What is Depression?
Key facts
Depression is a common mental disorder. Globally, more than 264 million people of all ages suffer from depression.
Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.
More women are affected by depression than men.
Depression can lead to suicide.
There are effective psychological and pharmacological treatments for moderate and severe depression.
(Source: WHO)
4 Conditions That May Seem to Be Depression, But Aren't
Why it never hurts to get a blood test before diagnosis.
"It ain’t what you don’t know that gets you into trouble. It is what you know for sure that just ain’t so.”
This quote, frequently misattributed to Mark Twain, describes the dangers of believing something false with all your heart. Instead of focusing on treating the real problem, you put all of your efforts into fixing an issue that bears little relevance to your future. This quote was famously used in the film An Inconvenient Truth to highlight the risks associated with denying climate change. Properly attributed or not, the wisdom is hard to ignore: When you believe in something false, you can suffer adverse effects. This is particularly true if that false belief involves your health.
A Common Misdiagnosis
Mental illness is often difficult to diagnose, particularly because there are few physiological tests to help clinicians make a diagnosis. Diabetes is diagnosed through blood tests, cancer is diagnosed through biopsies and medical imaging, but mental illness is largely diagnosed through checklists of self-reported symptoms.
For this reason, mental illnesses, including depression, are sometimes misdiagnosed. According to a 2012 article in Current Psychiatry, 26 to 45 percent of patients referred for “depression” did not meet diagnostic criteria for a depressive illness. A 2009 meta-analysis discovered that general practitioners can only correctly identify depression in 47.3 percent of cases—and many doctors diagnose depression in people who just don’t have it.
What if Some Mental Disorders Aren't Actually Disorders at All? Here are four conditions commonly mistaken for depression, both by clinicians and the public:
1. Bipolar disorder.
Like depression, bipolar disorder involves periods of intense lows. During these lows, people with bipolar disorder experience the same symptoms found in depression. They may feel hopeless, worthless, or even suicidal. Unlike depression, however, people with bipolar disorder also experience high periods, or mania, in which they feel confident, productive, or on top of the world. Sometimes this manic phase is so pleasant that people with the disorder are unable to recognize it as part of their illness, and so they only seek help during their low periods.
According to a study published in The British Journal of Psychiatry, up to 22 percent of people with bipolar disorder are mistakenly diagnosed with depression. Another study found that people with bipolar disorder experience an average gap of 10 years before they receive the proper diagnosis. But recognizing the difference between bipolar disorder and depression is vital because the medications used to treat depression can often worsen the symptoms of bipolar.
2. Hypothyroidism.
In this condition, the thyroid gland does not release a sufficient amount of hormones. Because these hormones are necessary for the brain and body to function, people with this disorder typically experience fatigue, diminished concentration, and a low mood—all characteristics of depression. Researchers estimate that as many as 20 million Americans have a form of thyroid disease, but up to 60 percent of them are unaware of their condition. Instead, they erroneously believe that they are easily fatigued, lazy or, yes, depressed. Unlike depression, however, people with hypothyroidism are overly sensitive to cold temperatures—and may feel cold all the time. They’re also more likely to experience dry skin, hair loss, and a hoarse voice. Hypothyroidism can be properly diagnosed through a simple blood test, and treatment requires only one pill a day.
3. Diabetes.
People often develop Type 2 diabetes without recognizing it. They may suddenly find themselves losing weight, feeling fatigued, and growing irritable. Because all of these symptoms are also associated with depression, people may fail to recognize that their body is having problems with insulin. One precursor to Type 2 diabetes, insulin resistance, has been significantly linked to depression.
People with diabetes are also at risk for “diabetes distress,” a condition that mimics depression. A 2014 study found that people diagnosed with both diabetes and depression experienced reduced depression symptoms after receiving interventions to help manage diabetes. In other words, their symptoms were not due to depression, but the stress of living with a chronic illness. “Because depression is measured with scales that are symptom-based and not tied to cause, in many cases these symptoms may actually reflect the distress that people are having about their diabetes, and not a clinical diagnosis of depression,” said Lawrence Fisher, Ph.D., ABPP, the lead author of the study.
4. Chronic fatigue syndrome.
Also known as myalgic encephalomyelitis or systemic exertion intolerance disease, this condition is characterized by extreme fatigue that has no apparent cause. Chronic fatigue syndrome also involves difficulty concentrating, muscle pain, and problems with sleep—all symptoms associated with depression as well, which is why people with chronic fatigue syndrome are so frequently misdiagnosed. A study published in The Primary Care Companion to the Journal of Clinical Psychiatry found that chronic fatigue syndrome is under-diagnosed in more than 80 percent of the people who have it, with depression being the most common misdiagnosis.
Thankfully, there is at least one clear difference between depression and chronic fatigue syndrome: People with depression are both exhausted and uninterested in their hobbies, while those with chronic fatigue may still want to participate in their interests despite their lack of energy.
Does anyone have depression?
Depression is a very real, very serious illness that affects millions of people each year. The majority of individuals who are diagnosed with depression are diagnosed correctly and able to recover with proper therapy and medication.
Still, a misdiagnosis is always possible. If you are being treated for depression but aren’t feeling better, it is entirely possible that you have a disorder that mimics the condition. Before starting an antidepressant regimen, it never hurts to take a blood test to rule out one of the commonly confused conditions, such as hypothyroidism or diabetes.
Remember, “It ain’t what you don’t know that gets you into trouble. It is what you know for sure that just ain’t so.”
Contributed by Courtney Lopresti, M.S.
