Depression

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When people say “depression”, what images are conjured up for you? Black rain drops or clouds? Staying in bed all day? Uncontrollable tears?

Well, sure… Maybe…

But that is not all that depression is, or can be…. So, what is it?

Let’s define “depression” first:

‘Depression’ is a serious medical illness, not merely ‘sadness’; not that sadness is a small thing in itself. This serious medical illness negatively affects every part of your life from how you function, to how you think and how you act.

Depression could be the root of deep sadness and/or loss of interest in activities you once enjoyed and can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home. The sadness felt within depression is so deep that sometimes the person experiencing this feeling may say, “I feel numb”, or, “I feel like I’m drowning/at the bottom of a hole/the walls are closing in” etc.

Depression symptoms can vary from mild to severe and can include:

Feeling sad or having a depressed mood
Loss of interest or pleasure in activities once enjoyed
Changes in appetite — weight loss or gain unrelated to dieting
Trouble sleeping or sleeping too much
Loss of energy or increased fatigue
Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
Feeling worthless or guilty
Difficulty thinking, concentrating or making decisions
Thoughts of death or suicide

Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.

This illness is not grief in response to an event, such as a death or big personal loss of some kind.

Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:

In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In depression, mood and/or interest (pleasure) are decreased for most of two weeks (or longer).

Another important difference is that times of deep depression are often ‘recurring’. A person with this illness may go months or years without an ‘episode’. When/if an episode does come, the effects/impacts of the illness can last a few months to a few years, usually with incremental recovery.

In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.

In grief, thoughts of death may surface when thinking of or fantasizing about “joining” the deceased loved one. In depression, thoughts are focused on ending one’s life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression. For some experiencing severe depression, the focus on suicide can start looking/sounding like a ‘good idea’ to the person.

Distinguishing between grief and depression is important and can assist people in getting the help, support or treatment they need. If you or a loved one are experiencing suicidal thoughts, as difficult as I know it is, please get help!! (National Hotline Number 800-273-8255)

For a complete list of suicide numbers for all counties in Oregon, scroll down under this article. Also listed on the “Resources” page.

A few important things to remember:

Your depression is not your fault.
Your depression could be chemical.
Depression is very common and can happen to anyone.
Continuous exposure to abuse; neglect; oppression; painful life circumstances; physical illness; drug abuse; violence; and/or poverty can all contribute to the development of depression.
Depression is often genetic.

But! Just because you feel depressed, or maybe you have a diagnosis (recent or not) does not mean you are broken!!

Here is Dr. Tracey Marks to give you more information about depression: Depression is an Illness, Not a Weakness: https://youtu.be/vYR9JPztdn4

Depression is very treatable, so that’s good right? And, most people respond to treatment and gain some relief within a few sessions. Just be sure to also have a full medical check-up/physical to rule out physical ailments that are causing, or contributing to feelings of depression as there are a number of medical conditions where-in depression is a symptom.

In my practice, I will usually get someone started in therapy, as getting started can be helpful while waiting to see your doctor. Once you and your doctor have ruled out/or discovered medical contributors, you and I can tailor your mental health treatment accordingly. I can/will also work with your doctor if needed for a holistic care approach and also to advocate for a referral for you if you would like to trial medication.

Self-help and Coping

Trying to manage your emotions/feelings of depression by yourself is never a good idea. People may say things to you like, “Stop whining and get over it!” or “Back in my day, we just pulled ourselves up by our bootstraps!” or other minimizing, unhelpful things. The truth is that “back in my day” there were many people walking around as very unhealthy, emotionally balled up individuals who were likely in a lot of emotional pain with no way to let it out.

Maybe you, or someone you know, is a person who tends to try to hide your feelings and emotions from others. Maybe you have some legit reasons like you do not want your kids/spouse/friends/family to see, you don’t want ‘pity’ from others or maybe you have thoughts such as, “If just remain strong, I can beat it.”

Remember, depression is often a medical condition, and I can honestly tell you from personal experience that even the strongest people may need assistance to recover from depressive symptoms. Here are a couple videos I am sharing from YouTube (not my work).

The first may give you some insight into what someone who is trying to hide their depression may ‘look like’.

"8 Signs Someone is Secretly Depressed": https://youtu.be/8F3vfUNDBtM

This second one gives information about how symptoms can affect us.

"10 Things Depression Makes Us Do" : https://youtu.be/pcmoQinDhJ4

Even though you may need some assistance managing your symptoms, there are many things you can do on your own, for yourself. First, figure out where your limits are. Don’t set a goal of walking 5 miles if you are feeling so exhausted you can barely make it to the mailbox.

Start where you ARE and when you can tolerate more, you can increase the goal. Ok, here are some things you can do today:

Regular exercise – creates positive feelings, releases endorphins, improves mood, improves circulation

2. Getting quality sleep, and “enough” – this can be quite challenging

and a place where many people need assistance. If you cannot

sleep, you cannot heal, either physically, spiritually or mentally.

3. Proper nutrition – I know… sometimes depression takes away the

appetite completely. For some people it kicks it into high gear and

includes cravings for foods high in fat, salt, sugar and

carbohydrates. Many people crave things like potato chips, ice

cream, breads, doughnuts, etc. For me its cookies! Oh GOD!!

4. Avoid drugs and alcohol – drugs and alcohol may feel good at the

time, but it actually aggravates depression.

5. Make a list of activities you enjoy, or used to enjoy. This will serve

as a “go to” for self-soothing and maybe remind you how much

fun you had in the past! (Included below is a “Self-Soothe” List I

grabbed off the internet to get you started!)

