Do the Blues have you Down?

Depression impacts millions of Americans.  In fact, reports state that 6.7% of Americans have Depression (National Institute of Mental Health, n.d.).  Depression is the most common mental health illness.  That’s right an illness. Just like diabetes or hypertension depression is a disease. Depression is a disease of the mind.

Most people experience times of sadness and upset in their life.  This can be caused by external factors such as stressors, loss, financial upset, relationship upset, and daily frustrations (NIMH, n.d.).  The difference between general sadness and Major Depressive Disorder is that general life sadness will pass quickly, whereas Depression lasts for more then two weeks (NIMH, n.d.). Depression is a deep sadness that interferes with your daily routine.

If you are feeling depressed, it is OK. You are not the only one, and I will even be bold enough to say that we ALL have experienced times of depression. If you are feeling

  • Very sad
  • Are no longer interested in activities you used to enjoy
  • Have difficulty concentrating
  • Feel like things will never get better (helpless)
  • Feel like there is no point in trying to feel better (hopeless)
  • Feel worthless
  • Have difficulty sleeping (i.e., decreased sleep or increased sleep)
  • Experience changes in appetite (i.e., increased appetite or decreased appetite)
  • Feel guilt, regret, and shame
  • And even have thoughts of hurting yourself or thoughts of suicide

then you may have depression.

Depression comes in many forms. Major Depression is the most common form of depression and a person may have just one, single, occurrence of Depression or a person may experience Recurring Depression (APA, 2000).  Recurring depression occurs multiple times in a person’s life, whereas Dysthymic Disorder is persisting depression symptoms that are less severe but symptoms last longer. This is more like a general sad mood (APA, 2000).  Depression can be associated with giving birth.  Postpartum depression is related to hormonal changes and changes in responsibility due to delivering a baby (APA, 2000).  Lastly depression can be caused by weather changes.  Seasonal Affective Disorder is associated with depressed mood in the winter months when there is less sunlight (APA, 2000).  Life events and stressors, life changes, hormonal changes, the environment, and the weather cause depression.  However depression may also be caused by genetics and biological factors.

The brain is most influenced by depression.  For example individuals with depression had changes in their frontal lobe compared to individuals without depression (Nelson, Sarapas, Robinson-Andrew, Altman, Campbell, & Shankman, 2012).  Hormones and chemicals regulate the brain. One brain chemical associated with depression is serotonin.  Primarily individuals with depression have serotonin imbalances due to decreased serotonin levels, decreased sites to receive serotonin in the brain, or decreased chemicals responsible for making serotonin (Cocchi, Tonello, Gabrielli, & Pregnolato, 2011).  Furthermore brain studies demonstrate that areas of brain are impaired that involve mood, thinking, appetite, behavior, and sleep (NIMH, n.d.).  It is uncertain whether these brain changes cause depression or if depression causes the brain changes.  Perhaps genetics play a role in the development of depression.  This is supported by research that indicates there is a family historical component of depression (NIMH, n.d.).  However it seems that environment, life events, and other stressful situations trigger depression.

Depression will affect not only mood and brain function but it will affect physical health. Psychoneuroimmunology research indicates that depression and immune function are closely related.  Essentially recent research suggests that psychological changes and physiological changes are closely related (Kendall-Tackett, 2009).  A symptom of depression is somatic complaints.  Perhaps this is related to physical changes in the body as a depressed mood increases.  For example people with depression often complain of gastrointestinal problems.  Research suggested that serotonin was also found in the GI tract and intestines and as levels in the brain were impacted by depression so were levels in the other areas of the body (Cocchi, Tonello, Gabrielli, & Pregnolato, 2011).  There is other evidence to support the brain/body connection of depression.  For example individuals with depression also have inflammation in the immune system due to increased cytokines (Leonard & Myint, 2009).  Cytokines regulate immune functions but also trigger brain chemicals in the hypothalamic-pituitary-adrenal (HPA) axis (Leonard & Myint, 2009).  The HPA is also triggered during time of stress and upset.  Individuals with depression have altered cytokines levels (Kendall-Tacket, 2009).  Increased inflammation will prevent the immune system from being able to fight off illness. People are more likely to catch a cold when they are feeling low because their body is trying to regulate mood and unable to protect against harmful organisms.

People with depression will have increased illness because a depressed mood causes the body to change physically. The body will have changes in cells, called natural killer cells, that fight illness (Howk & Bennet, 2012). How your mind feels your body will also feel. Therefore if the physical body is connected to psychological states, improving the body physically may also improve psychological functioning.

Depression is commonly treated with medications and psychotherapy (NIH, n.d.).  However given the current research to suggest that immunity and depression are related it is likely that behavioral lifestyle changes that improve health will also improve depression.  For example relaxation activities not only improve mood but also improve health.  One study found that individuals that received regular massage therapy treatment had decreased depression and improved immune functioning as evidenced by increased Natural Kill Cell production (Diego, Field, Hernandez-Reif, Shaw, Friedman, & Ironson, 2001).  Research is clear that cognitive-behavioral therapeutic techniques are most effective for reducing depressive symptoms (APA, 2013).  Therefore it is likely that cognitive behavioral techniques can be helpful to improve immune functioning.  This notion is supported by research that suggested that helping individuals improve negative thinking and gaining coping skills to manage upset also reduced adverse health and improved immunity (Crepaz, Passin, Herbst, Rama, Malow, Purcell, & Wolitski, 2008).  This research is intriguing.  Rather then treating each issue separately individuals can enjoy health and wellness when physical and psychological issues are addressed together.

