Depression: How did you find out if yours was seasonal, situational, or chemical

[lifejoy]

Not gonna lie - it has been an extremely tough winter for me. Add in a job I don't like and living far away from friends and family AND an illness in the family... well, let's just say I've felt better.

I would like to be proactive about it. I'm (sort of) going to yoga. Trying to eat healthfully. I walk an hour (minimum) every day. I'm consistently getting 7-9 hours of sleep.

But it's not enough. Next step will be to meet with a free counselor through my workplace, but if you have any ideas/thoughts/experiences that you would like to share, that would be really great! I have always found this community to be very supportive, so I'll thank you in advance :)

[jba302]

I found that simple journaling helped me register that I had real depression issues. I haven't done that in a while but it brought a huge amount of awareness that the unbelievably pervasive feelings of I hate everything was just a down cycle in my mood. It doesn't solve it, but being able to see that kind of thought to a point of "this will pass in x days" helped manage. Meditation helped that as well with getting through those points.

I also take adderall. Probably should mention that since that plays a large daily role for me. I am on a low dose and it helps with depression on top of a.d.d. I notice my baseline is a bit higher than if I wasn't on.

Also, possibly not a fantastic suggestion, but I like to read some websites that I would classify as odd to others- mopeilitywod and hyperboleandahalf are 2 examples. I imagine it's not a standard thing to laugh at suicide-type jokes but it helped me understand the process that I go through. Kind of like talk therapy without having to talk to anyone.

[dcheesi]

Sounds it could be "all of the above". Definitely talk to someone about it; internet armchair advice is no substitute for a real expert in this situation.

If it's seasonal, light therapy can help. Even just getting outside on sunny mornings can help, but the light boxes and such are more reliable.

But don't neglect the other aspects either. Stress and unhappiness can cause a problem on their own, and they certainly exacerbate any problems from other sources.

Along the lines of what jba302 said, CBT techniques can be helpful in clarifying and re-examining your thoughts and interpretations of various situations.

BTW, Don't be afraid to try medication if it comes to that, but also don't be afraid to tell your doc if you think a particular medication isn't working well for you. Individual meds in the same class can have very different side effects and different "feels", and occasionally a whole different class of meds is called for.

[galliver]

I'd like to hear about this, too. Grad school has been getting to me lately (but I feel great on weekends...)

[ReverendRN]

Seasonal and situational depression can also have chemical components. Seasonal through the hormones associated with your sleep/wake cycle getting out of whack because of changes in the light, and situational through over-stimulation of your sympathetic nervous system (aka "fight or flight response") so that it ends up being always "on" in a low-grade way, which suppresses the brain's ability to produce "happiness" chemicals like serotonin.

My advice is to go see that counselor and also to make an appointment with your healthcare provider of choice. We're all trained and equipped to do different things. They have specific tools and resources available to them to help with this sort of problem that general lay people do not. Although lay people can also be a big help!!! I'd encourage you to tell some people close to you that you're feeling down, if you haven't already. We still have this stigma around "mental health problems" which encourages feels of embarrassment/shame and hiding. But really, we all have experiences of our feelings being out of whack. It's estimated that 10 -25% of women experience clinical depression at some point in their lives. Write down the first 4-10 names that come to you: odds are, at least one of them knows what you're going through. And how many of the rest have had someone close to them struggle? My math skills aren't super fancy, but the point is that it's not an uncommon problem.

Thank you so much for trusting us enough to share. May the "joy" of your handle return to you soon. You'll be in my thoughts.

[lifejoy]

Great ideas so far.

I am definitely going to take advantage of the free counseling available through my job.

I am however, reluctant to share details with the people close to me in my real life. In the past, they have had a tendency to downgrade the seriousness of my feelings. Comments like: "We all have bad days" or "I know you feel down, but you always feel better eventually" are not exactly helpful at this point.

[ReverendRN]

No, that's not helpful at all. Makes me want to put on my mental health awareness hat and go shake my nursing finger at some people. =P

Glad you're going to see the counselor, though. That sounds like a really positive step.

[brewer12345]

I suppose that this will make me the skunk at the garden party, but before you start popping any recommended pills be sure to do a bit of research, understand what the side effects are and make sure you can live with them.  All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.  Medicine man speak with forked tongue (to say nothing of drug companies).

[lifejoy]

I suppose that this will make me the skunk at the garden party, but before you start popping any recommended pills be sure to do a bit of research, understand what the side effects are and make sure you can live with them.  All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.  Medicine man speak with forked tongue (to say nothing of drug companies).

