What is depression? 

We all know the classic belief of what depression looks like.

No energy, Not being able to get out of bed.

Sadness. Crying, or finding yourself beyond the ability to cry.

Yes, these are parts of depression, but it is actually more than that.

It’s irritability.

Mood instability.

The inability to concentrate.

Memory and recall issues.

Isolation.

No longer enjoying the things that used to hold meaning.

Agitation.

Not caring about things, people, tasks, work, school, friends…

It’s knowing what you have to do, and not having the energy to “get going” or follow through with the thoughts to do it.

Its guilt.

Worthlessness.

Feeling like life isn’t worth living.

Like nothing is worth fighting for. Depression says that giving up makes sense.

Depression can lead to sleeping too much, or having huge trouble falling asleep or waking during the night, and not being able to fall back to sleep. (Early morning waking.)

It can result in overeating, and weight gain; or losing interest in food, which will lead to weight loss.

Sometimes depression comes from overwhelming life circumstances, or personal challenges, such as: illness, chronic pain or fatigue, loss, bereavement, retirement (loss of career), divorce (loss of relationship),

Another source of depression can be from separation and retirement from the military (change of life and career context and the military culture). For some people, acclimating to civilian life is foreign… and the adjustment is far more difficult than anticipated.

Over the years, I have come to believe that depression creates its own thoughts.

Some of the most negative and irrational thoughts are created by the depression itself.

I believe that depression has a voice; it isn’t just thoughts.

And that voice can be dangerous.

To you, your loved ones, your family, your friends, your work, your education, your goals. Why?

Because depression undermines everything. It dismantles progress, goals, relationships, self-esteem.

Depression tries to convince people that life and living is too difficult to continue.

Suicide can begin to feel like a viable option.

Understand, that family members of someone who has committed suicide makes them at greater risk of suicide. That means if someone in your family has committed suicide, that everyone in the family is now at higher risk of attempting to do the same thing, maybe a different way, but still believing that suicide may be a solution.

I have had clients decide NOT to even THINK about the option of suicide because they do not want to leave their loved ones at risk.

The BEST outcome for depression involve both medication AND counseling. Medication works for the majority of the population, but it is not for everybody.

A lot of people can get an antidepressant prescribed by their family practice doctors; however, especially with life-threatening depression, a psychiatrist is, in our opinion, a better bet. Why?

They specialize in psychotropic medications, the ones that affect mood and cognition (thinking). I have seen psychiatrists systematically work with their clients on their medications; at times, using medication combinations, or even medications that predate the SSRIs (the popular antidepressant medications most commonly used these days, such as Prozac, Paxil, Zoloft, etc.) It sometimes takes familiarity with antidepressants as a whole in order to find the “right” medication.

Not everyone likes how medication affects their feelings or functioning, but trying is worth it. Antidepressants can kick depression out of the body and brain in 3-5 weeks. It is important to take your medication daily, at the same time. If you forget, take it as soon as you remember, or get back home to your medications. Try NOT to skip a dose as these meds build in the blood, and that is what makes them work.

Some people report feeling bland, or flat (like they just can’t feel anything)… others find it can interfere with sexual interest and functioning. In those cases, a psychiatrist can work to find a better medication or an agreement may be made to use the antidepressant for a limited amount of time.

Many times, my clients will stabilize on their medication, and then, after things have gotten better; they elect to taper off their meds. Many people successfully taper off and continue with counseling alone. Others may feel like there are falling back into depression. In those cases, clients can go back on their medications for another 3-6 months and then try to taper off again. Going off medication should always happen under the guidance direction of your doctor.

Some people feel bad about being depressed; it is important to know that some people are just genetically predisposed towards depression.

Long-term high stress levels will deplete the neurotransmitter systems, which leads to depression. The neurotransmitters are the chemicals in your body that make your brain work. For those old enough to remember the batteries we used to have to check, low transmitters are like having a dry cell in the battery. Adding medication is like of like adding water to those old batteries!

Negative core beliefs will also influence our internal world. Negative beliefs are part of what can create anxiety, depression, low self-esteem, negativity, etc. Part of counseling is exploring negative belief systems and negative self-talk that can feed depression.

If you have depressive symptoms, again, the best outcome has been found to involve counseling AND medication.

Depression can be life threatening in children, teens, and adults. So if you, or someone you know, is experiencing these symptoms, get assistance from a professional.

In a crisis: there is a national crisis text line. It can be reached by typing “START” to 741-741.

In Comal County, you can also call MCOT, the mobile crisis outreach team. It is staffed by a team of clinicians and is coordinated with our County Sheriff’s office. The Sheriffs who work with the MCOT team are also trained to assist with mental health concerns. The MCOT phone number is 877-466-0660.

If you or a family member has depression that is not currently life-threatening, please call for help.

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Post Traumatic Stress Disorder