Ask Beatty: Is Your Clinical Depression Getting in the Way of Your Life & Relationships?

Depression has become one of the major public health crises sweeping through the United States and the world. Even before the emergence of COVID-19, one in eight American adults was taking an antidepressant drug. According to the Centers for Disease Control and Prevention, that number rose by 18.6% during 2020. What’s even more troubling is there has been a 59% increase in adolescent depression since 2007, and the stressors from COVID-19 have only made it worse. Recent surveys indicate that as many as one in five teens suffers from clinical depression.

According to the National Institute of Mental Health, depression is the most common disability in the world, impacting people’s daily life. Stressful situations, loneliness, isolation, lack of a strong and loving support system, economic difficulties, unemployment, racism/homophobia, alcoholism, domestic violence, drug misuse/abuse, physical illness, family history, traumatic childhood experiences, including early child sexual abuse and physical, emotional and verbal abuse, are among the major variables used to explain the rise and causes of depression. The global market for depression treatment, including holistic/alternative medicine approaches to professional therapy-oriented solutions, has exploded and is expected to reach $16.14 billion by 2027.

Are You Clinically Depressed?: We all go through many ups and downs in our lives. No one is immune from experiencing feelings of sadness, grief, anxiety, loneliness and fear. However, if you find that you’re exhibiting any five or more of the following symptoms nearly every day during a two-week period or longer, it’s time to reach out to an experienced mental health professional. Ideally, get a referral from someone that you trust.

Do you exhibit: Depressed mood most of the day, nearly every day? Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day? Significant weight loss or weight gain? Insomnia or hypersomnia nearly every day? Fatigue or loss of energy nearly every day? Feelings of worthlessness or excessive or inappropriate guilt? Diminished ability to think or concentrate? Recurrent thoughts of death without a specific plan or a suicide attempt or with a specific plan for committing suicide?

Your Diagnostic Consultation: During an initial consultation (which should last a minimum of one hour), expect to be asked lots of questions about your current personal and professional situation, family background, relationship history, possible drug or alcohol abuse, traumatic events that may have occurred in your life, including any suicidal thoughts or gestures. Even though you may initially feel very uncomfortable talking about these issues, the questions that are being posed are essential and must be answered honestly so that your therapist will be able to make an accurate clinical diagnosis and help you to come up with a viable treatment plan.

It’s always important to rule out any physical or medical problems, including medications (both prescription and over-the-counter), that may be causing or contributing to your depression. So please consider making an appointment with your primary care doctor, who can give you a complete physical, including blood work.

Do Antidepressants Work?: Recent research is challenging their efficacy, and some researchers are finding that the medications are barely better than a placebo and less effective than a placebo in some studies. In 2002, a leading researcher, Irving Kirsch, in the field of placebo studies examined 47 drug company studies on various antidepressants. These studies included published and unpublished trials. He reported that all antidepressants, including the well-known SSRIs, had no clinically significant benefit over a placebo.

The adverse effects of antidepressant drugs including dry mouth, insomnia, sexual side effects, diarrhea, nausea and sleepiness have long been known and acknowledged by psychiatry and “Big Pharma.”

Treatments for Depression: Psychotherapy is the gold standard in helping people to successfully deal with their depression. Although there are many types of therapies and therapists, my bias in treating people who are struggling with depression is to help them find the root causes of their depression, and help them emotionally work through as best as they can the event(s) that contributed to or caused their depression in the first place. Even though we can’t change our histories, this process frees people up in ways that enable them to live more fully in the present. They are then more inclined to be able to follow through with behaviors and activities that foster positive emotional, mental and physical wellbeing.

Seasonal Affective Disorder (SAD) is a type of depression triggered by the change of seasons. Bright light therapy is considered among the first-line treatments for seasonal effective disorders.

As for psychedelic therapy, much of the available data regarding the therapeutic use of psychedelics for mental health disorders remains introductory. However, momentum is building with the potential to offer unique treatments for many complex mental health disorders including depression and post-traumatic stress disorder (PTSD). According to the National Institutes of Health some types of psychedelic drugs have shown great promise as therapies for treatment-resistant depression.

Transcranial Magnetic Stimulation (TMS) is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. Studies show that approximately 50% to 60% of people with depression who have tried and failed to benefit from medications experience a clinically meaningful response with TMS.

Antidepressants still remain the most common prescription medication that is prescribed for depression. If you decide to go this route, you and your healthcare provider need to work together to try to find one that may offer you some relief.

Lifestyle changes are critical. Remember to eat healthily, interact and socialize with supportive people, eliminate toxins — including toxic people from your life — exercise regularly and try and get eight hours of sleep most nights. Studies also show that weight training, yoga, meditation, aromatherapy and essential oils, massage, acupuncture, positive visualization, listening to music, dancing, getting out into nature, journaling, satisfying sex, helping others, joining a support group, minimizing the time that you spend on your various devices, eliminating sugar, soda, alcohol and nicotine and even getting a dog all help to alleviate symptoms of depression.

Please remember that you don’t need to navigate life’s stressors on your own. If I can be of any help, please don’t hesitate to contact me.

Beatty Cohan, MSW, LCSW, AASECT is a nationally recognized psychotherapist, sex therapist, author of For Better for Worse Forever: Discover the Path to Lasting Love, national speaker, national radio and television expert guest and host of the weekly “Ask Beatty Show” on the Progressive Radio Network. She has a private practice in NYC and East Hampton.

Beatty would love to hear from you. You can send your questions and comments to her at BeattyCohan.msw@gmail.com. For more info, go to beattycohan.com.