By Chris Sovey, RN,BSN
Not too long ago, I gave a presentation on my solutions for teenage depression, and the audience was quite receptive. One gentleman, however was not too convinced. He approached me with quite a boastful and confident attitude:
“When I was your age, we didn’t have time to get depressed. I’m not really sure why all these young people think they have it so bad. This depression thing doesn’t even seem real to me.”
I smiled, and nodded. I certainly wasn’t going to get very far with this man, as he was solely convinced that depression was a made-up fantasy. Unfortunately this is not the case, at all.
The statistics for Depression in the United States are disturbing:
1 in 4 Americans will meet the diagnostic criteria for major depression during their lifetime (NIMH, 2008). This translates into nearly 60 million Americans.
Depression affects over 121 million people worldwide (WHO, 2009).
Industrialized nations such as the U.S. have the highest rates of major depressive disorder (Ilardi, 2009).
- 15% of those who are depressed will commit suicide (AHRQ, 2003).
- The incidence of depression has increased by 10 times in the last two decades (Ilardi, 2009).
- 11.5% of 33 million teens (or 3,795,000) experience an episode of Major Depression in one year (NSFUH, 2008).
The most alarming fact about depression is:
By the year 2020, depression is projected to be the second largest killer following heart disease. In addition, depression has been significantly linked to coronary heart disease (WHO, 2001).
What is depression?
Depression is a category of mood disorders which can range from a chronic sense of uneasiness, commonly known as Dysthymia to severely debilitating forms such Major Depressive Disorder. These disorders must be diagnosed by a healthcare practitioner, and fit very specific criteria, according to the DSM-IV.
What are some of the symptoms of depression?
- Chronic sense of uneasiness
- Profound sadness
- Loss of interest in activities that were previously enjoyed
- Chronic fatigue
- Decreased performance in daily activities
- Poor sleep
- Difficulty concentrating
- In severe cases: suicidal tendancies
Why is depression on the rise?
There is a lot of speculation as to why depression rates are continuing to rise. Some possibilities include:
- Poor dietary habits and increasing food additives / toxicity of food supply and self-care products.
- Genetic pre-dispositions.
- Depression sufferers are afraid to seek help due to social stigma, as 54% of people view depression as an illness (NMHA, 2004).
- Other environmental influences.
What causes depression?
There is no conclusive literature that depression is caused by any particular chemical imbalance (Lacasse & Leo, 2005).
This may contradict what you have heard. The fact is we are still rather clueless what causes this disease, and drug companies simply label it as a “chemical imbalance” so they have a means to sell antidepressants. I’m not anti-drug, but if you sit back and look at the numbers, antidepressants are given out like candy.
UPDATE: December 24, 2012: Over the last year, I’ve learned a lot more about depression. The gut contains a significant amount of neural receptors for the production of serotonin. Based on works by authors such as Dr. Natasha Campbell-McBride (Gut and Psychology Syndrome), I believe there is a significant link between gut disorders and depression. The gut-brain connection been repeatedly demonstrated in research for other disorders such as autism. Focusing interventions on the gut may yield favorable results. Learn more here.
Why are teens depressed today?
- Teenagers are under an enormous amount of pressure. Expectations are very high in many aspects of their lives. This may be a contributing to increased depression in teens. See the above section for other possibilities.
What can I do if I’m depressed?
- Seek Help:
- About 80% of people who are depressed are currently not seeking any form of treatment (AHRQ, 2003).
- 41% of women suffering from depression are too embarrassed to seek help (NMHA, 1996).
Teenage Depression Treatment options:
Over 10% of the U.S. population (or 27 million Americans) are currently using antidepressants. This is DOUBLE the amount prescribed in 1995.
- The effectiveness of antidepressants is questionable, while other non-medical techniques (such as cognitive behavioral therapy) have demonstrated equal or better long-term outcomes. Anti-depressants tend to “poop-out,” or stop working after a while. This phenomenon is poorly understood.
