Depression: Part III - Causes & treatments

If you suffer from depression, or you have suffered an episode of depression in the past, then (hopefully) you've already spoken with your doctor to rule out the possible medical conditions that could be responsible for your symptoms. The list of possibilities is longer than you might think! However, this is a GOOD thing because knowing the cause of your symptoms can help you identify the most effective treatments. It is important that you see your doctor for annual physical exams, especially if you are noticing any changes regarding your physical or mental health.

A Vitamin D deficiency and hypothyroidism are two medical conditions that are well known to cause symptoms of depression and can be easily identified with a simple blood test. While a thyroid problem will likely require a prescription medication, a vitamin deficiency can usually be resolved with an over-the-counter supplement. In fact, Vitamin D may be a good supplement for you to take regardless due to its primary role in bone health. However, ask your doctor before you begin taking anything new (even if it's only a vitamin or mineral!) to make sure that you could benefit from it and to confirm the correct dosage. Other common medical conditions that are associated with depression are typically related to cerebrovascular risk factors (e.g. diabetes, hypotension). Any fluctuations in blood pressure and blood sugar levels can lead to drowsiness, fatigue, mental fogginess, and sadness. These conditions can sometimes be managed with diet and exercise, but they may also require prescription medications to stabilize. Less common medical conditions that can be accompanied by symptoms of depression include disorders that are more serious in nature, such as cancer or a brain tumor, which are usually treated aggressively with a strict medication regimen and/or surgery.

An episode of major depression that occurs for the first time during middle age or older adulthood can be particularly concerning, as mental health disorders are most likely to develop during late adolescence and early adulthood. That being said, medical conditions that can precipitate a later change in mental health status include menopause/hormone imbalances, chronic pain syndromes (e.g. fibromyalgia, complex regional pain syndrome), autoimmune disorders (e.g. lupus, rheumatoid arthritis), sleep disorders (e.g. sleep apnea, insomnia), and even dehydration. Treatment? Drink plenty of water, ensure that you are obtaining adequate sleep, attend to your body's nutritional needs, and follow the instructions of your treating physicians. Unfortunately, neurodegenerative disorders (e.g. Alzheimer's disease, Parkinson's disease) also tend to develop in late middle age and older adulthood, and these syndromes are frequently accompanied by changes in mood and behavior as well. While there are medications to reduce symptoms that are secondary to neurodegenerative disorders and delay their progression, there are currently no cures.

Lastly, symptoms of depression may arise due to a genetic predisposition or chemical imbalance. Ask questions about your family history to find out whether your parents or grandparents experienced any mental health problems. You might be surprised by what you discover, as the stigma related to mental illness has led to many a family secret. A history of abuse or trauma can alter the wiring of a developing brain as well, and major losses (e.g. death of a child or spouse) can trigger a complicated grief reaction. Far too often, people try to avoid mental anguish by self-medicating with alcohol or drugs. While these substances might provide some immediate relief, they can also reduce your brain's natural ability to defend itself from stress and set off the aforementioned chemical imbalance. Given enough time, damage from alcohol and drugs can be extremely difficult to repair. Don't place yourself at a disadvantage by taking this route! Instead, talk to your doctor about psychotherapy and medication options.

There have been many advances in anti-depressant medications over the years and you will need assistance to find the one that works best for you. The same rule holds true for psychotherapy. While some people may benefit from lying on a couch Freudian-style and talking about their childhood, other people make better progress by creating goals and completing assignments. Be your own advocate! If a treatment doesn't seem to be working, then I beg of you... Please speak up and give your doctor the opportunity to try something else that could help you. Statistics show that approximately 80% of people who have suffered from depression reported that they felt better after receiving treatment.

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