Understanding Quasi Depression

Depression rears its ugly head in all shapes and sizes. Sometimes our depression isn’t obvious. You don’t have to be stuck in bed for days to be considered depressed. Unfortunately we don’t always know we are in a quasi depression until it’s over, and we look back and recall the signs that we might have missed. Hind sight is always 20/20 but if you pay attention to slight changes in your behavior you might be able to better manage your mental health.

I was quasi depressed about a year ago. The quasi depression was written all over my body. I found myself wearing the same clothes everyday: torn jeans with a rotation of the same shirt just in different colors. I stopped keeping up with personal maintenance like waxing my eyebrows or plucking unwanted hairs. I was still getting out of bed and going to work every morning but I was miserable. I became isolative at work cause I didn’t want to deal with anyone and quite frankly, I felt like my poor co-workers were putting up with me cause they knew I suffered from depression, and just assumed eventually I would get out of it. Something as small as not washing your car or being anxious about picking up your phone are all signs of being in a quasi depression. I’d watch the same stupid shows over and over that I didn’t realize was a sign of depression until I got out of it and stopped watching them. I’m embarassed to admit I was hooked on junk food reality television and would never watch some of the shows that I repeatedly watched during that period of time in my life. You don’t have to stay in bed all day to be considered depressed. And in my experience being quasi depressed is almost worse cause, like I said, you don’t realize it occurred until you’re out of it and you can look back and say wow, that was a form of depression. In my experience quasi depression is worse than a full blown one, primarily cause when it is not blatantly obvious, we might not know how to treat it properly.

Be mindful of the little signs of being slightly depressed. Depression hurts but it can hurt more if you don’t even know you are in it, and looking back is no fun bu,t at the very least, you’ll know to watch for signs should you find yourself in a quasi depression sometime down the line.

7 Myths of Depression

Depression is often viewed as the “common cold” of mental disorders, because it is so prevalent in our lives. The lifetime prevalence of depression suggests that more than 1 in 9 people could be diagnosed with the disorder at one point in their lives. And unlike some other mental disorders, depression affects virtually every aspect of what you do and how you interact with others. Every year, it wreaks havoc in millions of Americans’ lives, especially amongst those who believe it is something you should just “get over” on your own.

Here are seven common myths about depression, and the facts that answer them.

1. Depression means I’m really “crazy” or just weak.

While depression is indeed a serious mental disorder, it is no more serious than most other mental disorders. Having a mental disorder doesn’t mean you’re “crazy,” it just means you have a concern that is negatively impacting how you live your life. Left unaddressed, this concern can cause a person significant distress and problems in their relationships and life. Depression can strike anyone, at any time — whether you’re “weak” or strong, it knows no bounds. Some of the strongest people I’ve met are people who’ve coped with depression in their lives.

2. Depression is a medical disease, just like diabetes.

While some pharmaceutical-influenced marketing propaganda might simplify depression into a medical disease, depression isnot — according to our knowledge and science at this time — simply a pure medical disease. It is a complex disorder (called amental disorder or mental illness ) that reflects its basis in psychological, social, and biological roots. While it has neurobiological components, it is no more of a pure medical disease than ADHD or any other mental disorder. Treatment of depression that focuses solely on its medical or physical components — e.g., through medications alone — often results in failure. Get to know the risk factors for depression.

3. Depression is just an extreme form of sadness or grief.

In most cases, depression is not just ordinary sadness or grief over a loss. If it were ordinary sadness or grief, most people would feel better just over time. In depression, time alone doesn’t help, nor does willpower (“Pull yourself up and stop feeling so sorry for yourself!”). Depression is overwhelming feelings of sadness and hopelessness, every day, for no reason whatsoever. Most people with depression have little or no motivation, nor energy and have serious problems sleeping. And it’s just not for one day — it’s for weeks or months on end, with no end in sight.

