- Depression is a common and serious medical illness that negatively impacts mood, thinking, and behavior. It causes feelings of sadness and loss of interest in activities. - Signs of depression include changes in sleep, appetite, energy level, concentration, and feelings of worthlessness. It can be treated through lifestyle changes, therapy, medication, or a combination. - Treatment options include cognitive behavioral therapy, lifestyle changes like exercise and nutrition, social support, and antidepressant medication. Finding the right treatment can take time and commitment. Long-term recovery usually requires ongoing management rather than just a short term solution.

1.  What Is Depression?
 Depression (majordepressivedisorder) isa common and seriousmedical illness thatnegatively affectshowyou
feel, the way you thinkand howyou act.Fortunately,it is also treatable.Depression causesfeelingsof sadness
and/ora loss of interest in activities once enjoyed.Itcan lead to a variety of emotionaland physicalproblems
and can decrease a person’sabilityto function at workand athome.
Signs and symptoms
 You may bedepressed if, formore than two weeks,you'vefelt sad,down ormiserable mostof the time, or have
lost interest or pleasurein usualactivities, and havealso experienced severalof the signsand symptomsacross
at least threeof the categoriesbelow.
 It’simportantto remember thatwe all experiencesome of thesesymptomsfromtimeto time, and it may not
necessarily mean you're depressed.Equally,noteveryonewho isexperiencing depression will haveall of these
symptoms.
 Behaviour
 not going out anymore
 not getting things done at work/school
 withdrawing from close family and friends
 relying on alcohol and sedatives
 not doing usual enjoyable activities
 unable to concentrate
 Feelings
 overwhelmed
 guilty

2.  irritable
 frustrated
 lacking in confidence
 unhappy
 indecisive
 disappointed
 miserable
 sad
 Thoughts
 'I’m a failure.'
 'It’s my fault.'
 'Nothing good ever happens to me.'
 'I’m worthless.'
 'Life’s not worth living.'
 'People would be better off without me.'
 Physical
 tired all the time
 sick and run down
 headaches and muscle pains
 churning gut
 sleep problems
 loss or change of appetite
 significant weight loss or gain
 If you think thatyou or someoneyou know may beexperiencing depression, completing ourchecklist is a quick,
easy and confidentialway to give you more insight.The checklist won'tprovidea diagnosis –for thatyou'll need
to see a healthprofessional–but it can help to guide you and providea better understanding of howyou're
feeling.
How many people have depression?

3.  Clinical depression hassurged to epidemicproportionsin recent decades,fromlittle-mentioned misery at the
marginsof society to a phenomenon thatisrarely far fromthenews.It is widespread in classroomsand
boardrooms,refugeecampsand innercities, farmsand suburbs.
 At any onetime it is estimated thatmore than 300 million peoplehavedepression – about4% of the world’s
population when thefigureswerepublished by the World Health Organization (WHO) in 2015. Women are more
likely to be depressed than men.
 Depression is the leading globaldisability, and unipolar(asopposed to bipolar) depression isthe10th leading
causeof early death,it calculates.The link between suicide,the second leading cause of death foryoung people
aged 15-29, and depression is clear, and around theworld two people kill themselvesevery minute.
 While ratesfor depression and othercommon mentalhealth conditionsvary considerably,theUSis the “most
depressed”country in the world,followed closely by Colombia,Ukraine,theNetherlandsand France.Attheother
end of the scale areJapan,Nigeria and China.
Why are there such wide variations?
 The starkcontrastsbetween countrieshaveled someto dub depression asa “first world problem”ora “luxury”.
The logic is thatif you are staring down thebarrel of a gun or you don’tknow wherethenextmeal is coming
from,you haveno time forsuch introspection.
 Recent research points to myriad reasons,many overlapping:in particularless developed countriesoften lackthe
infrastructureto collect dataon depression,and areless likely to recogniseit as an illness. Also,peoplein these
countriesare morelikely to feel a social stigma againsttalking abouthow they feel,and are reluctantto askfor
professionalhelp.
 Statistics arealso less simplistic than rich = depressed and poor= notdepressed.
 A paperin the journalPlosMedicine arguesthat,extremesaside,themajority of countrieshavesimilar rates of
depression.Italso found thatthemostdepressed regionsare eastern Europe,and north Africa and the Middle
East; and that,by country,thehighestrate of yearslost to disability for depression isin Afghanistan,and the
lowestin Japan.
What are my depression treatment options?

