The Depression Support Center

Being diagnosed with depression can be particularly difficult because the emotional distress you're feeling can be compounded by guilt and shame. You may find yourself asking the question, “Why can’t I just snap out of it?” But it's often not that easy.

Many people are reticent about talking about their experiences with depression, which can lead to feelings of isoation. The truth is that you are not alone. An estimated 19 million Americans are affected by depression each year. The good news for you and others facing this challenge is that depression is highly treatable. While it may sound daunting, your diagnosis is the first step to recovery.

The following guide is designed to help you navigate your journey with the best information and resources that have helped other survivors when they faced the same challenge.

TSC has scoured the Web and assembled links to the very best depression resources: articles, blogs, forums, and tools that can help you make better decisions and take action to overcome the range of physical, emotional, and other challenges you're facing now.

As you’ll see, we always welcome your ideas and suggestions to make this depression guide even more helpful to survivors like you.

JUST FOUND OUT

Survivors Say: The Best Resources for Depression

Survivors say these are the best resources for those who have just found out; check them out to find out more about your options:

• National Institute of Mental Health - Depression The National Institute of Mental Health (NIMH) offers explanations of several types of depression; ailments that commonly coexist with depression; and the different ways in which men, women, children, and seniors are affected by depression. The NIMH site also lists resources for those in crisis and for people who know someone battling depression.
• American Psychological Association - Depression The APA's topic page on depression covers some of the latest research and news on this very common condition, as well as the chance to find a psychologist who can help.
• The Depression and Bipolar Support Alliance This group offers authoritative information on depression and bipolar disorder (manic depression) and can connect you with one of almost 1,000 patient-run support groups around the country, as well as answer questions on its toll-free line.  

The Big Picture

Depression is a potentially debilitating illness marked by lasting feelings of sadness and unworthiness as well as physical symptoms. Because depression often spurs feelings of exhaustion and hopelessness, you may feel overwhelmed at the thought of confronting it. It is important to remember, however, that depression is highly treatable. This common ailment generally responds very well to intervention such as medication and psychotherapy/counseling.

Knowing the signs and symptoms of depression will help you catch it early and find help, putting you on the path to recovery. Signs of depression include: persistent feelings of sadness and hopelessness; a lack of interest in activities you usually enjoy; anxiety; and/or low energy. You may think of depression as a mental issue, but it can show up physically with weight gain or loss and insomnia.

Signs & Symptoms of Mood Disorders - Depression and Bipolar Support Alliance
Depression Symptoms - Yahoo! Health

A number of factors may contribute to a person’s risk for depression, ranging from long-term stress to the loss of a loved one to a traumatic event. Recent scientific research has emphasized the biological components of depression, such as imbalances in the brain’s neurotransmitters or hormonal imbalances.

Causes of Depression - WebMD

Your Depression

Do you know what type of depression you have? Be sure to ask your doctor if you're not clear, since understanding your condition better will help you in your recovery. If you are diagnosed with bipolar disorder, for instance, your symptoms will differ from general depression, as will the medication you may require. Your diagnosis should also indicate whether you have any other conditions that co-exist with depression, such as anxiety. For a description of various types of depression, check out the guide at WebMD:

Do You Know the Different Types of Depression?

If your doctor suggests starting on an antidepressant medication there are quite a few to consider. Expect that it will take time to discover which medication works best for you, as well as the optimal dosage. Many people try a few medications over a period of weeks or months before finding one that's best for them. Share any side effects with your doctor or therapist. For an overview of all types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs)  and tricyclic antidepressants, read this summary from Mayoclinic.com:

Antidepressants: Selecting the One That's Right for You 

Here's an excellent comparison of antidepressants from Consumers Union:

Antidepressants: Summary of Recommendations

Being depressed usuallly means facing an array of negative emotions ranging from sadness to anger to fear to apathy. Keep in mind that you are not your depression. As badly as you feel, you are still the same valuable person. With time you will begin to experience more positive feelings again.

