Break Free of Your Depression

by 50MINUTES. COM,

  If you choose to embark on psychotherapy, it is important to go regularly. Both the professional and the patient need to put in the work, which means that it is essential to establish an atmosphere of trust which fosters exchange. If this is not the case, it is better to change to another healthcare practitioner.

  Good to know

  Doctors and psychologists must maintain professional confidentiality.

  With the help of antidepressants

  A contract between the doctor and their patient

  Once depression has been diagnosed, it may be necessary to follow a course of medication. The decision on whether to take this option must be discussed by the patient and their doctor. The doctor must offer the patient medication which is appropriate to their needs, which means that they must be fully aware of how the treatment works and of the patient’s health before prescribing anything to them. There is therefore a sort of therapeutic contract between them.

  According to the General Medical Council in the UK, doctors should discuss the common side effects of the medication they prescribe with their patients and explain what to do in the case of one of these side effects.

  The patient should start taking the antidepressants as soon as possible, because most of them only begin working after two to three weeks. This is why those suffering from depression should continue psychotherapeutic support alongside any medication. Some patients who are unaware of the waiting time before feeling the benefits stop their treatment too early. In this case, the symptoms develop and the illness remains.

  Function and side effects

  Antidepressants act on a biological level on certain parts of the brain. The most widely used antidepressants act on serotonin, while others act on both serotonin and noradrenaline. These are both substances which are produced by the brain and help with the transmission of information between neurones. In this way, psychoactive drugs allow patients to shake off their depressive feelings and general torpor. However, you must avoid relying on medication alone and should also try to improve your lifestyle.

  While antidepressants have become much more bearable over time, they can nonetheless have a series of side effects. If you experience any of these, you must talk to your doctor about it so that they can adapt your treatment by reducing the dosage or changing your medication.

  Stopping treatment

  When you feel that you are gradually moving past your depression and rediscovering your taste for life, it is time to think about stopping treatment. You need to discuss this with your doctor, who will put a plan in place to gradually reduce your medication.

  With the help of alternative treatments

  Nowadays, many people are trying to adopt healthier lifestyles and prefer treatment that is as natural as possible. Alternative treatments can improve your mental and physical wellbeing. However, they should always be adopted following a medical opinion and be approved by your doctor.

  Luminotherapy or phototherapy aims to compensate for the reduction in light in cases of seasonal affective disorder. It affects the secretion of melatonin, the sleep hormone which decreases in the morning and increases in the evening. Some people (for example hospital patients and those with reduced mobility) cannot take advantage of the daylight. In these cases, using special luminotherapy lamps or glasses in the morning can help them to be more awake during the day and make it easier for them to go to sleep at night.

  Homeopathy involves using vegetable, animal, mineral or chemical substances, in very weak concentrations. You can get these medications from a pharmacy after being prescribed them by a homeopath, who will provide instructions and the dose to take. Although there are no studies showing that homeopathy is genuinely effective as of yet, it is still used by many people.

  Dietary supplements have been recognised for their mood-boosting effects. Magnesium, omega-3 fatty acids and tryptophan (an amino acid which affects serotonin, and therefore mood regulation) can be used to prevent or treat depression, as they all have a direct impact on mental health and sleep, and improve brain function.

  Plants have certain benefits which may have a positive effect on mental health. For example, St John’s wort, valerian and passion flower have tranquilising or sedative effects, but you should never take them without consulting a medical professional, because the active ingredient in these plants may interact with the active ingredient in other medications, such as antidepressants, oral contraceptives or migraine medication. You must therefore avoid self-medicating and talk to your doctor if you want to treat yourself using plants. They will be able to develop a suitable course of treatment for you.

  In all cases, you are advised to consult a healthcare professional and closely follow their advice if you want to opt for an alternative treatment, and to establish a dietary plan with the help of a registered nutritionist.

  How can I help a loved one with their depression?

  If you observe an unexplained change in the behaviour of a loved one, and this lasts for several weeks, they may be suffering from depression.

  Even if you do not have the necessary skills to treat them, there are still a number of ways you can help and support them:

  Encourage them to see a doctor. Offer to go with them if they need it. If they refuse and you sense that they are suffering, talk to them about your fears and the symptoms that are worrying you.

  Avoid giving them advice like “if I were you, I would…”, “don’t let yourself go”, “do something”, or “you’ll feel better if you some exercise”. This may make them feel guilty and powerless.

  Listen to them, reassure them and show them that they are not alone and can count on you.

  Praise any effort they make, no matter how small it is, and stay open to discussion.

