Treating depression: Finding the right mix

Everyone gets sad sometimes. It’s part of being human. But if you're one of the 10 million Canadians with true depression, you know all too well the struggles accosted with depression. Today, promising treatments are revolutionizing the course of this potentially devastating illness.

Because depression is such an individualized battle, you may need to combine several therapeutic approaches to find the mix that’s best for you. Medications or psycho­therapy — or both — are the first step for most people with milder depression.

The newer antidepressants (SSRIs particularly) adjust chemical imbalances and have transformed the lives of lives of those who take them. When an SSRI works, you'll likely feel a bit better within a week, although its full effect will take several weeks. If it doesn't work, your doctor may switch you to another SSRI or different antidepressant entirely. These drugs aren't addictive and can be taken long term.

Depending on the type of depression you have, psychotherapy often works as well as medication for mild to moderate cases. However, your best chance to feel better, and even to banish the depression altogether, is to pursue drugs and therapy simultaneously. So if you start with psychotherapy and don't feel any relief within six weeks or feel only somewhat better by 12 weeks, adding antidepressants is an option. Antidepressants have proven to be effective, even for severe, debilitating depression.

After that, ECT (electroconvulsive therapy) may be your next logical option. Along with these medical approaches, you'll also need to develop smart lifestyle strategies, focussing on communicating openly with your doctor, exercising regularly and maintaining a healthy diet.

The good news is that most people eventually find a balanced approach for dealing with depression that makes them feel much better. Concentrate on finding the combination that works best for you. If your depression doesn't lift completely during the first intensive phase of treatment, the risk for relapse is high. So enlist those who care for you to help you get on the road to recovery as quickly as possible.

Swim, bike, walk — get regular exercise — and you'll feel better in part because you are taking charge. You may also experience "feel-good" (and pain-relieving) substances called endorphins.

• Countless studies reinforce the emotional lift of exercise. Stress and anxiety drop. Blood gets flowing. Blood pressure falls. Negative emotions — helplessness, anxiety, hostility — diminish. Even a simple 15-minute walk can enhance your mood.
• A small Johns Hopkins University study found that adults who were fit and relatively lean were more likely to feel happier. But the benefits won't last unless you keep at it.
• Exercise also helps sleep, another key factor in improving mood. The right amount of sleep is critical; seven to eight hours a night is ideal. Avoid napping, and get up at the same time every morning.
• Also aim for a healthy diet. Poor eating can increase fatigue and feelings of unease. You can also explore your spiritual side, whether religion or other beliefs, for answers to meaning in life.
• Meditation and yoga are risk-free ways to get perspective on your daily troubles.
• You'll also want to stay connected socially. Adopt a pet. Take a class. Or join a club related to something you're interested in (such as bridge, chess, gardening or walking). If you find yourself turning to alcohol or drugs, ask your doctor about a support group that can help you; both alcohol and drugs can trigger and intensify depression.

While living with depression can be a challenge, the support is available and symptoms are manageable.  Know that you are not alone and that treatment has been successful for so very many people. It can dramatically change your life.