Depression is a serious, debilitating illness that’s also one of the most commonly-diagnosed mental disorders. When you’re first diagnosed, you may feel both relief (finally, a name for your pain) and overwhelmed (what the heck do you do next?).
Below, two psychologists who specialize in depression reveal what you need to know about the illness and how to get better.
Make Sure You’re Properly Diagnosed
“Make sure that you’re not leaving with a diagnosis in minutes after meeting a professional,” said Deborah Serani, PsyD, a clinical psychologist and author of the books Living with Depression and Depression and Your Child.
“[M]any medical conditions can mimic, worsen or cause depressive symptoms,” so it’s important to rule those out and have a thorough evaluation, said Lee H. Coleman, Ph.D., ABPP, a clinical psychologist, author of Depression: A Guide for the Newly Diagnosed and assistant director and director of training at the California Institute of Technology’s student counseling center.
Serani agreed: “An evaluation for depression should involve a thorough medical exam, a series of blood and urine tests, and then an assessment from a mental health professional that specializes in mood disorders.”
Also, be honest with your providers about your symptoms and habits, including any substance use, Coleman said.
If your provider diagnoses you with depression, ask them why they think this, and what alternative diagnoses they’ve considered, he said. “A competent healthcare professional will respond to your question respectfully and should even be glad that you asked. She should explain her thinking to you in a way that you understand.”
If you’re still unsure about the diagnosis, get a second opinion.
Depression is Highly Treatable
In the beginning, many people with depression think they’ll feel this terrible forever and they won’t get better, Coleman said. However, “Research clearly shows that depression is very treatable.”
Both psychotherapy and medication are effective for moderate to severe depression. “For milder forms of depression, research shows that talk therapy is extremely helpful,” Serani said.
She uses medication as a last resort with her clients. If a client’s depression isn’t significantly improving in several weeks, she suggests exploring medication.
According to Coleman, there are many types of therapies that can help. For instance, cognitive-behavioral therapy helps clients recognize and challenge negative ways of thinking, and change behaviors that inadvertently exacerbate or perpetuate their depression.
When picking a therapist, inquire about their track record with treating people with depression, he said. Also, it’s critical to have a trusting relationship with your therapist and a clear understanding of the goals you’re working on, he said. (“Therapy shouldn’t be mysterious.”)
“The goal is to find what combination of treatments work best for your depression, and then create a treatment plan that makes it successful,” Serani said. It’s also important to remember that you and your providers are a team. Be an active participant in your treatment, speak up, ask questions and voice any concerns.
Know Your Medication
If you’re trying medication, make sure you’re clear on the specifics. Coleman suggested asking what you can expect the medication to do; how long it typically takes to notice improvement; what kinds of side effects may occur; and how long you may have to take the medication.
Also, ask your doctor if they’re starting with the lowest dose, instead of an “average” dose, Serani said. “Different metabolisms influence the therapeutic effect of antidepressants, so beginning low and adding over time is the best way to determine which dosage benefits you.”
She also suggested asking about the best time of day to take medication (e.g., taking medication before bed helps you “miss” side effects such as headaches, stomachaches and fatigue “because you sleep through them”); and how to discontinue the medication. Having a plan is key because abruptly stopping antidepressants can trigger side effects, she said.
And “ask how to get in touch with your healthcare provider if you start to notice any problems, side effects or worsening symptoms,” Coleman said.
Treatment Takes Time to Work
Whether you’re taking medication or seeing a therapist (or both), it takes about a month to see improvement, Coleman said. If you’re going to therapy, you should experience a reduction of serious symptoms, such as suicidal thinking, hopelessness and helplessness, within weeks, Serani said.
Antidepressants typically take four to six weeks to relieve symptoms, she said. If you’re not getting better after six weeks, talk to your provider, Coleman said. “Sometimes you might need to change the focus of therapy slightly, or your psychiatrist might want to talk with you about trying a different medication if the first one isn’t working well.”
If you think your symptoms are getting worse, talk to your provider right away, he added.
Monitor Your Symptoms in the Future
Having one episode of depression increases your likelihood of having another episode. So it’s important to monitor your depressive symptoms in the future, Coleman said.
“I liken it to someone with diabetes needing to monitor their blood sugar even if they’re feeling fine.” Talk to your provider about the signs of recurrence, he said.
Depression sinks your self-worth. But compassion is crucial, Coleman said.
“If one of my clients had a broken leg in a giant cast, they pretty obviously wouldn’t expect themselves to run a marathon. Because depression isn’t outwardly visible like a broken leg or a cast, though, it’s easy to want to bully ourselves into ‘toughening up’ and ‘snapping out of it.’”
However, this approach just makes you feel worse — and guiltier, he said. Instead, think of it like having the flu: “you’re expected to stay home for a little while and get better, and nobody would think that you’re weak or lazy for doing that.”
Remember that you’re struggling with an illness, and the best thing you can do is to focus on getting better and being kinder to yourself.