Michael Thase, MD, psychiatrist and director of the Mood and Anxiety Program at the University of Pennsylvania, says “When you treat depression with medication, the actual ‘magical’ chemical ingredients matter maybe 15 percent. It’s really the process of working with a doctor and finding the motivation to recognize the problem and take steps toward fixing it that counts for most of the good.”
“You can get that much of the good in a non-medication intervention that includes diet, exercise, and talking to someone,” he believes. It’s really when you start taking care of yourself — which taking control of your diet certainly counts as — you get remoralization, Thase adds. “Your spirits pick up and that’s an antidepressant.”
15 Holistic Treatments for Depression
If you’re depressed, taking medication is just one of many treatment options. A holistic approach focuses on treating your whole being -- body and mind -- to help you feel better.
Being depressed can make you feel helpless. You're not alone and there's a lot you can do to fight back. Changing your behavior -- your physical activity, lifestyle, and even your way of thinking -- are all natural depression treatments.
These tips can help you feel better -- starting right now.
1. Set a Routine and Daily Goals.
If you’re depressed, you need a routine to help you stay on track. “Start very small. One day at the time.” Make your goal something that you can succeed at, like doing the dishes every other day. As you start to feel better, you can add more challenging daily goals.
Go to bed and get up at the same time every day. Try not to nap. Take all the distractions out of your bedroom -- no computer and no TV. With 6 Tips to Build a Better Bedtime RoutineIn, you may find your sleep improves.
2. Exercises and Mediation.
It boosts feel-good chemicals called endorphins. It may also have long-term benefits for people with depression. Regular exercise seems to encourage the brain to rewire itself in positive ways.
Research on yoga, stress reduction and relaxation therapy shows positive outcomes for anxiety and depression. There is an especially large body of research showing that the practice of mindfulness can have a profound impact on mood.
Mindfulness meditation has been shown to improve symptoms of anxiety and depression after just eight weeks.
Mindful movement practices, such as yoga, tai chi, and qigong, may also offer relief. In addition to evidence of effectiveness, these practices can provide a sense of control over at least one aspect of life.
Start something simple, short, and easy to do such as 5 minutes Guided Meditation, 10 minutes Yoga/Tai Chi/Qigong, and 20 minutes Walk.
3. Healthy Diet
One of the most overlooked aspects of mental health is nutrition. Food plays a significant role in our physical health, as well as our mental and emotional health. When you are struggling with depression, it can feel a bit overwhelming to think about eating the right foods. However, some of these small changes in your diet may help to decrease your symptoms and have a positive effect on your daily life.
WHAT TO EAT
Fish – Wild-caught fish, especially the more oily types such as salmon, mackerel, trout, sardines, and tuna (not canned), are great choices to help fight depression because they are rich sources of omega-3 fats. Omega-3 fats are important in brain health and may be involved in the functioning of serotonin, a neurotransmitter important in the regulation of mood.
Nuts – Walnuts are known to support overall brain health, being one of the highest plant-based sources of omega-3 and a great source of protein to help keep blood sugar levels at a healthy balance. They found that adults who ate nuts, and specifically walnuts, were more likely to have higher levels of optimism, energy, hope, concentration, and a greater interest in activities.
Beans – Beans are a great source of protein and fiber, both of which help to maintain stable and consistent blood sugar levels. In addition to helping minimize the blood sugar spikes and dips that can affect our mood, beans are also great sources of folate.
Folate is a B vitamin that helps the body produce blood cells, DNA and RNA, and metabolize proteins. Garbanzo beans (also known as chickpeas) and Pinto beans are very high in folate.
Seeds – Flaxseed and Chia seeds are particularly great sources of omega-3 fats.
Additionally, pumpkin and squash seeds are a great way to increase tryptophan. Tryptophan is an essential amino acid that helps create serotonin.
Poultry – Chicken and Turkey are both great sources of lean protein and provide high amounts of tryptophan that can help to stabilize blood sugar levels, maintaining healthy sleep and a balanced mood.
Vegetables – Folate, fiber, and other nutrients make vegetables, especially the darker leafy greens, a good source of alpha-linolenic acid (ALA). ALA is one of the three main types of omega-3 fatty acids, the other two being DHA and EPA.
When considering vegetables to help increase your omega-3s, the powerful players tend to be Brussels sprouts, spinach, kale, and watercress.
Probiotics – More and more research is linking good gut health with good mental health. They have found that microorganisms living in your gut, including probiotics, can play a key role in mood regulation by helping to reduce inflammation in your body, produce feel-good neurotransmitters, and affect your stress response. This might be a factor in why a higher-than-average number of people with irritable bowel syndrome also develop depression as well as anxiety.
Foods that contain probiotics include:
Kimchi
Kombucha
Miso
Sauerkraut
Tempeh
Tofu
Yogurt
Whole Foods – Generally speaking, it's best to allow your body the freedom to digest foods as close to their natural state as possible. Many of the processed foods or things you might find at a convenience store are filled with preservatives and offer little to no nutritional benefit. Your body is trying to make sense of what to do with such food, and it can significantly interrupt or rob your body (and mind) of key nutrients and energy it needs to function at its best.
Dark Chocolate – When choosing dark chocolate, aim for 70 percent or more. Dark chocolate still contains added sugars and fats, so a small serving of 1 to 3 grams (g) is appropriate.
Although it is still unclear how dark chocolate reduces stress, it is a rich source of polyphenols, especially flavonoids which might reduce neuroinflammation and cell death in the brain as well as improve blood flow.
Chocolate has a high tryptophan content, which the body uses to turn into mood-enhancing neurotransmitters, such as serotonin in the brain.