4.  Justas no two people are affected theexactsameway by depression,thereis no “one size fits all” treatmentthat
cures depression.Whatworksforoneperson mightnotworkforanother.The best way to treatdepression is to
becomeas informed aspossibleaboutthetreatmentoptions,and then tailorthem to meet yourneeds.
Depression treatmenttips
 Learn asmuch as you can aboutyourdepression. It’simportantto determinewhetheryourdepression symptoms
are dueto an underlying medical condition.If so,thatcondition will need to be treated first. The severityof your
depression is also a factor.The moresevere the depression,themoreintensivethe treatmentyou'relikely to
need.
 It takestime to find the right treatment. Itmight takesometrial and error to find thetreatmentand supportthat
worksbestfor you.Forexample,if you decide to pursuetherapy it may takea few attemptsto find a therapist
thatyou really click with. Or you may try an antidepressant,only to find thatyou don'tneed it if you takea daily
half hourwalk.Be open to changeand a little experimentation.
 Don’trely on medicationsalone. Although medication can relievethe symptomsof depression,itis notusually
suitablefor long-termuse.Othertreatments,including exerciseand therapy,can be justaseffectiveas
medication,often even moreso,but don'tcomewith unwanted sideeffects.If you do decide to try medication,
rememberthatmedication worksbest when you makehealthy lifestyle changesaswell.
Get social support.
 The more you cultivateyoursocial connections,themoreprotected you are fromdepression.If you arefeeling
stuck,don’thesitateto talkto trusted family membersor friends,or seekout new connectionsata depression
supportgroup,forexample.Asking forhelp isnot a sign of weaknessand it won’tmean you’rea burden to
others.Often,thesimple act of talking to someoneface-to-facecan bean enormoushelp.
 Treatmenttakestime and commitment. All of these depression treatmentstaketime,and sometimesit might
feel overwhelming orfrustratingly slow.Thatis normal.Recovery usually hasits upsand downs.
Lifestyle changes:
 An essential partof depression treatment
 Lifestyle changesaresimple butpowerfultoolsin the treatmentof depression.Sometimesthey mightbeall you
need.Even if you need other treatmentaswell, making the rightlifestyle changes can help lift depression
faster—and preventitfromcoming back.
 Lifestyle changesto treat depression
Exercise.
 Regular exercise can be as effectiveat treating depression asmedication.Notonly doesexercise boost
serotonin,endorphins,andotherfeel-good brain chemicals,ittriggersthe growth of new brain cells and

5. connections,justlike antidepressantsdo.Bestof all,you don’thaveto train fora marathon in order to reap the
benefits.Even a half-hourdaily walkcan makea big difference.Formaximumresults,aimfor30 to 60 minutesof
aerobicactivity on most days.
 Social support. Strong socialnetworksreduceisolation,a key risk factorfor depression.Keep in regular contact
with friendsand family,orconsider joining a class or group. Volunteering isa wonderfulway to get social
supportand help otherswhile also helping yourself.
 Nutrition. Eating well is importantforboth yourphysicaland mentalhealth.Eating small, well-balanced meals
throughouttheday will help you keep yourenergy up and minimize mood swings.While you may be drawn to
sugary foods forthequickboostthey provide,complex carbohydratesarea better choice.They'll get you going
withouttheall-too-soon sugarcrash.
Coping with Depression:
 Overcoming Depression OneStep at a Time
Sleep.
 Sleep hasa strong effecton mood.When you don'tget enough sleep, yourdepression symptomswillbe worse.
Sleep deprivation exacerbatesirritability,moodiness,sadness,and fatigue. Makesureyou'regetting enough
sleep each night.Very fewpeopledo well on less than seven hoursa night.Aim forsomewherebetween seven to
nine hourseach night.
Stress reduction.
 Makechangesin yourlife to help manageand reducestress.Too much stressexacerbatesdepression and puts
you at risk forfuturedepression.Takethe aspectsof yourlife thatstress you out,such as workoverload or
unsupportiverelationships,and find waysto minimizetheir impact.
Ruling out medical causes of depression
 If you suspectthat you may bedepressed,and lifestyle changeshaven’tworked,makean appointmentto see
yourprimary care doctorfora thorough checkup.If yourdepression istheresult of medical causes,therapy and
antidepressantswilldo little to help. The depression won’tliftuntil the underlying health problemis identified
and treated.
 Your doctorwill check for medicalconditionsthatmimic depression,and also makesureyou are nottaking
medicationsthatcan cause depression asa side effect.Many medical conditionsand medicationscan cause
symptomsof depression,including sadness,fatigue,and thelossof pleasure.Hypothyroidism,orunderactive
thyroid,is a particularly common mood buster,especially in women.Olderadults,oranyonewho takesmany
differentmedicationseach day,areat risk for drug interactionsthatcausesymptomsof depression.Themore
medicationsyou aretaking,the greaterthe risk fordrug interactions.
Psychotherapyfor depression treatment
 If there is no underlying medicalcause foryoursymptomsof depression,talktherapy can bean extremely
effectivetreatment.Whatyou learn in therapy givesyou skills and insightto feel betterand help prevent
depression fromcoming back.
 There are many typesof therapy available.Threeof themore common methodsused in depression treatment
include cognitivebehavioraltherapy,interpersonaltherapy,and psychodynamictherapy.Often,a blended
approach isused.
 Sometypesof therapy teach you practical techniqueson how to reframenegativethinking and employ
behavioralskills in combating depression.Therapy can also help you workthrough therootof yourdepression,

