gain a sense of your state of underarousal: Shift from brooding and
   apathy to noticing physical sensations: aches, heaviness, emptiness,
   or trouble smiling.
   

7. Refocus to break the vicious cycle of gloom: Do not withdraw from
   people or activities that provide needed stimulation. Without
   expecting too much of yourself, do something! Break tasks down into
   small parts. Be proud of anything you accomplish.

• Get your attention outside yourself: Smell perfume, examine a leaf,
  listen to music, feel textures, or take a bath. Engage senses that help
  you turn outward.

• Exercise your body: Pick activities that will get your metabolism in
  gear without being exhausting: leisurely walks, slow dancing, window-
  shopping, or bike riding.

• Exercise your mind: Read engaging books, do crossword puzzles, or
  play cards.

• Reach out to others: If you don’t want people to know you are
  depressed, make excuses for your lack of energy and even
  tearfulness by saying you’re not feeling well. That is the truth! Find at
  least one or two people with whom you can be open. Get a telephone
  or e-mail buddy or find (online) support groups.

References
  
See “Focusers” in Mastering Your Moods by Melvyn Kinder (Simon &
Schuster, 1995).

www.appollolight.com, 800-545-9667 or www.lighttherapyproducts. com,
800-486-6723—product information. Full-spectrum bulbs are also available
at some hardware stores, nurseries, and health food stores.