My depression won't go away

Theresa Nguyen, Mental Health America

Depression sucks.  It's awful to feel sad, tired, irritated, and especially to feel like you can't get out of the situation you're in.

While depression is treatable, there are a couple things to know that are specific to depression.

1) Depression won't go away if other underlying causes don't change. While you're trying to figure out if clinical depression is what you're dealing with, it's important to take a look at other issue. You might have low energy and feel sad if you have a medical condition. Make sure you get a full check up that takes into consideration your thyroids and even hormones. In a similar way, consider if environmental factors like lonliness, financial insecurity, relationship problems, or grief are underlying factors for your depression. Your depression won't necessarily go away if you don't process on these life issues.

2) You might have clinical depression. If you've started to tackle life situations that contribute to your depression and you still feel depressed, you might consider if you have depression that would be responsive to medications. People with clinical depression often feel like they're depressed and don't really know why. There's no other explanation except that something might be wrong in their brain. Maybe a medication can help.

3) Depression takes a while to respond to medications.  If you've tried antidepressants, you probably heard that it can take anywhere from 2-6 weeks for you to feel any kind of change from the medication. Most doctors will tell you to give it 4-6 weeks before changing medications.  Scientist don't really understand why it takes antidepressants so long to kick in. Some scientists have hypothesized that this is because the depression is actually alleviated by some other change on the brain besides what antidepressants do on our levels of neurotransmitters. If you just started on the process of tackling your might have to try multiple medications.

4) You might have to try multiple medications. If the first medication doesn't work, your doctor is probably going to recommend that you try another one.  This process can take a really long time and become incredible frustrating as you're trying to deal with your brain's constant attack. Part of this process is made worse by insurance policies that require you to "fail first" on multiple medications before getting coverage for a medication that might work better. This is especially true for medications that are newer.

5) There's this thing called Treatment Resistant Depression. People who have tried 2 or 3 antidepressants with no response or minimal response might get diagnosed with Treatment Resistant Depression or TRD. If you are diagnosed with TRD, it might mean that you have insurance access to a different treatment options. These options include antidepressants designed to treat TRD or device based treatments like electroconvulsive therapy (ECT) or vagus nerve stimulation.


What do I do if my depression won't go away

1) Fight in the open. Fighting is hard when we fight alone. Find a network or check out online options to get connected and get support. If you haven't tried counseling or medication, these are other options to consider.

2) Don't give up. Living with depression sucks. Don't settle and don't give up the fight. If you're trying medications or seeing a support person, can you combine it with some other strategies? For example, is there something that helped before?  Go back to these strategies.

3) Investigate. Keep track of your depression. Noticing patterns might help to shed light on what's going on.  Maybe the symptoms get worse in a cyclical way. For example, having changes that are monthly might mean there's a hormone influence.  Or you might notice that you feel worse after certain things happen (talking to a particular person) or after several days of poor rest.

4) Eat better and exercise. Yes, it's so hard and we all (MHA staff) struggle with following our own advice. What can you do that's incremental that moves you in this direction? Honestly, the science shows this has a huge impact on improving our overall brain health.

5) Tackle the TRD. If you have clinical depression (vs situational depression), and you've tried multiple antidepressants, talk to your doctor about other options including new medications and other medical based strategies. We've heard from people that they finally found relief after trying device based strategies like ECT, and newer and better medication based treatment options are being discovered - such as antidepressants that are ketamine based (wild, right?)



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