Just the Blues? How to rule out Clinical Depression

When is sadness, feeling down or a depressed mood something that needs professional treatment with counseling or medication?

When the prominent, dominant mood state you experience is sadness and depression, that’s an indication that there is an emotional imbalance.  Not only is this a miserable way to feel, it can influence every area of your life.  

• Social: withdrawal from normal level of engaging with friends and family​

• Mood Stability: frequent tearfulness including tearfulness while watching tv programs or listening to music; chronic irritation and low frustration tolerance, with minor hassles becoming overwhelming obstacles
• Thoughts:  cognitions become distorted, characterized by themes of Helplessness, Hopelessness and Worthlessness.  Outlook is unrealistically pessimistic and harsh.  Concentration is poor.  Thoughts of wanting to be dead or of harming oneself. 
• Activity: slow to respond, lethargic, lack of energy or stamina, absenteeism from work or school, low work productivity
• Sleep: distrubed by early morning awakening, difficulty falling asleep, or frequent awakening in the night
• Appetite: reduced appetite and weight loss, or weight gain due to unhealthy eating
• Physical Health:  untreated depression exacerbates common medical conditions including arthritis, chronic pain, cardiovascular disease, diabetes, asthma and obesity

What is the most effective treatment for depression?

Depression is not a condition you should suffer without getting help—it is treatable and you can regain, and even improve, your level of happiness and satisfaction with life. “Talk therapy” forms of treatment that focus on thoughts, behaviors and interpersonal relations are effective with mild-to-moderate depressions.  

And  research consistently shows that the most effective treatment for moderate-to-severe depression is a combination of counseling and medication.  In working with clients, I thoroughly assess the level of depression, any other existing conditions, as well as the strengths and resources available at the beginning of counseling so that I can recommend the best tools for treating depression. ​​

How can I know if medication is necessary for treating my depression?

In counseling, an evaluation of depressive symptoms, their history and severity, may result in a recommendation for a consultation with a physician who has experience prescribing medications for depressed mood, such as a psychiatrist or a primary care physician.  Based on their recommendation, a client may decide to begin treatment with medication.  Psychologists do not prescribe medications, however I am knowledgeable of most medications used to treat psychological symptoms, and their side effects.  Together, the client, psychologist and physician make an effective team to monitor improvement in symptoms and minimize any side effects.

The typical course of treatment with antidepressant medication is 6-12 months.  

Some clients with chronic or very severe symptoms of depression prefer to stay on medication longer to manage their symptoms effectively.

How soon will I feel better?

​I don’t want to take antidepressant medication for the rest of my life.

Taking the first step in dealing with symptoms of depression is usually a relief, however it may take 4-6 weeks to notice significant improvement in how you feel. Therapy provides needed support and encouragement to manage symptoms and address underlying issues in ways that promote long-term change and growth toward satisfaction and healthy choices.  Getting physically active is another way to jumpstart recovery from depression.  Reaching out and expanding your support network (family, friends, a support group) is also a powerful tool for healing.  Letting others know how they can best support you is key: listening (not providing solutions), going on a walk, checking in with you once a week, attending a social function, support group, class with you, etc.

If I seek counseling or take medication will I be labeled?

When you feel depressed it is common to feel alone and as though others can’t relate to what you are going through.  

The reality is that many people suffer from depression and many seek professional help, including medication, to treat their symptoms.  In fact, antidepressants are in the top 20 most widely prescribed medications in the US.  Fear of what others may think should not prevent you from seeking the help you need; strengthening the ability to advocate for your best self is one of the skills I work on with clients in counseling.