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How to get going when depressed


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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

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How to get out of depression: effective advice from psychologists

How to get out of depression: effective advice from psychologists | Restorative medicine center "Altiva"

Depression is the most common mental disorder worldwide. It can occur in people of different status and age, in any life period. This disorder reduces the quality of a person’s life: it interferes with enjoying what is happening, working, maintaining social relationships, and even serving oneself.

5 ways to get out of depression on your own

There are different forms of this disorder. However, treatment will be most effective if started early. When depression is mild, you can get out of it on your own. To do this, you must follow the recommendations of psychologists, and not selectively, but in combination:

  • Sports. During physical activity (about 30 minutes), the production of the "hormone of happiness", endorphin, increases 5 times. Yoga, aerobics, or dancing can help you get out of depression. nine0011
  • Travel. Interesting trips, unfamiliar places, meeting new people - all this contributes to emotional upsurge. In a state of depression, solitude and loneliness should be avoided. Various hobbies and hobbies help well. And even ordinary walks in the fresh air.
  • Meditation. Stimulates the production of endorphin and norepinephrine, a neurotransmitter associated with mood. Techniques such as art therapy, massages, acupuncture, and the like may also be used.
  • Personal care. One of the main signs of depression is indifference, even to one's own appearance. Therefore, even if there is neither desire nor strength, it is still worth taking care of yourself and, if possible, visiting spas.
  • Healthy eating. If there is no appetite, it is better not to skip meals. In depressive conditions, immunity is often impaired, so it is better to focus on fruits and vegetables rich in vitamins and microelements.

During a period of depression, you should not make important decisions, because. the surrounding world is perceived biased. nine0004

Do's and don'ts for depression

Most people with depression don't realize they need help. There is no universal cure, but psychologists give recommendations on what exactly should not be done in this condition:

  • Alcohol. Alcoholic drinks can restore the joy of life for a very short period. In addition, many people suffering from depression often experience alcoholism or drug addiction.
  • Bad habits. People in a depressed state have low self-esteem, they are not interested in anything. They have no desire to even move, they can lie for days and do nothing. It is necessary to fight against this, it is impossible to follow the lead of such pernicious desires. nine0011
  • Ignore medication. Such severe forms of depression as chronic, bipolar, endogenous, cannot be cured without medical help.

Overcoming depression: when specialists are indispensable

Depression is a serious disorder that often requires medical attention. Therefore, contacting specialists is the most preferable and effective option. When there is neither the strength nor the desire to do anything, it is very difficult to get rid of a depressive state on your own. And when it comes to severe forms of depression, it is almost impossible. In such cases, treatment consists of several stages:

  • Taking antidepressants. The selection of the drug is carried out by the attending physician. The selection takes into account interactions with other drugs, previous treatment results and other indicators.
  • Psychotherapy. Interpersonal, psychodynamic, cognitive behavioral and other therapies may be used. The use of these methods allows patients to look at the world in a positive way, learn to overcome depressive attacks, and also recognize signs of their approach. nine0011

The effects of antidepressants appear after a while: usually, the drugs begin to work a few weeks after the start of administration, and their effect lasts for six months to a year. And psychotherapy is especially important when working with patients diagnosed with major depressive disorder. Therapy helps to cope with feelings of fear and hopelessness.

Remember, timely treatment will help prevent more severe forms of depression and greatly improve the patient's quality of life. nine0048

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psychotherapist named 4 typical mistakes //Psychological newspaper

Depressions are divided into two large groups. According to Tatyana Arturovna Karavaeva , Doctor of Medical Sciences, Head of the Department for the Treatment of Borderline Mental Disorders and Psychotherapy of the National Medical Research Center. V.M. Ankylosing spondylitis, they occur approximately 50/50, but they manifest themselves and are treated differently.

Endogenous depressions are associated with a chemical malfunction in the brain. Because of it, the level of the main neurotransmitters, more often serotonin, decreases in the body. No one can say for sure why this failure occurs - there are many mechanisms and it is difficult to single out one. An exacerbation of the disease, as a rule, occurs in spring or autumn, although it can happen at any time. nine0004

Psychogenic depressions occur after difficult events in life - for example, the death of a loved one, loss of a job. In other words, there is a specific reason for which a person reacts with a disease. This type of depression does not depend on the season and is associated exclusively with traumatic circumstances.

What do doctors call depression?