Dark chocolate is also a good source of magnesium. Eating a diet with enough magnesium in it or taking supplements may reduce symptoms of depression.
WHAT “NOT” TO EAT
Sugar – There are food choices all around us that are filled with sugar such as cakes, cookies, cereal, drinks, and even condiments such as barbecue sauce, salad dressings, and more. You may be surprised how many foods are perceived as "healthy," yet contain extraordinary amounts of added sugar. Examples of tricky foods like this are granola bars, energy bars, trail mix, and honey roasted nuts.
Keep in mind that sugar will not always be labeled simply as "sugar" on the ingredient list. In order to be on the lookout for added sugar, you may want to also look for the following terms:
Corn syrup
Dextrose
Fructose
High fructose corn syrup (HFCS)
Honey
Lactose
Maltose
Sucrose
Alcohol – Alcohol is a depressant and can lead to impaired judgment and reaction time. Many alcoholic beverages can actually be quite sugary which, as noted above, can have a way of sabotaging your mood and causing blood sugar levels to elevate and crash.
Although some research has shown that small amounts of alcohol such as red wine can be helpful, it is generally in your best interest to steer clear if you struggle with depression.
Caffeine – Yes, caffeine can help you start your day with a boost. However, it can also lead to crashes later in the day, and leave you feeling as though you need more to regain energy. A moderate amount of caffeine, two to three cups per day, however, has been linked to a lower risk of suicide.
A better alternative is Green Tea. In addition to antioxidant benefits, green tea is also known to provide theanine, an amino acid that offers an anti-stress benefit that can be helpful for people with depression.
Refined Grains – Just as with sugar, we are surrounded by processed foods that use refined grains. Foods such as white rice, pasta, crackers, bread, chips, and breaded foods are full of refined carbohydrates that offer little to no nutritional value and rob you of important B vitamins in the process of digestion.
Loading your diet with these refined carbohydrate foods will take your blood sugar levels on a roller coaster ride throughout the day, which can also result in symptoms of low mood and fatigue.
Our bodies interact with the foods we eat, and the choices we make each day can impact our body's ability to function at its best. Consider removing or cut back sugar, alcohol, caffeine, and refined grains from the diet for two weeks to see if these substances are making the depression worse.
4. Supplements
The uniqueness of each person’s biochemical processes is only just beginning to be appreciated. The evolving field of Functional Medicine attempts to take into account both the genetic information and the unique differences that occur in each person’s metabolism, including their extra need for certain nutrients. Current recommendations, as follows, come from a generalized understanding of human brain chemistry, without these individual considerations.
Note: The best source of nutrients for the body-mind is from nutrition-dense organic foods.
Basic Nutritional Supplements
The following is often recommended daily for people who suffer from mood disorders:
✔ Multiple Vitamin with B6 and minerals
✔ Omega-3 fatty acids EPA/DHA totaling 1,000-3000 mg daily
✔ Vitamin D-3 – Dosage dependent on the vitamin D blood level and season of the year, with a higher dosage in the winter months; Good read - 7 Signs of a Vitamin D deficiencies)
✔ Probiotics with two or more live cultures
Other Nutritional Supplements
Vitamin B complex – protects against stress-induced nutrient depletion, supports neurotransmitter production for a positive mood, promotes the nervous system, immune and cardiovascular health.
Zinc
GABA, Inositol
Magnesium Glycinate (citrate, or oxide)
Folic Acid – support cardiovascular health and healthy red blood cell production
NAC (N-Acetyl-Cysteine)
S-Adenosylmethionine (SAMe)
Amino Acids (5HTP, L-tryptophan, L-theonine, Taurine, L-tyrosine and DL-phenylalanine) – help with moodiness, stress, anxiety, panic, insomnia
Always check with your doctor before starting any supplement, especially if you’re already taking medications.
5a. The Bach Flower Remedies (英國巴哈花精)
Healing with flowers is not a new idea as the ancient Egyptians and Romans used flowering plants for medicinal purposes. But, the modern tradition of healing with flowers began in the early 1930’s with physician and bacteriologist, Dr. Edward Bach (pronounced Bāhè 巴赫 or 巴哈).
Dr. Bach believed (and modern physicians now agree) that a person’s mental state plays a vital role in physical well-being and the ability to recover from illness and injury. Dr. Bach utilized 38 various dilutions of flower essences, termed “Bach Flower Remedies,” as natural remedies for depression and anxiety. Each flower is believed to have very specific qualities, and they can be taken alone, in combination or together with other natural remedies for depression. Determining which of the flower remedies to utilize depends mostly on the specific depression symptoms a person experiences:
Gentian (龍膽) – For people who have depression symptoms of pessimism and discouragement. Gentian is used as one of the natural remedies for depression when a person knows the reason for his or her sadness i.e. loss of a job, death of a close family member or friend, etc.
Elm (榆樹) – For people who experience depression symptoms of feeling overwhelmed, anxious and exhausted, typically caused by being overworked or under a tremendous amount of stress.
Agrimony (龍芽草) – For people who suffer from emotional anguish and constant feelings of despair.
Cherry Plum (櫻桃李) – For people who experience fear on a “more-than-normal” basis. This fear can be due to a genuine, real threat (such as an impending loss) or it can be fear caused by a perceived or imaginary danger.
Gorse (荊豆) – For people who have overwhelming, persistent feelings of doubt, despair and hopelessness i.e. feeling “nothing can be done to help” or their “fate is sealed”.
Sweet Chestnut (田栗花) – This is also for people who have persistent feelings of despair and hopelessness.
