While anti-depressants seem to be the first treatment of choice requested by patients who are bombarded by television and magazine ads, research over the past decade plus, has reported the most effective treatment overall for depression is a combination of both medications and talk therapy, rather than either meds or therapy alone. Mind you, most folk do not read the research, yet they do absorb the ads, and therefore make their choice for meds. After all, pills and / or capsules present as certainly quicker and easier, when and if they are effective.
Many of us remember, from the popular press’ reportage a decade or so ago, about a large number of suicides by those taking a then popular anti-depressant. These powerful and popular drugs are not always effective. As a clinician, I have heard, for want of a better cliché, horror stories about adverse reactions to anti-depressants. I am also aware, that frequently, when several anti-depressants are tried and fail, that the next line of treatment is electroshock therapy.
Anti-depressant medications seem to be miracles for severely depressed people with what is likely to be a genetic and genuine depression—in the olden days, it was called endogenous, meaning inner, in terms of being in the body, rather than—again, in the olden days—exogenous, meaning outside the body.
While the terms might not be used any longer, the distinction between an inner or genetic depression, and an outer or environment-caused depression exists. Reactive depression can be caused by another’s death, a job loss, a divorce, an ending of a relationship / friendship, a lack of physical activity, a lack of activity in general, a narrowing of one’s life to few or no interests, a lack of involvement in one’s own life that reflects back as helplessness / hopelessness.
You may have noted that my list began with possible causes for depression, and moved on to what might be thought of as symptoms of depression. They are both / and. Please read on.
Dr Beck—please see earlier blog--created a self-inventory to screen for depression, which you can find on his web site. Some of the questions ask if you, the one taking the inventory, have lost pleasure in people, places, things and activities which formerly brought you pleasure. Mental health clinicians routinely ask folk coming for treatment if they have lost interest in or no longer enjoy what used to be pleasurable for them. This lack of pleasure phenomenon is called anhedonia. It encompasses the hopelessness and helplessness not only of Beck’s dogs, but of people who describe their depression as paralysis—please see earlier blog.
Now back to my above paragraph summing up the possible causes of reactive depression as also sounding like symptoms people describe as their depression.
Point being, to my mind, which came first, the inactivity or the depression?
I believe it is both /and. If one’s depression is a lifelong malaise which deepens over time to become unbearable, depression likely came first. Medication and therapy likely work. I also wonder, however, if this lifelong depression might not be learned from family members who model anhedonia, narrow lifestyles and inactivity, rather than inherited from one’s gene pool.
If the depression results from a negative life event, it is likely that a person’s coping skills, being pushed to the max and more, lead to feelings of helplessness and hopelessness, along with a narrowing of interests and a lack of pleasure. I think that perhaps the inactivity exacerbates feelings of loss, lack of pleasure and so on, and that therapy and exercise will be most effective.
The newest research gives accolades to exercise once again, as being not only beneficial both as prophylaxis and as treatment for diabetes, heart disease, hypertension, obesity, and cancer, but also for depression.
University of California, Berkeley’s November 2007 issue cites a “growing body of research” reporting that depressed people improved with several months of supervised “cardio-fitness” programs, when they had not responded positively to anti-depressants. Remember, the usual protocol when depressed people do not respond to several anti-depressants is electroshock treatment.
This particular article did not designate if the depression was lifelong or reactive depression, calling the malaise major depression. Either way, the fact that activity lifted the malaise is positive. The researchers credited both the change in brain chemistry created by activity and the phenomenon of getting a depressed person out of life-narrowing isolation and giving him / her a sense of accomplishment.
If depression plagues you, make room in your life for exercise and
life-expanding activity.
Please go to Mayo Clinic’s website for more information—their research includes exercise as beneficial for anxiety—and I shall write on that soon.
Many of us remember, from the popular press’ reportage a decade or so ago, about a large number of suicides by those taking a then popular anti-depressant. These powerful and popular drugs are not always effective. As a clinician, I have heard, for want of a better cliché, horror stories about adverse reactions to anti-depressants. I am also aware, that frequently, when several anti-depressants are tried and fail, that the next line of treatment is electroshock therapy.
Anti-depressant medications seem to be miracles for severely depressed people with what is likely to be a genetic and genuine depression—in the olden days, it was called endogenous, meaning inner, in terms of being in the body, rather than—again, in the olden days—exogenous, meaning outside the body.
While the terms might not be used any longer, the distinction between an inner or genetic depression, and an outer or environment-caused depression exists. Reactive depression can be caused by another’s death, a job loss, a divorce, an ending of a relationship / friendship, a lack of physical activity, a lack of activity in general, a narrowing of one’s life to few or no interests, a lack of involvement in one’s own life that reflects back as helplessness / hopelessness.
You may have noted that my list began with possible causes for depression, and moved on to what might be thought of as symptoms of depression. They are both / and. Please read on.
Dr Beck—please see earlier blog--created a self-inventory to screen for depression, which you can find on his web site. Some of the questions ask if you, the one taking the inventory, have lost pleasure in people, places, things and activities which formerly brought you pleasure. Mental health clinicians routinely ask folk coming for treatment if they have lost interest in or no longer enjoy what used to be pleasurable for them. This lack of pleasure phenomenon is called anhedonia. It encompasses the hopelessness and helplessness not only of Beck’s dogs, but of people who describe their depression as paralysis—please see earlier blog.
Now back to my above paragraph summing up the possible causes of reactive depression as also sounding like symptoms people describe as their depression.
Point being, to my mind, which came first, the inactivity or the depression?
I believe it is both /and. If one’s depression is a lifelong malaise which deepens over time to become unbearable, depression likely came first. Medication and therapy likely work. I also wonder, however, if this lifelong depression might not be learned from family members who model anhedonia, narrow lifestyles and inactivity, rather than inherited from one’s gene pool.
If the depression results from a negative life event, it is likely that a person’s coping skills, being pushed to the max and more, lead to feelings of helplessness and hopelessness, along with a narrowing of interests and a lack of pleasure. I think that perhaps the inactivity exacerbates feelings of loss, lack of pleasure and so on, and that therapy and exercise will be most effective.
The newest research gives accolades to exercise once again, as being not only beneficial both as prophylaxis and as treatment for diabetes, heart disease, hypertension, obesity, and cancer, but also for depression.
University of California, Berkeley’s November 2007 issue cites a “growing body of research” reporting that depressed people improved with several months of supervised “cardio-fitness” programs, when they had not responded positively to anti-depressants. Remember, the usual protocol when depressed people do not respond to several anti-depressants is electroshock treatment.
This particular article did not designate if the depression was lifelong or reactive depression, calling the malaise major depression. Either way, the fact that activity lifted the malaise is positive. The researchers credited both the change in brain chemistry created by activity and the phenomenon of getting a depressed person out of life-narrowing isolation and giving him / her a sense of accomplishment.
If depression plagues you, make room in your life for exercise and
life-expanding activity.
Please go to Mayo Clinic’s website for more information—their research includes exercise as beneficial for anxiety—and I shall write on that soon.