4. Depression just affects old people, losers and women.

Depression — like all mental disorders — does not discriminate based upon age, gender, or personality. While generally more women than men are diagnosed with depression, men suffer for it all the more since many people in society believe that men shouldn’t show signs of weakness (even a man’s own upbringing may reinforce such messages). And while aging brings many changes in our life, depression is not a normal part of the aging process. In fact, teenagers and young adults grapple with depression just as much as seniors do. Some of the world’s most successful people have also had to deal with depression, people such as Abraham Lincoln, Theodore Roosevelt, Winston Churchill, George Patton, Sir Isaac Newton, Stephen Hawking, Charles Darwin, J.P. Morgan and Michelangelo. So being a loser is not a prerequisite to being depressed.

5. I’ll have to be on medications or in treatment for the rest of my life.

While some doctors and even some mental health professionals believe that medications may be a long-term solution for people with depression, the truth is that most people with depression receive treatment for it for a specific period of time in their lives, and then end that treatment. While the exact amount of time will vary from person to person based upon the severity of the disorder and how well the various treatments may work for each individual, most people who have depression do not need to be on medications for the rest of their lives (or be in treatment for the rest of their lives). In fact, a lot of research suggests that most people can be treated for depression successfully in as little as 24 weeks with a combination of psychotherapy, and if needed, medications.

6. All I need is an antidepressant to treat depression effectively.

Sorry, no, it’s not as easy as popping a pill. While certainly you can have an antidepressant medication quickly prescribed to you by your primary care physician, you’re unlikely to feel any beneficial effects from that medication for 6 or more weeks in most cases. In two-thirds of patients, that first medication won’t even work! Combined psychotherapy treatment with medication is the recommended gold standard for the treatment of depression. Anything else is going to be significantly less effective, meaning most people will suffer with their depressive symptoms longer than they need to.

7. I’m doomed! My parents (or grandparents or great uncle) had depression, and isn’t it inherited?

While in the past there’s been research to suggest the heritability of depression, more recent studies have called into question how much of depression really is genetic. The upshot? While researchers continue to explore the neurobiology of mental disorders like depression, having a relative with depression only marginally increases your risk for getting depression (10 to 15%). Remember, too, that relatives impart a lot of their own coping strategies upon us in our childhood development — strategies that may not always be the most effective when dealing with things like depression (making one more vulnerable to it).

To hell and hopefully…eventually back??

It’s been one HELL of a month, and what I mean by hell is I have felt like hell, my life has been hell, my mood has been hell, and everything went to hell. I’ve been in a deep depression since the beginning of March about. I’ve barely done anything but lay in bed, sleep, and sit on the couch in the living room staring at the wall. My depression has been so bad that suicide has become an issue again. On top of the depression, my anxiety has been atrocious, some days I have up to 3 full blown panic attacks, I take my Ativan but sometimes that’s not even enough so I have learned that using my Cpap helps with managing my breathing which means more time in bed but if it works I don’t care. Now even on top of that my hallucinations have been wreaking havoc on my life as well. The usual 7 people, 6 voices, and now I’ve acquired a lion, a snake, an elephant, and a little monkey. So imagine all this going on at one time. That is my definition of hell. There are some days that all I can think about is killing myself but the one thing that stops me is not wanting to hurting anyone. 2 weeks ago I went to the ER because I was suicidal and they turned me away because, “she seemed fine” but they obviously don’t get it. I go to see my therapist this morning to see what we should do now, I’m running out of options and I’m running out of patience. I want to get better, get back to feeling good but I’m beginning to think that’s never going to happen. It’s extremely hard having an illness that you know you will have to live with and deal with for the rest of your life, it makes things seem a little less hopeful that I will ever have the “normalcy” that I’ve always yearned for. 

5 Essential Remedies for Treating Depression: Coming Back from the Brink

Graeme Cowan suffered through a five-year episode of depression that his psychiatrist described as the worst he has ever treated.

Part of his recovery involves helping people build their resilience and mental fitness as the Director of R U OK? In his book, Back From the Brink: True Stories and Practical Help for Overcoming Depression andBipolar Disorder, he offers advice gleaned from interviews with 4,064 people who live with mood disorders.

