Could these dark moods be depression? - Ask the Experts

by Vicki Rackner MD

Everybody has days that bring sadness, low energy, or aches and pains. Maybe you see it in your aging parents, your partner, or even in yourself. While all of these symptoms are an expected part of normal life, they can also be symptoms of clinical depression.

Clinical depression is a real illness that causes real pain. You’ve seen enough TV ads to know that depression is associated with a chemical imbalance in the brain. Depressed people describe unwanted moods and thoughts that don’t lead anywhere productive. One caregiver said, “It’s like my thoughts get stuck driving around a traffic circle, and I can’t find a way out.”

The relationship between thoughts and mood are like the chicken and the egg. Each thought creates a chemical reaction in the brain, then the chemical reactions influence the thoughts the brain chooses. The treatment of depression involves changing the brain chemistry with medication and offering skills about how to choose your thoughts.

Family caregivers are twice as likely to be diagnosed with depression as their non-caregivign peers; the elderly get depressed much more often than previously imagined. Clinical depression is treatable in the young and the old and everyone in between. It must be diagnosed before it’s treated.

Ask the doctor, “Could I be depressed?” If you’re a caregiver, you know that feeling sad or overwhelmed is a normal response to super-sizing your job caring for others. Your doctor can distinguish an expected under-the-weather mood from true clinical depression.

Sometimes it’s easy to make the diagnosis of depression, and other times it’s tricky. Sometimes disorders of the mind, such as depression, can manifest as aches and pains in the body, and other times disorders of the body, such as thyroid problems, can manifest as mood changes.

People of your parents’ generation resist the diagnosis of depression because they believe that there is shame associated with problems of the mind. You can suggest, “You would not be ashamed if you had appendicitis or the flu or needed eyeglasses. Depression is just another illness that affects a different organ system.”

Go play. Your grandmother was right. Regular exercise benefits the mind and the body. Exercise changes the brain chemistry in a way that improves sad moods. Even a 10-minute walk can make a positive difference. Park a little farther away from work or the store. Take the stairs instead of the elevator. You will reap many rewards, including a sound night’s sleep.

Use your stress-busters. Let’s face it: caregivers live with lots of stress. While you may not be able to control the stress in your life, you decide how you respond to the stress. Make a list of 5 things you can do when you feel stressed. Maybe it’s taking that brisk walk or writing in your journal or calling a friend. The time you most need stress-busters is the time you’re most likely to forget them, so put the list on the fridge.

Rethink people-pleasing. People-pleasers go to great lengths to make others happy. They often care for others at their own expense; many take pride in their ability to ignore their own needs. They run the risk of depression both from the lack of self-care and from the futility of efforts to make another person happy. Attending to your own needs puts you in a better position to nurture others.

Reach out to others. Connect with friends who are good listeners. If getting out of the house is impossible, join an online community. Tell your story and see chapters of your own story told by others.

Redefine hope. It may be true that cure may not be an option, but there’s always hope. Capture the joy that’s always there.

About Dr. Vicki

Vicki Rackner, MD is a board-certified surgeon and clinical faculty member at the University of Washington School of Medicine. She left the operating room to be on the cutting edge of healthcare consumerism. She is now a full-time patient advocate, helping people get the health care they want, need and deserve. Dr. Vicki is an author, speaker and consultant.