The official diagnosis is "depressive episode" if the depression happened once, or "recurrent depressive disorder" if the episodes recur. nine0004

There is another type of depression, which is even singled out separately in the updated International Classification of Diseases of the 11th revision (ICD-11) - “pathological grief reaction”. According to Tatyana Karavaeva, this diagnosis implies too deep and prolonged reaction to life events, often associated with the death of a loved one. And although a normally healthy person is going through a loss hard, for some, grief drags on for years, while the strength of experiences remains as if it were yesterday. nine0004

Why does serotonin suddenly become “deficient” in some people or the loss of a job provokes depression, while others feel sad and worried, but cope with the situation? According to the psychotherapist, a lot depends on the resources of a person, the characteristics of his upbringing and character traits. They interfere with getting out of the situation, for example, a tendency to increased anxiety, a critical perception of oneself and others, rigidity of thinking (unwillingness to change one's position and attitude).

nine0067 Who is at risk.

  • People with hereditary predisposition. If someone in the family suffered from depression or other mental illnesses, there is a risk that this will be inherited. Whether the risk is realized during life or not is not known in advance.
  • People living in constant stress - it depletes the body.
  • Alcohol abuse and smoking are thought to increase the risk.
  • Psychogenic depression develops more often in women (this is due to greater emotionality compared to men), and endogenous depression is more common in men. nine0011

Symptoms of Depression: Common and Unusual

The symptoms differ for different types of depression, although there are common features.

6 classic symptoms:

  1. depressed mood;
  2. difficult thinking;
  3. decreased activity, unwillingness to do anything - for example, getting out of bed in the morning, cooking, socializing;
  4. sleep disorders; nine0011
  5. change in appetite, it can both decrease and, conversely, increase;
  6. change in body weight, sometimes weight loss can be very noticeable - up to 10-15 kg.

- I am often asked how long and how often the mood should be lowered in order to suspect depression. If the bad mood has no specific cause, and it is reduced within 2 weeks, most days of the week and most of the day, this is an occasion to see a doctor as soon as possible. As a rule, with depression, a decrease in mood is painfully tolerated - a person feels longing, hopelessness, sometimes accompanied by a feeling of guilt or shame. Moreover, a person begins to blame himself for absolutely any reason, remembers the mistakes of the past and thinks about his worthlessness. During this period, the risk of suicide is high - against the background of a depressive state, unfortunately, this is not uncommon, - warns Tatyana Karavaeva. nine0004

What is the difference between endogenous depression and psychogenic.

  • With endogenous depression, as a rule, sleep disturbances manifest themselves in the form of early awakenings - a person wakes up at 5-6 in the morning and cannot fall asleep anymore. For psychogenic, rather, difficulties with falling asleep are characteristic - experiences, disturbing thoughts prevent falling asleep.
  • With endogenous depression, a lowered mood is more pronounced in the first half of the day - in the pre-morning hours, the lowest level of serotonin in the body, and with depression, it is below the usual minimum (such a decline just “throws you out” of sleep, wakes you up). It begins to rise only by the middle of the day, and the person becomes a little easier. Psychogenic depression is characterized by mood “waves” and frequent tears - when a person is immersed in thoughts about life, it becomes worse, distracted - feel better. nine0011
  • Endogenous depression is not always manifested by low mood. This type of disorder has unusual symptoms - the so-called masks. Masked depression can be hidden, for example, behind pain in the heart, arrhythmia, heartburn, bloating, asthma-like attacks. Such a person has been going to cardiologists or gastroenterologists for years, but the treatment does not bring relief - the reason for the same arrhythmia is not in heart problems, but in depression and a chemical failure in the body. nine0011

Self-diagnosis

On the net, you can find questionnaires on the Beck scale (a scale of depression) or Zang (a test for self-reported anxiety). According to the psychotherapist NMIC them. Bekhterev, such tests help to better understand your condition, but not to make a diagnosis. Scored a high score, so it makes sense to consult a doctor who will confirm or refute your suspicions.

- Unfortunately, there are no specific laboratory or instrumental methods that would show "this is definitely depression." The main tools of the psychotherapist in making a diagnosis are a detailed interview of the patient and the identification of clinical symptoms. If a person has a bad mood for no apparent reason and it does not go away for a long time, or he is very worried about events in life and cannot cope with emotions on his own, you need to go to the doctor and deal with him, Tatyana Karavaeva believes. nine0004

Self Action

According to doctors, very few people can cure themselves of depression. Especially if you suffer from endogenous depression, which requires antidepressants to treat. And they are prescribed by a doctor - a psychotherapist or a psychiatrist and are sold only by prescription.

