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002 - Depression

posted Nov 9, 2015, 9:53 AM by Doug Muha   [ updated Nov 9, 2015, 10:12 AM ]

Counselor Notes 2

October 28,2011



America has some mental health problems.   Recently in the news were articles about how many Americans were taking prescription drugs for mental health issues.    (See:  http://www.huffingtonpost.com/2011/11/16/women-and-prescription-drug-use_n_1098023.html  and  http://www.foxnews.com/health/2011/11/17/one-in-five-american-adults-takes-psychiatric-drugs/
The biggest among these mental health issues is depression.  The World Health Organization claims within the next 20 years, depression will affect more people than any other health problem.  http://news.bbc.co.uk/2/hi/8230549.stm
To be considered having a major depressive disorder an adult "must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood. Social, occupational, educational or other important functioning must also be negatively impaired by the change in mood."  http://psychcentral.com/disorders/sx22.htm
The site further goes on to explain that “clinical depression is characterized by the presence of the majority of these symptoms:
  • Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
  • Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation nearly every day
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive or inappropriate guilt nearly every day
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day
  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide 
In addition, for a diagnosis of major depression to be made, the symptoms must not be better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.”
We tend to think of depression being something that doesn’t impact kids, but it can occur in children too.  (See: http://www.time.com/time/magazine/article/0,9171,2058206,00.html )  According to http://www.webmd.com/depression/guide/depression-children , about 1 in every 40 children suffer from depression.  They list the symptoms as:
  • Irritability or anger.
  • Continuous feelings of sadness, hopelessness.
  • Social withdrawal.
  • Increased sensitivity to rejection.
  • Changes in appetite -- either increased or decreased.
  • Changes in sleep -- sleeplessness or excessive sleep.
  • Vocal outbursts or crying.
  • Difficulty concentrating.
  • Fatigue and low energy.
  • Physical complaints (such as stomachaches, headaches) that do not respond to treatment
  • Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests.
  • Feelings of worthlessness or guilt.
  • Impaired thinking or concentration.
  • Thoughts of death or suicide.
(Suicide is very rare in children under 12, but it can happen.)  
When dealing with depression a competent professional therapist is a good start.  In addition, there are a number of things you can do as well:
1.  Exercise
Getting enough exercise can help ease the symptoms of depression.  http://www.mayoclinic.com/health/depression-and-exercise/MH00043
“In 1999, Duke University researchers demonstrated in a randomized controlled trial that depressed adults who participated in an aerobic-exercise plan improved as much as those treated with sertraline, the drug that, marketed as Zoloft, was earning Pfizer more than $3 billion annually before its patent expired in 2006.”
“Subsequent trials have repeated these results, showing again and again that patients who follow aerobic-exercise regimens see improvement in their depression comparable to that of those treated with medication, and that both groups do better than patients given only a placebo. But exercise trials on the whole have been small, and most have run for only a few weeks; some are plagued by methodological problems. Still, despite limited data, the trials all seem to point in the same direction: exercise boosts mood. It not only relieves depressive symptoms but also appears to prevent them from recurring.”