Your World

You may feel like you are on an emotional rollercoaster. It can be pretty scary to feel out of control, so it is important that you surround yourself with a support system of people who can help you through this tough time. Don’t be afraid to look to professionals who are experienced in dealing with depression and to friends and family members upon whom you can lean. It’s easy to feel like a burden to our loved ones when facing depression, but it is important to admit when when we need help.

Some people choose to tell their employers and coworkers about their condition, while others opt to keep their illness confidential. You might find that your boss is sympathetic to mental illness, or telling her may adversely affect her or others’ view and treatment of you. Talk over your options with a close  friend, relative, healthcare professional or a religious advisor.

Types of Treatment

Medication

Many people suffering from depression find relief with medication. Depending on the severity of your depression, a doctor may recommend that you take one or more medications to help balance your mood. Some people are reluctant to try medication because they don't want to be on a drug for the rest of their lives; they're apprehensive about side effects; or they fear becoming dependent. Talk over your concerns with the doctor who is prescribing the drug. For more information on treating depression with medication, go to this Medline Plus page for trustworthy information about antidepressants assembled by the National Institutes of Health:

Antidepressants

Psychotherapy

When suffering from depression, it helps to talk out your feelings with a mental health professional. A psychologist, psychiatrist, or counselor can help you identify challenges, as well as thoughts, beliefs, and actions that are keeping you in an unhealthy pattern that's contributing to your depression. A psychotherapist can give you tools for seeing a more positive side to things and suggest activities and exercises that break old patterns. Check out MayoClinic.com's overvieof the different types of psychotherapists:

Types of Mental Health Providers

Online Group Support

Many sites offer a safe, supportive place where those suffering from depression can congregate to discuss their condition, ask questions, and offer support. These online communities and support groups can also make you feel less isolated. Look for sites with feedback from survivors of depression who have "come out the other side" and have a more positive point of view. Here are a couple of online communities to try:

WebMD's Depression Online Community
DepressionTribe.com

Possible Treatment Side Effects

Common Side Effects of Antidepressants

The most common side effects of antidepressant medication are anxiety/agitation; drowsiness; dry mouth; headache; dizziness; diarrhea/constipation; insomnia; weight loss or gain; and sexual issues such as difficulty achieving an erection or reaching orgasm. If you are affected by these or other symptoms, talk to your doctor; he may be able to prescribe another drug with fewer side effects. This WebMD guide can help you manage some side effects, but you should be sure to tell  your doctor about anything you're experiencing:

Managing the Side Effects of Antidepressants

Stopping Your Antidepressant

If you've been taking an antidepressant for a while and decide to stop it, you may experience physical and mental effects. Some withdrawal symptoms are simply a nuisance, while a few of the potential effects of going “cold turkey” can be dangerous, which is why you shuld gradual taper your dosage and do so under the guidance of your doctor Check out this Q&A on antidepressant withdrawal from Mayoclinic.com:

Antidepressant withdrawal: Is there such a thing?

Holistic Treatments Available

Many people suffering from depression find relief through complementary remedies like herbal supplements, yoga, massage, meditation, and acupuncture -- either alone or in tandem with medication and/or psychotherapy. Check out Mayoclinic.com's summary of the usefulness and safety of these approaches for major depression:

Major Depression: Alternative Medicine

St. John’s Wort

Many people believe that herbal supplements, especially St. John’s Wort, can have help alleviate depression. Find out more about the use of St. John’s Wort to treat depression at the National Center for Complementary and Alternative Medicine's site

St. John's Wort and Depression

Lifestyle

Many people believe that a healthful lifestyle, including a balanced diet, regular exercise, stress reduction, and plenty of sleep, can help alleviate depression. Find out more about lifestyle and depression at this About.com page:

A Healthy Lifestyle and Depression

Complementary Medicine

There are any number of alternative therapies that may help with depression. These include massage, omeage-3 fatty acids, acupuncture and acupressure, meditation, Ayurvedic medicine, yoga, meditation, and alternative therapies such as biofeedback and neuro-linguistic programming. Here are two sites with more information on integrative medicine approaches to depression:

HowStuffWorks.com - Alternative Medicines for Depression

About.com - Alternative Medicine Treatments for Depression

Creating a support circle

• Set up your TSC survivor profile.
• Join support groups of other survivors or set up your own.
• Interact and provide updates.

