There are many specific subgroups of depression, but the psychological condition is characterized by consistent low mood, feelings of guilt or hopelessness, and physical fatigue. The mood disorder affects how a person is able to interact with their job, education, and loved ones. Depression can manifest as insomnia or oversleeping, changes in appetite like overeating or undereating, reduced pleasure in hobbies or previously enjoyed activities, feeling sad or afraid much of the day, or experiencing no emotions. A psychologist or physician diagnoses depression if this mood persists for two weeks or more with no relief.
Types of Depression
Specific types of depression include:
- Persistent depressive disorder (dysthymia): This involves a depressed mood that persists for two years. While symptoms may feel more or less severe at different times, the low mood continues with very little relief.
- Major depression: This occurs when the symptoms of depression persist for two weeks or more. This condition is sometimes referred to as clinical depression.
- Psychotic depression: This involves a combination of depressive symptoms and psychotic symptoms, like delusions or hallucinations. A person experiencing psychotic depression may, for example, hear voices telling them that they are worthless.
- Seasonal affective disorder (SAD): This condition is tied to a low mood that begins during a seasonal change and persists during that season. Mood will typically lift at the opposite seasonal change. Most people experience SAD during the winter months, although some people experience depression during the summer and elevated mood during the winter. This is believed to be related to a brain chemistry change tied to daylight.
There are many therapies available to help people struggling with depression. Medication is often used, but it is not an effective treatment on its own. Most medical practitioners recommend a combination of therapy and medication. Everyone has different experiences with medication and may not find available treatments effective; instead, they find alternative or holistic treatments more effective in long-term management of depression. The specifics of medicinal treatment and holistic treatment are outlined below.
The Medicinal Approach to Treating Depression
There are several types of medications available to treat depression. All of these medications function by adjusting the level of neurotransmitters in the brain, which can elevate mood. However, they affect different neurotransmitters in slightly different ways. These medications include:
- Selective serotonin reuptake inhibitors (SSRIs): These antidepressants reduce how much serotonin is absorbed by neurons, so more serotonin is available to transmit brain signals. This improves mood. Popular SSRIs include Zoloft, Lexapro, and Prozac.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): These medications change how much serotonin and norepinephrine are absorbed, which can elevate mood due to better transmission between neurons. Popular SNRIs include Cymbalta and Effexor.
- Norepinephrine-dopamine reuptake inhibitors (NDRIs): These medications change absorption rates of norepinephrine and dopamine, which is often considered the “happy neurotransmitter.” The most common type of NDRI is bupropion, available under the brand name Wellbutrin. This medication has also been found helpful in smoking cessation.
- Tricyclic antidepressants: These medications affect all three major neurotransmitters, both allowing greater production and release of these into the brain and inhibiting uptake. This class of antidepressants can be very potent and is no longer considered a frontline treatment for depression due to side effects. However, tricyclic antidepressants are very effective for some people who are not helped by other antidepressant medications.
- Monoamine oxidase reuptake inhibitors (MAOIs): These powerful antidepressants were some of the first medical treatments for depression, and they are very potent. They are so powerful, in fact, that people taking them must limit their diets and be cautious about other medications they take due to common interactions. They also cause serious side effects, but are very useful for people who have severe depression that has not been successfully treated with other medications.
- Atypical antidepressants: Some sedatives, like Remeron, and some antipsychotic medications have been shown to be useful in treating depression. While these are not effective in many people, they can be useful for some specific types of depression or for serious depression that has been resistant to other antidepressant medications.
Common side effects of antidepressant medications include:
- Changes in sleep patterns
- Changes in appetite, leading to weight loss or gain
- Reduced sex drive
- Nervousness or anxiousness
- Drowsiness or fatigue
- Dry mouth
It is important to keep the prescribing doctor up to date on side effects, original symptoms of depression, and the severity of all issues. Medication can be adjusted, although it is important to work with a professional therapist to understand the underlying causes and triggers for depression. Understanding this mental health condition can make coping with symptoms easier.