Mustard (芥末) – For people who experience the depression symptoms of sadness or gloom that have no apparent cause – like “a dark cloud” has blocked out all joy.
Willow (楊柳) – For people who are highly critical, hold a grudge, have a tendency to blame others for their problems in life or often experience self-pity.
Honeysuckle (忍冬) – For people who constantly focus on past events and have overwhelming inadequacies of being able to “let go” and live in the present.
Wild Rose (野玫瑰) – For people with anxiety and depression symptoms of apathy, lack of interest, lethargy or feeling like they are “drifting” from life.
Rescue Remedy* (急救花精) – This is the most popular of the Bach Flower Remedies and is useful to stabilize emotions in a crisis or emergency, shock, stress or acute anxiety episode, that is, a panic attack. (When you’re not sure which remedy to choose, rescue remedy is a good choice initially.)
5b. Botanical Medicines (Other Herbs)
St. John’s Wort (聖約翰草/貫葉連翹/金絲桃) – St. John's wort is most commonly used for "the blues" or depression and symptoms that sometimes go along with mood such as nervousness, tiredness, poor appetite, and trouble sleeping. There is some strong scientific evidence that it is effective for mild to moderate depression. St. John's wort is also used for symptoms of menopause, and many other conditions, but there is no good scientific evidence to support these uses.
An oil can be made from St. John's wort. Some people apply this oil to their skin to treat wounds. Applying St. John's wort directly to the skin might be risky. It may cause serious sensitivity to sunlight.
St. John's wort might cause serious interactions with some medications. Because of this, France has banned the use of St. John's wort in products. In other countries St. John's wort is only available with a prescription.
Valerian (纈草) – Valerian is most commonly used for sleep disorders, especially the inability to sleep (insomnia). Valerian is also used orally for anxiety and psychological stress, but there is limited scientific research to support these uses. In manufacturing, the extracts and oil made from valerian are used as flavoring in foods and beverages.
Rhodiola (紅景天) – Rhodiola is used as a so-called "adaptogen", to help the body adapt to and resist physical, chemical, and environmental stress which might help protect cells from damage, regulate heartbeat, and have the potential for improving learning and memory.
Hot Kava (卡瓦胡椒) – Kava is most commonly used for anxiety. Some people take kava for stress, restlessness, sleeping problems (insomnia), and many other conditions.
Chamomile (洋甘菊) – Chamomile has been used as a traditional medicine for thousands of years to calm anxiety and settle stomachs. Some research suggests that chamomile could help with other conditions, like diarrhea in children, hemorrhoids, anxiety, and insomnia. When used on the skin, chamomile might help with skin irritation and wound healing. Some research has documented that it may be as effective as hydrocortisone cream for eczema.
Ginseng (人參) – Ginseng is one of the most popular herbal medicines in the world. There are two main types of ginseng: Asian or Korean ginseng (Panax ginseng) and American ginseng (Panax quinquefolius). Studies have found that the different types have different benefits. In traditional Chinese medicine, American ginseng is considered less stimulating than the Asian variety.
Although many other herbs are called ginseng -- like eleuthero, or Siberian ginseng -- they don’t contain the active ingredient of ginsenosides.
Ginseng has traditionally been used for a number of medical conditions. These include:
Build immunity. Some studies have found that ginseng may boost your immune system. There’s some evidence that one particular type of American ginseng extract might decrease the number and severity of colds in adults.
Regulate blood sugar. Several studies in people have also shown that ginseng may lower blood sugar levels.
Improve focus. There’s some early evidence that ginseng might give a small, short-term boost to concentration and learning. Some studies of mental performance have combined ginseng with extract from leaves of the ginkgo tree, another traditional remedy said to help with dementia. While these studies are intriguing, many experts feel we need more evidence. Ginseng has also been studied as a way to improve mood and boost endurance as well as treat:
Menopausal symptoms
Saffron (番紅花) – It can take 75,000 saffron blossoms to produce a single pound of saffron spice. Saffron is largely cultivated and harvested by hand. Due to the amount of labor involved in harvesting, saffron is considered one of the world's most expensive spices. The stigmas, and sometimes the petals, are also used to make medicine.
People use saffron most commonly for depression, anxiety, Alzheimer disease, menstrual cramps (dysmenorrhea), and premenstrual syndrome (PMS). Saffron contains chemicals that alter mood, kill cancer cells, decrease swelling, and act like antioxidants.Ashwagandha (印度人參) – Ashwagandha is commonly used for stress. It is also used as an "adaptogen" for many other conditions. Ashwagandha contains chemicals that might help calm the brain, reduce swelling (inflammation), lower blood pressure, and alter the immune system.
Don't confuse ashwagandha with Physalis alkekengi. Both are known as winter cherry. Also, don't confuse ashwagandha with blue cohosh, canaigre, codonopsis, ginseng American, ginseng panax, or eleuthero.Ginkgo (銀杏) – Ginkgo seems to improve blood circulation, which might help the brain, eyes, ears, and legs function better. It may act as an antioxidant to slow down Alzheimer's disease and interfere with changes in the brain that might cause problems with thinking.
Ginkgo seeds contain substances that might kill the bacteria and fungi that cause infections in the body. The seeds also contain a toxin that can cause serious side effects like seizures and loss of consciousness.Turmeric (薑黃) – The active ingredient in turmeric is called curcumin. Curcumin may help lower anxiety by reducing inflammation and oxidative stress that often increase in people experiencing mood disorders, such as anxiety and depression. An increase of curcumin in the diet also increased DHA and reduced anxiety.
