Scary or dangerous thoughts are a symptom of depression. Here's how to handle troubling, scary or dangerous thoughts associated with depression.

Gold Standard for Treating Depression (part 21)

Depression creates some terrible, scary and often dangerous thoughts. The first thing to remember when you experience these thoughts is that they are normal. Depressed people all over the world have the same thoughts.

Once you recognize the specific thoughts you have when you're depressed, you can remember them, realize it is depression speaking and then counteract them with realistic thoughts. This can be very hard to do at first, especially if these depression thoughts have been in your life for years, but a change can be made.

For example, if you have the thought, "I have no friends. I'll be lonely forever.' You can do the following: remind yourself that you may feel this way when you're depressed as it's a normal part of depression. You sure don't have to like it, but it's a normal part of depression. You can then look at the thought realistically and break the hold the thought has on your brain.

You can say to yourself, "Wait a minute. I have friends and I have always had friends. And truthfully, there is no way that I will be alone forever. If I make even just a few changes in my life by taking meds and doing what I can to deal with the depression naturally, there is a good chance I can get better and make more friends. I will not listen to this thought. I will keep trying to manage depression."

You can then get on with your day. And when the next depression thoughts start, you can do the same technique.

video: Depression Treatment Interviews w/Julie Fast

Depression symptoms can make socializing and interacting with friends and family very difficult. Things to consider if you feel to sick to make friends.

Gold Standard for Treating Depression (part 20)

There is no question that positive human contact improves depression symptoms. And yet, many people with depression isolate themselves because they either lack the energy or the desire to be with other people. This can lead to more depression and the problem becomes a vicious circle.

If you want to manage depression successfully, you will need human contact in order to feel alive and find hope in what seems like a hopeless situation. One of the most important things to remember is that you don't have to 'feel' like getting out and meeting new people or reconnecting with old friends. You simply have to do it. Once you get over the initial lethargy or fear and just get out of the house, it gets easier.

Start with one step. If you work in a social environment, ask someone to lunch or to take a walk. Make a phone call. Go to a movie with someone! Ask someone for help. Do what it takes to just make one connection today and see how much better you feel.

video: Depression Treatment Interviews w/Julie Fast

Your diet, what you eat and drink, can contribute to depression. Here's some guidance on the relationship between diet and depression.

Gold Standard for Treating Depression (part 18)

It's obvious that what you put into your body affects your physical well-being and appearance. And yet, many people don't see the connection between food, drink and brain chemistry. If coffee can make you agitated, it is certainly making your brain agitated. Eating a high sugar, high fat diet not only affects your weight, it also affects the body's ability to regulate the blood sugar levels needed for stable moods. Eating too much or not eating enough can also affect the body's ability to keep the brain and body stable. By making one change at a time, you can improve depression symptoms significantly, even if it's just feeling better about your body. Depression itself and the medications used to treat depression can affect your diet significantly. You will have to adjust your diet accordingly.

Is Caffeine Really That Bad?

Caffeine is a very enticing substance because it seems to help you maintain energy levels. The problem is that it's a drug induced energy that doesn't last. You will always need more to maintain the energy you feel you need. It then builds up in your system and can destabilize your mood by affecting your sleep patterns and sometimes making you so anxious it's difficult to function normally. Caffeine is not a treatment for depression. And considering that up to 90% of people with depression experience anxiety, caffeine causes many more depression symptoms than it seems to help. If you do one thing to help yourself manage depression naturally, switching to decaf or stopping coffee completely is one of the best choices you can make. Maybe the thought of tea is not as enticing, but as always, it's a trade off.

video: Depression Treatment Interviews w/Julie Fast

Exercise can improve depression symptoms. Find out more about depression and exercise as part of your depression treatment program.

Gold Standard for Treating Depression (part 17)

Like sleep, exercise can help regulate the brain chemicals that cause depression. Exercise often feels impossible when you're depressed, but it's imperative you at least get out of bed and take a walk. You can get outside and walk in one direction for ten minutes and then come back for ten.

This is an easy way to get a daily walk into your life. It's especially helpful if you can take this walk in bright light with a friend. As you walk, you can say to yourself, 'I'm treating my own depression. I'm going to feel better after this walk.' Walking with a friend helps as it means you can't back out because you just don't feel up to walking.

Many people don't want to get out and walk, but few say, "Wow, I wish I hadn't taken that walk today." It's important that you don't listen to the thoughts that make it feel impossible to exercise. Exercise is possible. You just have to get out and do it no matter how you feel.

video: Depression Treatment Interviews w/Julie Fast

Sleep deprivation, no matter what the reason, can cause depression. Learn more about why it's important to look at your sleep patterns.

Gold Standard for Treating Depression (part 16)

Sleep is a powerful regulator of brain chemistry. A night of regular, uninterrupted sleep helps reduce depression by making sure that your hormones and neurotransmitters can function normally and give you the physical energy you need to get through the day.

