UNDERSTANDING DEPRESSION
– depression is not a single condition and does not have a single cause
– anxiety and depression are closely related and frequently intermixed
SITUATIONS THAT CAN CONTRIBUTE TO DEPRESSION
– loss or failure
– social isolation
– unemployment or financial problems
– unsafe environments
PHYSICAL FACTORS THAT CAN CONTRIBUTE TO DEPRESSION
– lifestyle (poor diet, insufficient sleep, lack of exercise)
– use of alcohol and other depressants
– withdrawal from stimulants
– some illnesses and medications
WHAT TO DO
– structure your time with daily routines
– maintain a regular sleep pattern by getting up at the same time every day
– limit use of drugs and alcohol
– have a check-up for possible medical causes of depression (eg. anemia, B12, thyroid)
ANTI-DEPRESSANTS
– lifestyle changes and psychological treatments should be tried before anti-depressants
– anti-depressants can help severe depression (‘melancholia’)
– anti-depressants are only marginally effective in mild to moderate depression
– anti-depressants take up to 2 weeks to start working and up to 12 weeks for full effect
– when coming off anti-depressants, taper down over 3-6 months to avoid withdrawal effects
OPTIONS WHEN ANTI-DEPRESSANTS AREN’T HELPING
– add psychotherapy
– medication algorithims
– ketamine assisted therapy
– reconsider the diagnosis
EVOLUTION OF DEPRESSION
1950s – depression is rare and severe (1/10,000 people)
1970s – depression is common, but usually resolves without treatment
1980s – most depression is Major Depression
2000s – depressed mood is not essential to Major Depression
2010s – “Depression is the leading cause of ill health and disability worldwide”
SAFETY PLAN FOR SUICIDAL THOUGHTS
– if you are having suicidal thoughts, use crisis services
– if suicidal thoughts are uncontrollable, call 911 or go to an Emergency Department:
Toronto Distress Centres 416-408-4357
Gerstein Centre 416-929-5200
CAMH Emergency Department 416-535-850
SEE ALSO:
Self-fulfilment or Self-erosion – Depression as Key Pathology of Late Modernity