6. helping you understand why you feela certain way,whatyourtriggersare fordepression,and whatyou can do
to stay healthy.
 Therapy and “the big picture” in depression treatment
 Oneof the hallmarksof depression isfeeling overwhelmed and having troublefocusing.Therapy helpsyou step
backand see whatmightbe contributing to yourdepression and how you can makechanges.Hereare some of
the “big picture” themesthattherapy can help with:
Relationships.
 Understanding thepatternsof yourrelationships,building betterrelationships,and improving current
relationshipswill help reduce isolation and build social support,importantin preventing depression.
Setting healthy boundaries.
 If you are stressed and overwhelmed,and feellike you justcan’tsay no,you are moreat risk for depression.
Setting healthy boundariesin relationshipsand atworkcan help relieve stress,and therapy can help you identify
and validatethe boundariesthatarerightfor you.
 Handling life’s problems. Talking witha trusted therapistcan providegood feedbackon morepositivewaysto
handlelife’s challengesand problems.
Individual or group therapy for depression treatment?
 When you hear the word “therapy”you mightautomatically thinkof one-on-onesessionswith a therapist.
However,group therapy can bevery usefulin depression treatmentaswell. Both group and individualtherapy
sessionsusually lastaboutan hour.Whatare the benefitsof each? In individualtherapy,you arebuilding a
strong relationship withoneperson,and may feel morecomfortablesharing somesensitiveinformation withone
person than witha group.You also get individualized attention.
 In group therapy,listening to peersgoing through thesamestrugglescan validateyourexperiencesand help
build self-esteem.Often group membersareatdifferentpointsin their depression,so you mightget tipsfrom
bothsomeonein the trenchesand someonewho hasworked through a challenging problem.Aswellas offering
inspiration and ideas,attending group therapy can also help increase yoursocialactivities and network.
When the going gets tough in therapy...
 As withremodeling a house,when you takeapartthingsthathaven'tworked wellin yourlife, it often makes
themseem worsebeforethey get better. When therapy seemsdifficultor painful,don'tgive up.If you discuss
yourfeelingsand reactionshonestly withyourtherapist,it will help you moveforward ratherthan retreatback
to yourold,less effective ways.However,if the connection with yourtherapistconsistently startsto feel forced or
uncomfortable,don’tbeafraid to exploreotheroptionsfortherapy aswell. A strong trusting relationship is the
foundation of good therapy.
Finding a therapist
 Oneof the mostimportantthingsto considerwhen choosing a therapistis yourconnection with this person. The
right therapistwill bea caring and supportivepartner in yourdepression treatmentand recovery.
There are many ways to find a therapist:
 Word of mouthis oneof the best waysto find a good therapist. Yourfriendsand family may havesomeideas,or
yourprimary care doctormay be able to providean initial referral.

7.  Nationalmentalhealthorganizationscan also help with referral lists of licensed credentialed providers.
 If cost is an issue,check outlocal senior centers,religious organizations,and community mentalhealthclinics.
Such places often offertherapy on a sliding scale forpayment.
Medication treatment for depression
 Depression medication may be themostadvertised treatmentfor depression,butthatdoesn’tmean itis the
mosteffective.Depression is not justabouta chemical imbalancein the brain.Medication may help relieve some
of the symptomsof moderateand severedepression,butitdoesn’tcurethe underlying problem,and it’susually
nota long-termsolution.Antidepressantmedicationsalso comewith sideeffectsand safety concerns,and
withdrawalcan be very difficult.If you'reconsidering whetherantidepressantmedication isright for
you, learning all the factscan help you makean informed decision.
Antidepressant Medication: What You Need to Know
 If you are taking medication fordepression,don’tignoreothertreatments.Lifestylechangesand therapy not
only help speed recovery fromdepression,butalso provideskills to help preventa recurrence.
Should you get antidepressants from your family
doctor?
 Your family doctormightbe the first professionalsto recognizeyourdepression.However,whileyourdoctorcan
prescribe antidepressants,it’sa good idea to exploreyouroptionswith a mental health professionalwho
specializes in depression.Askfora referral.You mightend up working with a therapistand notneeding
medication at all. If you do need medication,a psychiatristhasadvanced training and experiencein depression,
treatments,and medications.
Alternative and complementary treatmentsfor depression
 Alternativeand complementary treatmentsfordepression may includevitamin and herbalsupplements,
acupuncture,and relaxation techniques,such as mindfulnessmeditation,yoga,ortaichi.
Vitamins and supplements for depression treatment
 The jury is still out on howwell herbalremedies,vitamins,or supplementsworkin treating depression.While
many supplementsarewidely availableover thecounter,in many casestheir efficacy hasnot been scientifically
proven.If yourdepression symptomsarein partdueto nutritionaldeficiency,you may benefitfrom vitamin
supplements,butthisshould beon the advice of yourhealthcareprofessional.