  Help them with day-to-day activities without treating them like a child.

  In case of emergency (suicide risk, danger to themselves or others), call a doctor or the emergency services, and make sure that you explain the worrying symptoms clearly.

  It is very difficult to care for a loved one who is depressed, because they may talk aggressively, dwell on the same negative thoughts and be ungrateful for your support. However, you must keep in mind that they need care and attention. They will only be able to put things in perspective to understand the situation and acknowledge the important role you played once their symptoms start to get better.

  However, this does not mean that you have to put up with everything. You should set boundaries and be fair to yourself. If you feel out of your depth, remember that there are trained medical professionals who specialise in treating depression. You therefore need to work with the depressed person. Some distance is necessary to keep up your support for several weeks, or even several months.

  Warning!

  If you feel that your loved one is dragging you into their depression, remain vigilant. Do not abandon them, but ask for help from those around you and do not carry the burden of their depression alone. If you are not careful, you could become depressed too!

  How can I protect myself against a relapse?

  Maintain a healthy lifestyle

  A balanced lifestyle and respect for your body are essential to stay healthy and in shape.

  There are many indoor and outdoor activities that can get you moving and help keep your body in good condition. From yoga or stretching exercises to walking in the woods, all physical activity is beneficial as long as you do it regularly and enjoy it. You could think about finding a personal trainer or kinesiotherapist, who can help you to set personalised goals. You can also take part in a sport with your friends: this will help you to maintain a social network and stop you from becoming isolated.

  Food plays an important role and should be a source of pleasure. If you feel another imbalance, get in touch with a dietician or a nutritionist. Another option is to get a friend who is a great cook to teach you a f
ew simple recipes, or offer to help them. Taking part in the cooking yourself allows you to know exactly what you are eating and visualise portion sizes. Furthermore, cooking with other people is fun and rewarding for everybody.

  Finally, keep in mind that good sleep habits will give you the energy you need to be on top form as you face the day. Try to always go to bed and get up at a similar time to structure your day.

  Change your outlook

  Once you recover from depression, one thing is certain: you never want to fall back down that hole! It is therefore essential to remain vigilant and be aware of your emotions, behaviour and thoughts in order to continue to enjoy a sense of wellbeing.

  Gradually, work returns to its old place in your life, activities resume and you start going out with your friends again. If it is still difficult for you to go back to places you cut out of your daily life, refocus on the facts rather than on your negative assessment of them. In their book Faire face à la depression (“Face Up to Depression”), the psychiatrists Ivan-Druon Note and Charly Cugni suggest a simple and effective exercise called the effectiveness/pleasure scale.

  Your turn!

  On a sheet of paper or in a small notebook, draw a table like the one below. In the first row, write all your daily activities. Mark with a cross the level of effectiveness and the pleasure felt, on a scale from 0 to 10.

  Sophia, 45, is recovering from depression. She completes the exercise.

  The exercise shows that Sophia positively evaluates activities with other people in terms of both pleasure and effectiveness. However, although she has no trouble getting ready, she does not take much pleasure in it.

  Noting your feelings in a table allows you to pay attention to your emotions in everyday activities. Rather than dwelling on the negative, as depressed people tend to do, we hold on to the things that give us pleasure and personal satisfaction. This technique should be used regularly to have a positive effect.

  Even when life seems to be going better, we still feel negative emotions from time to time. We must be able to let them in and accept them. Being aware of them already means putting things into perspective. Negative emotions are not necessarily harmful; we just need to be vigilant and avoid letting them overwhelm us. Unlike thoughts, which can go on indefinitely, all emotions end at some point. Individuals are shaped by all their past experiences, their values and their rules, which they bring together in a complete structure that they follow throughout their life. This is known as a schema. Some of these can encourage depression, because they are too strict and demanding, which results in a series of negative thoughts. To get out of this schema, the individual must turn their negativity into positivity. Techniques which have an impact on cognitive restructuring have the advantage of helping the person to behave more independently.

  Exercise

  Taking the table below as an example, write down a situation that inspires a negative emotion in you and note down the behaviour you generally adopt and, more positively, the behaviour you could adopt.

  Similarly, systemic therapy helps the patient to put their difficulties into perspective by dealing with the person based on their situation. The Argentinian psychiatrist and systemic therapist Salvador Minuchin refers to Lewis Carroll’s (1832-1898) famous novel Alice’s Adventures in Wonderland to explain one of the fundamental principles of the systemic approach. He explains that changing Alice was not enough, but that her environment also needed to be modified; it was only then that she felt a real change in herself. This theory therefore aims to explain that a series of elements must be modified for the person to feel the benefits and see their symptoms disappear. It is a relational and communicational dynamic that will bring about real change.