He asked the respondents to rate the treatments they had tried and how much each had contributed to their recovery. Here’s what he found.

The following were the top eleven most effective treatments:

  • Supportive psychiatrist
  • Supportive psychologist
  • Support group, emotional support of family and friends
  • Vigorous exercise
  • Psychotherapy
  • Fulfilling work, paid or voluntary
  • Sleep
  • Cognitive-behavioral therapy (CBT)
  • Electroconvulsive therapy (ECT)
  • Reducing intake of alcohol and other non-prescription drugs
  • Belief in God, spirituality, religion

Other helpful treatments include:

  • Mindfulness-based cognitive therapy (MBCT)
  • Acceptance and commitment therapy (ACT)
  • Hobbies, such as gardening, pets, or music
  • Massage
  • Yoga/meditation
  • Medication
  • Relaxation
  • Good nutrition
  • Keeping a gratitude journal
  • Acupuncture

Cowan then categorizes the effective approaches into five major themes:

1. Emotional Support

We are social creatures who crave empathy and connection. That’s why emotional support, reassurance, and compassion from psychiatrists, psychologists, support groups, and family and friends dominate the top ten effective strategies. Cowan’s findings indicate that the emotional support and reassurance provided by psychiatrists and psychologists is judged more important than their treatments, which concurs with previous studies that have shown that the quality of the relationship between a clinician and patient is the best predictor of a successful outcome.

2. Psychological Treatments

Some psychological treatments that were listed as effective: psychoanalysis, counseling, cognitive behavioral therapy, mindfulness-based cognitive therapy, interpersonal therapy, acceptance and commitment therapy, and letting go of unrealistic goals.

3. Lifestyle Strategies

Both vigorous exercise (equivalent of running for 30 minutes 4-6 days per week) and moderate exercise (equivalent of walking for 30 minutes 4–6 times per week) were rated as very effective. Other helpful lifestyle approaches include: getting a good night’s sleep, being able to relax, doing meditation or yoga, engaging in hobbies, getting massages, and reducing intake of alcohol and recreational drugs.

4. Fulfilling Work

Cowan credits his fulfilling work — offering hope to persons stuck in depression — as one of the most powerful tools he uses to stay well. “I experienced personally the benefits of doing voluntary work in my own recovery,” he writes. “My voluntary work involved placing discouraged people (new migrants or people rehabilitating from physical or mental illness) into volunteer positions with charities. I saw how the work lifted their self-esteem and confidence.”

Fulfilling work was rated more highly than cognitive-behavioral therapy, which is often considered a highly effective depression treatment. Cowan cites the Gallup poll that found that only 20 percent of employees like what they do, but that people with a high career well-being were more than twice as likely to succeed in life overall. Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, and many other positive psychologists believe that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression.

5. Prescription Medications

The results of Cowan’s surveys found that, while prescriptionmedications can play a vital role to recovery from depression and bipolar disorder, they should not be relied on as the sole strategy. Pharmacology is still in its infancy. A drug that works wonders for one person might not do anything for another except give her a dry mouth and nausea. Cowan writes: “This stresses the importance of working with a doctor who’s highly experienced in successfully treating mood disorders.”

6 Famous People with Depression Who Inspire Me

When a famous actor/actress, politician, or prominent figure of any kind risks ridicule to discuss their mood disorder, the world stops to listen.

For as long as his or her face graces the cover of a glossy magazine or the TV interview runs, folks seem to appreciate the sweat and suffering that those with depression andbipolar disorder endure as part of their illness.

I know that for me, I certainly listen to their stories, empathize with them, and take away lessons that I can use in my own recovery from depression and anxiety. Celebrities, for better or worse, can inspire us.

Here are just six of those celebrities that inspire me.

1. Rosie O’Donnell

What’s not to love about a celebrity who hangs herself upside down for 15 to 30 minutes a day to jumpstart her neurotransmitters (along with yoga and antidepressants) using inversion therapy? Seeing Rosie demonstrate it on “The View,” reading a teleprompter from a swing, made me laugh out loud at all the ways –some quite creative – we depressives use to treat our mood disorders.