8.  If you decide to try naturaland herbalsupplements,rememberthatthey can haveside effectsand drug or food
interactions.Forexample,St.John’sWort—a promising herb used fortreatmentof mild to moderate
depression—can interferewithprescription drugssuch asblood thinners,birth controlpills, and prescription
antidepressants.Makesureyourdoctorortherapistknowswhatyou aretaking.
Other alternative depression treatments
Relaxation techniques.
 As well as helping to relieve symptomsof depression, relaxation techniques may also reducestressand boost
feelingsof joy and well-being.Try yoga,deep breathing,progressivemusclerelaxation,ormeditation.
Acupuncture.
 Acupuncture,thetechniqueof using fineneedles on specific pointson the body fortherapeuticpurposes,is
increasingly being investigated asa treatmentfor depression,with someresearch studiesshowing promising
results.If you decide to try acupuncture,makesurethatyou find a licensed qualified professional.
Can Depression Be Cured without Medication?
 “Can I recover from depression withoutantidepressants?”
 This is a question thatmany peopleaskme. They search theweb,talk to their doctors,and seekalternative
treatments,hoping thatthey can recover“on their own.”The answerto this question is both simple and very
complicated.It often dependson theseverity and persistenceof depressivesymptoms.Few people,in my
experience,recover spontaneously and fully fromdepression entirely on theirown.Reaching outfor help is an
importantpartof the recovery process.Butgetting help can takemany forms,and whatworksforoneperson
may notbe the answerforanother.
 Studiesshowthatpsychotherapy can beaseffective as medication in improving depressivesymptoms,andthe
benefitstend to persist aftertreatmentends.Therapy addressestherootcausesof depression,such
as unresolved grief,anxiety,early childhood trauma,negativethinking,poorself-image,lossof meaning,
and relationship difficulties.Therapy can also help to improvecoping skills and resilience. But forsevere or
persistentdepression,boththerapy and medication may beneeded fora complete recovery.This article will talk
aboutwhatindividualsshould considerwhen deciding whetherto takeantidepressantsfortreatmentof
depression orwhetheranotherapproach mightworkaswell.
1. Severe, debilitating depression warrants a consultation with a doctor.
 When a person comesinto my office complaining thatheor she is depressed,it is importantto assessthe
severityof the depression.Severedepression with suicidalthoughts needsto betaken much more seriously and

9. warrantsa consultation witha medical professionalregarding possiblemedication.Severedepression isa life-
threatening condition and should betreated assuch.
 In addition,depression with severeinsomnia may requiremedication.Withoutadequatesleep,it is extremely
difficultto recover fromdepression.Thereare strategiesthatcan greatly improvesleep in somecases,but if
sleep doesnotimprovequickly,medication may be required to preventa worsening of depressivesymptoms.
2. There are effective non-drug treatment options for mild to
moderate depression.
 Many peoplewithmild to moderatedepression,wheresleep is adequate,can recoverfromdepression withtalk
therapy and adjunctivestrategiessuch asexercise,improved nutrition, mindfulnesstechniques,sunlightorlight
therapy,supportfromfriends,family ora supportgroup,and lifestylechanges.Allindividualswith depression
should rule outa medical issue which may contributeto their depressed mood.Many medicalproblems,
including vitamin deficiencies and hormoneimbalances,can contributeto depression.Getting a thorough
physicalexamto rule outa medical causeis important.
 If there is no clear medical cause,psychotherapy which focuseson improving self-care,reengaging in pleasurable
and meaningfulactivities,and managing negativethoughtscan behelpfulin many cases.Working on issues that
are impacting relationshipswithfriends,loved ones,and family can also greatly relieve depression in some
individuals.And forsome,exploring and resolving unresolved grief orearly childhood trauma may beimportant.
Otherapproachesthatcan contributeto recovery include bodywork,acupunctureorotheralternativemedical
approaches, meditation,yoga,orspiritualexploration.
3. Taking medication for depression, when needed, should notbe viewed as a failure.
 However,it is importantto recognizethatdepression is an issue as seriousasdiabetes, epilepsy,or even cancer.
Becauseit involvesmood,thoughts,and behavior,itcan often be treated through thosechannels.Butthereare
also genetic and environmentalfactorsthatmakesomeindividualssusceptibleto depression and which may
result in a morepersistent condition thatis moredifficult to treat.
 Justas otherconditionssometimesrequiremedication fortheir treatment,depression may also require
medication to fully resolve.And it is importantto recover fully ratherthan settle forpersistent mild depression.
Persistentdepression can becomechronic and moresevere overtime as the brain becomesaccustomed to the
depressed state.Therapy and medication combined havethehighestsuccessratein termsof resolving
depression,and when therapy aloneisnotsufficient,it may help to consultwith a doctoror psychiatristto
discussmedication options.
 It is importantto remember that,when it comesto treating depression,thereis no prize forrecovering “better”
than anotherperson.Recovering withouttherapy,withoutmedication—literally “on yourown”—doesnotearn
you any awards.Theprize is being emotionally healthy.It’simportantto recognizetheimpact thatoursociety’s
attitudestoward mentalhealthconditions,psychotherapy,and psychotropicmedicationsmay haveon your
decision-making.Howyou recoverisa personalchoice,based on yourown needsin consultation withtrusted
professionals.Yourchoiceshould bemadefroma place of compassion and self-love.
Alternativeremedies for depression

