Clinical depression is a serious but treatable condition. Seeking help from a mental health professional can bring sufferers back to life.

There’s a difference between feeling depressed and being ill with clinical depression.

Unfortunately, many people don’t know the difference, so they use the “J word” when trying to help a friend who’s clinically depressed, according to Jon G. Allen, Ph.D., director of psychology at The Menninger Clinic in Houston and author of Coping with Depression: From Catch-22 to Hope.

“The word is ‘just,’” Allen explains. “They say things like ‘Just enjoy yourself,’ ‘Just quit moping,’ ‘Just snap out of it.’”

It would be nice if it were that easy. If you were “just” feeling down for a spell, that would be one thing. But when you’re severely depressed, all the things you must do to recover are made more difficult because of your symptoms. You get caught in a catch-22.

“Realizing the challenges you face—and the many reasons for hope—are the first steps toward regaining real, lasting enjoyment in life,” Allen stresses.

Understanding the Causes
You can inherit a predisposition for depression—meaning if a close relative has been clinically depressed, you have an increased chance of becoming depressed yourself.

Depression also can be triggered by an intensely stressful event. There’s even evidence that it’s linked to biochemical changes in the brain as well as changes in brain activity.

“Although predisposition plays a role, with enough stress almost anyone is liable to get depressed,” Allen notes.

Death of a loved one, loss of a job, illness, alcohol or drug abuse, giving birth, even certain medications can bring on depression.

Most experts have come to see depression not as a one-time, shortterm event, but as a long-term vulnerability to illness that can recur throughout life, seldom goes away rapidly by itself, and can require ongoing treatment.

Reason for Hope
Even though depression can be dark indeed, there is a dawn. Depression tends to respond well to two primary modes of treatment: antidepressant medications, which can help restore healthy brain chemistry and improve mood, sleep, appetite, and other symptoms; and psychotherapy, which helps identify triggers of depression and can change negative thought and behavior patterns.

Importantly, both talk therapy and ongoing medication can reduce your chance of falling back into depression the next time you face a stressful event.

“Especially if you have severe depression, it’s best if you can do both,” says Allen. “Medication may be necessary for a person to move forward in psychotherapy. But if you aren’t doing something to change the situation that’s causing the stress, such as conflict in close relationships, medication may have only limited effects.”

Most important, get ongoing support and advice from your primary care physician, therapist, counselor, or other health professional. A psychiatrist has the best medical training to prescribe effective medications, Allen notes.

“He or she also can help identify when depression isn’t caused by stress, but by some other existing medical condition or by drugs prescribed for that condition,” he says.

Breaking the Cycle
These self-care steps also can help relieve depression’s hold:

• Connect with family and friends. Doing so can be a major challenge because depression tends to make you want to isolate yourself, climb into bed, and pull the covers over your head.

  “It’s hard to make conversation because you may feel your depression is contagious, that you’ll be a burden to other people,” Allen explains. “But it can be a great mood elevator to be connected with someone who’s not in that condition and can help you see past that state.”

• Get physically active. You may believe you lack the energy for exercise, but activity itself can energize you, and some studies have found exercise can even be an effective antidepressant.
• Stay away from alcohol and illegal drugs. These can numb the emotional pain in the short term, but used over time they actually tend to worsen depression.
• Stay on your medications. It’s common for people to start feeling better after they start taking antidepressants, then stop taking them—and lapse right back into the cycle of suffering. Some people find it takes several weeks for these medications to take full effect.

Recovery is likely to take time; however, the vast majority of people recover from episodes of depression.

“Don’t give up,” Allen urges. “Get the treatment you need.”

Recognize Depression
If you experience symptoms of depression nearly every day for two or more weeks, get help. If you have thoughts of suicide, immediately call 911 or a crisis hotline.

Depression symptoms include:

• Feeling sad or down
• Feeling hopeless, helpless, or worthless
• Trouble sleeping or excessive sleeping
• Crying spells for no apparent reason
• Unintended weight gain or loss
• Fatigue and lack of energy
• Feelings of worthlessness, self-hate, or inappropriate guilt
• Problems concentrating or making decisions
• Agitation, restlessness, or irritability
• Loss of interest in normal daily activities
• Recurring thoughts of death or suicide

Some people have severe symptoms, others may have a general feeling of unhappiness that doesn’t seem to have a reason and doesn’t go away.

For information and support:
Depression and Bipolar Support Alliance, visit www.dbsalliance.org or call 800-826-3632.

National Institute of Mental Health, visit www.nimh.nih.gov or call 866-615-6464.

National Suicide Prevention Lifeline, call the toll-free, 24-hour hotline at 800-273-TALK (800-273-8255) to be connected to a trained counselor at a suicide crisis center near you.

Polly Turner spoke with Jon G. Allen, Ph.D., director of psychology at The Menninger Clinic in Houston, and author of Coping with Depression: From Catch-22 to Hope. American Psychiatric Publishing, 2005, $33.

© StayWell Custom Communications. Information is the opinion of the sourced authors and organizations. Personal decisions regarding health, diet, and exercise should be made only after consultation with the reader's own medical advisers. This material may not be reproduced for redistribution without written permission from StayWell Custom Communications.