2. Art Buchwald

Art Buchwald was unsure if he should go on Larry King Live in the early ’90s to discuss depression; the Pulitzer Prize-winning columnist didn’t want to become a poster boy for mental health. But he did it because the author William Styron had been a role model for him, and because he realized celebrities can play a role in helping depressed people. After that show (which received the most viewer reaction of any Larry King episode ever), Buchwald decided to speak about his depression whenever he received an invitation because it helped him as much as it did the millions of people listening to him.

3. Zach Braff

Actor and director Zach Braff loves it when people tell him that they relate to Andrew Largeman, the depressed character he played in the 2004 movie “Garden State” (which Braff wrote and directed), because in that role, he didn’t have to do much acting. Like his character — an actor confronting his demons when he heads home after his mother dies — Braff doesn’t hide under any celebrity image and isn’t afraid to be himself, he says, even if that self is very emotional and wears sweatpants all day.

4. Marie Osmond

Marie Osmond is one of the most sympathetic entertainers to speak about mental illness. “All I know is that anybody who goes through [depression], I have such incredible empathy,” the actress and singer said on “Larry King Live” in 2003. “I’m telling you that depression is…a very scary, dark place…you see no light.”

5. Brooke Shields

Brooke Shields had just released her book “Down Came the Rain” when I plunged into my most severe depression. My agent sent the book to me as a gift, wrapped in a ribbon. I read the title and wept. I read the back cover and cried some more, feeling as though this actress-model was giving me permission to bawl my eyes out. “Sitting on my bed, I let out a deep, slow, guttural wail,” she writes. “I wasn’t simply emotional or weepy …. This was something quite different. This was sadness of a shockingly different magnitude. It felt as if it would never go away.”

6. Kay Redfield Jamison

As a healer and a patient, Kay Redfield Jamison understands depression and bipolar disorder from every possible angle. Compassionate, wise, and articulate, she speaks from someone who has experienced the sheer terror and heartbreak of a mood disorder firsthand and as a knowledgeable clinical psychologist. My two favorite lines about depression come from her classic book, “An Unquiet Mind”: “tumultuousness, if coupled with discipline and a cool mind, is not such a bad sort of thing. That unless one wants to live a stunningly boring life, one ought to be on good terms with one’s darker side and one’s darker energies.”

Can You Choose Happiness?

The concept of choosing happiness can be an incredibly controversial topic. For anyone who has experienced distressing experiences like anxiety, depression, addiction, chronic pain, trauma or a stress-related medical illness, to say “choose happiness” can appear shaming. When conditions are genetic or biological nature, there is no choice and pain is inevitable. However, while we can never change what happens to us in any given moment, with awareness, we can choose how to respond to it.

Let’s take a closer look at what “choose happiness” can mean and how it may be the most powerful phrase we know to change lives.

First we have to ask ourselves, what is happiness? Some people define it as feeling satisfied with life and having a good mood (subjective well-being), while others find it to be related more with deep meaning and feeling connected (psychological well-being).

In my opinion, to “choose happiness” and to “choose love” are synonymous and not only possible, but essential to real happiness. Real happiness is not about the grin we wear on our face, it’s about learning how lean into loving ourselves and others in the good times and in the bad.

For example, I may be in a downward spiral of depression, but the moment I am aware of this is a choice point. In that choice point I might bring myself to the shower instead of staying in with the covers over my head. I may get outside to exercise or call a friend instead of eating that extra pint of ice cream. This may not put a giant grin on my face, but I am leaning my mind and action toward loving myself. This to me is choosing happiness over depression.

I may be riddled by automatic negative thoughts, but choose to put up the stop sign, engage in a brief mindful check-in and then apply a more self-compassionate break. Here is a good example from Kristin Neff, PhD:

  1. This is a difficult moment
  2. Life is full of difficult moments
  3. May I be kind to myself, May I find freedom from these negative thoughts, May I love myself exactly as I am, May I be happy.