10.  The U.S.Food and Drug Administration (FDA) hasapproved a numbermedicationsforthetreatment
of depression.If you live with depression butoptnotto takeone of these medications,you still haveother
options.Somepeoplelookto herbsand naturalremediesto find relief fromtheir symptoms.
 Many of theseremedies havebeen used medicinally for centuriesas folkand alternativetreatments.Today,
many herbsare marketed asmood boostersforpeoplewho experiencechronicfeelingsof sadnessor
hopelessness.
 Studieshaveattempted to track thebenefitsof herbsfortreating depression.Here are severalherbsthat may
help lift yourmood when you experiencemild to moderatedepression.
1. St. John’s wort
 St. John’swort isa plantthat’snativeto Europe,western Asia,and northern Africa.Europeanscommonly takeSt.
John’swortasa way to treat depression,buttheFDA hasn’tapproved theherb to treatthis condition.
 Taking St. John’sworthasbeen linked with increasing the amountof serotonin in the body.Serotonin isa feel-
good chemicalin thebrain thatpeoplewith depression areoften low in. Severalantidepressants workby
increasing the amountof serotonin in the brain.
 According to the NationalInstitutesof Health (NIH),St.John’swort may help milder formsof depression,
although itseffectshaven’tbeen conclusively proven eitherway.A 2008 review of 29 studieson St.John’s wort
found thattheplantwasjustas effectivefortreating mild to moderatedepression asantidepressants,yet
resulted in fewerside effects.On the otherhand,theNIH’s NationalCenterfor Complementary and Integrative
Health sponsored two separatestudiesthatfounditwasn’tbetterthan a placebo fortreating depression.
 It’simportantto note thatSt. John’swortisknown forinteracting with lots of medications.Thisis especially true
forblood thinners,birth controlpills, and chemotherapy medications.Alwayscheckwith yourdoctorbefore
taking this herb.
2. Omega-3 fatty acids
 Omega-3fatty acids are a healthy typeof fat found in fish such as salmon,trout,and sardines.They’reavailable
in supplementformand aresometimescalled fish oil capsules.According to the Mayo Clinic, researchershave
found thatpeoplewho havelowlevels of two brain chemicals found in fish oil supplementsmay beat an
increased risk of depression.It’sidealto get a higher ratio of DHA to EPA,which are both typesof omega-3fatty
acids.
 In addition to taking fish oil supplementsto getomega-3fatty acids,you can also increasethe amountof fish
you eat.Eating fish three times a weekcan increase youromega-3fatty acidswithouttheaid of supplements.
 Keep in mind thatsome fish can havehigh levels of mercury.These include swordfish,tilefish,king mackerel,and
shark.Avoid thesein favorof fish with lower levels of mercury,such as light canned tuna,salmon,freshwater
trout,and sardines.

