When Depression Becomes Debilitating

What to Know About Debilitating Depression

Anyone who has struggled through a period of deep melancholy can attest to the intense power of emotions it triggers. We all suffer the occasional emotional fallout associated with difficult life events or circumstances. The pain endured from the loss of a loved one, a divorce, loss of a job, diagnosis of a serious medical condition, or a broken heart can sideline us for a period, these phases are commonly referred to as “the blues.” Most will manage to wind through the disappointment, fear, or sadness and the low mood will eventually stabilize with no intervention required.

For others, a cluster of pronounced symptoms may linger long after the triggering event, refusing to let up no matter how much time has passed. Depression can cause severe fatigue, impairing the person’s ability to function at work or at home. Even getting out of bed is a chore for those with serious depression. When depression becomes debilitating it is important to ensure the person is receiving the professional treatment they need, as an increased risk of suicide can develop.

Treatment for major depressive disorder must involve an integrated program that includes both traditional evidence-based therapies and medication, as well as holistic and experiential activities that enhance the treatment process by complementing psychotherapy. Depression can be successfully treated and managed with the right combination of interventions.

About Major Depressive Disorder

Although major depressive disorder (MDD) affects about 16 million U.S. adults per year, only a small percentage of people actually seek out treatment. A stubborn stigma still surrounds mental health conditions, including depression, acting as a barrier to getting help. Some people may not know where to even begin to get help and instead continue to suffer in silence. As a result, some may begin to use alcohol or drugs to self-medicate as a means of masking the unbearable depression symptoms.

But treatment for MDD can be very effective and should be sought out especially when depression becomes debilitating. The DSM-5 criteria for diagnosing depression involves five or more of the following symptoms have been present most of the time for more than two weeks:

• Persistent depressed or sad mood
• Recent unexplained weight gain or loss
• Difficulty concentrating or making decisions
• Fatigue
• Lack of interest in the activities once enjoyed
• Persistent feelings of hopelessness and despair
• Irrational feelings of guilt or shame
• Slowed thinking and motor skills
• Obsessing about death or suicide

The cause of MDD is still widely unknown, although science has identified several potential factors in developing clinical depression. These include genetics, temperament, environmental factors, and brain chemistry/biology

Different Types of Depression

Depression is a mood disorder that can have specific features that differentiate one type of depression from another. The different forms of depression include:

• Major depressive disorder (MDD). When five or more of the primary symptoms are present most of the time for a minimum of two weeks, MDD is diagnosed. These symptoms include:
  • Persistent low mood, sadness, feelings of despair
  • Loss of interest in activities normally enjoyed
  • Sudden weight gain or loss
  • Sleep disturbances
  • Fatigue
  • Difficulty concentrating or making decisions
  • Slowed cognitive or motor functioning
  • Feelings of worthlessness, guilt, or shame
  • Thoughts of suicide
• Persistent Depressive Disorder (PDD). Also referred to as dysthymia, this type of depression is present most of the time for at least two years.
• Seasonal affective disorder (SAD). This type of depression is more prevalent in areas further from the equator that receive less sunlight during the winter months.
• Postpartum depression. This depression has its onset during pregnancy or soon after childbirth.
• Premenstrual dysphoric disorder (PDD). More intensified PMS symptoms, especially mood swings and irritability.
• Bipolar depression. Bipolar disorder features extreme mood swings alternating between mania and depression.

Dual Diagnosis

A dual diagnosis, which indicates a co-occurring substance use disorder, is present in a significant number of individuals who suffer from depression. This may come about when the individual begins to use the substance in order to find relief from the symptoms of MDD. Alcoholism is the most common coexisting disorder with MDD, only adding to the person’s misery. Alcohol is a central nervous system depressant, so instead of helping the individual, it only increases the intensity of their symptoms while also adding profound health risks.

A dual diagnosis creates a more complicated treatment strategy. It is now believed that to achieve the best long-term treatment outcome both disorders, MDD, and alcoholism, should be treated simultaneously. Dual diagnosis treatment requires specialized training, so treatment should be sought in a dual diagnosis program when debilitating depression presents with a coexisting substance use disorder.

How Depression Can Cause Health Problems Too

The brain-body connection is increasingly being studied for important clues about how our state of mind impacts physical health. Clinical evidence shows that persistent low moods can stress the organs and lead to health conditions. These potential medical conditions include:

• Inflammation
• Chronic pain
• Increased risk of heart disease
• Diarrhea
• Constipation
• Loss of libido
• Insomnia
• Headaches
• Nausea
• Changes in appetite can lead to significant weight loss or gain

Someone with existing health conditions may find that depression worsens the condition. Also, that battling depression may not be motivated to adhere to their medication protocol for the health issue, which can cause symptoms to get worse.

