Depression is more than a classification of symptoms for diagnostic purposes. Today, all mental health professionals use the DSM V (Diagnostic and Statistical Manual Of Mental Disorders), which allocate 9 symptoms of depression to the disorder. In short, if 5 out of the 9 symptoms are met during the same 2-week period (with at least one symptom being depressed mood or loss of interest), then the criteria for the illness are met. The other 4 symptoms include different or opposite experiences, such as excess sleep or too little sleep, restlessness or lethargy, appetite/weight loss or gain and feelings of worthlessness or inappropriate guilt. It is an assumption that all these 9 factors are interchangeable and have similar risk factors to be diagnosed as having depression. A recent journal article from Psychological Medicine challenged this assumption because these 9 factors lead to 1497 potentially different symptom profiles that qualify for the same illness. Some profiles do not have a single symptom in common. Furthermore, this article reports a study done on about 1300 medical interns over a period of time that concludes that different risk factors are related to different symptoms of depression. Based on this knowledge here are 3 simple things to remember when you have been depressed for a substantial amount of time.
Know your depression on all levels.
Most importantly know yourself. Indicators from your past and present circumstances will most likely predict why you might be gaining weight or feeling lethargy, for example. Stress is a huge factor that plays around depression and it is well known to be associated with any illness. The pathophysiology of depression is still poorly understood today, and a simple explanation like ‘chemical imbalance’ lacks adequate validity. Believing the notion that depression is a ‘chemical imbalance’ may limit your understanding of treatment options or possibly make you have high expectations of treatment success.
The chemical imbalance theory has been useful in many ways because it has been the impetus for advancing research and new medications. However, it is very simplistic and oversold in the media. There are potentially various different causes of depression. We still do not know to what degree biology plays a role in depression. Today, depression is not diagnosed through objective chemical tests, so if it was merely a chemical imbalance, such tests would be readily available, and depression could be easily resolved.
Acceptance leads to change
Although you may be experiencing a unique combination of symptoms, the time is always now to accept what you are experiencing. Although it may seem contradictory, the process of acceptance goes hand in hand with the process of change. On one hand, we have to stay where we are in terms of acceptance to be able to move forward towards change. One easy way to do this is to change your perspective on things. The best way to change your perspective is to mirror your thoughts and feelings to another person, so that they may be able to shift your focus. Acceptance is the hard part, but the starting point is self-awareness and knowledge. A big part lies in which stage of change you are in. The question to ask yourself is “Am I ready to take action towards recovery or am I still contemplating?”
Explore your options
There is so much availability in terms of treatment modalities for depression today. In addition, exercise and good nutrition play a key role in the body’s biochemistry. The new antidepressants have lesser side effects and could help stabilize your system, while you take action in a new direction. It also helps to do the opposite of what you feel like doing, it activates you into action, and helps you improve your mood in a quicker, healthier way.
Sonal Dani is a Marriage and Family Intern who specializes in depression, anxiety and spiritual growth. She has been trained in CBT (Cognitive Behavioral therapy) and helps adults create transformative change in their lives by applying the basic concept that thinking, feeling and actions are all interconnected. If you change any one, the rest change as well.
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