“Depression is the sadness that informs as it leads an animal to pursue that course of action which is most beneficial.”  Charles Darwin

Today, I’m revisiting a post that I wrote in September of 2011 called the Beneficial Face of Depression. Undeniably, there is an upside to depression, as I talked about in this post. But, for the most part, clinical depression is a dark curtain that closes you off from the world.

Many people do not understand clinical depression. They see it as a weakness of strength, faith, will or personality. This may be true of even some of you who may have it. It’s not easy to wrap our minds around depression, as it seems like something basic to one’s nature, rather than the biophysical disease that it is. There’s still a social stigma attached to clinical depression. It’s easier to share with people that you are diabetic than you are being treated for clinical depression, although both are medical disorders.

Thus, I understand your resistance to accepting that you or a loved one may have a depressive disorder that needs treatment. Nonetheless, if you want to live well, despite depression, you need to accept its causes and treatments. By any measure, living with depression is one of the toughest mental health diseases to endure. So many of you have shared stories of how depression has affected your life. Some of you have been living with depression for most of your life and worked hard to manage it. Others of you have lost children, siblings, parents, relatives and friends to it, through suicide and drug and alcohol addiction. Although depression can open you to psychological and spiritual reflections, understandings, creative self-expression and wisdom of inner spirit, for the most part, it feels like a hell that you, alone, must suffer.

But, you are not alone. Depression affects 121 million people worldwide and is responsible for 850,000 deaths per year, through suicide. 1 out of 6 (17%) Americans have a depressive episode, in his or her lifetime (New Worldwide Statistics for Depression). And, like alcohol and drug addiction, clinical depression does not discriminate. It affects every country, culture, and race, rich and the poor. Some of culture’s most beloved writers, musicians, poets, painters, producers, directors, celebrities, and royalty have struggled with clinical depression. (Famous People Living With Depression).

What is clinical depression?

Clinical depression is a persistent sadness and loss of interest in living. It is more than transient blues or a bad mood; it is a severe, unrelenting state of physical, mental, and behavioral symptoms that affect how you think, feel, and act, and the will to live.

The clinical depressive disorders include Major Depression Disorder (MDD) and Depressive Disorder, unspecified. But, I’m also including the Bipolar I and II Disorders that are predominantly of the depressive type and Dysthymic Disorder, which is a lower grade, long term depression that may also require clinical intervention. Clinical depression can stand alone as in MDD or be part of a larger psychiatric disorder as in narcissistic and borderline personality disorders. But, whatever form of it you have, for sure:

Clinical depression is a huge, unwieldy ship that must be steered properly, so as to avoid personal destruction. If steered well, it can enrich existence as much as threaten it.

What causes depression?

Clinical depression is the result of biological, genetic, environmental and personality influences that alter the brain’s chemistry. The character and intensity of these influences can create a stress load that depletes the body’s nerve chemicals and hormones implemented in mood, problem solving and behavior. This can lead to a clinical depression. Remember, your brain chemistry is to you, like a fancy computer system is to a car. If it breaks down, you stop running.

Also, no two depressions are exactly alike, because of these varying influences. Take, for example, the death of a child. This loss would cause all of us to be depressed. But, it is your state of physical and mental health, past experience, and beliefs and value system that can move you from the sadness of normal grieving into a full-blown depressive episode. It is the complexity of these influences that makes it challenging to accurately diagnose and treat a depressive disorder.

Rule of Thumb: Psychiatrists and Psychologists have the most education and training to diagnose and prescribe treatments. The treatment plan for a first-time Major Depressive Episode can be quite different than prescribed treatments for the more recalcitrant types of depression that have a strong biological contribution to them, like Dysthymic Disorder, and Bipolar I and II Disorders. Also, there are many accompanying mood and behavior features, like anxiety, anger, or impulsivity that also dictate the recommended treatment.

Five-Step Treatment Plan

You can live well, despite your depression. I know this, personally. Indeed, I’m more than an arm-chair philosopher. I have lived with depression for most of my life and have learned to manage it very well. Today, you would never know that I have a strong biological tendency toward depression. My education and training has helped me to steer this unwieldy disease quite well. But, even more than this, it is my dedication to living life well that has seen me through periods of depression.

Thus, in the words of Charles Darwin, let your depression inform and lead you to a beneficial course of action. The five-step treatment plan that follows is beneficial to your physical and mental health. It’s grounded in research and practice, and also in personal experience.

1. Consider Medication. You may resist this idea (many people do), but please consider the need for antidepressant medication. Clinical depression is a disruption in the brain’s chemistry. If you don’t get the brain chemistry right, you lessen your chance for getting better. Also, give your Psychiatrist a chance to help you. Although he or she knows how to treat you, prescribing medication is not an exact science, because of so many individual differences in clinical depression.
2. Get psychotherapy. Psychotherapy in conjunction with medication can help you to understand better the circumstances and events, thought patterns, and learned behaviors that worsen depression. It also provides you with information and resources for understanding its treatments. Also, psychotherapists give you the support you need to come to grips with your depression, to see that you have choices in managing it, and to regain control of your life.
3. Examine Choices. Even if your depression has a strong genetic contribution, the choices that you make in life can send you into a depressive episode or worsen one that you already have. For example, if you keep repeating past mistakes of relationship, job choice, or whatever else it is that is keeping you unhappy, you need to choose differently, so that your choices do not worsen your depression. If you do not, no medication or psychotherapy will be enough to keep depression at bay for you.
4. Keep up your health habits. Sleep, nutrition and exercise are vital to good physical and mental health.  There is a lot of research that shows the benefits of good health habits on depression. Eating nutrient-deficient foods, not getting enough carbohydrates, protein or fat in your diet, or not eating enough in the day can fluctuate blood-sugar levels that worsen depression. In particular, however, the omega-three fatty acids have been shown to be quite helpful in treating depressive disorders. Also, exercise has been shown to extend the positive effects of psychotherapy treatment (USA Today, Exercise and Depression).
5. Live authentically. Depression does inform; it can cause you to question much of what you once believed to be true and purposeful to your life. It’s a time of great self-doubt, dismantling your normal way of being. The confusion that depression often brings with it opens a space within you for examining and clarifying what you want. This is the beneficial face of depression. It is a blessing in disguise, if you make it so. You may be taken out of life temporarily, but if you use the passage well—you’ll come out on the other side more authentic and whole, healthy and wise.

Thus, do not let the social stigma that comes with depression stop you from getting help for it. Have courage. Do what you need to live well, despite depression. You deserve it.

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