What Kind of Doctors You Will Need

• If antidepressants are part of your treatment you'll need to get your prescription from a medical doctor (which includes psychiatrists, but not psychologists or counselors). If you'd like to pursue psychotherapy or “talk therapy,” you should find a licensed therapist. Some people depression may feel more comfortable talking to their pastor, rabbi, or a spiritual director.

Resources to Find Doctors

• Use Psychologytoday.com's site to search its extensive database for all types of counselors based on location and areas of specialization: Find a Therapist

Handling the Emotional Rollercoaster

As you recover from depression try to take things day by day. You may experience several days of improvement and then wake up one day feeling terrible. Try to take the long view, understanding that improvement may be slow, but steady. Don’t give up! And whatever you do, don’t shut yourself off from others. Tell your loved ones, your doctor, and your mental health professionals how you're feeling, especially if you feel that you are relapsing into depression.

Books Survivors Found Helpful

• Healing Anxiety and Depression by Daniel G. Amen and Lisa C. Routh
• The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness by J. Mark G. Williams, John D. Teasdale, Zindel V. Segal, and Jon Kabat-Zinn
• Overcoming Depression: A Step-by-Step Approach to Gaining Control Over Depression by Paul Gilbert 
• Undoing Depression by Richard O'Connor

Things Survivors Wish They’d Known

Communicating with Your Doctor/Psychotherapist

It can be very hard to talk about dark, deep emotions, from depression and grief to loss and anxiety. Deep pain may make it uncomfortable to open up to a healthcare professional. But in order to get better it's important to tell your doctor, psychiatrist, or therapist about how you're feeling. Being honest with healthcare professionals gives them the information they need to fully assess and treat your condition. If you feel reticent about opening up remember that your doctor/licensed counselor is obligated to maintain confidentiality about what you tell him/her, it is very likely that he/she has dealt with many people going through the same things you are. In other words, you are definitely not alone in your struggle with depression.

Keep phone numbers for important contacts (psychiatrist, therapist, doctor, pharmacy) handy at all times. You may also wish to share this information with a trusted relative or friend who can contact your doctor/therapist if you are unable to do so yourself or if they are worried about you.

Information and Recommended Links for Co-Survivors

How you can help:

• If you suspect a friend or relative is suffering from depression, urge him or her to see a doctor or mental health professional for diagnosis and treatment. You may need to contact a healthcare professional yourself and accompany your loved to their appointments.
• Listen, offering understanding and support.
• Encourage your loved one to join you on a walk, to watch a lighthearted movie, or engage in other activities. If he or she turns you down, don’t press the issue, just ask another time.
• Avoid caregiver burnout through self-care and by giving yourself a break when other offer to help. A person suffering from depression may need support for a long period of time, so pace yourself.
• Educate yourself about depression and your survivor’s specific diagnosis. This will help you understand the symptoms of depression and better equip you to talk with your loved one about what they're going through. For more information on providing support for someone suffering from depression, visit the Mayo Clinic website: Depression: Supporting a Family Member or Friend with Depression
• If your survivor is on medication, ask about that, too. Find out what drug(s) they're taking, as well as how much and how often. Go online and do a bit of research to learn more. Check in every once in a while to make sure your loved one is taking the medication as prescribed, and ask how it is affecting them. If they seem “off” to you after starting a medication, let them know and encourage them to talk to their doctor/psychiatrist.
• Being in a romantic/sexual relationship with someone with depression can present specific challenges. Check out About.com's "Top 10 Tops for Coping with Depression in a Relationship" 

What to say

• “I care about you.” Let your friend or relative know that you love and value them.
• Remind them as often as possible that “this, too, shall pass,” and that their depression will lift over time.
• “We are a team; we’ll beat this thing together.” These simple words can help a survivor see that you are on their side, no matter how many tense moments you share, and that you are not giving up on them.