My experience with anti-depressants: I was on several of them in the past, in multiple different drug classes. I personally felt little benefit from them. Most anti-depressants “level off” your emotions so you feel little highs or lows. I suppose this could be of benefit to those who also experience manic episodes or severe psychotic depression / suicidal ideations. However, people need to understand that anti-depressants are undeniably still in their infancy. By altering neurotransmitters in the brain, such as serotonin, norepinephrine, dopamine, etc., we are essentially playing a crap shoot. The drugs are sloppy. They need a lot more refinement.
COGNITIVE BEHAVIORAL THERAPY (CBT):
Analyzes dysfunctional behavioral and thinking patterns and uses strategies to correct these patterns.
Most research agrees that it is a superior intervention to antidepressants (Butler, et al., 2005).
Fluoxetine (Prozac) treatment alone typically results in a 33% higher cost to a patient than CBT. Also only 29.5% of CBT patients relapsed compared to 60% of patients using antidepressants alone. (Butler, et al., 2005)
My experience with CBT: To this day, I still work on the skills I learned through CBT therapy. It requires a lot of dedication. Over time, it becomes easier to see the world in a different light, especially if combined with several of the other therapies I mention on this page. I found CBT to be one of the most essential components of my recovery from depression.
- Even 10 to 15 minutes per day of exercise can decrease depressive symptoms in the short term.
- 30 minutes of exercise per day for 3-5 days per week can significantly decrease depressive symptoms (Mayo Clinic, 2007).
Multiple well-designed trials have shown moderate exercise to be as effective as anti-depressants (Blumenthal, et al, 1999 & Singh, et al, 2001).
Start small and gradually work your way up.
Find a routine you enjoy doing.
Add a distractor (music) to increase satisfaction.
My experience with exercise: It is by far one of the most powerful immediate mood boosters. Of course the biggest barrier to exercise for depression is the depression itself. The motivation component is a real challenge. It is best to have someone, such as a friend, to encourage you to work out with them. As I have become more aware of my body symptoms over time through meditation, I can recognize aan incoming depressive episode, so it no longer “comes out of nowhere.” If I catch it early enough, a solid 30 minutes of moderately intense exercise has done me wonders.
Research shows diet has a strong impact on mood:
- Increase fruits and vegetables
- Decrease / eliminate processed foods
- Switch to a whole foods diet
- Eat organic produce
- Current research shows that Omega-3 fatty acids found in fish and many nuts are effective at reducing cholesterol and preventing heart disease. There is also a growing body of evidence to support fish oil as having positive effects as an anti-depressant, mood stabilizer, and anti-inflammatory agent (Riediger, et. al, 2009).
My experience with diet modifications: If you follow the site (I highly recommend it!), you are aware that I believe food is a powerful healer. If you believe that food does not impact mood, you are kidding yourself. The effects of switching from a fast-food junk diet to a whole foods diet completely changed my world. My energy skyrocketed. My concentration improved exponentially. I felt all around better. Of course, the depression greatly improved as well.
BRIGHT LIGHT THERAPY:
- Involves using a bright light box to stimulate cells in the eye, and relay to the brain.
- One of the best-studied nonpharmacological biologically oriented treatment approach in psychiatry” (Kasper, 2005).
- Personally, I have found bright light therapy to be very effective in many cases.
- Bright light therapy should not be used in cases of bi-polar disorder.
My experience with bright light therapy: I live in a cloudy state. In the winter there are stretches of 2 weeks or more without sunshine. Bright light therapy works. It isn’t as good as the real thing (sunshine), but I certainly notice an improvement in my mood with regular use of the device. The key is regularuse. Also, a light box must have a brightness rating of 10,000 lux to be considered therapeutic.
Social isolation exacerbates psychological conditions (House, J, 2001).
Having at least one social contact may greatly reduce the severity of acute depression (Ilardi, 2009).
Force yourself to plan at least 3 social activities per week.
Get involved with community and / or religious organizations to form meaningful bonds with others.
Inform someone close to you of your depression and ask them to encourage you to join them for activities.
When you feel your worst is actually when you need to get moving the most.
My experience: Much like the flu, when you feel depressed, you want to curl up in a ball and just lay around in bed. In the case of the flu, this is exactly what the body needs. However, with depression, stagnation is the worst thing ever. We need movement, even if someone else needs to help us with it. We need to get out and talk to people. We are naturally social creatures. As much as I didn’t want to talk to others or attend concerts / other events when I felt blue, I was always glad I went.
