Depression, in its simplest and spiritual form, is a sense of lack of connection with Light, G-d, the Universe, or whatever you wish to name that which illuminates our entire world and personal being.  Imagine sitting on the beach on a bright and sunny day but being covered with a blanket over your entire body which puts a filter between you and the sunlight.  This metaphor represents depression, and the thickness of the blanket—meaning the amount of light that is able to filter through—represents the degree to which one experiences depressed feelings.  I think it is safe to say that most people experience in their lifetime feelings of being down or unhappy, or days or periods of time when the sunlight is not quite reaching us.  Perhaps it is related to a particular circumstance or event, or perhaps it is more a general sense of discontent or despair.

Regardless, depression manifests in a variety of different ways and can last anywhere from a few hours to several months or even years.  In the category of “Depressive Disorders” in the Diagnostic and Statistical Manual of Mental Disorders (DSM) there are pages and pages of depressive disorder diagnoses along with very specific categories of those disorders that indicate length of depression, symptoms of the depression, etc.  Although we may sometimes say, “I’m depressed”, in truth depression comes in a variety of shapes and sizes and is not so simple. Most important, if you or someone you know is experiencing symptoms of depression lasting more than a week or two, it is important to seek proper medical and psychological support to prevent the depression from worsening.  Of course if someone is experiencing thoughts of harming one’s self or someone else, this calls for immediate intervention via a doctor or hospital.

The following is a brief general description of the main signs of depression with some basic guidelines for how to manage and/or prevent depression.

Signs of possible depression needing professional attention (not all need be present, one or any combination of these points can indicate depression):

• Depressed mood most of the day or almost every day (specific type of depressive diagnosis depends upon length of depressive symptoms, especially length of depressed mood along with other symptoms)
• Sadness, crying
• Anxiety, irritability, paranoia
• Loss of interest in activity or pleasure
• Appetite change and/or weight gain or loss
• Changes in sleep patterns, more or less sleep than usual
• Fatigue and/or low energy
• Lack of motivation
• Low self-esteem
• Physical symptoms such as headache, backache, neck pain and/or other vague pain
• Thoughts of guilt or hopelessness/worthlessness
• Impairment in ability to think or concentrate
• Thoughts of death or suicide

These symptoms, or any combination thereof, have been shown to be related to depression, however it will take a mental health professional to differentiate depression from other possible diagnosis that may exist along-side the depression.  When treating depression it is essential to have an accurate diagnosis so that the treatment does not accidentally worsen or aggravate other conditions that may be less obvious to the untrained eye.  One very specific and important example of this is distinguishing between depression and bipolar disorder, as treating depression when there is truly a bipolar disorder can severely impact the bipolar condition.

Treating depression

Most likely you know people who attempt to manage their own depression, even those who are unaware their condition is actually depression, through what I term “self-medicating” techniques.  These are quite commonly eating, excessive drinking of alcohol, use of recreational drugs, gambling, shopping, and/or other behaviors that provide a short-term mask or “high” that alleviates the depression.  I think most would agree that although these techniques may work for a few moments or hours, they are neither healthy nor effective in the treatment of depression in the long-term.

There are a variety of methods for addressing depression, and depending upon the nature of the condition any one or combination of these treatment options can bring relief.

• Exercise:  Exercise is crucial to the successful management of minor to major depression.  It increases circulation, balances bodily functions and hormones, and helps to release certain brain chemicals that combat depressive symptoms.
• Omega-3:  There have been significant clinical studies done proving the effectiveness of therapeutic doses of omega-3 for the treatment of depression.  A therapeutic dose is considered between 1200 and 1800 mg of omega-3 per day to be taken consistently.  Omega-3 has little if any side effects and does not interact with other medications, however prior to starting any supplement it is always good to check in with your doctor or health care provider to be sure it is the proper match for you.  One important note:  be sure to do the math and read the back of the label to take the proper milligrams of omega-3.  Often the capsule will have a milligram amount but the omega-3 content will be much less than the total amount per capsule.  I also always recommend purchasing an omega-3 supplement that is USP certified to ensure it will not contain toxins such as mercury.
• Sunlight:  Good old fashion exposure to sunlight is an excellent remedy for fighting depression.  This is especially helpful if the depression is seasonal, most often related to winter months.
• Nutrition:  Educate yourself on proper ways to eat in order to stabilize blood sugar and bring balance and sustenance to your body.
• Stabilize sleep patterns:  Believe it or not sleep plays a huge role in managing depression.  Having regular wake and sleep times can assist in setting the body’s rhythm and functions.
• Express gratitude:  Yes, you read that correctly.  Experience has shown me that regular and consistent expression of gratitude—to friends, family, and/or G-d—can actually create a shift of consciousness leading to a lessening of depressive symptoms.  To my knowledge there have not been studies to prove it, but try keeping a Gratitude Journal each day and see what happens.
• Counseling:  Especially when depression is brought on by life events or circumstances, counseling can provide the necessary emotional support and guidance to help work through the situation and move through the depression to happier times.  When the depression seems to be more physiologically based, a counselor can provide consistent support for proper lifestyle and wellness choices to compliment any medical treatment.
• Engage in activity:  Although most times when a person is depressed the very last thing they want to do is to engage socially, it is important to stay connected to other people.  Even if the activity is with only one other person and for a brief outing, be sure to get out of the house at least once or twice per week with another person or group of people.
• Medical intervention:  When change of lifestyle as mentioned above is not enough to relieve depression, it is time to seek medical assistance.  This can be in the form of a psychiatrist (a mental health professional who can also prescribe medication) or perhaps you may be more inclined to seek holistic options through holistic medicine.  Either way, the timely and aggressive treatment of depression is essential if the depression has reached a point of not retreating when all other techniques have been attempted.  Depression can be serious and at times life-threatening and needs to be treated as such.

Those who experience depression often times experience a sense of guilt and hopelessness.  I’ve heard many times, “I have a wonderful spouse, great kids, a great home, but I’m still so depressed I can barely function at work.  I don’t know what’s wrong with me.”  In these moments all options of treatment must be examined including the spiritual, emotional, and physical.  With the proper support, lifestyle changes, and interventions the alleviation and/or complete recovery of depression can be experienced.  No matter what, do not give up and remember that behind the clouds the sun is always waiting to shine through.

 By Mia Adler Ozair, MA, LPCC, NCC

Mia Adler Ozair, MA, LPCC, NCC is a licensed clinical psychotherapist and educator with a private practice in Beverly Hills, California.  Mia is licensed in both California and Illinois and she can be reached through her website at www.bhcounselingcenter.com, e-mail at mia@bhcounselingcenter.com, office 310-464-5226, or followed on Twitter @MiaAdlerOzair