I may have just made a huge parenting mistake, yelling at my kid for yelling in the house. When I become mindful of this at first guilt and shame may overtake me with thoughts such as, “What is wrong with me” or “What a terrible parent I am.” To choose happiness here means to recognize this as a difficult parenting moment and to also recognize the common humanity behind difficult parenting moments and mistakes. Then I might say to myself, “May we all find peace with our imperfections.” With this awareness, I can go back to my child and apologize showing my child that I can be responsible for my own mistakes and this may even bring us closer.

Choosing happiness doesn’t mean putting a happy mask on. In fact, you can choose happiness and still feel deep emotions of sadness, grief, guilt, shame or anger. But it is all about how you respond to it once aware.

It simply means choosing love for ourselves and others.

What would the days, weeks and months ahead be like if there was more love in your day?

With this definition in mind, you can choose happiness and why not choose happiness moment-to-moment.

Depression in Men and Women

In my previous post, I wrote about depression, the signs and symptoms and treatment options. In this post, I will discuss how depression looks different for men and women. Being aware of the differences is important in order for the problem to be recognized and to get the proper help. “While the symptoms used to diagnose depression are the same regardless of gender, often the chief complaint can be different among men and women,” says Ian A. Cook, MD, the Miller Family professor of psychiatry at the University of California–Los Angeles.

Depression in Men: In men, depression is overlooked because they may think that it is a sign of weakness. They deny depression because they usually believe that they need to be strong and in control of their emotions. And in American culture, expressing emotions is usually considered  a feminine trait. Depression in men can also be traced to cultural expectations.  Men are supposed to be successful or have control over their emotions. These cultural expectations can cover up true depression. Depression in men can be overlooked because they usually do not talk about their feelings. Instead, they talk about the physical symptoms that accompany depression such as fatigue, pain, or difficulty concentrating. This can lead to depression being untreated which can lead to negative consequences, such as suicide. Men can experience depression in different ways to women. A man can become irritable, aggressive, drinking more than usual, or overworking. A man can deny his feelings and hide them from others.

There are three common signs of depression in men:

Pain: Backaches, headaches, or sleep problems that do not respond to normal treatment.

Anger: Can lead to irritability, loss of humor, road rage, short temper, or aggression. Can also lead to abusing their wife or becoming controlling.

Reckless behavior: Engaging in risky activities such as driving too fast, having unprotected sex, abusing drugs, or gambling.

There is no single cause for depression in men. Lifestyle changes, stress, biological and psychological causes, lack of social support, anything that makes them feel useless, alone, or hopeless can trigger depression.

Treating Depression in Men:

Don’t try to tough out depression on your own. There is help such as therapy and medication. You could also make lifestyle changes such as exercising, eating well, building a social network, joining a support group, and reducing stress.

There is treatment for depression. What works for one person may not work for another and no one treatment is appropriate in all cases. The best approach involves:

support: talking to someone about how you feel can be great help. The person you talk to needs to be a good listener. Having a strong support system can speed your recovery. Reach out to others, because being alone can make depression worse.

lifestyle changes such as exercise, eating healthy, learning to manage stress, relaxation techniques and challenging negative thoughts can help alleviate depression. I mentioned some relaxation techniques under my post Natural Ways to Cope with Panic and Anxiety Attacks.

balancing emotions: learning how to recognize stress and expressing your feelings and emotions can make you more resilient.

professional help such as talk therapy or medications can help. Therapy can give you tools to treat depression and can give you skills to prevent depression from coming back. 

stock-photo-depressed-woman-sitting-on-floor-isolated-on-black-background-138150662Depression in Women: The causes of female depression and symptoms  are different than from men. There are a number  of theories that explain why women have a higher incidence of depression such as biological changes, hormonal changes and psychological causes:

Premenstrual problems:Hormones fluctuate during the menstrual cycle often causing premenstrual symptoms (PMS). For some women the symptoms are mild, but for others it is severe enough it cause disruption in their lives. Often the diagnosis of premenstrual dysphoric disorder (PMDD) is made.

