What has made you smile recently? Take a moment to think about it. I hope it made you smile again. Recently I read an article in the NY Times about how botox helped individuals reduce their depression scores. Imagine that. Just smiling helps.
In the last couple weeks I have been thinking about this blog I’ve been writing for two years now. Wow how time flies! Well I was thinking that the majority of time I am writing about what to do if you have depression or anxiety. I’ve been thinking that perhaps it is time again to write about what IS depression or anxiety?
While I will try to describe what depression and anxiety is as well as what causes them, this will not be a complete research paper on the subject. It is also important to note that there are many forms of depression (i.e. major depression, dysthymia, Bipolar depression) and anxiety (i.e. OCD, Agoraphobia, Generalized Anxiety, PTSD).
Having said that, to be diagnosed with any mental health disorder a person must be experiencing various symptoms for a period of time which interfere with his or her ability to function in his or her day to day life activities and responsibilities. The primary symptoms of depression involve: 1. depressed mood; 2. loss of pleasure in activities and interests; 3. weight and eating changes; 4. fatigue and low energy; 5. poor concentration or memory; 6. feeling worthless, hopeless or guilty; 7. isolating and avoiding interactions with others; and 8. thoughts of death. The primary symptoms of anxiety involve: 1. worry; 2. avoidance behaviors; 3. physical symptoms such as fatigue, numbness, pain, tension, headaches, GI problems; 4. fear that something bad is going to happen either to you or someone else.
When we look to identify the cause of depression or anxiety, research has indicated that it is a combination of biological and environmental factors as well as cognitive factors. There are certain neurotransmitters that have been identified such as serotonin, dopamine and norepinephrine that are associated with depression and anxiety. Some research indicates that it is a lack of these neurotransmitters or an imbalance of these that are thought to be influencing factors. The stress hormone cortisol has also been studied and found to be a factor. As stress increases our cortisol level tends to increase which causes a drop in serotonin and dopamine. Still these alone do not cause depression or anxiety. Environmental factors such as family relationships, work satisfaction or stress level, unemployment, getting a poor grade or a poor review at work, lack of supports, conflictual relationships, living arrangements. Cognitive factors such as negative self-talk and beliefs that you are not worthy, valuable, lovable, good enough, smart enough, rich enough, etc… We could also include physical factors such as illness, physical handicaps or disability, cognitive impairment, or physical living situation.
As you can see, the list of contributing factors could go one for several pages. Keep in mind, that in order to have a medical diagnoses, you would have to meet a certain number, for a certain amount of time and it would have to be interfering in your ability to function in your day-to-day activities and responsibilities.
The good news is that all of the forms of depression and anxiety are treatable. There are many forms of treatment that have shown to be effective. These include many different Selective Serotonin Reuptake Inhibitors (SSRI’s) such as Lexapro, Zoloft, Celexa, and Prozac. There also Selective Norepinephrine Reuptake Inhibitors such as Pristiq and Effexor. Mood stabilizers like Lamictal and Abilify are also often used. There are numerous other medications often prescribed with good results. The problem often involves that mediation takes several weeks to take effect or to reach a therapeutic level and require many adjustments until the right dose and right combination is found.
There are numerous forms of psychotherapy such as Dialectical Behavior Therapy (DBT) which is a form of Cognitive Behavior Therapy that teaches individuals coping skills on how to manage their mood and regulate their emotions in order to improve relationships with others. Cognitive Behavior Therapy (CBT) as developed by Aaron Beck focuses on how one’s thoughts and behaviors maintain how a person feels. The emphasis is more on challenging and replacing maladaptive thought patterns and beliefs as well as behaviors as opposed to a person’s emotions. Interpersonal Therapy is a treatment that focuses on one’s social relationships and how to create maintain and improve relationships as a way to improve mood. There are many other forms of therapy as well.
The bottom line for treatment to be effective involves you believing or trusting in your doctor or provider. The mind is extremely powerful and if you believe nothing will work, you will most likely be right. The first step to healing is acknowledging that you want to change. You then need to take one step at a time in making those changes. A therapist is often the person you can talk with to identify what those steps would be.
When looking for a therapist/psychologist it is important to do your research. Found out about the person. What is their degree in? Do they have a license? What is their experience? Do they have any specialties? Be careful though. Some people list twenty specialties! What kind of reviews have they had (although keep in mind that most people writing reviews do so when they have had poor experiences). Meet with the person and see if you like them. Research shows us that the number one influential factor in treatment effectiveness continues to be the relationship you have with your therapist. Research also indicates that if after 4 sessions, you don’t feel connected it’s time to look for someone else.
I hope this has been helpful. If you are looking for treatment, please feel free to call (484) 678-0525 or email me @ dr.bevilacqua@verizon,net.
I offer individual, couples and family therapy as well as groups for anyone struggling with depression and anxiety.
~ Dr. Lou