6. Aromatherapy (芳療)
Essential oils are concentrated plant extracts. They serve many medical purposes, and it may also help reduce anxiety, insomnia, and stress, which often occur alongside depression. Some research has shown that using essential oils may improve sleep, enhance mood, and improve quality of life.
They do not cure depression and people should not use essential oils in place of prescribed medication. However, essential oils demonstrate benefits as a complementary therapy alongside conventional treatments for depression, such as behavioral therapy and antidepressants. As with all forms of alternative therapy, use essential oils with caution. Always discuss the use of these oils with a doctor or aromatherapist.
This report from 2017 on a number of studies suggested several oils that might have positive effects when used as part of a mixture, including:
Lavender (薰衣草)
Bergamot (佛手柑)
Mandarin (柑橘)
Rose (玫瑰)
Chamomile (洋甘菊)
Sage (鼠尾草)
Jasmine (茉莉花)
Rosemary (迷迭香)
Ylang Ylang (依蘭依蘭)
Frankincense (乳香)
The report suggests that aromatherapy massage with these oils has a greater effect on mood symptoms than inhaled aromatherapy. Lavender was the most common oil in the studies and has also demonstrated positive effects on anxiety symptoms.
The chemicals in essential oils can interact with the body by being absorbed through the skin into the bloodstream or by stimulating areas of the brain through inhalation. When specialized nerve cells in the upper part of the nose detect smells, they send an impulse to the brain along the olfactory nerve to an area called the olfactory bulb.
The olfactory bulb processes the impulse and delivers the information about the smell to other neighboring areas of the brain. These other areas are known as the limbic system. The limbic system is a set of brain structures that might play an essential role in controlling behavior, emotions, memory, and mood.
Using essential oils to help ease symptoms of depression might work because of their smell. A sense of smell is one of the five senses and a powerful connector between people and the world around them. Aromas are highly emotive. Everyone reacts to scents differently — how they respond to a smell depends on what they associate with that smell. For example, they may associate a certain scent with a long-forgotten memory.
The emotionally suggestive nature of smells might link to the improvement of mood after aromatherapy from essential oils. This, in turn, may provide some relief in mood disorders, such as depression.
7. Cannabidiol Oil (大麻二酚油)
Cannabidiol (CBD) oil is a derivative of the cannabis, or marijuana, plant. Unlike other forms of marijuana, CBD oil does not contain tetrahydrocannabinol, or THC, which is the substance that creates a “high.”
CBD has shown promise in initial studies as a treatment for both depression and anxiety, and it may cause fewer side effects than pharmaceutical drugs in some people. CBD appears to have a positive interaction with serotonin receptors in the brain. Serotonin impacts a range of functions in the body, including a person’s emotional state and feelings of well-being or happiness. Keeping serotonin levels balanced is often a key therapy for people with depression.
The compound exhibits a clear anti-stress effect after short- or long-term use. In certain tests, CBD acted as an antidepressant. They found that the compound worked without activating the brain’s endocannabinoid receptors directly, which may indicate that there is less risk of CBD becoming habit-forming, or addictive. Researchers have even studied CBD’s potential to help reduce cravings in people with opioid use disorder.
CBD oil is readily available without a prescription in many alternative healthcare shops. In areas where medical marijuana is legal, doctors may also be able to prescribe the oil.
8. Talk Therapy (諮商師)
Talk therapy, or psychotherapy, is another valuable tool to combat depression. Two kinds of therapy -- cognitive-behavioral therapy and interpersonal therapy -- have been found to be especially useful in treating depression.
Cognitive-behavioral therapy (CBT) helps you look at how negative thoughts and behaviors may be contributing to your depression. CBT teaches you how to make positive changes in how you think.
Interpersonal therapy can help you improve your relationships with family and friends, so you feel better.
Talk therapy can last anywhere from several weeks to several years and can be one-on-one with a therapist or in a group. Many people combine therapy with other treatments, such as medication or exercise.
Talk therapy gives you the skills to help deal with your depression long term. A therapist can work with you to give you strategies to help fight your depression and ways of handling your depression so you have more control. This helps you stay feeling better in the long run.
9. Acupuncture (中醫針灸)
In the Eastern worldview, symptoms like depression and anxiety are warning bells — indicators that something bigger is going on in the body. The source of life energy (known as Qi in Traditional Chinese Medicine) is off-balance, leading to disease, which can manifest in depression and anxiety. Acupuncture is not a cure-all, but when it’s used as part of an integrative approach to making the entire body well, it can help alleviate the symptoms of depression and anxiety.
7 Reasons to Try Acupuncture for Depression and Anxiety
There are many benefits to this ancient practice, including potential relief from depression and anxiety. Here are seven reasons to try acupuncture if you are looking for relief from anxiety and depression.
It works! Through a metanalysis of a variety of research studies on acupuncture and depression, acupuncture can significantly reduce the severity of depression, as measured by the Hamilton rating scale for depression or the Beck Depression Inventory.
It’s an alternative to toxic medications. There are virtually no negative side effects to acupuncture. When used as a part of a holistic approach to treating depression, it can help you heal depression naturally.
It releases endorphins. Endorphins are a hormone that act as a natural pain killer in the body. When needles are inserted into sensory nerves just below the skin’s surface, the body stimulates a response in the immune system, which increases circulation to that area of the body and triggers the release of endorphins.
4. It’s a good option for pregnant women. If you’re expecting a child, you might want to reduce or eliminate your intake of medications to prevent adverse side effects in the child. Studies show that acupuncture is an effective option for pregnant women who do not want to take medication.
It can reduce inflammation. Because the needles act as tiny wounds throughout the body, acupuncture prompts an anti-inflammatory response from the immune system as it combats the small invasions. There is increasing evidence that chronic inflammation keeps you depressed.
