I’ve watched patients and loved ones struggle through depression with its darkness and downs, challenges and even, devastatingly, suicide. I have had my share of personal experience as well. I was injured at work years ago and moved from treating chronic pain to being a sufferer myself; the trauma transformed my life in ways I couldn’t previously have imagine.
I discovered that one of the most harmful aspects of this common condition is that we simply do not talk about it openly. This lack of honest conversational feeds into the negative stigma, so if you are reading this… I am here, and I feel for you. Let’s look at this condition together.
According to The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), considered by many the Bible for mental health diagnosis, depression is defined as “A period of (at least) two weeks… during which there is either depressed mood or loss of interest or pleasure, and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.”
And with an estimated 16.1 million US adults experiencing at least one episode of severe depression in 2015 alone, approximately 6.7% of adults suffer from this mental health illness at any one time.
Yet, we still barely talk about it.
While there are a variety of depression disorders including bipolar, psychotic, dysthymia, both female and male postpartum, seasonal affective and premenstrual dysphoric disorder, in this article we’ll focus on clinical depression.
As with anxiety, this disorder more commonly occurs with other mental health illness, including anxiety, Schizophrenia, eating and panic disorders and substance abuse, and physical and intellectual issues such as chronic pain, incapacity, disability, and chronic or terminal illnesses.
Warning signs of depression
Depression manifests in a variety of signs and symptoms, both mental and physical, and while not every sufferer has every issue, sometimes a person can have warning signs of depression without an inkling of the underlying cause.
Emotional and mental signs and symptoms of clinical depression include:
- Withdrawing from society, including family and friends
- Poor concentration
- Feeling overwhelmed
- Lack of self confidence
- Being unhappy
- Tearfulness, often without a known reason
- Constant, repetitive thoughts (rumination)
- Having difficulty making decisions
- Problems sleeping, including waking in the wee hours of the morning
- Loss of ability to enjoy once loved pass times or hobbies
- Physical signs and symptoms of clinical depression include:
- Constant fatigue (I’d personally describe this as incessant, exhausting and consuming tiredness)
- Aches and pains
- Tummy troubles
- Change in bowel movements
- Altered appetite, including either a loss of, or even carbohydrate cravings
- Weight changes
With the relationship of depression to an overactive sympathetic system, as I discussed with anxiety, the way this omnipresent illness manifests begins to make more sense. Let’s look at the autonomic nervous system briefly, both the parasympathetic and sympathetic components (don’t worry, it’s not too scary!), to help you better understand what is happening in your body and your mind.
The autonomic nervous system (ANS) is the part of the nervous system that enables communication from and to your internal organs; think heart, lungs, stomach, intestines, bladder, genitals and even your sweat and salivary glands. Your ANS has two parts; the sympathetic and the parasympathetic systems.
In general the sympathetic system gears the body for fight or flight, and our parasympathetic system for repair, relaxation and recovery.
When humans lived in wild environments, with neighbors of rattlesnakes, bears and enemies, where a life threatening situation could happen in an instant, we required the ability to react immediately. See, as the bear drew his claws through the air, a slowly considered response was not the best option, lest we find ourselves in dinner bits on the ground. Lag time was not a helpful option. Our sympathetic system is the ingenious innovation to ensure a fast, lifesaving reaction. It’s how our body instantaneously ramps up the flight or fight response.
But fight or flight is biologically expensive; it significantly taxes the body and mind. So once the threat disappears, we must rest, recoup and recover. The parasympathetic system is the measured counter system designed to enable us to do just this.
In modern day society, however, the stresses and strains have morphed, from serious but fleeting events to non-stop bills, barking dogs and work pressure. This chronicity can turn our ANS predominantly toward a sympathetic approach, known as sympathetic dominance, and as mentioned, this is taxing. And when you look at the sympathetic changes in the body and mind, they do look remarkably like those we see and experience in clinical depression.
The good news?
While major depression can feel like a heavy undercurrent of never ending despair, most people recover. And those of us who have experienced more than one episode, and so are more likely to live through more, can begin to understand that, as my husband says, “This too will pass”.
There are important depression treatment strategies, both natural and medicinal, and I recommend you seek professional support and encourage you to follow the options that sound right for you. Remember, we are all different and respond to alternative approaches individually.
10 Healthy Coping Skills For Depression
Oftentimes depression is accompanied by easy overwhelm and an accompanying feeling of failure. Please, remember to be gentle with yourself and do just what you can. This is an illness, and as with other serious illnesses, you won’t be able to continue as you did previously. This is expected and normal.
