By Raul J. Rodriguez M.D., DABPN, DABAM, MRO
This sucks. Everything sucks. What difference does it make anyway? These are just some of the thought patterns that are characteristic of an individual suffering from major depression. Depression does suck. Depression does make everything seem like it sucks and it makes people not care anymore. This common disorder can be silent personal hell for some and slow, agonizing death for others. So many people suffer from this yet many of them go untreated. Many others desperately try to treat themselves by self-medicating with drugs or alcohol. The outcomes for these poor souls typically are bad, but they do not have to be. Major depression is a very treatable condition and can carry a favorable prognosis if managed properly.
The first step in treating depression is the identification of symptoms and making an accurate diagnosis. Depression feels bad. Feeling bad may encompass any combination of a sad or depressed mood, low energy, low self-esteem, poor concentration, increased feelings of guilt, feelings of hopelessness and helplessness, and a general slowing down of physical movement. A diminished capacity for enjoyment, especially with activities that would normally be pleasurable, is an especially telling sign. Emotional shifts including tearfulness and irritability are also frequent. This may all worsen with the use of alcohol or drugs in a desperate attempt to feel better. Any combination of these symptoms to any degree that affects happiness or the ability to function would indicate that some form of a mood disorder is present. A psychiatrist would be the physician specialist most skilled and qualified to make a specific diagnosis and give recommendations for treatment.
Treatment for depression has come a long way. The holistic approach that treats the patient as a whole has grown in both popularity and effectiveness. Newer psychotherapies, vitamins, exercise therapy, nutrition, meditation, art, yoga, and acupuncture have all taken on a greater role. Patients no longer have to rely on just medication and basic psychotherapy. These elements are not definitive treatments in their own right. But, when in combination, it can be very powerful. Much of this benefit is from affecting the human mind-body connection.
What is done to the body will directly affect the human brain. [Exercise] gets a depressed brain moving in a way that is not easily replicated by other means.
– Dr. Raul J. Rodriguez
What is done to the body will directly affect the human brain. Movement in the form of resistance training, yoga, and other forms of exercise have a significant positive effect on brain chemicals. Dopamine, Serotonin, Norepinephrine, and Endorphins, among other brain chemicals, are all released in response to exercise. This gets a depressed brain moving in a way that is not easily replicated by other means. This can be one of the fastest first steps to recovery from depression. When a physical activity becomes a permanent part of a person’s life, it helps resist a depressive recurrence. Nutritional and vitamin therapies provide the fuel for exercise as well as the nutrients for optimal brain functioning. When the benefits that can be derived from the body are optimized, the conditions are much more favorable for the human brain to derive benefit from antidepressants and advanced psychotherapy.
Dialectical Behavioral Therapy often referred to as “DBT”, is an advanced form of cognitive-behavioral therapy that has changed the face of modern depression treatment. DBT teaches highly effective coping skills that help individuals deal with some of the most stressful elements of human existence. DBT skills are organizable into 4 categories: Mindfulness, Interpersonal Effectiveness, Emotional Regulation, and Distress Tolerance.
Mindfulness skills allow members to learn to observe, describe, and participate in thoughts, sensations, emotions, and external phenomena without judging these experiences as “good” or “bad.”
Interpersonal effectiveness skills help participants successfully assert their needs and manage conflict in their relationships.
Emotional regulation skills help participants identify and manage emotional reactions in healthy and adaptive ways, reducing the negative emotional surge that may result from an adverse event.
Distress tolerance skills allow members to accept and tolerate distress without resorting to negative or destructive behaviors. DBT has proven clinical effectiveness and has helped thousands. These tools are efficiently taught and practiced in DBT skills groups. DBT skills group participation requires ongoing individual therapy, which another fundamental part of treatment. Individual therapy reinforces the learned skills and addresses the underlying issues.
The combination of individual psychotherapy, DBT skills training, medications, and the holistic modalities of depression treatment help individuals achieve stronger clinical responses than just medications or basic therapy alone. These forms of treatment are best helpful in a cohesive manner and within a program with structure. A depressing life is at best a sad existence and at worst intolerable. Effective treatment for depression is available and the veil of sadness can lift. The depressed person needs only to ask for help.
Dr. Raul J. Rodriguez is the founder, CEO, and Medical Director of the Delray Center For Healing, which offers a comprehensive depression treatment program that consists of advanced medical treatment, DBT therapy and skills training, and holistic treatments. This article was originally posted in The Delray Newspaper.
Since 2003, the Delray Center for Healing has provided exceptional psychiatric and therapeutic care for mental health, eating, and substance use disorders. To learn more about our philosophy and treatment approach, download our free e-book, “Psychiatry Redefined,” written by our founder and medical director, Raul J. Rodriguez, MD.