Dates back to simple Buddhist principles
Excellent for many other psychiatric conditions.
Not just living in the present moment, but having the intention to be aware of certain aspects of our existence that help us understand ourselves and subsequently, our illness.
Recommended Reading: The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Williams, Teasdale, Segal, and Kabat-Zinn.
A systematic review found that Mindfulness-Based Meditation: Was “effective effective in reducing depression levels or depressive symptoms” (Tsang, et al., 2008).
Several small-to medium sized studies have confirmed these results.
Larger studies will need to be performed for the public to start accepting MBSR as an acceptable treatment option.
My experience with mindfulness meditation: I can’t think of a more rewarding experience than learning this technique. It has assisted me on multiple levels. Not only have I been able to recognize oncoming depressive symptoms sooner, my concurrent symptoms of anxiety, fear, and other bodily sensations have reduced. Mindfulness meditation helps me to get a jump on depression before it takes a hold. It is a powerful tool in the management of depression when used correctly.
- There is a common link between depression and insomnia (inability to sleep)
- Depression and sleep disturbances create a vicious cycle that feeds the depression
- Most Americans are receiving only 6.9 hours of sleep.
- Put a priority on sleep. Set a regular bed-time and rituals. Maintain consistency with sleep patterns.
- Don’t sleep too much. It doesn’t help either. (>9 hrs for most teens / adults)
My experience with proper sleep: Who am I to tell you about proper sleep? I still haven’t figured this one out. I have managed to up my average sleep to about 7.5 hours which has helped, but on days where I consistently get 8.5 hours, my mood significantly improves. Try it out, and see you feel. The results speak for themselves.
OTHER HELPFUL TIPS / SUGGESTIONS:
- Explore the role of spirituality in healthcare and recovery from depression.
Pet Therapy is an excellent option to help with depression.
Don’t give up if a particular treatment doesn’t work.
Read books. A lot of them.
Talk to others who are depressed. You are an excellent resource for each other.
HOW CAN I HELP SOMEONE I KNOW IS DEPRESSED?
Encourage the person to seek treatment. Go with them if necessary.
Read books on the subject so you have a better understanding of what they are going through.
Understand that this is not their fault.
Recognize little bits of progress.
Try not to overwhelm someone during an episode of acute clinical depression.
Push them to participate in activities.
Set limits on behaviors.
Take care of yourself. (avoid Caregiver burnout)
WHAT NOT TO DO / SAY TO SOMEONE WHO IS DEPRESSED:
- “Snap out of this.”
- “Stop being such a baby.”
- “What is wrong with you?”
- “I don’t even know who you are anymore.”
- “I was sad once, and I got over it just fine.”
- “I’m sick of you acting like this.”
- Any comments like these are counter-productive to positive treatment outcomes. Work with the person, not against them.
I hope you’ve found this information helpful. Watch my following video presentation for more information on understanding depression, and effective treatment options:
DISCLAIMER: This is not a substitute for medical or professional dietary advice. Please consult with your healthcare provider before undertaking or modifying any healthcare intervention. Please read our disclaimer.
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Check back every Friday for more empowering health articles.
- Agency for Healthcare Research and Quality. (2003). National healthcare quality report. Retrieved from: http://www.ahrq.gov/qual/nhqr03/nhqr03.htm.
- James A. Blumenthal, Michael A. Babyak, Kathleen A. Moore, W. Edward Craighead, Steve Herman, Parinda Khatri, Robert Waugh, Melissa A. Napolitano, Leslie M. Forman, Mark Appelbaum, P. Murali Doraiswamy, and K. Ranga Krishnan: Effects of Exercise Training on Older Patients With Major Depression, Arch Intern Med, Oct 1999; 159: 2349 – 2356.
- Andrew C. Butler, Jason E. Chapman, Evan M. Forman, Aaron T. Beck, The empirical status of cognitive-behavioral therapy: A review of meta-analyses, Clinical Psychology Review, Volume 26, Issue 1, January 2006, Pages 17-31, ISSN 0272-7358, 10.1016/j.cpr.2005.07.003. (http://www.sciencedirect.com/science/article/pii/S0272735805001005)
- James S. House, PhD: Social Isolation Kills, But How and Why?