1) Seek Professional Support
This needs to go first because there are few health challenges that can be as overwhelming as the burden of clinical depression. Psychology, including well-researched cognitive behavioral therapy (CBT) helps many. Talk to your medical doctor or other health professional. Psychiatric care can help you find a medicinal approach that works.
Talk to trusted loved ones. This can be a God send, but please remember, they are likely not experts in the mental health field and so you need to balance any advice with that from a professional.
2) Focus On Breathing
When depressed our breathing patterns can change. Our posture also hunches forward, compressing our lungs.
Let’s take a quick look by interesting exercise:
Slump forward and breath in.
Sit up straight, shoulders back, head up and breath in.
Notice the difference?
By focusing on the breath, including Yogic breathing, we can drive ourselves toward parasympathetic dominance, calm the stress response system, normalize blood PH levels, improve our physiologic functions and, potentially, improve depressive signs and symptoms.
3) Walk, Jog, Potter… Whatever Exercise You Can Manage Is Key
To enhance the production of happy hormones, we must move. Research shows that exercise is key in the prevention and treatment of this ubiquitous disorder. Yet when suffering from clinical depression, there is a good chance your energy levels will be challenged and remaining in bed may seem more appealing that doing anything physical. Find a way to move that isn’t too onerous and commit, as best you can, to doing it regularly. Accept that at times, you will feel well enough to do more, and at other points, a potter up and down your hallway will be the best you can for that day.
4) Natural foods for depression
When you have a mental health disorder your appetite can be markedly altered, either disappearing into the ether or enhanced to the point of weight gain. Yet there are certain nutrients essential in the creation of the hormones important for mental wellbeing, including dopamine and serotonin. These include vitamin B6, omega three fatty acids, zinc and magnesium (otherwise known as ‘the great relaxer’).
I often recommend high quality, liquid based supplements to ensure sufficient consumption and encourage the inclusion of foods rich in these compounds, like chick peas, tuna and salmon, bananas, nuts, oysters, beans and free range eggs.
5) Natural herbs for depression
There are a number of herbs that have been recommended in the treatment of depression, however, many are limited in clinical study evidence. While this doesn’t not rule out their use, I do recommend you consult your health professional about these.
St John’s Wort
A Cochrane review stated that, “Overall, the St. John’s wort extracts tested in the trials were superior to placebo, similarly effective as standard antidepressants, and had fewer side effects than standard antidepressants.”
In his article, Herbal remedies for depression and anxiety, Edzard Ernst noted that common lavender was promising in the treatment of those with moderate depression.
6) Soothing Shut-Eye
Insomnia is common in clinical depression, and those who sleep poorly are significantly more likely to develop this disorder. Is it the chicken or the egg? Maybe both. Either way, working toward a better sleep pattern is an important strategy.
Set a regular wake time and stick to it.
If you can’t get to sleep, get up for 20 minutes and then return and try again.
Avoid blue light – TV’s, phones, screens — for at least an hour prior to bed.
Ensure your mattress and pillow are comfortable.
Your room should be dark and comfortably cool.
Consider supplementing or medication, where needed.
As a Chiropractor, I noticed many patient report improved sleep post adjustment.
7) Learn About Your Condition
There can be much judgment around this disorder, at a time of vulnerability when you need this least. Learn about your condition so you can understand it better and practice self kindness and prioritize restorative strategies.
8) Support Groups
There is often solace in like experiences, and some people with depression find speaking with others about shared and unique experiences can help. There are many online groups, and it could take a few worthwhile attempts to find the perfect fit. You will find one list of groups here.
9) Address Other Depression-Provoking Challenges
There may be confounding challenges which contribute to, or exacerbate, clinical depression. Addressing these in a holistic manner is advised. As someone who both experiences, and has cared for those with, chronic pain, I strongly encourage you to take this matter seriously and put in place steps to minimize the impact this has on you. Hypothyroidism, Polycystic Ovary Syndrome (PCOS) or a medication reaction might also be contributory.
10) Incorporate Stress Management Techniques
A discussed earlier, the physical, mental and emotional changes that occur in depression, and those triggered in sympathetic dominance, are keenly similar. So by reducing stress, we can better manage depression. Meditation, mindfulness and visualization techniques can direct your body and mind toward parasympathetic function. Through online or offline classes, YouTube videos, and other internet sources, you can practice these techniques either with others or in the anonymity of your own home.
You can download a complimentary progressive muscle relaxation exercise here under ‘relaxation training’.
While clinical depression can feel overwhelming, at times even unbearable, there are a multitude of expert therapists and approaches which may offer relief.Remember, the majority of people do not suffer at length and those of us with chronic depression can find comfort and quality of life with a little effort and support.
As I mentioned with anxiety, in depression it is also important to prioritize your health and yourself.