It gives you much more than a mood boost. Because acupuncture aims to make the body well, not treat specific symptoms, you’ll benefit from an overall increase in health. In fact, acupuncture is an effective treatment for migraine and tension headaches and has been shown to help treat allergies and infertility.
10. Chiropractic (整脊)
The chiropractor will give a thorough examination in the hope to find places within the spine that could benefit from adjustments to certain parts of the body that will allow blood to flow more freely and can relax the muscles. This stress relief can be quite therapeutic for those with depression.
Some people with depression may find that imbalances within their bodies were contributing to their symptoms. If spinal vertebrae are out of place, it can place pressure on the surrounding nerves. Since the nervous system circulates throughout our bodies, a blocked nerve in the lower back can actually affect all sorts of places in the body. Once a chiropractor has identified a problem area, symptoms can often be alleviated after one adjustment. The chiropractor will recommend a regimen that will more than likely include regular visits and perhaps other related treatments such as massage.
New studies now back up the effectiveness of chiropractic care in relieving certain mental health symptoms. Let’s take a closer look at how chiropractic care can help patients with mental health disorders.
Aims for a mind-body approach
In general, chiropractic care aims to find the right balance between your mind and body. A chiropractor will do this by looking at all health areas, including adjustments, therapies, exercise, diet and supplements.
Lowers your blood pressure
Several studies support the idea that chiropractic care and massage therapy can reduce blood pressure and stress symptoms. High blood pressure is a common symptom of anxiety and/or stress. Researchers found that blood pressure was reduced after both chiropractic sessions and massage therapy.
Promotes an all-natural solution without side effects
One of the best benefits of chiropractic care is that it’s all-natural. Patients taking anxiety and depression medication often complain of the side effects, which include insomnia, nausea, weight gain and fatigue. Chiropractic care works to reduce anxiety symptoms, so you can potentially avoid taking medication and dealing with its side effects. (Don’t change or stop medication without the approval of your doctor.)
Adjusts your spine to trigger positive hormones
Spinal health influences almost every region of your body. Studies show that after getting a chiropractic adjustment, your body triggers an increase in hormones such as neurotensin, oxytocin, and cortisol. These hormones are involved in positive nervous system functioning, such as:
Neurotensin: neutralizes stress-induced pain
Oxytocin: boosts neuro-communication and feelings of social bonding
Cortisol: blocks pain deriving from inflammation
As you can imagine, spinal adjustment can have a positive impact by triggering these hormones throughout your body.
Helps you get to sleep
Insomnia is also a symptom of anxiety and/or depression. With chiropractic care, you may find getting to sleep a little easier. Studies report that some chiropractic manipulation may improve patient sleep patterns. Massage therapy also has seen good results.
Relieves tension, stiffness and headaches
Patients with anxiety and/or depression also suffer from muscular tension. Chiropractic care can aid in reducing tension and stiffness. In addition, it can help relieve pain related to tension headaches, as many patients who live with mental health disorders also suffer from migraines.
When approaching an illness such as depression, a multidisciplinary approach can often be the most effective. Studies have shown that certain people respond better to different treatments, so adding chiropractic into the list of options will allow more people than ever to find relief from depression-related symptoms, many of which can be severely debilitating.
11. Massage Therapy (按摩)
Massage therapy can relieve muscle pain and tension, improve circulation, and increase flexibility. It can also reduce symptoms of depression, anxiety, and even stress by affecting the biochemistry in our bodies.
Massage, when used as a holistic treatment method within a comprehensive mental health program spanning a variety of treatment modalities, can be greatly beneficial and serve your mental health in a variety of ways proven by science:
Massage can decrease cortisol levels (stress hormone). Consistently high cortisol levels can negatively alter the brain’s structure and level of functioning and directly contribute to the onset of anxiety by destroying neurons in the hypothalamus.
Massage simultaneously increases levels of both dopamine and serotonin (the feel-good happy hormone). Dopamine deficiency has been linked to low levels of motivation and an inability to feel pleasure—two of the most common symptoms of depression.
Massage can boost lower blood pressure—a symptom often associated with adrenal fatigue, anxiety, and depression due to poor circulation and blood flow.
Massage therapy can help treat depression by manipulates your muscles and tissues to enhance their activity, and improving physical health. Massage helps strengthen your body-mind connection. It is believed that touch also releases hormones in your body that create a positive emotional reaction, helping to put your mind at ease and improve your mood.
12. Sound Therapy (音療)
Our body has a natural drive and ability for self-healing if just given the right inputs. While chemicals are intricately involved in the process, there is growing evidence that stimulating our sensory systems can affect the way our brain produces and uses chemicals.
Sound Therapy has been found to help to support those suffering from depression by bombarding the ear and brain with mega doses of high-frequency sounds. These are in fact high energy vibrations, which can help to lift the listener’s state of vitality. It is also possible that Sound Therapy may stimulate the brain to begin naturally producing and utilizing some of the neurotransmitters that create positive emotional states. It is common for Sound Therapy listeners to report greater states of well-being, happiness, and an end to depressed feelings.
In addition, the specific stimulation of the left brain has been found to be an important part of the therapeutic impact on depression. Research on the effects of meditation has shown that prolonged practice of meditation stimulates certain centers in the left forebrain that stimulate feelings of happiness and peace. Sound Therapy’s direct stimulation of the left brain through the increased high-frequency sound input to the right ear has been observed to have a similar effect.
Although Sound Therapy is not a cure for any mental health condition, it can be an effective and enjoyable tool for reducing the symptoms of numerous conditions, including depression and anxiety.
