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IMPORTANT INFORMATION.

By reading this site, the reader acknowledges their personal respnsibility in choices for mental health for themselves and their children, and agrees that the AYCNP or anyone associated with this site, bears no responsibility for one's personal decisions in choices for mental health. Anyone coming off medication should do so gradually rather than abruptly, and under a doctor's supervision. Anyone experiencing thoughts of suicide should seek support.


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Page last updated: August 3, 2009

Help for Depression

Depression: Description, symptoms, solutions.
Positive non-pharmaceutical self help and professional solutions.

12% of women (nearly 12 million women) in the United States are diagnosed with depression compared to 7% of men (over 6 million men). Mild depression can be differentiated from clinical depression, which includes major depression, dysthymia and bipolar disorder. (University Health Services Tang Center Berkley, CA).

There are many factors that can contribute to  what is referred to as unipolar depression, that is depression without any bipolar symptoms. A genetic predisposition can play a role. While there is often much discussion about "chemical imbalance" and its role in depression, really, this simple theory has not held up under closer scrutiny.
See this page for more information and graph.

Lifestyle changes and learning positive coping skills can help in overcoming depression
You can overcome depression.
Never give up!
Photo: Hendrike, 2004.

Depression and Television
There appears to be a link with much time watching television and depression. Cutting back on, or doing with televsion, then, may be one positive step in overcoming depression. The authors of the study liken television to an opiate, which provides immediate pleasure at the expense of long term happiness and good mental health.

Study: University of Maryland, (2008). Science Daily.

Depression and lifestyle changes
While one might think of depression in terms of something akin to catching a cold, coming on for no apparent reason, there are, in reality, usually reasons why someone might become seriously depressed.

Depression Self Help:

Lifestyle changes
can make a big difference in terms of "curing" depression, for many persons. Much has been said about diet and nutrition, and for some, this is something that might need attention. Children and teens might often skip breakfast, at times, breakfast in public schools (as has been true in Newark, NJ public schools), is no more than a pop tart and juice. Hardly adequate for a rapidly growing teen or child. Some children or teens might skip both breakfast and lunch, and at times, lunches at school are also seriously lacking in terms of nutrition.

For adults, changing habits in smoking and alcohol consumption can also result in positive affect. Persons who suffer from mental illness of any sort, or any mental health difficulties, need to give serious thought to doing without alcohol, which is a depressant.

Adults, too, need to give attention to diet. Good nutrition can make a positive difference in reducing symptoms of bipolar disorder and depression. Low sugar, low carbohyrdate diet is the best. Keep refined carbohydrates out of your diet as much as possible, in addition to the suggestions above. Eat a steady three meals a day. Some who suffere with depression rarely have three nutritious meals, including breakfast, daily.



More Depression Solutions

Green Therapy has proven to be more effective for some, than antidepressants, that is, getting out in the outdoors regularly, along with a little exercise.

Help for Depression
Exercise: A natural remedy for depression.

Exercise
is something that has found to help all forms of depression. One Duke Universtiy study indicated that, for mild and moderate depression, regular moderate exercise was more effective than medication both in terms of short term improvement and in long-term results, recurrence rate.

Another study, published in the Archives of Internal Medicine in 1999, divided 156 men and women with depression into three groups. One group took part in an aerobic exercise program, another took the SSRI sertraline (Zoloft), and a third did both. At the 16-week mark, depression had eased in all three groups. About 60%?70% of the people in all three groups could no longer be classed as having major depression. In fact, group scores on two rating scales of depression were essentially the same. This suggests that for those who need or wish to avoid drugs, exercise might be an acceptable substitute for antidepressants. Keep in mind, though, that the swiftest response occurred in the group taking antidepressants, and that it can be difficult to stay motivated to exercise when you?re depressed.

A follow-up to that study found that exercise?s effects lasted longer than those of antidepressants. Researchers checked in with 133 of the original patients six months after the first study ended. They found that the people who exercised regularly after completing the study, regardless of which treatment they were on originally, were less likely to relapse into depression.

A study published in 2005 found that walking fast for about 35 minutes a day five times a week or 60 minutes a day three times a week had a significant influence on mild to moderate depression symptoms. Walking fast for only 15 minutes a day five times a week or doing stretching exercises three times a week did not help as much.
(Harvard Mental Health Letter).

Cognitive behavioral therapy has been found to be as effective as medication in terms of both short and long term results, as a whole. When combined with other lifestyle changes, it can prove to be all that is needed for the vast majority suffering with depression.

Additionally, American culture is high on both media time and media violence. Violence is evident in most movies that we have grown accustomed to, from Rambo and Jaws, Star Wars to Chucky. Television cartoons for children, and much in the TV sporting world, focus on violence and action violence, which can produce a high and low effect in mood. That is, when watching such programming, the mind is stimulated, afterwards, it suffers from a corresponding low.