Final words:

Depression is a real, medical illness. Many people utilize support from a therapist as a tool toward recovery. Through support and time, most people are able to realize benefits and learn to manage symptoms in a healthy way. To start addressing your needs and starting your path toward recovering from depression check out the ‘Resources’ page. On the ‘Resources’ page I have a Depression Inventory that you can take and score on your own; a Mood Tracker Worksheet; and Journaling prompt pages for Depression, Anxiety, Panic and Emotion Regulation, all FREE for downloading/printing and using! You don’t have to sign up for anything, just go download what you want!

And, of course, I am accepting new clients if you are ready to start your healing process!

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.
National Institute of Mental Health. (Data from 2013 National Survey on Drug Use and Health.) www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml
Kessler, RC, et al. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593602. http://archpsyc.jamanetwork.com/article.aspx?articleid=208678

Suicide Hotline Numbers of all Counties in Oregon

BAKER COUNTY New Directions Behavioral Health & Wellness

General Access

Crisis Number

541.523.3646

541.519.7126

08:00 – 17:00

After 17:00

BENTON COUNTY Mental Health Program

General Access

Crisis Number

541.766.6835

1.888.232.7192

CLACKAMAS COUNTY Mental Health Center

General Access

Crisis Number

503.742.5335

503.655.8585

CLATSOP COUNTY Behavioral Healthcare

General Access

Crisis Number

503.325.5722

503.325.5724

COLUMBIA COUNTY Community Mental Health, INC.

General Access

Crisis Number

503.397.5211

503.397.5211 or 1.866.866.1426 (after hours) Vernonia: 503.397.5211

COOS COUNTY Mental Health Program

General Access

Crisis Number

541.266.6700

541.266.6800

CROOK COUNTY Best Care Treatment Services

General Access

Crisis Number

541.323.5330

CURRY COUNTY Community Health

General Access

Crisis Number

Gold Beach: 541-373-8001

Brookings: 541-813-2535

Port Orford: 541-373-8085

1-877-519-9322

DESCHUTES COUNTY Mental Health Services

General Access

Crisis Number

541.322.7500

1.800.875.7364

DOUGLAS COUNTY Compass Behavioral Health

General Access

Crisis Number

541.440.3532

1.800.866.9780

GILLIAM COUNTY Community Counseling Solutions

General Access

Crisis Number

Condon: 541-384-2666

Arlington: 541-454-2223

911

GRANT COUNTY Community Counseling Solutions

General Access

Crisis Number

541.575.1466

911

HARNEY COUNTY Symmetry Care

General Access

Crisis Number

541.573.8376

HOOD RIVER County Mid-Columbia Center for Living

General Access

Crisis Number

541.386.2620

1.888.877.9147 or 541.386.7534

JACKSON COUNTY Health and Human Services

General Access

Crisis Number

541.774.8201

JEFFERSON COUNTY Community Mental Health Program

General Access & Crisis

541.475.6575 (24 hours!)

JOSEPHINE COUNTY Options for Southern Oregon

General Access

Crisis Number

541-476-2373

541-474-5360 (24 hours)

KLAMATH County Basin Behavioral Health

General Access & Crisis Number

541-883-1030

LAKE County Mental Health Center

General Access

Crisis Number

541-947-6021

541-947-6021 or 1-877-456-2293

LANE County Health and Human Services

General Access

Crisis Number

541-682-3608

White Bird Clinic: 541-687-4000 (after hours)

LINCOLN County Mental Health Program

General Access

Crisis Number

Adults: 541-574-5960

Children: 541-265-4179

Lincoln City: 541-265-4196

1-888-232-7192 (24 hours)

LINN County Mental Health

General Access

Crisis Number

541-967-3866

541-967-3866 or 1-800-304-7468 (24 hours)

Malheur County Lifeways, Inc.

General Access & Crisis Number

541-889-9167

MARION County Mental Health Services

General Services

Crisis Number

503-588-5351

Woodburn: 503-981-5851

503-585-4949

MORROW/WHEELER County Community Counseling Solutions

General Services

Crisis Number

(Heppner) 541-676-9161

(Boardman) 541-481-2911

911

MULTNOMAH County Mental Health Services

General Services

Crisis Number

503-988-5887

503-988-4888

Toll-free at 1-800-716-9769

POLK County Mental Health

General Services

Crisis Number

Dallas: 503-623-9289

West Salem: 503-585-3012

503-623-9289 (days)

503-581-5535 or 800-560-5833 (after hours)

SHERMAN County Mid-Columbia Center for Living

General Access

Crisis Number

541-296-5452

1-888-877-9147

541-296-5452

TILLAMOOK County Family Counseling Inc.

General Access

Crisis Number

503-842-8201

503-842-8201 or 1-800-962-2851

UMATILLA County Lifeways, Inc.

General Access

Crisis Number

Hermiston: 541-922-6226

Milton-Freewater: 866-343-4473

Pendleton: 541-276-6207

Hermiston & Milton-Freewater: 1-866-343-4473

Pendleton: 541-276-6207

UNION County Center for Human Development

General Access & Crisis Number

541-962-8800

WALLOWA County Valley Center for Wellness

General Access

Crisis Number

541-426-4524

541-398-1175

WASCO County Mid-Columbia Center for Living

General Access

Crisis Number

541-296-5452

541-296-6307

1-888-877-9147 (after hours)

WASHINGTON County Mental Health

General Access

Crisis Number

503-291-1155

503-291-9111

WHEELER/MORROW County Community Counseling Solutions

General Access

Crisis Number

541-763-2746

911

YAMHILL County Adult Mental Health and Family & Youth Mental Health Programs

General Access

Crisis Number

Adults: 503-434-7253

Youth: 503-434-7462

1-844-842-8200