Sound Therapy offers people a creative and accessible way of expressing their feelings and processing their experiences. People have used sound for its powerful effects on mood and emotions for a long time.
13. Hypnotherapy (催眠)
In your fight against depression, a lot of the work is mental -- changing how you think. When you're depressed, you leap to the worst possible conclusions.
Hypnosis is one of the oldest forms of psychotherapy in the Western world, and it may also be the most misunderstood. Although long associated with charlatans or performers, all true hypnosis is, by definition, self-hypnosis. In spite of the prevailing myth, nobody can be hypnotized against his or her will. Instead, hypnosis is generally induced by focusing attention on positive mental imagery.
The American Medical Association approved hypnosis as a therapy in 1958, and the American Psychiatric Association followed in 1961. Since then, reviews have provided evidence about when this therapy is effective.
Depression often has a cause, and when the cause is found and released and transformed, the depression lifts. Hypnosis uses the ability of the brain to create new neural pathways and connect to the new experiences, imagined vividly in hypnosis. Another way hypnosis addresses depression is by helping people focus on a better, brighter future. In this future moment or future memory, the brain creates expectations on a subconscious level and creates new emotions and beliefs about what the future holds.
For the right patient, hypnotherapy for depression can be extremely effective. Good candidates for hypnotherapy are individuals who get easily absorbed in books or movies, those who are adept at visualization, and those who are open to hypnosis.
14. Energy type of Therapy - Reiki, Access Bars, Qigong
15a. Weighted Blanket & Hot Bath
If you suffer from anxiety, feel extra stressed or you’re simply looking for a better night’s sleep, a weighted blanket could be a good place to start. The best-weighted blankets put the right amount of extra weight on your body to simulate light hands-on pressure that can help calm you—and your nervous system—down. Officially called “pressure therapy,” this mimics the feeling of being hugged, held or swaddled.
Weighted Blanket (you can find it online with lots of choices such as amazon, Etsy)
Hot Bath* with 2 cups of Epsom Salt and 10 drops of Essential Oil such as Angelica, Bergamot, Clary Sage, German Chamomile, Goldenrod, Lavender, Mastrante, Patchouli, Vetiver, Ylang Ylang.
*If you don't have a bathtub at home, try to use a deep bucket to soak your feet.
15b. Go outdoor into nature.
Research in a growing scientific field called ecotherapy has shown a strong connection between time spent in nature and reduced stress, anxiety, and depression.
When people are depressed or under high levels of stress, in the prefrontal cortex, a brain region that is active during rumination — defined as repetitive thoughts that focus on negative emotions malfunctions, and people experience a continuous loop of negative thoughts.
It appears that interacting with natural spaces offers other therapeutic benefits. For instance, calming nature sounds and even outdoor silence can lower blood pressure and levels of the stress hormone cortisol, which calms the body's fight-or-flight response.
The visual aspects of nature can also have a soothing effect. Having something pleasant to focus on like trees and greenery helps distract your mind from negative thinking, so your thoughts become less filled with worry.
Anything from 20 to 30 minutes, three days a week, to regular three-day weekends in the woods is helpful. The point is to make your interactions a part of your normal lifestyle. Your time with nature could be something as simple as a daily walk in a park or a Saturday afternoon on a local trail.
The type of natural setting doesn't matter. Focus on places you find the most pleasing. The goal is to get away from stimulating urban settings and surround yourself with a natural environment. Nature can have a powerful effect on our mental state, and there are many ways to tap into it.
15c. Do something new, and try to have fun.
When we challenge ourselves to do something different, there are chemical changes in the brain. Trying something new alters the levels of [the brain chemical] dopamine, which is associated with pleasure, enjoyment, and learning.
If you’re depressed, make time for things you enjoy. What if nothing seems fun anymore? As strange as it might sound, you have to keep trying anyway. Plan things you used to enjoy, even if they feel like a chore. Keep going to the movies. Keep going out with friends for dinner. You have to relearn how to do it. In time, fun things really will feel fun again.
How to help someone with depression?
Major depression is one of the most common mental health disorders in the world, so it’s likely someone you know or love has been affected. If someone you love is depressed, you may be experiencing helplessness, frustration, anger, fear, guilt, and sadness. These feelings are all normal. Helping someone with depression can be a challenge so remember to take care of your own emotional health—you’ll need it to provide the full support your loved one needs.
That said, your companionship and support can be crucial to your loved one’s recovery. You can help them to cope with depression symptoms, overcome negative thoughts, and regain their energy, optimism, and enjoyment of life. Start by learning all you can about depression and knowing how to talk to someone living with depression can be a great way to support them.
Depression is a serious condition. Don’t underestimate the seriousness of depression. Depression drains a person’s energy, optimism, and motivation. Your depressed loved one can’t just “snap out of it” by sheer force of will.
The symptoms of depression aren’t personal. Depression makes it difficult for a person to connect on a deep emotional level with anyone, even the people they love the most. It’s also common for depressed people to say hurtful things and lash out in anger. Remember that this is the depression talking, not your loved one, so try not to take it personally.
Hiding the problem won’t make it go away. It doesn’t help anyone involved if you try making excuses, covering up the problem, or lying for a friend or family member who is depressed. In fact, this may keep the depressed person from seeking treatment.
Your loved one isn’t lazy or unmotivated. When you’re suffering from depression, just thinking about doing the things that may help you to feel better can seem exhausting or impossible to put into action. Have patience as you encourage your loved one to take the first small steps to recovery.