Joel Robertson, Ph.D. of Saginaw, MI, in his book Natural Prozac, documents the affect that music can have on mood. Music that is intense, of any type, can have a similar roller-coaster affect on the mood of some persons.

Pornography can cause some to suffer from depression as can isolation, too much time spent alone. We all need loving attachments, meaningful relationships with others, as well as a purpose in life and purposeful work. This contributes to good mental health and the absence of these can contribute to depression.

Some who have been abused as children have experienced relief from depression after being able to talk to sympathetic listeners about their experiences over an extended period of time. There needs to be healing from abuse, and this is true of adults or teens who may be abused by spouses or others.



Antidepressants: Why medication is over-prescribed for depression Therefore, there is much that can be done to overcome depression before one needs to consider the idea of taking medication. Many thoughtful psychologists and even psychiatrists, have stated that they recommend medication only as a very last resort, rather than a first line treatment. And really, one needs to be a little naive to believe that the marketing and lobbying efforts of multi-billion dollar pharmaceutical industry has not influenced the current practice of using pharmaceuticals as the first-line treatment for millions who suffer from depression.

Drugs for depression address symptoms but do not address the "illness".

In considering the thought of the role of a "chemical imbalance" and depression, what is being measured is the chemical nature of the mind itself after the thoughts have been established. In other words, we are considering as much the effect as we are the cause.  

It is generally agreed by serious psychiatrists and those in the mental health professions that medications are, in general, treating and addressing symptoms, but they are not in any way curing an "illness". This thought is well documented. Martin S. Willick, M.D., a practicing psychiatrist in New Jersey, USA, and a co-host of a recent (April 2009) meeting on mental health at Columbia University stated that we know that "medicine addresses the symptoms but does not treat the disease." This is a statement reflective of the current evidence on the limits of psychiatric medications.

More on the medical model and holisitic models of psychology, moods and behavior.



Dysthymia:

Diagnosed when a person is depressed mood for most of the day, most days, and at least two other depressive symptoms, but not of sufficient persistence or severity to be considered major depression. No manic or hypomanic episodes.

Green Therapy, time spent outdoors enjoying nature, positively affects depression as reported in some clinical studies

Symptoms of Depression or Major Depression

One or more major depressive episodes in absence of any manic or hypomanic episodes. Symptoms consist of a prominent and persistent depressed mood or loss of pleasure for at least two weeks, accompanied by four or more symptoms such as poor appetite, insomnia, psychomotor retardation, fatigue, feelings of worthlessness or guilt, inability to concentrate, and thoughts of death or suicide.

If a person is depressed but experiences less than four of these symptoms, is not having feelings of suicide or of hurting oneself, then the depression would not be considered major depression but mild to moderate depression.

Antidepressants help about 45% of those who take them, at least for the short term. There is also evidence that there is a strong placebo response, which some interpret as giving evidence that SSRI's are statistically comparable to placebos in their positive effects. In all likelihood, antidepressants do help some to make short term gains. However, over half who take antidepressants do not make significant gains from taking antidepressants alone.

Additionally, antidepressants increase the rate of suicdality two-fold, in groups from childhood until the age of 24, and in seniors. It does not seem to increase suicidality in those from the age of 25 to the mid-50s. The rate increase from 2% to 4% on antidepressants.

For this reason, the FDA requires that antidepressants carry the strongest warning possible, other than removing the drug from the market, a black box warning, so that those using antidepressants can be aware of this affect from antidepressants. (FDA off-site link)

At the same time, it is also acknowledged that depression that goes untreated can carry a risk factor. Depression, especially when it is deep or long-term, does need attention. What many don't realize, though, is that there are options in treatment. The greatest need in treating depression or in finding help for depression is getting support. This can come in many forms, but some do need professional support. Those who isolate themselves or don't seek any type of support, can put themselves at risk. So, it is important to talk to qualified persons for support when one is in depression. This alone can be of value, and it can be a protection, in the case of those who might be suicidal. On the other hand, it is possible for many to find professional support which does not necessarily need to be in the form of pharmaceutical treatment. A non-pharmaceutical approach can be effective for many.

New Link & Study: SSRI Antidepressants 'Clinically Insignificant' For Most People - Off-site link

Music and mental health

Most persons  feel sad at times, but in major depression, it is intense and of long duration, causing difficulties in functioning day to day.

The University of Arkansas Medical Department states, as for most mental disorders, that research indicates there is no single cause of depression, but that it results from complex interactions among multiple factors.

Biological, genetic, neurophysiological, hormonal. Cognitive distortions, poor coping skills, problematic interpersonal relationships, poor social support, and stressful life experiences can all contribute to depression. A history of abuse can also result in depression as well.


