Depression comes in many forms and there are many different levels of depression. To start, I will explain the most common forms of depression to help you get a better understanding.
Adjustment Disorder, with depressive symptoms:
The onset of this depression is triggered by an adjustment such as loss of job, an unwanted move, or a breakup. The DSM 5 lists the following symptoms for a depression specifier: low mood, tearfulness, or feelings of hopeless are predominant.
Persistent Depressive Disorder (formerly known as Dysthymic Disorder):
This type of depression is more of a low level, constant depression. The DSM 5 lists the following criteria for this disorder: depressed mood for most of the day, for more days than not, for at least two years in adults or one year in children, presence of two or more of the following symptoms: poor appetite or over eating, insomnia or hypersomnia, low energy, low self-esteem, poor concentration/difficulty making decisions, feelings of hopelessness.
Major Depressive Disorder:
This type of depression can come and go and is marked by feeling certain criteria for the same two-week period on more days than not and must show a difference in how one previously felt and acted. The person must show either a depressed mood or loss of interest or pleasure. The DSM 5 asks that one meet at least five of the following markers for this diagnosis: depressed mood most of the day, nearly every day, markedly diminished interest or pleasure in all or almost all activities, significant weight loss when not dieting or weight gain, insomnia or hypersomnia nearly every day, psychomotor agitation or retardation nearly every day, loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, recurrent thoughts of death or suicidal ideation.
Now knowing a bit more about the different types, you can see that all three share many traits, making it hard for us to always know exactly what is going on. As a therapist, I have learned that many of us do not have strong self-insight making it hard for therapists to give a proper diagnosis. I always tell my clients to begin tracking their moods to help build self-insight. A great app to do this with is Daily-O. This will allow you to track how you feel everyday, look for patterns, and overall learn more about yourself, your feelings, and your mood.
There are many different options for depression including counseling and medication. The combination of both is always the most helpful, but if you are weary on medication, a good place to start would be counseling and to see if it helps. If it does not, or does not help significantly, then it may be time to think about taking some medication and make an appointment with a psychiatrist.
Outside of counseling, there are many different things you can do in your life to help you cope. Journaling is a great way to help you get your feelings out so you do not keep them bottled up inside.
Set small goals for yourself. You do not want to set goals too big, then fail, then become more upset. Set small, uplifting goals, to help you try to become a bit happier. A small goal could be making your favorite food today, going on a small hike, watching your favorite movie.
Exercise is a great way to help combat depression. Exercising releases what I like to call “happy chemicals” into your brain. When we are depressed our brain does not release as much of this, which makes fighting depression harder.
Creating a routine can help to try to get you on more of a sleep schedule. It can also help you with motivation to do things that you may not be doing when you are depressed.
Try to make small plans with friends to push yourself to stay social. When thinking about this task, it can seem very daunting and you think to yourself that you will not enjoy it anyway. But… give yourself the chance to try to enjoy it. What is the worst that could happen, you do not enjoy it? When depressed, you are usually not enjoying your day, so there is no loss in trying to do this.
Allow others to help you. Do not shut people out. It is okay to ask for help. People think that asking for help shows weakness. It actually shows the complete opposite. It shows strength. It shows you are strong enough to realize that you cannot do something in that moment. And believe it or not, many people enjoy helping others so allow them to help you.
Avoid substances including drinking and alcohol. Although we may think this helps us, it really does not.
Having depression can be very hard. People describe it as not even knowing who they are anymore. You are aware of the person you were, the things you loved to do and all of a sudden feel as though you are not even you anymore. You do not understand why you are not getting pleasure in activities you used to love to do. You are confused why you are not laughing as much. You are still you, but you aren’t you at all. Noticing these changes are so important, because the sooner you notice and treat them, the more you can start to become yourself again.
When someone begins to feel hopeless, it is one of the most disturbing feelings. How can one not be hopeful anymore you may ask yourself? Simply stated, when you are feeling that low, you almost feel trapped and so far away from good that it seems virtually impossible to think that it could get better. This is the area in depression where suicidal ideations can creep in. There is a strong link between individuals who are depressed and suicide. Suicide can seem like a great answer to someone who is depressed. It can heal the pain in you. It can heal the pain others have seeing you like this. You do not have to keep fighting. But…. what I have asked many of my clients thinking these thoughts is, “Have you thought about everything else it ends too?” It ends your friendships, the bond you have with your pet, watching that show you love, seeing the sunrise, eating your favorite food, playing soccer, and so forth. It is a permanent end and an end all be all to every single aspect of your life, both big and small. This is the time when I try to make a client think about all they would lose to trade off not feeling the pain and try to encourage them to take small steps to regain their happiness. You try to show them that when life does not end, there are always options, whereas when life ends, there are none. Something a very important person said to me once was, “When there is life, there is hope.” That short quote was some of the most powerful words I have ever heard. They were right. In life there is always hope, because there are options and choices. Each day is a new day, a new start to life, a new day something can change, a new day life can be better. When I have had the opportunity to speak to survivors of suicide, or watched some of their stories, many of them have said, that in the moments of them in the process of ending their life, they have thought to themselves, what have I done, I do not want to die. Sadly, I imagine, there are many that have had those same exact thoughts but were not as fortunate to survive their attempt to speak those words…
I have counseled individuals for over 10 years and have practiced privately for over 8 years, and whenever the words of suicidal thoughts or attempts are muttered to me it brings a chill throughout my whole body. It is something that never be taken lightly and it is something that we cannot turn our heads to it. Talking about and realizing it does exist brings awareness. It also brings hope. Hope for those having those thoughts that other people may understand, that other people are willing to help, and that there are ways to feel better and get better and continuing living life. Something I can share, that is completely factual is I have seen some individuals, as they describe, at the lowest points of their life. And I have been on a journey with them and was able to see them get a bit better, then a bit more better, and so on, until, as they put it, felt like themselves again, showing, there is always hope, and treatment can help if you allow it to. If you are someone suffering from depression or know someone who may be, today can be the day you can begin the journey to combat these symptoms and start feeling like you again. If you would like to set up an appointment, please reach out to us. Below I will also list different hotlines for you or someone you know to call.
National Suicide Awareness Hotline: 1-800-273-8255
NJ Hope Line: 1-855-654-6735