Pregnancy:Hormonal changes that occur during pregnancy can contribute to depression, especially if you are already at high risk.

Postpartum depression: This is a normal reaction that subsides within a few weeks but for some women it can be severe and can last for a long time. This is also believed to be influenced by hormonal changes.

Health problems: Chronic illnesses and or disabilities can lead to depression.

Negative feelings: Women tend to ruminate when they are depressed which makes the depression worse. Men tend to distract themselves which can reduce depression.

Overwhelming stress: Women tend to develop depression from stress and produce more stress hormones than men do.

Below is a table taken from author Jed Diamond. It shows the differences between men and women depression:

Differences between male and female depressionWomen tend to:Men tend to:Blame themselvesBlame othersFeel sad, apathetic, and worthlessFeel angry, irritable, and ego inflatedFeel anxious and scaredFeel suspicious and guardedAvoid conflicts at all costsCreate conflictsFeel slowed down and nervousFeel restless and agitatedHave trouble setting boundariesNeed to feel in control at all costsFind it easy to talk about self-doubt and despairFind it “weak” to admit self-doubt or despairUse food, friends, and “love” to self-medicateUse alcohol, TV, sports, and sex to self-medicateAdapted from: Male Menopause by Jed Diamond

Treating Depression in Women:

Treatment is the same as everyone. You can refer to my previous post, Not Just the Blues for more information on treatment options or refer above to Treating Depression in Men.

Depression is common and treatable. The goal to recovery is to start small and take things one day at a time. Feeling better takes time, but you get to feeling better by making positive choices for yourself. Talking to someone, seeking help and having a positive support system is also essential in the treatment for depression. Don’t deny your feeling or symptoms. It is important to listen to how you feel and get the proper treatment for recovery.

Newly Diagnosed? What You Need to Know About Depression

This new monthly series reveals tips and insights for individuals recently diagnosed with a mental illness. Future pieces will cover everything from anxiety to bipolar disorder.

Depression is a serious, debilitating illness that’s also one of the most commonly-diagnosed mental disorders. When you’re first diagnosed, you may feel both relief (finally, a name for your pain) and overwhelmed (what the heck do you do next?).

Below, two psychologists who specialize in depression reveal what you need to know about the illness and how to get better.

Make Sure You’re Properly Diagnosed

“Make sure that you’re not leaving with a diagnosis in minutes after meeting a professional,” said Deborah Serani, PsyD, a clinical psychologist and author of the books Living with Depression andDepression and Your Child.

“[M]any medical conditions can mimic, worsen or cause depressive symptoms,” so it’s important to rule those out and have a thorough evaluation, said Lee H. Coleman, Ph.D., ABPP, a clinical psychologist, author of Depression: A Guide for the Newly Diagnosed and assistant director and director of training at the California Institute of Technology’s student counseling center.

Serani agreed: “An evaluation for depression should involve a thorough medical exam, a series of blood and urine tests, and then an assessment from a mental health professional that specializes in mood disorders.”

Also, be honest with your providers about your symptoms and habits, including any substance use, Coleman said.

If your provider diagnoses you with depression, ask them why they think this, and what alternative diagnoses they’ve considered, he said. “A competent healthcare professional will respond to your question respectfully and should even be glad that you asked. She should explain her thinking to you in a way that you understand.”

If you’re still unsure about the diagnosis, get a second opinion.

Depression is Highly Treatable

In the beginning, many people with depression think they’ll feel this terrible forever and they won’t get better, Coleman said. However, “Research clearly shows that depression is very treatable.”

Both psychotherapy and medication are effective for moderate to severe depression. “For milder forms of depression, research shows that talk therapy is extremely helpful,” Serani said.

She uses medication as a last resort with her clients. If a client’s depression isn’t significantly improving in several weeks, she suggests exploring medication.

