In-Depth: Living with Depression
Living with depression is like living with a 40 ton weight on your chest — you want to get up and move, but you just feel like you can’t.
– David J.
After coming out the other side of depression, I felt like a part of my life was stolen from me. I will never get those 3 years back.
– Julie P.
After receiving a diagnosis of major depression, you might feel relieved to have a name for your emotional pain and you might feel overwhelmed about the treatment at hand. However, you’re not alone. Between 10 and 25 percent of women and 5 to 12 percent of men will have a major depressive disorder in their lifetime. And, though it might seem impossible at first, depression is effectively treated and your mood and life will improve.
Here’s a rundown of what you can expect from treatment, how to boost your chances for effective treatment and general tips for reaching relief and recovery.
Before understanding how treatment works, it’s important to ensure you received the right diagnosis through a comprehensive evaluation. This typically consists of a careful interview, including questions about symptoms and current stressors, a standardized questionnaire (such as the Patient Health Questionnaire or PHQ; Beck Depression Inventory or BDI) and suicide assessment. The practitioner also might conduct related blood tests to rule out a medical condition.
Even though depression is extremely common, misconceptions still abound. These are some common myths:
- Depression isn’t a serious condition. Many people mistakenly view depression as a “moral failing,” said Allen J. Dietrich, M.D., co-chair of the MacArthur Foundation Initiative on Depression & Primary Care, whose goal is to help primary care physicians diagnose and treat depression. Others also view being depressed as a weakness, said Christopher Martell, Ph.D, depression researcher and clinical psychologist in Seattle.
Nevertheless, depression is a serious clinical disorder “characterized by a complex integration of biological and environmental vulnerabilities, life events and patterns of thinking and behaving that lead to the clinical presentation,” said Martell. The cause can vary for each person. But whatever the contributing causes for your depression, all practitioners agree that depression requires treatment.
- “I should just toughen up and take it.” It’s important to realize that “depression isn’t a natural consequence of living life; it’s an aberration that doesn’t have to be tolerated,” said Steven D. Hollon, Ph.D, clinical psychologist and depression researcher at Vanderbilt University.
- “I’ll snap out of it.” Letting depression go untreated in hopes that it’ll go away can actually exacerbate the episode, make it last longer and increase the risk for suicide.
- “I’ll be like this forever.” The biggest misconception patients have is that their depressed feelings, fatigue, irritability, inability to concentrate and loss of interest will last forever; that there is no relief in sight, said Rosalind S. Dorlen, Psy.D, ABPP, New Jersey clinical psychologist and New Jersey public education coordinator for the American Psychological Association. Fortunately, however, thanks to effective treatment, patients do find relief and recovery.
Telling Others about Your Diagnosis
Many people wonder how much they should disclose about their depression to everyone from loved ones to co-workers. “The level of intimacy in answers is an individual decision,” said Mark E. Oakley, Ph.D, director and founder of the Center for Cognitive Therapy in Beverly Hills, California.
You can reveal more details to loved ones who are supportive. For co-workers or anyone who’s less supportive, you can simply say that you’re “going through a difficult time,” and feel free to provide “as little information as possible,” said Martell. You also might want to say that you’re working on the problem. Sometimes people feel that they need to make suggestions about what you should do. Saying that you’re getting help or working through your problems might minimize that response, he said.
What To Expect from Treatment
Treatment can consist of medication, psychotherapy or a combination of the two. Various practitioners, including psychologists, psychiatrists, licensed professional counselors and social workers, and primary care physicians can treat depression. Which professional and which treatment you choose is up to you.
“In our experience, fully half of patients can be managed exclusively in primary care. Many others would benefit from mental health consultation and some may need or prefer to be managed in mental health,” Dr. Dietrich said. Taking medication “can work on its own, is more accessible to many people and may require less frequent visits,” he said.