Some  factors that can contribute to depression:

  • Stressful life events
  • The loss such as the death of a loved one.
  • Romantic losses
  • A promiscuous lifestyle for some can contribute to depression.
  • Current or former substance abuse.
  • Some studies suggest that "chronic strains," ongoing relatively low-key  stressful situations may lead to depression in some
  • Several stressful situations coming in a series can also lead to depression such as a romantic relationship, doing poorly on a test, losing one's job, a major family crisis, etc.
  • The thwarting of a major goal can contribute to depression for some.
  • Early parental loss can contribute to a predisposition towards depression in some.
  • Child abuse can contribute to a predisposition towards depression forsome.
  • Some physical conditions can lead to depression.
  • Having an abortion can result in depression for many women, and  surprisingly for men as well. See Psychology Today, May/June 2004. Sometimes that grief that comes as a result of abortion can be long-term.
  • Situations that lower self-esteem be a contributing factor
  • The need for a more healthy diet and exercise.
  • A genetic predisposition can also predispose certain persons towards depression, in conjunction with any of the above or other stressors.



Childhood Depression:

"A warm caring relationship with a parent or caring adult acts as a protective factor against depression. Young adults who have lost a parent before the age of 16 experience more depression and suicide attempts than those adults who came from intact families. Consistent nurturance from another adult, however, can lessen these negative reactions." Lillian M. Range, PhD. Children's Health.

Major Depression in a child:

The symptoms of Major Depressive Disorder, (MDD), or major depression, a child or teen must have experienced one or more major depressive episodes. This might be from 2 weeks to 1 year in duration and can be characterized by extreme sadness or hopelessness, thoughts about death or dying, loss of energy, inability to sleep, or concentrate. The same is true in the case of adults as well.

Experience of childhood depression symptoms: Roberto is 8 years old, he has lost interest in playing with his friends, he only sleeps after school. It is difficult to get him to eat a complete meal. His grades have slipped, his teachers say he doesn't talk or play with the other children and often looks sad. He has trouble sleeping at night and this has been a pattern for several months.       

Many of these self help skills can have a positive effect for both adults, teens and children.

One of the causal factors for depression can be child abuse which can take on many forms, both verbal, and physical as well as sexual. These are a possibility in both childhood and adult depression. Adults need to talk about these things, if they have taken place in the past, and children do as well. Healing and comfort is needed for emotional wounds of child abuse, more than anything else.



Depression and Diet for Children and Teens

Diet plays a role in depression. A healthy, nutritious diet, low in sugar in low in refined carbohydrates is needed for children and adults. Children need breakfast. Breakfast in school is often high in sugar and refined carbohydrates. Children need a healthy breakfast at home, before going to school. Some children are more sensitive, and this is true of adults as well. Some adults suffering with depression might eat only one meal a day, not necessarily nutritious.

Depression Causes-Media Violence

Excessive television and movies, and video games,can be a factor for some children, and adults, in both depression, ADHD, and other mental health disorders. For some experiencing mental health problems, it might be better to do without TV and movies completely. It is a measure that can be implemented for six months, to see if it does not contribute to better mental health in children or adults.

The stimulation with many action movies and the fast pace of television commercials, can correspond with a plummet in levels of key neurotransmitters, resulting in depression or even contributing to bipolar disorder. For children, cartoons and children's movies, Disney, etc, can be contributing to depression, for some children, and it might be an area that a parent can give attention to.

There is much violence on Television for children and young people today. Even Disney channel has some rather intensely violent (non-cartoon) programming for children and young teens.

The average child will:

  • Watch 4,000 hours of TV before they enter kindergarten.
  • Are exposed to 20 to 25 acts of violence per hour on Saturday morning TV programs intended for children.

See Adults and Children Act Against Violence website for more information. - off-site link

This can be true of music as well. For some, a steady auditory diet of radio rock and roll is too much for their minds. Dr. Joel Robertson’s advances the idea that music effects brain chemistry, and so the type and intensity of the music one listens to can lead to depression and other disorders in some persons, and some children.



Cognitive Behavioral Therapy and Depression

Psychology Today, July/Aug 2007 also recently wrote on the subject of depression and cognitive-behavioral therapy, summarizing a study on CBT and its positive effects on depression, demonstrating stating cognitive-behaviroal therapy has proven to be more effective than antidepressants in both the short and long-term benefits.

The reason is cognitive behavioral therapy works from the "top down," that is, it is getting right down to changing one's thinking, whereas, medication is working from the bottom-up, that is it is addressing symptoms, medicating symptoms, rather than helping to address any serious issues that need to be addressed in order to recover. Medication for depression is like the proverbial Chinese "handing a man a fish." It feeds him for the day, but you haven't given him anything to be self-sufficient in the long-term.

