Last week’s article discussed the association of depression and the often-stressful Christmas holidays. To review, major depression is defined as lasting longer than two weeks and associated with symptoms such as irritable mood, impaired concentration, worthlessness, hopelessness, fatigue and sleep disturbance. Minor depression is less than two weeks duration with some of the above symptoms. This difference is important because the intensity of treatment varies with the diagnosis.
Unfortunately, the treatment of major depression is not simple. Severe major depression with thoughts of suicide or harming oneself or others needs immediate intervention such as ER evaluation and possibly hospitalization. Less severe major depression responds favorably to antidepressant medication (Prozac, Celexa, Effexor), and/or psychotherapy by either a psychiatrist or a trained counselor.
In minor depression, simple, common-sense activities can make a big difference. For example, discussing the trials of life with a good friend, having breakfast with a long-term acquaintance, and my favorite, exercise, maybe all you need do shake off the case of the dumps. An article published earlier this year in the British Medical Journal looked at over 14,000 depressed individuals treated with walking, jogging, yoga or strength training had twice the improvement versus individuals treated with a placebo tablet. It was also noted that the improvement of depression was related to the intensity of exercise (no surprise there).
Two thoughts I would like to stress:
- Treatment of depression could be very difficult and sometimes takes years. This article, for the sake of brevity, has oversimplified treatment but hopefully the point is made that help is there if you seek it.
- Unfortunately, the treatment of depression is not perfect. We just don’t have the equivalent of a penicillin for a sore throat. Reviewing all the different studies in treating depression, the placebo effect is approximately 20% while the active treatment is only approximately 50%.
In other words, even our best treatments are not wonderful, but please, if you are a victim of any form of depression, don’t waste another day in its depths when help is available. The first step must come from you so take it and each one after will continue to help you climb out.
Dr. Charlie Barnett is a contributor at KnoxTNToday for a weekly column, DocTalk, providing his expertise on health and wellness management.