Some people may simply not respond to antidepressant medications, however. This can be a frustrating process and lead the person to feel overmedicated or out of control of their mental stability. People who go through this difficult experience may turn to other methods of treating symptoms when they appear or when they worsen. Holistic treatments or alternative health treatments can also work for some people, in conjunction with psychotherapy or mindfulness.
The Holistic Approach to Treating Depression
If a person experiences very negative reactions to antidepressant medications, does not experience any benefit from taking medications, or simply does not want to be concerned with the potential physical effects of taking medication, they may turn to holistic treatments to treat their depression. Holistic medicine is based on an inclusive approach to treating illness, which includes treating the body, mind, soul, and emotions. By balancing all of these together, instead of trying to focus on one area or another, holistic treatments aim to create a more balanced, stable, and satisfying life for the person in need.
Medical treatment for depression typically involves a combination of medicine and therapy; similarly, holistic treatments for depression likely combine several recommendations rather than relying on just one area. Some of the common holistic treatment recommendations for depression include:
- Exercise: Physical movement, from walking and jogging to yoga or weightlifting, can release more dopamine. When levels of this neurotransmitter are increased in the brain, mood is elevated, which can begin to alleviate some symptoms of depression.
- Healthy eating: This includes eating less sugar and fat, and more fruits, vegetables, and protein. Some diet recommendations include “serotonin-enhancing” foods, like fish for omega-3 fatty acids, coconut oil, and turkey.
- Removal of toxins from diet: This means eliminating, or limiting, intake of caffeine, alcohol, nicotine, and sugar, along with prescription medications that have been linked to depression and illicit drugs.
- More sunlight: This works especially well for people struggling with seasonal affective disorder, but it may apply to anyone with any kind of depression.
- Dietary supplements: Be careful with dietary supplements since these can interact with certain prescription medications, including birth control. Many people report getting relief from their depression symptoms with supplements like St. John’s wort, folate or folic acid, and fish oil.
- Mindfulness or meditation: Learning to observe the present moment, and observe thoughts and emotions objectively, can help people cope with depression and experience relief from some symptoms.
- Guided imagery: This is a form of meditation that uses a specific image to focus the mind. It can also sometimes involve metaphorical references to experiences and develop methods to overcome serious depressive symptoms by working through the imagination.
- Massage therapy: Some people experience lowered cortisol levels when they receive a massage from a licensed practitioner. Touch has also been linked to increased levels of serotonin and dopamine, which can alleviate symptoms of depression.
- Acupuncture: Using thin, sterilize needles inserted at specific energy points in the body, acupuncture has been shown to regulate and stabilize neurotransmitters in the brain, especially serotonin.
- Spiritual groups or art therapy: Participating in group activities with a focus on healing, such as creating expressive works of art, or being involved in a spiritual or religious tradition, can help some people develop a supportive community and improve overall mood.
While holistic treatment for depression can work well for some people, the reported benefits are largely self-reported and unscientific. In contrast, medication and psychotherapy have the best objective, scientifically supported outcomes. Working with a physician can also uncover potential underlying conditions, such as a thyroid or pituitary problem, that may be causing depressive symptoms but resolves with different treatment.
Holistic therapies often work best in combination with medical treatment for depression. It is important for the person choosing any or all of these options to make sure practitioners on all sides know about all treatments that are being given. For example, St. John’s wort interacts with many prescription medications, including antidepressants, and can negate their effects.
The Importance of Professional Help
People with untreated mental health problems are more likely to struggle with addiction or substance abuse, often as a method of self-medicating the symptoms of their mental health condition. People who struggle with substance abuse are also at risk of changing their brain chemistry enough to induce a mental health issue, such as depression. In these cases, symptoms of one disorder are likely to make symptoms of the other condition worse.
Fortunately, many rehabilitation programs are equipped to help people struggling with co-occurring disorders like substance abuse and depression. Medical detox can ease the person off their physical dependence on an addictive and intoxicating substance; individual therapy and group therapy help the person learn about triggers for their substance abuse and/or addiction; and prescription medication can ease symptoms of both withdrawal and depression. Some rehabilitation programs may also offer complementary, holistic, or alternative therapies, which work in concert with more traditional, evidence-based treatments.