What not to say

• “Can’t you just snap out of it?”
• “It’s all in your mind.”
• “They wouldn’t really harm themselves; it’s all talk.” Never brush aside remarks about suicide. Report any comments or behavior that could be suicidal to your loved one’s doctor or therapist immediately.

What not to do

• Encourage your survivor's depression by joining them in persistent negativity. Listen to their concerns but encourage optimism whenever possible.
• Disparage potential treatments your survivor wants to try, including medication, psychotherapy, or alternative therapies. Your loved one’s depression is not about you and it can be hard to predict which therapies (or combination of therapies) will help. 
• Behave as though you are panicked by depression. Watching someone go through this challenging condition can be frustrating and scary but it is important that you maintain a level head, urging patience and adherence to treatment.
• Don’t give up on someone suffering from depression. They need the support of someone who is in this with them for the long haul. Remind yourself that they will improve in time.

Things you can do for a survivor today and every day

• Ask your friend or relative how they are doing.
• Encourage your loved one to maintain healthful routines such as eating, bathing, and dressing.
• Help keep track of any medication he/she is taking.
• Support depression survivors in any efforts to reach out to friends, family, mentors, and mental health professionals, especially during the tough time of getting the worst symptoms of depression under control.

How to build a support network for friends/family

• Set up your TSC co-survivor profile.
• Create a support group for your friend or family member.
• Interact and provide updates.

How to help a survivor deal with disruptions in day-to-day life

• People experiencing depression may have difficulty with their usual work or school routine, as well as their relationships. The most destructive thing a depression survivor can do is just disappear, failing to show up for work or other obligations. Help your loved one call in sick as needed, obtaining a doctor’s note if necessary. 

Remission / Recovery / Recurrence

Some people have a single episode of depression, often brought about by a traumatic incident or major life transition, such as a divorce or a death. More than half of depression survivors, however, will continue to have intermittent episodes of depression, sometimes as often as once or twice a year. Some people with recurrent depression choose to remain on medication and continue with counseling on a long-term basis, while others choose to remain vigilant about their moods, seeking treatment as needed. More information on the recurrence of depression - and how to keep it at bay -- is found in this AARP guide:

The Problem of Recurrence

Adopting a healthier lifestyle, marked by regular routines, is one way to help prevent or lessen the effects of depression. It’s important to get plenty of sleep and to eat regularly; fatigue and low blood sugar can exacerbate a mood disorder. Depression survivors also benefit from regular exercise; research indicates that physical activity helps boost energy and mood. Tips on maintaining a healthy diet and getting regular exercise are found on WebMD:

Diet for Depression

Exercise and Depression

Keeping mentally fit also includes three Rs: recreation, relaxation, and relationships. Make sure that you schedule plenty of time to relax, whether it’s simply taking time out to watch a comedy or practicing specific relaxation techniques such as meditation, yoga, or deep breathing. Pursuing activities that give you pleasure, from fixing up classic cars to walking in the woods, help nourish your soul. Keeping up personal relationships is also crucial. Whether it’s calling a relative or meeting a friend for coffee, engaging with others helps us look outside our own inner world, remember how to laugh, and cultivate a deep-rooted support system.

For many of us, depression can recur even when we are doing our best to maintain our mood. Many people experience symptoms of depression when they get stressed out by work, school or family difficulties. Some people report feeling blue during the dark and rainy days of winter. Occasionally, depression may “break through” even when life seems smooth—even, occasionally, if we are receiving treatment for depression. Always let the health-care professionals in your life know if you feel you are becoming depressed or anxious. It may be time to get back on medication, switch medications or dosage, or simply take the time to slow down.

Try not to become discouraged if your depression recurs. Remember, you are not back to square one. As bad as a depressive episode may feel, take heart in your progress. Depression survivors are strong people who have learned tools for coping and built a chain of support among friends, family, and healthcare professionals.

Give Back

Sometimes depression feels like a curse. You may wonder, “Why do things have to be so hard for me?” If there’s any consolation, it may be this: As a survivor of depression yourself you can help other survivors. If you know someone who is suffering from depression you may wish to share your experiences and what helped you through the darkest times. You can offer support, too, by sharing your stories and advice right here at The Survivors Club.