Treatment for Depression

There exists an industry standard within the field of mental health treatment for the treatment of MDD. This traditionally includes both antidepressant therapy and psychotherapy. Antidepressants are plentiful, with about thirty different brands on the market for treating depression. Initially, a doctor will take a leap of faith in prescribing antidepressants for a patient, using their training and treatment criteria to select the medication best aligned with the patient’s needs. Antidepressants can take upwards of four weeks to begin to take effect, which can be frustratingly slow. If one drug does not show promise, the doctor will have the patient trial another drug, or may just adjust the dosage.

Psychotherapy involves talk therapy and is available in various modalities. Generally, in treating individuals with MDD, mental health practitioners may select a behavioral-based therapy like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), or a cognitive-based therapy such as psychodynamic therapy. There are two main functions of psychotherapy for a depressed patients, to help them explore potential underlying pain points, such as past trauma or other distressing life events, and to help the patient reshape their internal thought-behavior messaging and responses.

Holistic Therapies for Depression

When depression becomes debilitating, it is in the complementary therapies that the most yardage is gained. That is because these holistic activities help the individual gain a deeper perspective into their spiritual being, discovering new insights about themselves that can become therapeutic breakthroughs. These activities include such things as:

Mindfulness training: Mindfulness involves training the mind to be aware of the present moment, versus ruminating over past events or stressing over upcoming events. Focusing on the present, the senses, and one’s breathing rhythm can help manage feelings of depression or anxiety.

Yoga: Originating in India, yoga blends exercise, breathing, and meditation to improve overall health and mood. There are many different yoga practices, each with their own styles and features.

Art therapy: Art can be used as a form of psychotherapy by encouraging self-expression through drawing or painting. Some patients may find it easier to communicate their feelings visually versus verbally.

Guided meditation: Meditation and breathing exercises that are guided through a sound recording or instructor who helps individuals get to a peaceful mental state.

Journaling: Writing thoughts, feelings, and experiences in a journal can help individuals process emotions and reduce stress.

How Regular Exercise Improves Mood

Getting regular exercise is an excellent complimentary activity to psychotherapy for treating depression. Incorporating a fitness routine into daily life can produce significant physical and psychological benefits. Being active for a minimum of 20-30 minutes several times a week causes an increase in the production of endorphins, a brain chemical associated with elevated mood. Exercise also stimulates neurotransmitters, such as serotonin, dopamine, and norepinephrine, which boost mood, help with sleep quality, memory, and the reduction of stress. Examples of cardio exercise include walking, running, hiking, cycling, swimming, dance cardio, and spin class.

How Diet Can Affect Mood

A recent meta-analysis published in Molecular Psychology reviewed 40 studies related to diet and depression. The analysis confirmed the compelling evidence showing how a Mediterranean diet, along with avoiding a pro-inflammatory diet, can prevent depression. The Mediterranean diet emphasizes plant-based foods, such as fruits and vegetables, healthy fats, such as olive oil and canola oil, legumes, yogurt, nuts, whole grains, fish, and poultry.

Recent interest in the microbiome, or gut health, and its relationship to depression has caught the attention of nutritionists who work with clients who have clinical depression. Evidence shows that inflammation in the gut may be linked to the mood disorder. Probiotics, fermented foods like kefir and yogurt, and curcumin may help remedy gut inflammation and improve mental health.

Elevation Behavioral Health Provides an Integrated Approach to Treating Depression

Elevation Behavioral Health is a luxury residential mental health and dual diagnosis treatment center in Southern California. Nestled in a tranquil canyon above Malibu, California, Elevation Behavioral Health provides an intimate six-bed setting for individuals in need of healing from depression, instead of an cold, institutional setting. The spacious and beautiful 10,000 square foot home features unmatched luxury in both the interior and exterior grounds.

This mental health and wellness program for depression or dual diagnosis is built upon a foundation of proven therapeutic modalities, such as CBT and DBT. Added to that are holistic therapies, such as yoga, mindfulness training, and meditation, to offer a fully integrated approach to debilitating depression treatment. When depression becomes debilitating, a serene, relaxing environment, compassionate therapists, and upscale accommodations can go a long way toward reintroducing joy in life. For more information, please contact Elevation Behavioral Health today at (888) 561-0868.