- Kasper, S., Ruhrmann, S., Schuchardt, H.M., 1994. The effect of light therapy in treatment indications other than seasonal affective disorder (SAD). In: Holick, M.F., Jung, E.G. (Eds.), Biologic Effects of Light 1993. Walter de Gruyter, Berlin.
- Lacasse JR, Leo J (2005) Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLoS Med 2(12): e392. doi:10.1371/journal.pmed.0020392
- Mayo Clinic. 2007. “Depression and anxiety: exercise eases symptoms.”
- National Institute of Mental Health: “NIMH Statistics.”
- National Mental Health Association. (1996). Mental Health America: Depression in women. Retrieved from: http://www.nmha.org/index.cfm?objectid=C7DF952E-1372-4D20-C8A3DDCD5459D07B.
- National Survey on Drug Use and Health. (2006). Major depressive episode among youths aged 12 to 17 in the United States: 2004 to 2006. Retrieved from http://www.oas.samhsa.gov/2k8/youthDepress/youthDepress.pdf.
- Natalie D. Riediger, Rgia A. Othman, Miyoung Suh, Mohammed H. Moghadasian, A Systemic Review of the Roles of n-3 Fatty Acids in Health and Disease, Journal of the American Dietetic Association, Volume 109, Issue 4, April 2009, Pages 668-679, ISSN 0002-8223, 10.1016/j.jada.2008.12.022. (http://www.sciencedirect.com/science/article/pii/S0002822308023353)
- Singh N, Clements K, and Singh M. The Efficacy of Exercise as a Long-term Antidepressant in Elderly SubjectsA Randomized, Controlled Trial. J Gerontol A Biol Sci Med Sci (2001) 56 (8): M497-M504. doi: 10.1093/gerona/56.8.M497
- Stephen S. Ilardi, PhD: “The Depression Cure”
- World Health Organization: “Depression“
The Causes And Solutions Of The Great Depression
March 4, 2000 The Causes and Solutions of the Great Depression The collapse of the stock market began on October 24, 1924. Approximately thirteen billion shares were sold. The collapse was devastating and long-term. On Tuesday, October 29th, more damage was done. It became known as Black Tuesday, and about sixteen million more shares were sold. Many businesses closed, and millions of people were left unemployed. Wages for the employed dropped drastically. The value of money fell as the demand of goods decreased.
In John Kenneth Galbraith's book, The Great Crash 1929, one of the most renowned attempts to explain the damage of the 1929 crash was made. He claims there are five important factors: 1) The consumer gods market was limited by an inadequate dispersal of cash flow. People's incomes were not high enough to purchase the goods being manufactured.
2) Corruption and fraud was rampant in big business and in the stock market. Wall Street was depending on useless paper that had no money behind it.
3) The banking structure collapsed after making too loans that could not be called in, resulting in a loss of people's savings.
4) The United States was put in further debt when loans of large amounts of money to foreign nations could not be repaid. High trade barriers in the United States led to the damage of foreign markets because they were not able to send their exports to the United States.
5) In the years prior to the Stock Market Crash, information about the economy was not nearly as detailed and profound as it is today. Economists of the day were not able to predict economic trends in industry, investment, consumer spending, and other factors that would have allowed them to identify a potential crisis. This is known today as The Stick Market Crash of 1929 and was followed by the Great Depression (Galbraith 182-187).
According to John Garraty, people believe there are many factors that lead up to the Great Depression. One of the most widespread causes of the depression came a as a direct result of The Great War of 1914-1918, known now as World War I. After the war, a reconstruction period lasted until 1925, bringing current economic levels back to those of 1913. Continuous growth and prosperity ended abruptly in 1929. The end of the post war economic uplift was the last major increase in growth our nation was to see for the next ten years. In 1939, as quickly as the depression hit, it was over. World War II had begun (2).
Many people also feel that if the great nations of the world, who were all experiencing similar signs of economic depression, had attempted to correct them, together they could have avoided,...
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