11. 3. Saffron
 Saffron isa spice derived froma dried portion of a crocus,a flowerin the iris family.According to a study
in AlternativeMedicine Review,taking saffron stigma (theend of the carpel,or rod-like stem,in the flower) has
been shown to be effectivein treating mild to moderatedepression.
4. SAM-e
 SAM-eis shortforS-adenosylmethionine.Thissupplementisdesigned to act like a syntheticformof the body’s
naturalmood-boosting chemicals.Accordingto the Mayo Clinic, SAM-eis regarded asa supplementin the
United States — the FDA doesn’tconsiderit a medication.
 You shouldn’ttakeSAM-ealong withantidepressants.You should also beawarethatSAM-ecan causehealth
effectssuch as upsetstomach and constipation if you taketoo much.
5. Folate
 There may be a link between low levels of folic acid (the syntheticformof folate) and depression.Taking 500
microgramsof folic acid hasbeen linked with improving theeffectivenessof otherantidepressantmedications.
 Oneway to increase yourfolatelevels is to consumefolate-rich foodsdaily.Theseinclude beans,lentils,fortified
cereals, darkleafy greens, sunflowerseeds,and avocados.
6. Zinc
 Zinc is a nutrient linked with mentalfunctionssuch aslearning and behavior. Low levels of blood zinc are
associated withdepression,according to an analysisin Biological Psychiatry.
 According to Nutrition Neuroscience,taking a 25-milligram zinc supplementdaily for12 weeks can help reduce
depression symptoms.Taking zincsupplementscan also increasetheamountof availableomega-3fatty acidsin
the body.
Herbs not yet proven to ease depression
 Health food storesmay marketherbsand supplementsasbeing ableto treat depression.However,according to
a review published in BJPsych Advances,severalof thesetreatments haven’tbeen shown to beeffectivein
treating depression.Theseinclude the following herbs:
 Crataegus oxyacantha (hawthorn)
 Eschscholzia californica (California poppy)
 Ginkgo biloba
 Lavandula angustifolia (lavender)
 Matricaria recutita (chamomile)

12.  Melissa officinalis (lemon balm)
 Passiflora incarnate (maypop, or purple passionflower)
 Piper methysticum (kava)
 Valeriana officinalis (valerian)
 If you do chooseto use theseor other herbs, alwayscheckwith yourdoctorfirst to makesure they won’tinteract
with any medication you mightbe taking.
 Also note thatherbsand supplementsarenotmonitored by the FDA,so theremay be concernsaboutpurityor
quality.Alwaysbuy froma reputablesource.
Talk to your doctor
 Although someherbsand supplementsshowpromisein treating depression,they aren’ta consistentor reliable
option when you experiencesevere depression.Don’trely on supplementsasa way to pull you through severe
depression symptoms.Depression can bea seriousdisease.Workwith yourdoctorto find a treatmentplan that
worksforyou.
Depression and anxiety: Exercise eases symptoms
 Depression and anxietysymptomsoften improvewith exercise.Here are somerealistic tips to help you get
started and stay motivated.
 When you havedepression or anxiety,exerciseoften seemslike thelast thing you wantto do.But onceyou get
motivated,exercisecan make a big difference.
 Exercise helps preventand improvea numberof health problems,including high blood pressure,diabetesand
arthritis.Research on depression,anxiety and exerciseshowsthatthepsychologicaland physicalbenefitsof
exercise can also help improvemood and reduceanxiety.
 The links between depression,anxiety and exercisearen'tentirely clear — butworking outand otherformsof
physicalactivity can definitely easesymptomsof depression oranxiety and makeyou feelbetter. Exercise may
also help keep depression and anxietyfromcoming backonceyou'refeeling better.
How does exercise help depression and anxiety?
 Regularexercise may help ease depression and anxiety by:
 Releasing feel-good endorphins, naturalcannabis-likebrain chemicals(endogenouscannabinoids)and other
naturalbrain chemicals thatcan enhanceyoursenseof well-being
 Taking yourmind off worries so you can get away fromthecycle of negativethoughtsthatfeed depression and
anxiety
 Regularexercise hasmany psychologicaland emotionalbenefits,too.Itcan help you:

