Why Do I Feel So Blue?

Fighting off depression is a major battle for millions of people in the world. It affects every aspect of your life, ranging from how you feel and think to your daily habits, such as sleeping, eating, or working. It feels like you are slogging uphill with a huge weight holding your back. If you have the symptoms for two weeks or more, you should see a doctor to get out from under its heavy shadow.

Several types of depression fall under the umbrella of this disorder:

• Persistent depressive disorder (also known as dysthymia) can ensure for up to two long years. You may experience episodes of major depression mixed with periods of less severe blues, but it still drags you down.
• Postpartum depression hits after the birth of a child and lasts beyond the two-week window of the usual “baby blues.” It may begin with full-blown major depression during your pregnancy or after delivery. New mothers will wallow in feelings of extreme sadness, worry, and exhaustion, rendering it nearly impossible for them to care for themselves and/or for their babies.
• Psychotic depression is a mix of severe depression followed by some form of psychosis, such as visual or auditory delusions or hallucinations. These symptoms usually have a ‘theme,’ based on poverty, sickness, or blame.
• Seasonal affective disorder begins in the winter months when less natural sunlight is available to fuel our sun-loving brains. It generally dissipates in the spring and summer months, thankfully. Also known as ‘winter depression,’ this disorder usually inspires withdrawal from social engagements, prolonged sleep, and extra weight gain. If not dealt with, it will return year after year.
• Bipolar disorder differs from depression, but it comes with episodes of extremely dark moods that lead to so-called “bipolar depression.” It also inflicts the person with extreme highs of joy or irritability and extreme lows, making life unpredictable and limiting social inclusion.
• Disruptive mood dysregulation disorder is demonstrated by severe outbursts of anger and persistent irritability in children and adolescents. Its symptoms go far beyond a bad mood of a tired tot or a truculent teenager.
• Premenstrual dysphoric disorder comes with severe mood swings, irritability, anger, and a lack of enjoyment in hobbies or the company of loved ones. These symptoms typically appear during the week before your period, then dissipate in the first few days of bleeding. In that short time, they can have a significant impact on your relationships, disrupting your home, and work-life. 

What to Watch For

Track the following signs and symptoms to see if they show up daily or nearly every day for at least two weeks, to gauge if you are suffering from depression:

• Persistent moods where you feel sad, anxious, or “empty”
• A sense of hopelessness or pessimism
• Short temper
• A flood of guilt, or a sense of worthlessness or helplessness
• Disinterest in hobbies and activities that used to bring you joy
• Low energy or fatigue that doesn’t improve with rest or exercise
• Moving or talking in slow motion
• Restlessness
• Inability to concentrate, indecisiveness, or lack of memory
• Disrupted sleep or prolonged but non-restorative sleep
• Loss of appetite or bingeing, followed by body weight changes
• Contemplation or attempts at death or suicide
• Unexplained aches or pains that do not ease with treatment

While you may not have all these symptoms, even experiencing a few of them is a sign of trouble. If they are persistent or extreme, you should seek professional help right away. How long they last and how deeply they affect you is very personal. Don’t compare your assessment to your peers’ experiences and wait until they worsen. The sooner you acknowledge how you are feeling and act to get help, the sooner you will begin to heal.

Warning Signs

Depression is a toxic soup arising from a recipe of your biology, genetics, psychology, and the world around you. It can hit at any age but usually waits until adulthood. Children with high anxiety, irritability, and low moods tend to experience depression when they grow older. It often coincides with the arrival of serious physical ailments, such as Parkinson’s Disease, heart problems, cancer, or diabetes, which makes them worse. Cruelly, some of the medications for these illnesses have side effects that amplify depression. Your doctor and pharmacist need to pay close attention to your treatment plan to balance your physical and mental health.

You may be more at risk if you have:

• High stress arising from trauma or a major life event
• A family history of depression
• The illnesses listed above and medications that treat them

What to Do to Overcome Depression

The good news is that even severe depression can be reversed with treatment. The usual approach is a combination of medication, therapy, or both. If progress is slow, your doctor may wish to try electroconvulsive therapy (ECT) and other brain stimulation therapies to shock your system back into health.