You can’t “fix” someone else’s depression. As much as you may want to, you can’t rescue someone from depression nor fix the problem for them. You’re not to blame for your loved one’s depression or responsible for their happiness (or lack thereof). While you can offer love and support, ultimately recovery is in the hands of the depressed person.
WHAT TO SAY TO SOMEONE WHO HAS DEPRESSION
1. Do you want to talk about it? I’m here when you’re ready.
You can’t force someone to talk, but knowing you’re available can really help them feel supported.
If they haven’t been forward with you about their depression, you may want to mention you’ve noticed they’re having a hard time and you’re there if they want to talk. If you simply ask “Are you OK?” they may be used to pretending and reply “I’m fine.”
If they’re not ready to talk now, remind them you’re here for them when they’re ready. When they’re having a hard time and need someone to talk to, they may remember your offer and come to you.
2. What can I do to help today?
Depression often causes fatigue, trouble sleeping, and a lack of motivation. Sometimes just getting out of bed can be hard.
Asking what you can do can really help them through their day.
Maybe they’re not eating well and you can pick up dinner. Maybe they need a morning call or text to ensure they get to work on time.
Sometimes you just need to listen. Helping doesn’t have to be a huge, drastic effort. It can be as simple as picking up a phone, sharing a meal, or driving them to an appointment.
Remember that being a compassionate listener is much more important than giving advice.
3. How are you managing? How is your depression?
This can give you some insight into how their treatment is going or if they need help getting professional assistance.
Depression is a medical condition. It’s not a flaw or weakness. If someone you love has depression, encourage them to seek professional help if they haven’t already done so. Remind them that asking for help is a sign of strength, not weakness.
Asking how their treatment is going can also encourage them to stick with their treatment plan. You may also tell them when you’ve noticed improvements. This can help validate it’s working, even if they don’t always feel like it is.
4. You’re not alone. I may not understand exactly how you feel, but you’re not alone.
Depression can make many people feel alone and like they should isolate. Tell them they’re not alone. Be there for them, even if you don’t have a similar personal experience.
If you’ve had depression, you can share that you know what they’re going through. This can help them relate. However, keep the focus on them. Remember to listen first.
5. You’re important to me.
It’s always nice to know you’re loved or wanted. When someone’s depressed, they may feel the exact opposite.
That’s why telling someone that they’re important to you, that you need them in their life, and that they matter can be so comforting. You can also be more specific to what you love about them or how you appreciate them for something they do.
6. That sounds like it’s really hard. How are you coping?
The purpose of this is to simply acknowledge that you realize how hard it is for them. Acknowledging how hard depression and its symptoms can be can help them feel seen.
It’s a good reminder that you’re listening, you see them, and you’re here to help them cope.
7. I’m really sorry you’re going through this. I’m here for you if you need me.
The fact is, there’s no perfect thing to say to someone living with depression. Your words won’t cure them. But they can help.
Reminding someone that you’re there for them whenever they need you — whether that’s in the form of help with a small task or someone to call in a crisis — can be so essential to saving a life.
WHAT “NOT” TO SAY TO SOMEONE WHO HAS DEPRESSION
Advice isn’t the same as asking for help. If they ask for your advice, give it if you so choose. But don’t offer them “helpful” solutions or statements that seem like a cure for their depression. This can feel judgmental or not empathetic.
DON’T say:
“This is all in your head”
“Everyone goes through tough times.”
“Try to look on the bright side.”
“Why do you want to die when you have so much to live for?”
“I can’t do anything about your situation.”
“You should be feeling better by now.”
“Just think happy thoughts.”
“I don’t understand what you have to be so sad about.”
“Everything will be OK, I promise.”
“I cut out sugar and I was cured! You should try it.”
“You just need to snap out of this.”
“So many people out there are worse off than you.”
THE RISK OF SUICIDE IS REAL
It may be hard to believe that the person you know would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain they’re feeling.
Since suicide is a very real danger when someone is depressed, it’s important to know the warning signs:
Talking about suicide, dying, or harming oneself; a preoccupation with death
Expressing feelings of hopelessness or self-hate
Acting in dangerous or self-destructive ways
Getting affairs in order and saying goodbye
Seeking out pills, weapons, or other lethal objects
A sudden sense of calm after depression
If you think a friend or family member might be considering suicide, don’t wait, talk to them about your concerns. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you’re concerned and seek professional help immediately!
REMEMBER TO TAKE CARE OF YOURSELF
There’s a natural impulse to want to fix the problems of people we care about, but you can’t control someone else’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority.
Remember the advice of airline flight attendants: put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand.
Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, honest communication will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse. Gently talk about how you’re feeling before pent-up emotions make it too hard to communicate with sensitivity.
Set boundaries. Of course you want to help, but you can only do so much. Your own health will suffer if you let your life be controlled by your loved one’s depression. You can’t be a caretaker round the clock without paying a psychological price. To avoid burnout and resentment, set clear limits on what you are willing and able to do. You are not your loved one’s therapist, so don’t take on that responsibility.
Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for your friend or relative, do your best to keep appointments and plans with friends. If your depressed loved one is unable to go on an outing or trip you had planned, ask a friend to join you instead.
Seek support. You are NOT betraying your depressed relative or friend by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time. You don’t need to go into detail about your loved one’s depression or betray confidences; instead focus on your emotions and what you are feeling. Make sure you can be totally honest with the person you turn to—choose someone who will listen without interruption and without judging you.
(Sources: WebMD, UMN.edu, HealthLine, MedicalNewsToday, Alleviant, rtor.org, thejoint, Harvard Medical School, helpingGuide, VeryWellMind, )
