The question I get asked a lot when people learn what I do for a living is: “how do you know it’s already depression and not just some bad days?” And then there’s the next one that follows -“what can I do to fight the bad moods and not let them transform into depression?”
The answer to the first one is pretty clear. There are indexes that help us distinguish between the normal feeling of sadness or recurring worse mood and depression.
There are several key points a psychotherapist or a psychiatrist needs to recognize in the patient’s functioning in order to diagnose a depressive episode. Depending on where in the world you are the list might be slightly different but I’ll copy them here for your reference.
DSM 5 criteria for depression:
1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
5. Fatigue or loss of energy nearly every day.
6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
ICD 10 criteria for single episode depressive disorder:
“Single episode depressive disorder is characterized by the presence or history of one depressive episode when there is no history of prior depressive episodes. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue.”
Please keep in mind it’s not a good idea to diagnose yourself. If you’re feeling depressed and you feel some of the descriptions from the lists above apply to you, it’s best to seek professional help and consult a specialist with whom you can work.
Depression is a complicated and multilayer condition, it’s not my intent to go deeply into the areas of diagnosis in this article. But what’s important to know, is that depression may start after a life-changing event or a trauma, and you may be predisposed genetically too. It may also be a condition often present with some other physical illness.
There are situations when it’s virtually impossible to avoid a depressive episode, but it’s almost like with physical exercise. If you work out to gain strength – you’ll be able to lift heavier weights. Similarly – if you take care of yourself on day to day basis – chances are should the episode appear, you’ll be stronger and you’ll be better equipped to deal with it in the end.
This text is for you if:
- you’re doing rather alright but you’re simply trying to take care of your mental health,
- you’ve experienced a depressive episode in the past and you want to know what might work in the future,
- you have swings of depressive moods coming back to you and you want to find out how to work on your well being.
So what exactly do you do?
Whenever I get asked the question about so to say ‘prevention’ I always answer the same. The first step is to acknowledge that our life is not a flat line. We experience ups and downs, days that are better and then worse. Months even when we might feel we’re confused – looking for a clue what’s next. There’s a whole range of emotions people experience and it’s only natural. They all tell us something. What’s important is to be able to self-reflect. Feel the pulse of what’s going on. In order to do that you absolutely need to:
Know yourself– this one is probably worth starting with. We hear it from our patients constantly – people are not encouraged enough from the start to learn who they are, what they like and how to properly express themselves. Because of that, they might be making all the wrong decisions, feel lost and confused. What’s worse, a very common notion in that is the belief they are the only ones feeling like that. The best and only way to approach this is to stay curious. Learn to discover yourself – through the world around you. Might sound a bit like a coaching advice, but it is a valid way to start a good relationship with yourself. Get to know yourself like you’d be getting to know somebody dear to you.
Be with people -we are social animals above all. Nothing beats a friend who cares for you and is willing to lend a hand and a listening ear. Too often the lack of human connection is what deprives people of the sense of their humanity. So going out there, simply connecting, staying in the loop, sharing moments, situations, laughs and talking about most ordinary things help you stay connected with yourself, but also feel you’re a part of something bigger.
Stay active – I’ll paste a quote from another article of mine I haven’t yet published here. It’s about the brain and how to take care of it. I think it fits perfectly here:) “Every single workout that you have will immediately cause the levels of the neurotransmitters – dopamine, noradrenaline, serotonin – to rise – and there’s your first added value – a recipe for a better mood right there. Also, you’re getting a better focus that will last – as Wendy Suzuki – the world-renowned neuroscientist – claims – for more than 2 hours. And that’s just the short span of it. Because according to neuroscience you will additionally get the long-term effects on your ‘good mood’ neurotransmitters (“The Big 3″ – dopamine, noradrenaline, serotonin). And we are talking about one half an hour workout only! The same workout will also make your reaction time better. Suzuki says that exercise actually changes your brain’s anatomy, physiology and function.”
Sleep well – Sleep may influence your mood. It’s a fact. What’s more lack of sleep WILL influence your mood for sure. “Sleep deprivation weakens the prefrontal cortex’s (reasoning) ability to control the amygdala (emotions), making it difficult to process and cope with emotions. When the brain is deprived of adequate sleep, it also struggles to concentrate and regulate growth and appetite. Sleep deprivation can have a profound effect on both the emotional and cognitive functioning of the brain. This results in bad moods, negative thinking, decreased empathy, and poor impulse control.” More about it HERE.
Avoid stress and find a way to fight it – It’s only natural that some days are more stressful than others. That’s just the way it is, though it doesn’t make it any easier, too. And while the first part is quite obvious – avoid toxic situations, relationships, the later might cause some question marks. One of the best ways to deal with stress is to understand the nature of it and then to find a way of dealing with it that feels good for you. For some people it might be meditation, for some a physical exercise, reading, meeting people, watching movies, listening to your favorite music – you name it. First things first – if you try to get to know yourself – you may already have a bunch of ideas about your personal preference in ways of coping with stress.
Eat well – while we don’t have any scientifically proven ‘anti-depressive’ diet we know that the way we eat has an enormous impact on our overall wellbeing. What we also know is that vitamin B12 deficiency impacts the condition of our nervous systems. It’s advisable to check with your doctor, but most people need to supplement this vitamin. Some studies show that there’s a higher likelihood of having depression in people with low levels of vitamin D. Read about it HERE. That’s the one that our bodies produce when we’re exposed to sunlight. Most of us have to supplement that during thee ’no-sun’ season. Another crucial ingredient is Omega 3 fatty acids. “Different mechanisms of action have been proposed. For example, omega-3s can easily travel through the brain cell membrane and interact with mood-related molecules inside the brain. They also have anti-inflammatory actions that may help relieve depression“.
To sum it up
There’s no good and easy answer to the question ‘what to do to avoid depression’. It is a serious – potentially lethal disease and sometimes you can’t help it. However, there’s a lot of ways in which we can contribute to our overall health. Pretty straightforward and intuitive ways too. By taking care of our minds, health, bodies and relationships we can lower the chance or severity of an episode and we can make the process of getting better more efficient and faster. If an episode occurs though or you feel your sadness goes beyond what’s a regular feeling – reach out to a mental health specialist and ask for help. Sometimes it’s a talking therapy, and sometimes it has to be combined with a pill.
What are your ways to stay in good health? share some ideas in the comments:)