There is no “one-size-fits-all” for every patient so count on taking some time – and some trial and error – to find the treatment that makes you feel like your old self.

Prescriptions

Antidepressants aim to help improve the way your brain processes certain chemicals to control your moods or stress levels. You may need to experiment with different scripts before discovering the secret formula that alleviates your symptoms with the fewest side effects. Knowing which type helped a close family member in the past will narrow the search for the right drug for you.

No matter how hard it is, give yourself two to four weeks before your mood lifts and your symptoms – such as sleep, appetite, and concentration – ease. Be patient to see if the medication is effective. Never stop taking it without consulting your doctor to avoid the inevitable withdrawal symptoms. You should always cut back on your dosage based on the advice of your doctor, but not until you have used it for six to 12 months.

In some cases, people under age 25 may experience a spike in suicidal thoughts or behavior when taking antidepressant medications, especially when they start taking the drug or when the dose changes. Therefore, patients of all ages taking antidepressants should be supervised closely, especially in the first few weeks of the prescription.

If you are pregnant, planning to become pregnant, or breastfeeding your child, talk to your doctor before taking any antidepressants. Obviously, the drug will affect your child and you need to be aware of those risks.

Some people swear by an herbal medicine called St. John’s wort, omega-3 fatty acids, and S-adenosylmethionine (SAMe) as remedies for depression. The FDA has yet to approve their use as effective treatments for depression and they should never be taken with a prescription antidepressant. Always talk to your doctor before adding supplements like this to ensure it doesn’t interfere with prescribed medication.

Psychotherapy

Several types of psychotherapy or counseling can ease the suffering of depression. Cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy are examples of approaches that have produced tangible results. 

Brain-Stimulation Therapies

Electroconvulsive therapy may be an option to explore if medication does not give you relief after the first year. Research tells us that it is worth trying due to these reasons:

• It helps people with severe depression who are resistant to other treatments.
• In severe cases, it is used as an initial treatment when a quick intervention is needed or medications cannot be administered safely.
• The treatment consists of three sessions per week, for two to four weeks, as an inpatient or – increasingly – an outpatient basis.
• It may cause confusion, disorientation, and memory loss in the short term. Memory problems tend to linger the longest, sometimes for months after treatment. Improvements in methods and devices make it safer and more effective but talk to your doctor about the potential benefits and risks before agreeing to undergo this treatment.
• It is not painful, although you cannot feel the electrical impulses during the few minutes of actual treatment. Before a session starts, a patient is given anesthesia and muscle relaxants. The patient awakens and is alert within an hour after the treatment ends.

You can also ask your doctor about repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). If you think you may have depression, the first step is making an appointment to see your doctor. Then you can discuss which option or combination of treatments is best suited to you.

How to Care for Yourself (or a Loved One)

Here are other tips that may help you or a loved one recover:

• Movement really does help. Get out and be active via moderate exercise.
• Be realistic about your recovery. It usually takes weeks, if not months or years.
• Push yourself to spend time talking and laughing with trusted friends or relatives.
• Resist the urge to isolate yourself. Be honest and let others help you recover.
• Put off major life decisions until you feel better. This is not the ideal time to start a new job or get married or divorced. If you’re tempted to do so, discuss decisions with someone who knows you well so they can be a good sounding board for you.
• Learn all you can about depression, so you are equipped with a solid background.
• Find out if other family members have been through this and see what helped them.

Help Find the Next Solution

Should You Join a Clinical Trial?

Research studies are always looking for new ways to detect, prevent, or treat diseases and conditions, including depression. If you wish to sign up to help, you may get a chance to try new drugs or new combinations of drugs before they go on the market. Likewise, you can experiment with new surgical procedures or devices, psychotherapist, or approaches to current treatment practices. These trials aim to determine if a new test or treatment is effective and safe for the broader community.

Just like other treatment options, consult with your doctor before participating in a clinical trial. The overall goal of a study is not necessarily to make YOU better but to help others in the future. You may find it helpful, but that is not what motivates researchers.

Reference: https://www.nimh.nih.gov/health/topics/depression/index.shtml