13.  Gain confidence. Meeting exercisegoalsor challenges,even small ones,can boostyourself-confidence.Getting
in shapecan also makeyou feel better aboutyourappearance.
 Get more social interaction. Exercise and physicalactivity may giveyou the chanceto meet or socialize with
others.Justexchanging a friendly smile or greeting as you walkaround yourneighborhood can help yourmood.
 Copein a healthy way. Doing something positiveto managedepression oranxiety isa healthy coping strategy.
Trying to feel better by drinking alcohol,dwelling on how you feel, or hoping depression oranxietywill go away
on its own can lead to worsening symptoms.
Is a structured exercise program the only option?
 Someresearch showsthatphysicalactivity such asregular walking — not justformalexerciseprograms — may
help improvemood.Physicalactivityand exercise arenot the samething,butboth are beneficialto yourhealth.
 Physicalactivity is any activity thatworksyourmusclesand requires energy and can include workor household
or leisure activities.
 Exercise is a planned,structured and repetitivebody movementdoneto improveormaintain physicalfitness.
 The word "exercise" may makeyou thinkof running lapsaround thegym.But exercise includesa wide rangeof
activities thatboostyouractivity level to help you feel better.
 Certainly running,lifting weights,playing basketballand otherfitnessactivities thatget yourheartpumping can
help.But so can physicalactivity such as gardening,washing yourcar, walking around theblockorengaging in
otherless intense activities. Any physicalactivity that getsyou off the couch and moving can help improveyour
mood.
 You don'thaveto do all yourexercise or otherphysical activity at once.Broaden how you thinkof exercise and
find waysto add small amountsof physicalactivity throughoutyourday.Forexample,takethestairsinstead of
the elevator.Parka little fartheraway fromworkto fit in a shortwalk.Or, if you live close to yourjob,consider
biking to work.
How much is enough?
 Doing 30 minutesormore of exercise a day forthree to five daysa week may significantly improvedepression or
anxietysymptoms.Butsmalleramountsof physicalactivity — aslittle as10 to 15 minutesat a time — may
makea difference.It may takeless time exercising to improveyourmood when you do more-vigorousactivities,
such as running orbicycling.
 The mentalhealth benefitsof exercise and physicalactivity may last only if you stick with it overthe long term —
anothergood reason to focuson finding activitiesthat you enjoy.
 Howdo I get started — and stay motivated?
 Starting and sticking with an exercise routine orregular physicalactivity can be a challenge.These stepscan
help:
 Identify whatyou enjoy doing. Figureoutwhattypeof physicalactivities you'remostlikely to do,and thinkabout
when and howyou'd bemostlikely to follow through.Forinstance,would you bemorelikely to do some
gardening in the evening,startyourday with a jog,or go for a bike ride or play basketballwith yourchildren
afterschool?Do whatyou enjoy to help you stick with it.
 Get yourmental healthprofessional'ssupport. Talkto yourdoctoror mentalhealth professionalforguidance
and support.Discussan exercise programorphysicalactivity routine and how it fits into youroverall treatment
plan.
 Set reasonablegoals. Yourmission doesn'thaveto be walking foran hourfive daysa week.Thinkrealistically
aboutwhatyou may beable to do and begin gradually.Tailor your plan to yourown needsand abilities rather
than setting unrealistic guidelinesthat you'reunlikely to meet.

14.  Don't thinkof exercise or physicalactivity asa chore. If exercise is justanother"should"in yourlife thatyou don't
thinkyou're living up to,you'll associateit with failure. Rather,lookat yourexercise or physicalactivityschedule
the sameway you lookat yourtherapy sessionsormedication — as oneof the toolsto help you get better.
 Analyzeyourbarriers. Figureout what'sstopping you frombeing physically activeorexercising. If you feel self-
conscious,forinstance,you may wantto exercise athome.If you stick to goalsbetter with a partner,find a
friend to workoutwith or who enjoysthesamephysicalactivities thatyou do.If you don'thavemoney to spend
on exercise gear,do something that'scost-free,such asregularwalking.If you thinkaboutwhat'sstopping you
frombeing physically active or exercising,you can probably find an alternativesolution.
 Prepareforsetbacks and obstacles. Give yourself credit forevery step in the right direction,no matterhowsmall.
If you skip exercise oneday,thatdoesn'tmean you can't maintain an exercise routineand mightas well quit. Just
try again thenext day.Stickwith it.
Do I need to see my doctor?
 Checkwith yourdoctorbeforestarting a new exercise programto makesure it's safeforyou.Talk to yourdoctor
to find outwhich activities, howmuch exerciseand whatintensity level is OK foryou.Your doctorwill consider
any medicationsyou takeand yourhealth conditions.He or shemay also havehelpfuladviceaboutgetting
started and staying motivated.
 If you exercise regularly butdepression oranxiety symptomsstillinterfere with yourdaily living, see yourdoctor
or mentalhealthprofessional.Exerciseand physicalactivity aregreat waysto ease symptomsof depression or
anxiety,butthey aren't a substitutefortalk therapy (psychotherapy) ormedications
Common Side Effects of Antidepressants
 Antidepressants can sometimes cause a wide range of unpleasant
side effects, including:
 nausea
 increased appetite and weight gain
 loss of sexual desire and other sexual problems, such as erectile
dysfunction and decreased orgasm
 fatigue and drowsiness
 insomnia
 dry mouth
 blurred vision
 constipation