According to Coleman, there are many types of therapies that can help. For instance, cognitive-behavioral therapy helps clients recognize and challenge negative ways of thinking, and change behaviors that inadvertently exacerbate or perpetuate their depression.

When picking a therapist, inquire about their track record with treating people with depression, he said. Also, it’s critical to have a trusting relationship with your therapist and a clear understanding of the goals you’re working on, he said. (“Therapy shouldn’t be mysterious.”)

“The goal is to find what combination of treatments work best foryour depression, and then create a treatment plan that makes it successful,” Serani said. It’s also important to remember that you and your providers are a team. Be an active participant in your treatment, speak up, ask questions and voice any concerns.

Know Your Medication

If you’re trying medication, make sure you’re clear on the specifics. Coleman suggested asking what you can expect the medication to do; how long it typically takes to notice improvement; what kinds of side effects may occur; and how long you may have to take the medication.

Also, ask your doctor if they’re starting with the lowest dose, instead of an “average” dose, Serani said. “Different metabolisms influence the therapeutic effect of antidepressants, so beginning low and adding over time is the best way to determine which dosage benefits you.”

She also suggested asking about the best time of day to take medication (e.g., taking medication before bed helps you “miss” side effects such as headaches, stomachaches and fatigue “because you sleep through them”); and how to discontinue the medication. Having a plan is key because abruptly stopping antidepressants can trigger side effects, she said.

And “ask how to get in touch with your healthcare provider if you start to notice any problems, side effects or worsening symptoms,” Coleman said.

Treatment Takes Time to Work

Whether you’re taking medication or seeing a therapist (or both), it takes about a month to see improvement, Coleman said. If you’re going to therapy, you should experience a reduction of serious symptoms, such as suicidal thinking, hopelessness and helplessness, within weeks, Serani said.

Antidepressants typically take four to six weeks to relieve symptoms, she said. If you’re not getting better after six weeks, talk to your provider, Coleman said. “Sometimes you might need to change the focus of therapy slightly, or your psychiatrist might want to talk with you about trying a different medication if the first one isn’t working well.”

If you think your symptoms are getting worse, talk to your provider right away, he added.

(It can take time to find the best medication. About 40 to 50 percent of people don’t respond to the first antidepressant they try. Here’s more on what to do when your first treatment isn’t working.)

Monitor Your Symptoms in the Future

Having one episode of depression increases your likelihood of having another episode. So it’s important to monitor your depressive symptoms in the future, Coleman said.

“I liken it to someone with diabetes needing to monitor their blood sugar even if they’re feeling fine.” Talk to your provider about the signs of recurrence, he said.

Be Self-Compassionate

Depression sinks your self-worth. But compassion is crucial, Coleman said.

“If one of my clients had a broken leg in a giant cast, they pretty obviously wouldn’t expect themselves to run a marathon. Because depression isn’t outwardly visible like a broken leg or a cast, though, it’s easy to want to bully ourselves into ‘toughening up’ and ‘snapping out of it.’”

However, this approach just makes you feel worse — and guiltier, he said. Instead, think of it like having the flu: “you’re expected to stay home for a little while and get better, and nobody would think that you’re weak or lazy for doing that.”

Remember that you’re struggling with an illness, and the best thing you can do is to focus on getting better and being kinder to yourself.

I know depression #DayOfLight

Brave.

I hear that word a lot. You think it’s brave that I write this blog. You think it’s brave that I have come out of the “bipolar closet.” You find my honesty akin to bravery.

Thank you for that, but it doesn’t always feel brave. It feels intimidating and vulnerable and uncomfortable a lot of the time. But I do it because I know I am not alone. You’ve reached out to me, dear reader, and told me so.

Today is the “Day of Light,” a day where bloggers everywhere share their experiences with depression. I’ve talked about depression on “Being Beautifully Bipolar” before, but let’s delve a little deeper.