This can often seem impossible if depression is either taking away your energy or making you so agitated you can't sleep. It helps if you plan for a good night's sleep throughout the day.

One choice is to avoid the people who stir up your brain to the point that you can't sleep. Caffeine and alcohol are also two of the main culprits in sleep disruption. Like many people, you may use caffeine for energy and alcohol to wind down before you go to bed. The problem with this is that they affect your ability to go into deep sleep mode once you finally do fall asleep. Thus, for example, making changes in these two areas, even if it's gradually, can significantly help you fall asleep easier and get up more refreshed.

video: Depression Treatment Interviews w/Julie Fast

Behavior and lifestyle choices can affect your depression. Here are changes you can make as part of your depression treatment.

Gold Standard for Treating Depression (part 15)

For many people, depression medications alone, or even the combination of antidepressant medications and psychotherapy, are not enough to end depression. Considering that depression can often be triggered by your personal choices as well as outside events, the more control you take over your lifestyle, behaviors and thoughts, the better chance you have of managing depression more effectively. There is no question that making these changes and learning what triggers your depression can be difficult at first. The good news is that you have the most control here and the changes are easier to implement than expected and are often free.

What are the Main Lifestyle Changes I Need to Make?

There are many steps you can take to reduce your depression symptoms naturally:

• Regulating Sleep
• Exercising
• Changing your diet
• Getting bright light exposure and fresh air
• Staying connected with other people and getting involved -- finding a daily purpose so that you can get break the hold depression has on your behavior
• Reducing caffeine, alcohol and avoiding substance abuse

When you first look at this list, you may feel overwhelmed. This is normal, but it's also important to know that these changes can be made very gradually. Something such as using a light box to increase your bright light exposure in the winter may be a better first step than completely stopping caffeine while adding a short walk to your day can be more realistic than making new friends.

Why Do I Need to Make These Changes?

Your lifestyle choices affect depression in many ways from damaging your physical health to actually increasing depression symptoms. How much sleep you get, what you eat, the alcohol and caffeine you drink, the street drugs you use, the amount of bright light you get daily and the people you interact with can all affect depression in a negative way if they are not examined and changed for the better. Whether you are mildly or seriously depressed, there is always at least one step you can make in order to feel better. The action of making a change can often help as much as the change itself. Depression can make you inert. You need to fight this by making positive changes one step at a time.

video: Depression Treatment Interviews w/Julie Fast

Psychotherapy can make a big difference in your recovery from depression. Learn what to expect from psychotherapy.

Gold Standard for Treating Depression (part 14)

Unlike other mental illnesses such as bipolar disorder and schizophrenia, there is a chance that depending on the severity and root cause of depression , therapy alone can be used to treat depression. This, naturally, depends on the type of depression you may have. If a person has been depressed for most of his or her life, there is a good chance that psychotherapy alone will not be able to alleviate the depression. On the other hand, if the depression is caused by a specific life event such as a divorce or moving to a new area, there is a good chance that psychotherapy can help end the depression.

What Can I Expect from Psychotherapy?

A good therapist can help you recognize the changes you need to make in order to have a happier and more productive life and then give you some tools on how to reach your goals. Psychotherapy can also provide the much needed people contact that has shown to improve depression symptoms as suggested by the Star*D research. When you look for a therapist, you can ask about a person's experience with the above therapies and decide what you think would work best for you. Because choosing the right therapist is an important decision that impacts your health for a lifetime, it makes sense to ask the people around you for a reference and then interview the therapist to see if he or she is the right fit.

video: Depression Treatment Interviews w/Julie Fast

Taking antidepressant medications plus psychotherapy appears to be the best treatment for moderate to severe depression.

Gold Standard for Treating Depression (part 13)

Numerous studies have asked the question: "what role can psychotherapy play in the treatment of depression?". The findings are positive. Two large-scale studies have strongly suggested that the combination of medications and psychotherapy yield better outcomes. A large study of treatment of adults (2. Keller, et al.2000) found response rates in severely depressed individuals as follows:

• Medication alone: 55%
• Psychotherapy alone: 52%
• A combination of medications and psychotherapy: 85%

In another large study supported by the National Institute for Mental Health (3. March, et al., 2004), adolescents were treated with psychotherapy alone, antidepressants alone and in combination. Response rates were: 43%, 61% and 71%, respectively. This is good news for people with depression.

Because primary doctors are now the main prescribers of medications and usually do not have the resources or time for the contact the Star*D project suggests, a trained psychotherapist can make a very large contribution to your depression treatment plan. Adding psychotherapy to existing medication treatment greatly increases your chance for recovery by

• helping you recognize and change unrealistic thoughts caused by depression,
• providing a safe place for you to discuss the problems you feel that cause depression or that are caused by depression,
• helping family and friends understand the illness and
• helping you to find ways to end the isolation and loneliness often associated with depression.