2.  Get Enough Sleep

There is a connection between insomnia and depression:  http://www.webmd.com/depression/features/sleep-problems  If you deal with the sleep problems, you may clear up the depression. (More on sleep issues in a future Counselor Notes)
3.  Eat Right / Vitamins & Minerals
"Let food be your medicine." – Hippocrates
There may be a link between obesity and depression.  Check out: http://psychologytoday.com/articles/index.php?term=pto-2828.html&fromMod=popular_foodndiet
Food & Mood by Elizabeth Somer (ISBN # 0-8050-3125-1) has a few comments on the relationship between diet and depression.  Let me share them with you here:
  • Carbohydrates (pasta, bagels) elevate brain levels of tryptopan (an amino acid that is a basic building block of serotonin) and serotonin.  This in turn elevates mood. (p. 135)
  • A high protein snack supplies more of the “competing amino acids and reduces trytophan and serotonin levels….”  (p. 135)
  • A researcher at the University of South Alabama notes that “depression often vanishes when sugar (and caffeine) are removed from the diet.”  (p. 135)
  • “Some people are so sensitive to sugar that even a small serving of something sweet… sends them on a mood swing roller coaster.”  (p. 136)
  • “… the more sugar you eat, them more likely your diet will be low in essential vitamins and minerals.  It could be that marginal intake of one or more of these nutrients, such as magnesium or vitamin B6, could be contributing to low energy and depression.” (p. 137)
  • “Numerous studies have shown that tryptopan supplements have an antidepressant effect and, in some people, may be as effective as antidepressant medications for improving mood.” (p. 137)
  • A researcher at Rush-Presbyterian-St. Luke’s Hospital in Chicago found that “a combination of vitamin B6 and phenylalanine improved mood in 9 out of 10 patients suffering from depression.”  (p. 138)
  • “One study … (found) one out of every four depressed patients was deficient in vitamins B6 & B12.  In fact, B6 deficiency is reported in as many as 79% of patients with depression, compared to only 29% of other patients.” (p. 139)
  • More than 70% of the B6 vitamins in whole grains are lost in processing. (p. 141)
  • “… 33% of patients suffering from depression-related psychological problems were borderline to clinically deficient in folic acid. (p. 141)
  • “One study of healthy people between ages of 25 and 83 showed that those with the highest blood levels of folic acid also has the best mood, while those with ‘low-normal’ levels were more likely to suffer from depression.” (p. 143)
  • “Iron deficiency … can cause depression associated with fatigue.” (p. 145)
Here’s a list of food to help with depression: http://www.health.com/health/gallery/0,,20351257,00.html?xid=comcast-hlh-metabolism-boost-022311
Others feel the key is to balance your fat intake: http://www.psychologytoday.com/blog/your-brain-food/201109/balancing-your-fat-intake-controls-depression
4.  Skip the Soda and Drink Green Tea
Some feel that soda and depression are linked: http://www.psychologytoday.com/blog/evolutionary-psychiatry/201105/could-soda-and-sugar-be-causing-your-depression
It may be better to drink green tea.  The September 2010 issue of Prevention Magazine (p. 21) noted:
“People who drink 4 or more cups of green tea a day are 44% less likely to be depressed than those who sip it less often.  Its amino acid theanine may spur the release of the feel-good brain chemical serotonin.”
5.  Watch Less T.V.
There was a research article I saw a few years ago that concluded that the excessive viewing of television produced a belief in a certain standard of living and materialistic consciousness.  Yet this image of "the good life" was not realistic or attainable to most people.  (It is easy for t.v. characters to find love, work out all their problems in under an hour, etc.)  They would run up their charge cards trying to get it and ended up in debt.  They would work long hours to get all these things they thought they had to have and when they couldn't get everything, quite often fell into depression.  They showed how countries with lower rates of viewing television had lower rates of depression.  
This is NOT to say that t.v. is the cause of every case of depression, but could it be involved in SOME cases of depression?  It would seem so according to http://www.tvsmarter.com/documents/depression.html   http://articles.latimes.com/2009/feb/03/science/sci-tv3  http://www.physorg.com/news145901411.html
6.  Social Comparisons
Related to watching too much t.v. is the concept of relative deprivation. 
“We tend to decide how well-off or deprived we are not from any absolute standard or how hungry are, but by comparing ourselves with other people.  In particular, we decide on what we deserve and what we should expect from looking at other people. We then compare ourselves with this standard.  http://changingminds.org/explanations/theories/relative_deprivation.htm
When we feel we can’t keep up, we can get depressed. 
This Time Magazine article is interesting and related too: http://www.time.com/time/magazine/article/0,9171,1015883,00.html
“… sociologists call reference anxiety--or, more popularly, keeping up with the Joneses. According to that thinking, most people judge their possessions in comparison with others'. People tend not to ask themselves, Does my house meet my needs? Instead they ask, Is my house nicer than my neighbor's? If you own a two-bedroom house and everyone around you owns a two-bedroom house, your reference anxiety will be low, and your two- bedroom house may seem fine. But if your two-bedroom house is surrounded by three- and four-bedroom houses, with someone around the corner doing a tear-down to build a McMansion, your reference anxiety may rise. Suddenly that two-bedroom house--one that your grandparents might have considered quite nice, even luxurious--doesn't seem enough. And so the money you spent on it stops providing you with a sense of well-being.
Our soaring reference anxiety is a product of the widening gap in income distribution. In other words, the rich are getting richer faster, and the rest of us are none too happy about it.” 
There are people who have it worse than you.  Find and help them.  Helping them may help you with your depression. 