Depression and I are old friends. Quite old. We got to know each other before any of my best friends were my best friends. I took my first antidepressant in 2000 – well over a decade ago. That was in college during my junior year. I was tired and I was irritable and I isolated myself.  I remember what a glorious feeling it was to graduate college because there was a time I didn’t know if I’d make it. I didn’t know I was beautifully bipolar at the time, perhaps because I hadn’t reached a state of full-blown mania or psychosis yet. Looking back I see signs, but for a long time it was just me and my unlikable friend, Depression.

Depression is a hole and it wants to suck you in. It craves all your attention until there is none left for anything else. Depression is an ache in your bones, a weariness. I have spent more days and nights than I care to remember thinking of ways to die. That’s what Depression does. It is a robber – of time and love and relationships and excitement. It is a robber of life.

Depression starts as a day spent in bed that turns into another then another and another after that until soon it has been a week since you’ve showered. Do you know how heavy a toothbrush is? That hairdryers were made for people who aren’t friends with Depression? I do.

I do.

But here’s the best bit, the good bit, the bit I hope you’ve read far enough to reach – it gets better. Depression is treatable. There are medications. There are lifestyle choices like getting enough exercise and plenty of sleep that can really, truly help. I know when you’re “in it” it feels suffocating and like you will never be well again and quite frankly, you don’t care if you are ever well again, you just want to make the aching stop. Now here’s where YOU get to be brave. You have to hang in there for the next ten minutes, then the next hour, then the next day and soon, inevitably Depression will walk out of your life.

I still deal with Depression. He comes to visit – uninvited – from time to time. And the world turns dark despite the shining sun. But I’ve learned just as he comes, so too will he go. I just have to hang in there because tomorrow could always be a better day.

Bipolar Disorder and Winter Depression: I Am Seasonally Affected

I live in the Sunshine State.

It is mid-January, and the high temperature will peak at around 55 degrees Fahrenheit today.

This is cold for Floridians. We take advantage of the sun and warmth we experience most days of the year.

Even though Winter in Florida is a stark contrast to the snow, darkness, and bitter cold that is experienced in many parts of the United States, mood patterns would suggest that I am still affected by this season.

I have been admitted to a psychiatric hospital three times, and all three of those times, it was Winter–December, January, February.

My online mood trackers show that my depression, exhaustion, and irritability causes me more trouble in the Winter than the warmer months of the year.

People often tell me that seasonal mood issues don’t exist in tropical parts of the US like Florida.

I would beg to differ–there is still a pattern here. Winter in Florida is much different from Summer in Florida. We still notice a difference, and I think our brains do too.

It is common for mood issues to wax and wane with bipolar illness, but it is very true that light and temperature can be a triggering factor.

Studies on seasonally-affected bipolar disorder have been conducted in more mild, light-fluctuating areas like the Northern US, but also less light-fluctuating areas like Catalonia, Spain.

There is evidence that some bipolar patients are seasonally-affected, no matter what the geographical location.

The positive side is that seasonal patterns can help clinicians predict when patients with bipolar are likely to become ill.

At these times, medications may need to be adjusted.

If you see a pattern in your moods that might be affected by the seasons, consider talking about it with your clinician. Any mood charts or patterns you provide your doctor are extremely helpful in deciphering course of treatment.

It is just as important for patients with bipolar to monitor their triggers as it is for doctors to find issues and treat them.

Treatment for bipolar requires thinking outside of the box, finding repeat issues, and most of all, a team effort.

Now that I’ve discovered this seasonal pattern, I’ve found the following things helpful:

  • Reminding myself I get more depressed during this time of year, and it will get better.
  • Bringing up any patterns I find with my treatment team.
  • Being cognizant that I have to be even more sensitive to self-care during the Winter.
  • Renewed commitment to using software and other tracking methods to find additional patterns–because I know they exist somewhere.

Not every person with bipolar is seasonally affected, but I have discussed the phenomenon with many of my peer consumers, who have also noticed patterns during the colder, darker months.

Bipolar disorder creates a heightened sensitivity to changes in environmental factors.

I am not surprised at all that changes in weather affect my bipolar symptoms.

Are you affected by the change in seasons? A certain season? How does it affect you? What do you do to help yourself stay well?