Depression symptoms can improve.

  • Try daily relaxation – find a time every morning or evening when you can be alone for 15-20 minutes. Turn off any distractions. Sit or lie comfortably. Take a deep breath in with your nose and out with your mouth. Pay attention to how your lungs feel as you breath in and out. Pay attention to your chest filling with air and collapsing as you breath out. Close your eyes and contine this breathing. Think about how your body feels against the floor. Imagine a halo of white warm light above your head. This halo starts to scan your body and presses firmly against you as it scan each body part. Focus on this light as moves from each body part. As it leaves each body part it leaves you feeling warmer and it takes with it all the tension in your body. As the halo reaches the floor it pushes all tension, upset, and sadness to the floor. Take a few. Ore deep breaths and slowly open your eyes when ready.
  • Journal – write your feelings. Can’t identify them, draw them. Write words that describe how you feel physically. Scribble thoughts that come through your head.
  • Take a walk – walk around your house, walk around the block, walk around the park. Just walk. As you walk focus on the sights and sounds around you. Focus on how they smell, sound, and feel. Think about how in this moment you are in control. You are in charge of moving your legs to take that next step, you are in control of where you go, you control what you choose to pay attention too. In this moment you are the boss.
  • Eat healthy meals – increase the amount of fruit and veggies you eat in a day. This will make you feel good for doing something good for your body, but it will also improve the body. Those foods will improve the chemicals in your brain that are in short supply due to your depressed mood. Those foods will also improve your body by increasing cell production and improving the body’s ability to fight infection and illness.
  • Talk to someone – a friend, a family member, a colleague, anyone. Find someone you trust. Tell them, “I am feeling sad I just need you to listen and hear me. You may not have the solution but please just listen to what I have to say”. If you have no one you can trust, that’s ok! A lot of people do not have a trusted person to talk to. Call a therapist. They are there to help you!
  • Exercise – even if it is the walk I mention above please just move. Stretching, yoga, running, walking, cycling, lifting weights, or jumping will improve your mood. This will improve your mood by increasing chemicals in your brain called, endorphins.  Endorphins make you feel happy. This will help decrease your sad mood as well as increase chemicals I’m the body that improve immune functioning.
  • Reframe negative thinking – write down negative thoughts. Then challenge that thought. This can be difficult. If you struggle to challenge the thought just write the exact opposite. I have worked with many clients that told me it is challenging to reframe negative thoughts because the more helpful positive thought was not true. Well that is not accurate. It is true but the bad mood is supported by these negative thoughts. We think because we feel bad those negative thoughts must be true. To challenge a negative thought just repeat the opposite more helpful thought. For example if you think, “I am worthless and a failure” then write down and speak aloud “I am worthy and have been successful before and will be successful again”. Now say it aloud. Say it again. Say it again. Keep saying it. Speak it loudly. The thinking will catch up and this will more helpful thought will become more believable.
These are not quick fixes. These should become daily practices. Improving physical health can improve depression and improving depression can improve health. The one step you take today will lead to more steps tomorrow.

*Note: Depression is a real illness that may need treatment. Please seek medical advise if symptoms do not improve after 4 weeks. Please seek a therapist if you feel the urge to hurt yourself. You do not have to suffer alone.  

References

 

American Psychiatric Association. (2000). Diagnostic and statistical manual of   mental disorders (4th ed., text rev.). Washington, DC: Author.

American Psychological Association. (2013).  Depression.  Retrieved from http://www.apa.org/topics/depress/index.aspx

Cocchi, M., Tonello, L., Gabrielli, F., & Pregnolato, M. (2011).  Depression,         osteoporosis, serotonin and cell membrane viscosity between biology and      philosophical anthropology.  Annals of General Psychiatry, 10(9).

Crepaz, N., Passin, W., Herbst, J., Rama, S., Malow, R., Purcell, D., & Wolitski, R.          (2008).  Meta-analysis of cognitive-behavioral interventions on HIV-positive   persons’ mental health and immune functioning.  Health Psychology, 27(1),            4-14. 

Diego, M., Field, T., Hernandez-Reif, M., Shaw, K., Friedman, L., & Ironson, G. (2001).  HIV adolescents show improved immune function following massage           therapy.  International Journal of Neuroscience, 106(1-2), 35-45. 

Howk, C. & Bennett, M (2010).  Immune function and health outcomes in women            with     depression.  BioPsychoSocial Medicine, 4(May 3), ArtID 3.

Kendall-Tackett, K. (2009).  Psychological trauma and physical health: A  psychoneuroimmunology approach to etiology of  negative health effects and            possible interventions.  Psychological Trauma: Theory, Research, Practice, and    Policy, 1(1), 35-48. 

Leonard, B., & Myint, A. (2009).  The psychoneuroimmunology of depression.    Human            Psychopharmacology, 24, 165-175. 

National Institute of Mental Health.  (n.d). What is depression?  Retrieved from    http://www.nimh.nih.gov/health/topics/depression/index.shtml

Nelson, B., Sarapas, C., Robinson-Andrew, E. J., Altman, S., Campbell, M., &      Shankman, S. (2012).  Frontal brain asymmetry in depression with comorbid         anxiety: A neuropsychological investigation.  Journal of Abnormal Psychology,      121(3),            579-591. 

 

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