  Identify risky situations

  To avoid becoming depressed again, it is essential that you learn to identify situations that could cause a relapse. In most cases, these are anxiety-inducing circumstances that are specific to each person or emotionally charged episodes such as:

  recently becoming a mother or father;

  moving house;

  losing a job;

  getting divorced;

  chronic unmanaged stress;

  the death of a loved one.

  In these particular cases, it is normal to feel negative emotions. To prevent a new bout of depression, you need to learn to give meaning to these feelings. For example, you could imagine the scenario of a relapse (situation, emotions, negative thoughts, behaviours). This will allow you not only to neutralise your fears and preconceived ideas, but also to put the situation into perspective. You also have the option of changing the end of the scenario. You are not only the actor in your own story – you are also the director!

  In the case of a separation or an emotional shock, the most important thing is not to remain alone. Talk to your loved ones and friends: it can be reassuring to see that the people around you have also been through very difficult times and managed to come out the other side. Everyone deals with life’s challenges differently, but sharing emotions and possibly solutions is always reassuring and beneficial.

  Overcoming depression is therefore a victory you should congratulate yourself on! Of course, your friends, family, psychologist and doctor will have helped, but change and improvement can only come from you. This means that it is very important to keep telling yourself that you are the driving force behind your change and your success.

  FAQs

  Lately, I have been feeling listless and constantly exhausted. Am I depressed?

  Not necessarily. Depression is a very serious mood disorder which is characterised by the presence of several particular symptoms, almost without respite and over a long period of time.

  It is completely normal to sometimes feel gloomy, sad or drained. There can be many explanations for this feeling, so it is important to first think about your situation and recent events in your life which could explain why you feel unhappy (grief, a difficult break-up, losing your job, and so on).

  However, if this state of continual sadness lasts for longer than two weeks and you observe a radical change in your day-to-day behaviour (general apathy, depressive mood, insomnia, difficulty thinking or concentrating, loss of appetite, and so on), as well as a loss of interest and pleasure in the activities you usually enjoy, you should consult a specialist.

  Why do women suffer from depression more often than men?

  Women are reportedly twice as likely to suffer from depression as men. Scientists are studying the question closely and have put forward biological, psychosocial and hormonal factors as possible explanations for this discrepancy. Hormones affect brain chemistry, and therefore influence moods. As women experience hormonal changes more often (puberty, the menstrual cycle, pregnancy, menopause), this factor could partly explain the higher rates of depression in women.

  Beyond these physiological explanations, there are also some factors linked to the socio-economic and familial environment. Women are now juggling an increasing number of obligations as they take on the role of wife and mother while simultaneously trying to advance in their professional career, and have to constantly prove themselves if they want to carve out a place in a society where men and women are still not treated equally.

  Finally, it is worth pointing out that this higher rate could also be explained by the fact that women go to the doctor more and are more open about their symptoms, which allows them to be diagnosed more frequently.

  Antidepressants often have a bad reputation. Are they really safe?

  No medication is completely risk-free but, while antidepressants had many side effects in the past, these have greatly decreased over time and nowadays most patients react well to this type of medication. However, if you do experience undesirable effects after taking antidepressants that last for longer than a week (since it takes some time for your body to get used to these substances), do not hesitate to go see
your doctor. They will be able to adjust the dosage or suggest another medication.

  Never self-medicate, for example by taking someone else’s antidepressants, because it is highly likely that they will not be suited to your specific medical needs. Treatment through medication should always be carried out in parallel with therapy and by prescribed by a qualified doctor after a precise diagnosis. Remember that you are advised not to stop your treatment suddenly, and to ask your doctor to establish a programme that will allow you to gradually reduce your dosage.

  Are alternative treatments effective?

  There are an increasing number of alternative treatments in response to the needs of a section of the population who want to go back to more natural solutions and medications. The best-known of these include luminotherapy, which is particularly effective in countering the effects of seasonal depression, and including plants such as valerian and passion flower in the patient’s everyday diet, as these are known for their tranquilising and sedative effects. However, although these natural medications can have significant benefits, it would be naïve, and even dangerous, to conclude that they can cure depression by themselves.

  The ideal approach is therefore to use them to complement psychological treatment and treatment through medication, and to speak with your doctor or pharmacist to make sure that they will not interact with your antidepressants.