An analysis of major studies on the effectiveness of medication and cogntive-behavioral therapy in treating depression revealed that, in the majority of cases, cognitive therapy was as effective as medication in the treatment of major depression, some studies showing a slight advantage to cognitive therapy over medication. DeRubeis, R. (1997, May). A second group of researchers reached similar conclusions. (Cris-Cristoph, 1996).

Cognitive-Behavioral therapy emphasizes the effects of thoughts on behavior along with performance-oriented focus. Two main themes in cognitive-behavioral therapy are:

1. cognitive processes influence emotion, motivation, nd behavior; and
2. the use of cognitive and behvior-change technique in a prgmatic manner.

Therapy sessions are often accompanied by homework sessions and assignments. The therapist and the client work together to evaluate and adjust changes these have on thought patterns. Faulty reasoning on the part of the client is challenged in real-life experiments and the therapist guides the client to adjust his view of himself, as he realizes that his negative assumptions are faulty. One might sum it up as, a way-of-thinking readjustment.

The thepraist helps to identify with them logical errors in their thinking, to challenge h validity of negative thinking. If a person feels they are totally worthless, the idea is to gain a balanced view of themselves, get away from the all-or-nothing thinking that can be crippling or which can lead to suicidal thoughts.

A therapist works with a client to develop real-life situations to help a client get over faulty thinking, in a step by step fashion. Also, a therapist might help a client schedule his day to day activities, which helps him or her to have a structural framework with less "down-time," which might lead to depression.

Three approaches to cognitive-behavioral therapy

Additionally, interpersonal therapy, which is less directed than cognitive-behavioral therapy, has been found to be effective, especially with teens, who often need just someone to talk things out with. Anyone going through depression can benefit from talking things out with a sympathetic listener, whether it be a friend, mate, minister, or professional. This can be and often is a necessary part of the healing process for child abuse or for other traumatic experiences in life.

School Psyhcology
Sometimes, social workers in the public schools, are trained in cognitive or talk therapy, and, because clinical psychologists are not always available in the public school system, social workers sometimes take on a more serious role as therapists for children who need to talk things out.

Spiritual Needs

Attention to spiritual and emotional needs are of importance in treating depression
Spiritual and emotional needs are important for good mental health and in overcoming depression. Photo: Microsoft

Spiritual Needs: Attention to one's spiritual needs is also an essential, often overlooked part of one's mental health. This is true of both adults, teens and children. Reading the Psalms is a stabilizing and comforting activity. The deep emotions of men who experienced inner turmoil, and their profound emotional expressions, often reflect one's own inner sentiments, and there can be idenity with such deep poetic expressions. It can be a gentle and soothing part of the healing process.



Coming Off Antidepressants

Anyone who is attempting to come off antidepressants or other psychiatric medications should do so gradually rather than abruptly. See Newsweek article How to Quit the Cure. Off-site link.


References for Help for Depression page:

1. Carson, R.C., Butcher, N. J., Mineka, S. (2000). Abnormal Psychology and Modern Life. 11th Edition. P. 662-668.

2. Cris-Christoph, P. & Connelly, M. B. (1996).

3. DeRubeis, R. (1997, May). Cognitive therapy IS as effective as medication for severe depression. A mega-analysis. Paper presented at the meeting of the American Psychological Society. Washington.

4. Exercise and Depression (Retrieved August 3, 2009). Harvard Mental Health Letter. http://www.health.harvard.edu/newsweek/Exercise-and-Depression-report-excerpt.htm

5. Kimberly Goldapple, MSc; Zindel Segal, PhD; Carol Garson, MA; Mark Lau, PhD; Peter Bieling, PhD; Sidney Kennedy, MD; Helen Mayberg, MD, (January, 2004). Arch Gen Psychiatry. 2004;61:34-41.
Treatment-Specific Effects of Cognitive Behavior Therapy. off-site link. http://archpsyc.ama-assn.org/cgi/content/abstract/61/1/34

6. Irving Kirsch1*, Brett J. Deacon2, Tania B. Huedo-Medina3, Alan Scoboria4, Thomas J. Moore5, Blair T. Johnson3
1 Department of Psychology, University of Hull, Hull, United Kingdom, 2 University of Wyoming, Laramie, Wyoming, United States of America, 3 Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America, 4 Department of Psychology, University of Windsor, Windsor, Ontario, Canada, 5 Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania, United States of America. (February 2008). PLoS Medicine, Public Library of Science.
Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration - off-site link
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

7. Marano, Hara Estroff, (July/Aug 2007). Talk Therapy vs. Drugs. Psychology Today http://www.psychologytoday.com/articles/pto-20040316-000004.html

8. Watching Television, Channeling Unhappiness, (November 14, 2008). Science Daily. http://www.sciencedaily.com/releases/2008/11/081113080006.htm

See also:
Antidepressants, side effects, birth defects, premature birth, sexual dysfuncition
Depression and sexuality



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