7.  Cognitive Therapy
Cognitive therapy is known to be effective with addressing depression.  Two of the more famous cognitive therapists are Aaron Beck and Albert Ellis. 
Aaron Beck found several thinking patterns in depressed patients (From Visualizing Psychology, 2nd ed., p. 380):
1.  Selective Perception- focusing on negative events while ignoring positive ones.
2.  Overgeneralization – overgeneralizing and drawing negative conclusions about one’s own self-worth – for example, believing that you are completely worthless because you lost a promotion or failed an exam.
3.  Magnification – exaggerating the importance of undesirable events or personal shortcomings, seeing them as catastrophic and unchangeable.
4.  All-or-Nothing Thinking – seeing things as black or white: totally good or bad, right or wrong, a success or a failure.
Adopting more functional thinking patterns would ameliorate the depression.
In Ellis’ approach, he would have looked for irrational beliefs.  When found, he would have tried to correct them.  Here are what Ellis considered to be the 11 main irrational beliefs people suffer from  (from http://changingminds.org/explanations/belief/irrational_beliefs.htm ):
1. It is a dire necessity for adult humans to be loved or approved by virtually every significant other person in their community.
2. One absolutely must be competent, adequate and achieving in all important respects or else one is an inadequate, worthless person.
3. People absolutely must act considerately and fairly and they are damnable villains if they do not. They are their bad acts.
4. It is awful and terrible when things are not the way one would very much like them to be.
5. Emotional disturbance is mainly externally caused and people have little or no ability to increase or decrease their dysfunctional feelings and behaviors.
6. If something is or may be dangerous or fearsome, then one should be constantly and excessively concerned about it and should keep dwelling on the possibility of it occurring.
7. One cannot and must not face life's responsibilities and difficulties and it is easier to avoid them.
8. One must be quite dependent on others and need them and you cannot mainly run one's own life.
9. One's past history is an all-important determiner of one's present behavior and because something once strongly affected one's life, it should indefinitely have a similar effect.
10. Other people's disturbances are horrible and one must feel upset about them.
11. There is invariably a right, precise and perfect solution to human problems and it is awful if this perfect solution is not found.
In therapy then Ellis would help another by helping them adopt a better belief system.  He would seek to show them “how extreme and irrational their generalized beliefs are. Then discuss with them how more rational and useful beliefs can be found.”  (quotes from the web site noted above) 

8.  Turn On The Lights
A number of individuals suffer from a type of depression known as seasonal affective disorder.  It comes about when the days get short and the nights get long.  “Bright light therapy” may offer them some relief.  http://www.foxnews.com/health/2011/09/21/seasonal-affective-disorder-affecting-many-this-time-year/ 

9.  Go to the Chiropractor
Traditional medicine may not completely value a good chiropractor, but I have seen people helped by them.  Most will say they can help a person suffering from depression.  Women who have just given birth and are dealing with post-partum depression are particularly advised to see a good chiropractor.
10.  A Few More Links on Depression
Depression also can cause 4 big health problems:
Here are 12 non-drug ways for treating depression:
Here’s a link on “9 sneaky causes of depression”:  http://www.foxnews.com/health/2011/08/16/sneaky-causes-depression/
Ten things to say (or not say) to someone with depression:
Twenty celebrities who have had troubles with depression: http://www.health.com/health/gallery/0,,20526304,00.html
One last note:
Here’s the link for the article mentioned in the last issue: http://www.psychologytoday.com/articles/201110/your-backup-brain