Antidepressants alone cannot offer all of this help. It makes sense that a combination of two such powerful treatments could increase your chance of remission. For some people, medications often regulate their brain chemistry to a point where a person can actually use the skills taught by psychotherapy.

What are My Psychotherapy Choices?

There are three specific psychotherapy practices that have been found to help depression.

1. Cognitive Therapy

Cognitive therapy helps people examine and change how they think about and respond to internal thoughts and outside situations. These changes can significantly reduce or help a person tolerate depression symptoms. Unlike some other psychotherapy techniques, cognitive therapy focuses on current problems and difficulties as opposed to, for example, looking at a person's childhood. Instead of focusing on the past, the focus of cognitive therapy is to improve a person's immediate state of mind.

An example would be how a person responds to the thought, "My life is hopeless and I will never get better." Cognitive therapy teaches a person to examine the reality of the thought and then counteract it with a more realistic thought such as, "I'm very depressed right now and it makes sense that I feel hopeless. The reality is that I don't feel hopeless when not I'm depressed and I can get better.

2. Interpersonal Therapy

Some people experience depression because of problematic relationships. Interpersonal therapy has been found to be effective for people who have poor communication, conflict resolution and problem-solving skills. The better they can improve these areas, the better chance they have of leaving the situations that cause the depression or at least deal better with those they cannot change.

3. Behavioral Therapy

This therapy helps people change the behaviors that cause their depression as well as offering suggestions for behavior that could improve their mood. For example, a person who isolates his or her self because of depression is encouraged to get out more in order to counteract the depression. This also helps when a person is depressed because they are lonely and need contact with people but are not sure how to start the process.

In this therapy, there is strong encouragement for a person to become more socially involved, strengthen ties with supportive family and friends, and make choices that decrease depression. Some examples include exercising with a friend, joining a group such as a church group, going to the movies, and simply becoming more active in life.

video: Depression Treatment Interviews w/Julie Fast

There are many causes of depression. In addition, you may have been misdiagnosed with depression and really have bipolar disorder.

Gold Standard for Treating Depression (part 12)

It's very important that you carefully monitor any physical or personal changes that can contribute to depression. These include menstruation, pregnancy and other female-related conditions such as ovarian cysts. Many drugs can cause depression including steroids, some heart medications and pain killers. A thyroid problem can also lead to significant depressions symptoms. On the more personal side, depression triggers from the loss of a job to a death in the family can lead to serious depression. All of these possibilities must be taken into account when you begin treatment for depression.

Is There a Chance I Have Bipolar Disorder?

It is sometimes the case that people who seek treatment for depression actually have bipolar disorder. Being treated with antidepressants when you actually have bipolar disorder can lead to serious complications. Because of this, it's very important that you talk with your healthcare professional about bipolar disorder symptoms, especially mania. You can also research the illness on this website to see if you have any bipolar disorder symptoms. If there is even a chance you have bipolar disorder, it's very important that you receive a correct diagnosis as the medication treatment for bipolar disorder and depression are very different.

video: Depression Treatment Interviews w/Julie Fast

How long do you have to stay on antidepressant medications and what if your antidepressant doesn't work anymore?

Gold Standard for Treating Depression (part 11)

Your body often changes, especially as you get older. Because of this, it's possible that an antidepressant that has worked well in the past will not be as effective in the future. If you see signs that your depression symptoms are returning or that you are experiencing new side effects, you will need to talk with your medications healthcare professional and explain the situation.

How Long Will I Have to Stay on Antidepressant Medications?

Studies show that people who remain on depression medications long-term, instead of stopping and starting the medications when needed, have a better treatment outcome. (1. Stahl, 2000) This can be difficult when you start to feel better and just want to 'get off all of these drugs' and give your body a rest.

As with any medication -- this is a balancing act. You may wonder if you really don't need the medications anymore and yet the reason you feel better is that the medications are working. On the other hand, going off may be a good idea if your depression has ended. It often depends on whether your depression was caused by a life event or has been chronic for many years. This is a decision you can make with your medications professional or a trained psychologist. Once again, it cannot be stressed enough that the more you work on your treatment options along with medications, the better chance you have of managing the depression on your own with less medications.

When asked what he felt were the most important parts of any medication treatment plan for depression, Dr. John Rush of the Star*D research project told HealthyPlace.com they are:

1. Careful diagnosis
2. Diligent regular assessment of symptoms and side effects
3. Timely adjustment of medication doses
4. Changes in medications if current treatment does not work well enough by 10-12 weeks.

"The most important component is patience and a strong collaboration between clinician and patient," says Dr. Rush. All current treatment guidelines recommend that once the depression symptoms are alleviated, a person should continue to take medications for at least six months before discontinuing. For people who have had recurrent or chronic depression with four or more episodes, the recommendation is to stay on medications for depression.

video: Depression Treatment Interviews w/Julie Fast