- Tips from the series “smile”, “pull yourself together”, “get distracted” or “do something” do not work, because endogenous depression is a biologically determined condition. We cannot affect the level of serotonin by willpower. You can cope with mild psychogenic depression on your own, but much depends on the strength of the traumatic event, the characteristics of the person and the resources of the person, motivation, current life circumstances and the support of loved ones. As a rule, even here it is difficult to do without the help of a specialist,” explains Tatiana Karavaeva. nine0004

Tips from a psychotherapist

  • Try to understand the cause of depression.
  • Think about how to change the situation.
  • If you can’t change, try to accept the situation (for example, parting with a loved one). Look at it from different angles and try to find the positives.
  • Don't hide in the house. This can only increase the feeling of loneliness, longing and exacerbate problems.
    • nine0010 Get support from friends and family. If this is difficult to do, seek the help of a psychotherapist. Not everyone is ready to share problems and experiences even with friends. For example, he is afraid that he will not be understood, does not want to seem weak, or is sure in advance that he will not hear anything useful.

Common Mistakes When Trying to Get Out of Depression

  • Go to a psychologist. You may lose time. And the longer a person with depression remains without help, the greater the risk of developing a chronic form of the disease and the more difficult it is to find therapy later. nine0011
  • Do not go to a specialist doctor trying to cope alone.
  • Wait for to pass. Mild psychogenic depression can go away without the help of a doctor. Every person in his life experienced events that made him very sad and sad, but over time everything returned to normal. But if time goes by, but it doesn’t get better, see the paragraph above.
  • To prescribe medicines to oneself or try to be cured with herbs, corvalol and so on. nine0011

How depression is treated

Antidepressants . With endogenous depression associated with disorders in the body at the chemical level, the appointment of antidepressants is a mandatory stage of treatment. With psychogenic, they are not always prescribed - it depends on the severity of the disease. However, antidepressants do not work quickly - the patient can feel the effect only 1-2 months after the start of therapy.

- These drugs are prescribed only by a doctor - a psychotherapist or psychiatrist. He selects a specific drug, the required dosage, the mode of administration. You should not be afraid of antidepressants - unlike some other classes of drugs, they do not cause dependence. But we must immediately prepare for the fact that it will take a long time to take them. According to the recommendations of the World Health Organization (WHO), if a person is diagnosed with depression for the first time, antidepressants are prescribed for at least six months, if the second time - for a year or longer. Modern drugs belong to a high safety class, so we can prescribe them for a long time and, when the condition stabilizes, calmly leave them. If the drug is not suitable, the doctor adjusts the therapy, changes the medicine, or selects a combination of several. They cancel antidepressants gradually and also under the supervision of a doctor: they lowered the dose - we look at how the patient feels. If everything is in order, we reduce a little more. Early or too quick withdrawal of an antidepressant is fraught with the return of depression, but in a more severe form, said Tatyana Karavaeva. nine0004

Psychotherapy . This is the main type of treatment for psychogenic depression, and additional - for endogenous. It’s also better not to count on a quick result here - individual work with a doctor can take more than one month, taking into account sessions 1-2 times a week:

“There have been many scientific studies that have proven that a combination of drug therapy and psychotherapy is more effective than using either one. Cognitive behavioral therapy is used in the treatment of depression. It was developed by a famous American psychotherapist Aaron Beck (like the popular scale), who died in November 2021 at the age of 100. But this is not the only method. Sometimes the doctor gives homework to help the patient work through depressive thoughts between sessions and feel lighter and more confident.

How to find a good psychotherapist

How to choose from a large number of offers of a professional who can be trusted with the treatment of depression and not be afraid of the consequences?

  • Choose a doctor - a person who graduated from medical school. He must have a valid certificate of a psychotherapist, which is required to be renewed every 5 years. nine0011
  • See where he works. A track record can speak of experience and a degree of professionalism.
  • Study reviews of his work and promotional messages. If he writes that he is engaged in psychotherapy of any condition, reads fortunes on tarot cards, and also conducts coaching, it is better to continue the search.
  • Another significant detail: whether this doctor participates in professional events, conferences, scientific work and whether he has scientific publications, an academic degree. Such activity always increases the level of professionalism of the doctor. nine0011

Advice to relatives

For those who have never experienced depression in their lives, it is difficult to imagine the feelings of such a person. From the outside, it often seems that he has dismissed himself, is lazy. Relatives like to say: “pull yourself together”, “set yourself goals”.

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