The first thing to understand is that we all have periods in our life when we have some degree of depression. But there is a distinction between clinical depression and the normal passing depression that we all have for as many reasons as there are people. It is important to know the difference because a passing depression can lead to clinical depression and clinical depression can lead to suicide.

We'll start with duration, or how long you have felt depressed. If there has been at least a two week period where your mood is depressed most of the day, nearly every day, compared with how you had been feeling, it is time to be concerned. Other criteria includes changes in sleep, diminished interest in activities that you used to like, crying repeatedly, weight loss or overeating, fatigue, people around you notice that you are moving faster or more slowly than you usually do, feelings of worthlessness or inappropriate guilt, repeated thoughts of death or suicide, and problems with concentration, or indecisiveness. If these symptoms are the result of bereavement, or the death of someone or something close to you, then the time period extends to two months. These are all criteria for a major depressive episode. There is more detail involved, but if you can relate to these symptoms then look up the specifics, or see a doctor or therapist right away.

Now you have an understanding of a major depressive episode, you should also know that these symptoms can also be an indicator of other disorders. This includes such disorders as bipolar, clinical, endogenous, major, melancholic, seasonal affective disorder or unipolar depression.

I will probably touch on many of these over the course of my web entries, but today I would like to focus on a type of depression that is particularly insidious, which is dysthymic disorder. One of the criteria for this type of depression is that it has lasted for over two years. Dysthymia is a low-grade depression and someone who has this issue has typically come to feel like it is their normal mood state, so they never bother to get it checked. They don't even know that there is a better feeling for them to have, so they can go through their whole life with a mood that is depressed and not know it.

So for a very simplified overview of what is happening in the brain of the depressed person, I can tell you that the cells of our brain communicate with each other with chemicals. If there is not the correct balance or amount of chemicals in our brain then it doesn't perform to the best of its ability. Think of your car having a clog in the air filter or carburetor. If the correct air/fuel mixture doesn't get to the engine then it won't run smoothly. Think of antidepressant medications in terms of restoring your brain engine by correcting the balance of chemical messengers in your brain.

Antidepressants will often correct these messenger defects but there are a couple important things to remember about taking antidepressants. The first thing is that it takes some time for antidepressants to take effect. It can take from two to five weeks for serotonin specific reuptake inhibitors (SSRI'S) to take full effect. The next thing to remember is that not every antidepressant works for everyone. If you take them it is important for you to keep your doctor informed about how it is going for you. If the medication you are taking isn't working that doesn't mean that antidepressants in general won't work for you. It only means that particular medication isn't working for your type of depression.

There are also plenty of ways to improve your depression without the use of medication. Always keep in mind the variables that need to be taken into consideration, such as the degree of your depression. For example if a person is so depressed that they are considering suicide, then I would not suggest that they exercise and call me in the morning. But for anyone who is dealing with a depressed mood, exercise can help. This includes cardio workouts for twenty minutes or more and raising the resting heart rate by 80%, which is not nearly as hard to do as it might sound. This activity will release endorphins in most people, which will in turn elevate their mood. Again we're talking about brain chemistry. Another thing to do is to interrupt the cycle of depressive thinking. Depression feeds on itself. The more we think about being depressed, worthless, guilty, unloved, underpaid, or anything else that is negative, the more we become depressed and the spiral continues downward. If a person is conscious of their negative thinking, they can intervene and disallow these thoughts to break the cycle. It is not easy to do by any means, but research shows that depressed people can learn how to do this.

There are plenty of other strategies. I have written in my web site about the positive effects of meditation. Depression studies show that meditation has very positive outcomes. What you eat, think, and do determines to a great extent how you feel and who you become. Recent research shows that most depressions respond better to therapy than any other strategy. Therapy is at least as good, and in most cases better than medications for people with anything but the most severe depression. A person with severe depression will typically be unable to get out of bed and is probably very close to suicide.

One problem for many people is that we have become a society of quick fixes and when we don't see immediate results from our efforts we tend to feel like we are wasting our time. Developing sustained changes in brain chemistry takes time, and it happens so incrementally, it is difficult to see the positive change. I like to use the analogy of a child growing up. From one day to the next we didn't notice as we were growing, but as we are now adults we know that it happened. I submit here that the exercises I suggested work similarly. If you do them then you won't feel much different from one day to the next. But if you develop the habit of doing them on a regular basis, then I would bet that by this time next year you will notice a definite difference. I hope you take me up on that bet, because you're worth it.


DAKOTA BAKER MA,LPCC,LADC TELEPHONE: 612•750•5378 FAX: 651•636•0243 EMAIL ME PROUD MEMBER OF: Minnesota Psychological Association MARRCH
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