Depression is the most common mental illness in the general population and the most common psychiatric health condition seen by family doctors. Getting the right kind of help for it can be challenging as access to mental health resources are quite variable across Canada. Your family doctor is generally the person you should see initially for help, but it’s important that you have as much information as possible when you meet with them so that you receive optimal treatment.
First, you need to be diagnosed correctly. True clinical depression is termed “Major Depressive Disorder” and has specific criteria. Some medical issues or medication side effects can cause depressive symptoms so these need to be ruled out. Sometimes you can have other mental health issues such as anxiety that are the true underlying cause of your symptoms. At other times, it may not be entirely clear what the correct diagnosis is, which will take some time to sort out – but try not to get discouraged. The important point is that you need to work with your doctor to get the right diagnosis so that you can get on the most appropriate treatment for you.
If your doctor feels that you have Major Depressive Disorder, then you need treatment. Treatment will be different for everybody. Most experts advocate the use of medication combined with some form of psychotherapy as the best treatment option. However, there is evidence that either medication alone or psychotherapy alone can help treat Major Depressive Disorder. Many of the decisions will be between you and your doctor about what makes the most sense for your situation. One of the issues that often helps in making the decision to use medication or not is your current ability to actively engage in psychotherapy. If your energy levels are very low and you have difficulty concentrating, you will find psychotherapy quite challenging. Medication can often help bring you out of that state of mind and allow you to engage in the psychotherapy better so that it is more effective.
Access to psychotherapy and psychiatric services can be difficult depending on where you live in Canada. If you need help in obtaining resources in your local community, or help finding a family doctor or other mental health professional that suits your needs, please contact us and we can help you develop a personalized plan.
Finally, one of the most important aspects of treatment that is often overlooked is the use of what has been termed “Antidepressant Behaviours”. Just like we use antidepressants for treating Major Depressive Disorder, doctors may prescribe lifestyle changes that can strongly impact treatment outcomes. These lifestyle factors are truly antidepressants in their own right. Daily exercise of at least 30 minutes of brisk exercise such as walking, biking or resistance training is recommended. Ensuring that you get at least 7 to 8 hours of restorative sleep each night is the goal. You may need some help with this from your doctor, as sleep quality is often affected by the depression itself. Attention to good nutrition is pivotal when you are suffering from depression, so this should be reviewed with your doctor as well. Journaling is a great way to get your feelings out, so this is encouraged. Think of creating a gratitude journal that allows you to focus on the good aspects of your life. Meditation and yoga can also help with quieting the mind and living in the moment, and increase your awareness of negative thought patterns associated with depression.
When someone is depressed, the mind is often overactive and tends to dwell on the negative. These behaviours can help to counteract that tendency. The problem I find with patients who are working on carrying out these antidepressant behaviours regularly is that they often must overcome their low energy to do them. They may also feel like they don’t notice an immediate difference in their symptoms. However, it is very important to understand that it is the repetition of these behaviours daily that adds up and slowly helps to improve one’s mood. Keep up these behaviours even though you may not feel up to it or that they are helping, and slowly but surely you will begin to see a difference.
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