15.  dizziness
 agitation
 irritability
 anxiety
Antidepressants and Sexual Problems
 Oneof the morecommon “though notfrequently talked about”sideeffectsis decreased interest in sex or
decreased ability to havean orgasm.Asmany ashalf the patientswho getSSRIsreporta sex-related symptom,
saysBradley N. Gaynes,MD,MPH,associateprofessorof psychiatry attheUniversity of North Carolina.
 Oneway to addresssuch symptomsisto add a differenttypeof antidepressantoreven a medication forerectile
dysfunction,Gaynessays.Butit’salso possiblethatswitching to anotherantidepressantwillmakethese
symptomsgo away.Neverstop taking theantidepressantwithoutdiscussingitwith yourdoctor.Stopping
abruptly could causeseriouswithdrawal-likeproblems.
Antidepressants and Weight
 Another,lesswell-documented sideeffectof antidepressantsisweightgain.Go on any health messageboard
and you’llread accountsof patientsdisturbed by theamountof weightthey’vegained -- orin a few cases,lost --
since going on an antidepressant.
 Oneof the problems,saysGaynes,isknowing how much of theweightgain or loss can be attributed to thedrug
and howmuch can be attributed to otherfactors,such asa person’snormalbehaviorsaround food.
 Yet some reliable medical studieshaveshown thatlong-termuseof antidepressantscan raisetherisk of weight
gain and related illnesses -- type 2 diabetes and hypertension.
 “Weight gain and loss of sexualinterest and performancearethemain thingsI hearabout,” saysMyrna
Weissman,PhD,a clinician and epidemiologistat Columbia University.“Thenew drugstypically claim to have
fewerside effects,butI don’tknowthatthedata supportsthat.Sometimestherearepretty striking weight
gains.”
 Somestudiesand anecdotalevidencesuggestthat bupropion (Wellbutrin),which workson both theserotonin
and dopaminechemicalsin the brain,may be less likely to causeweight gain than commonly prescribed selective
serotonin reuptakeinhibitors(SSRIs) like citalopram (Celexa), sertraline(Zoloft),and paroxetine(Paxil).
Antidepressants and Sleepiness
 Certain antidepressantsaremoreenergizing,which may be rightfor someonewho feelssleepy often.Other
antidepressantstend to havedrowsinessasa sideeffect,which may be good forpeoplewho are often anxious.
 For example,drugslikemirtazapine(Remeron),which can causeweightgain and sleepiness,may be the right
drug forpatientswho have troublesleeping,or gaining weight.
 If you feel sleepy on yourantidepressant,talkto yourdoctor.You havemany options.
 Antidepressants,TalkTherapy,and Challenges
 In addition to physicalsymptoms,recovering patientsmay experiencenew challengesasthewool
of depression is pulled fromovertheir heartsand eyes.
 “Peoplesometimesget worsein therapy beforethey get better,”saysGabrielle Melin, MD,clinical psychiatristat
the Mayo Clinic in Minnesota.“Talktherapy takeswork.Ittakes emotionalenergy.Itcan bephysically draining,
too.But sometimesyou’llfeel worsein the processof getting to where you wantto be and who you wantto be.

16.  “Depression can maska lot of things.You get so wrapped in a fog and feel so awfulthatyou don’thavethe
energy to deal withreal problems. Sometimes depression isself-protectivebecauseit limits theenergy you have
to go to certain places.”
 To a lesser extent,even taking a pill can create an environmentof new stresses.“You’refeeling better, more
aware,morefocused – sometimesyou’remoreable to recognize thingsyou weredoing wrong,”saysMelin.
“Your attention and focuscan beprofoundly affected.”
 When her patientsfeel better, Melin says,shemay encouragethemto workon feelingsand behaviorsin talk
therapy.If a drug helpsa patientlift the veil of listlessness and hopelessness,heorshewill havemore energy to
workon fixing problemsin life and relationships.
What About the Risk of Suicide on Antidepressants?
 Many peoplehaveheard aboutthesuicide warningsthattheFood and Drug Administration ordered
antidepressantmanufacturersto poston their packageinserts. Thepackageinsertsnotethat children,
adolescents,and young adultswith majordepressionorotherpsychiatricdisorderwho takeantidepressantsmay
be at increased risk of suicidal thoughtsand behavior,especially during thefirstmonth of treatment.They should
be monitored carefully.
 No increased risk hasbeen seen in older adultpatients.And if you areover the ageof 65, you may actually have
less risk of suicidewhen taking antidepressants.
 Having suicidal thoughtswhiletaking an antidepressantisa serious side effect.Itneeds theattention of your
doctoras soon aspossible.Pleasedon’ttry to deal with thosefeelingsalone.
 Remember,mostpeoplewith depression getbetter.You may need to try a few differentantidepressantsto find
the right oneforyou. And getting talk therapy atthe sametime is themosteffective treatmentfordepression,
studiesshow.Workclosely with yourdoctor,and giveyourtreatmenttime to succeed
FOR KNOWMOREABOUTDEPRESSION VISIT
https://www.depressionstar.com/