Breaking the Vicious Cycle of Depression

From the WebMD Archives

It sounds like good advice and it probably would help you feel better, but how are you expected to start exercising when you can barely get out of bed and take a shower each morning?

When you are in the throes of depression, it’s hard to summon the energy to do just about anything, especially exercising, re-connecting with friends and family, and eating a healthy diet. Even taking your medication may feel like a chore.

But breaking the cycle of depression is the only way to reclaim your life, experts tell WebMD. Here’s what you can do to take charge of depression:

Is It Depression?

Recognizing that you are depressed is the first step toward feeling better, says Subhdeep Virk, MD. She is an assistant professor of psychiatry at Ohio State University Werner Medical Center in Columbus.

Symptoms of depression may include:

  • Withdrawal from family and friends
  • Feelings of hopelessness
  • Preoccupation with death
  • Loss of energy
  • Loss of pleasure from things you used to enjoy
  • Sleeping too much or not enough
  • Eating too much or not enough
  • Increased anxiety
  • Increased irritability

Although everyone feels down from time to time, depression lingers and often interferes with your ability to live your life and cope with daily stressors.

When Antidepressants Are Necessary

“If you are so depressed that you can’t get up to wash or do your chores, and just getting out of the house feels like a tremendous hurdle, medication is definitely the way to go,” she says. “Antidepressants can help take the edge off and allow you to engage in therapy and get out of the vicious cycle.”

Medications may also help by stopping some of the negative thinking patterns that make it difficult to see out of a depression, she says. Thoughts such as “this will never end and will go on forever” make it hard to move forward. ��Therapy is beneficial along with medication, especially if you have psychosocial stressors in your life that are contributing to how you feel,” she says.

Some antidepressants are started at lower doses in case there are any side effects. After one or two weeks, doses can be gradually increased -- if needed -- to get the desired effects on your mood. Antidepressants typically don’t work overnight. Some may take longer than others to kick in. It usually takes about six weeks, on average, for antidepressants to begin to have a positive effect on your mood, Virk says. “Be patient and stay in close contact with your doctor.”

Continued

The good news is that there are many antidepressants for your doctor to choose from today. If one doesn’t work, he can adjust the dose, switch to another, or even add a second medication to the mix.

“The choice is often based upon which symptoms are most prominent and what kind of side effects might occur,” says Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital in New York City. For example, some antidepressants may cause “sedation” and this can sometimes be useful for people who are depressed and having trouble sleeping.

“It is important that you stay in close contact with your doctor if you take medication to treat your depression -- especially when you are starting new medication or making any changes,” he says. This will allow your doctor to monitor any side effects, should they occur.

Managing Depression with Lifestyle Changes

Lifestyle changes including getting regular exercise, eating a healthy diet, and getting plugged back into life also make a difference, especially when paired with medication and therapy.

Making these changes may be easier said than done if you are depressed, but it’s possible, says John L. Beyer, MD. He is an assistant professor of psychiatry and behavioral sciences at Duke University Medical Center and director of the Duke Mood and Anxiety Disorder Clinic in Durham, N.C. “Act as if you are not depressed in anticipation of feeling much better,” he says.

“Make a schedule for when you should shower, eat, exercise, go to sleep, and wake up, and stick to it.” The rest will follow. “After a while, it becomes much less difficult and things will begin to become enjoyable,” he says.

These healthful habits can also help prevent recurrences of depression. For people who are prone to depression, life stressors can propel them back to that dark place.

“We can’t change genetics, but we can change our environment to protect against relapses,” he says. The best way to do this is to bolster your personal resilience factor. “Difficult things can occur, but part of being well and being human is to develop social ties and networks,” he says.

Don’t let yourself become isolated. “This will build resilience that prevents depression from getting a grip on you in the future.”

WebMD Feature Reviewed by Laura J. Martin, MD on May 30, 2012

Sources

SOURCES:

Subhdeep Virk, MD, assistant professor, psychiatry, Ohio State University Wexner Medical Center, Columbus, Ohio.

John L. Beyer, MD., assistant professor, psychiatry and behavioral sciences, Duke University Medical Center; director, Duke Mood and Anxiety Disorder Clinic, Durham, N.C.

Bryan Bruno, MD, acting chairman, psychiatry, Lenox Hill Hospital, New York City.

© 2012 WebMD, LLC. All rights reserved.

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