It is always good to hear a variety of viewpoints, so thank you for including yours. Personally, I would only use medication as an absolute last resort. I would radically change my life before taking the pill approach.

[olivia]

I suppose that this will make me the skunk at the garden party, but before you start popping any recommended pills be sure to do a bit of research, understand what the side effects are and make sure you can live with them.  All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.  Medicine man speak with forked tongue (to say nothing of drug companies).

It is always good to hear a variety of viewpoints, so thank you for including yours. Personally, I would only use medication as an absolute last resort. I would radically change my life before taking the pill approach.

Why is that? Would you feel the same way if you had to take antibiotics? Or birth control?  The anti-medication sentiment feeds into the stigma of mental illness.  Mental illness is not a weakness, it's an illness like any other.  All medications have side effects that can be serious, including aspirin.  Yet I don't see posters here or in real life advising people strongly against taking aspirin for a headache.

[lifejoy]

Why is that? Would you feel the same way if you had to take antibiotics? Or birth control? [Or Aspirin?]

Yes. When I have a headache, I try drinking water, taking a nap, doing meditation, reading a book... many things, before I take a pill.

I try to avoid medications whenever possible. However, if it became obvious that pills were my best option, I would be open to it.

I think that anti-medication sentiments reflect personal preference. Although it could feed into the stigma of mental illness, IMO it feeds more into the stigma against taking pills in general. Which is maybe not a good thing, but *shrug*.

[NinetyFour]

I would encourage you to explore talk therapy (maybe it goes by other names as well). I found that someone who is good at this can be very helpful in guiding the client through important self-discovery.  What I learned about myself and my family stuff through therapy still helps me (a lot!) years later.  Good luck.

[galliver]

Why is that? Would you feel the same way if you had to take antibiotics? Or birth control? [Or Aspirin?]

Yes. When I have a headache, I try drinking water, taking a nap, doing meditation, reading a book... many things, before I take a pill.

I try to avoid medications whenever possible. However, if it became obvious that pills were my best option, I would be open to it.

I think that anti-medication sentiments reflect personal preference. Although it could feed into the stigma of mental illness, IMO it feeds more into the stigma against taking pills in general. Which is maybe not a good thing, but *shrug*.

I totally agree with you. There's nothing wrong with pills if they're needed but why alter your body's chemistry through brute force if there are other means?

[Zamboni]

The way I figured out mine was seasonal was just tracking it as happening in the fall over a period of a couple of decades.  You probably don't want to take that long to figure it out.

Getting an office with a big window helped me A LOT.  Going for walks at noon time also helped.  But still it comes every fall, and so now I expect it and just do my best with what I think helps and otherwise I endure knowing that I will feel better in the spring. 

I did try pills one winter; they did greatly enhance my mood and ability to get things done.  Plus, during a workout when the endorphins normally kick in it was like I became bionic.  Performance enhancing, no doubt about that.  On the downside, the pills made me shake a little sometimes and after about a month I started to get a skin rash so I tapered back off them and the rash went away. The doctor said the rash wasn't from the pills, but it was similar to rashes I get with antibiotic allergies and I could think of no other explanation.

Best wishes in your journey toward consistently positive mental energy.

[Nords]

I suppose that this will make me the skunk at the garden party, but before you start popping any recommended pills be sure to do a bit of research, understand what the side effects are and make sure you can live with them.  All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.  Medicine man speak with forked tongue (to say nothing of drug companies).

It is always good to hear a variety of viewpoints, so thank you for including yours. Personally, I would only use medication as an absolute last resort. I would radically change my life before taking the pill approach.

Why is that? Would you feel the same way if you had to take antibiotics? Or birth control?  The anti-medication sentiment feeds into the stigma of mental illness.  Mental illness is not a weakness, it's an illness like any other.  All medications have side effects that can be serious, including aspirin.  Yet I don't see posters here or in real life advising people strongly against taking aspirin for a headache.

It's not bias-- it's just due diligence and getting a second opinion. 

You wouldn't advise the headache sufferer to take Percocet for that headache either.  It's no different than paying fees to a financial advisor who's earning a commission to invest you in high-cost funds, or to hand your credit card over to the car dealer and say "How much of a monthly payment can I afford?"

There's a balance between those perspectives, and it's worth taking the time to decide whether medication is appropriate-- just as it's worth titrating to the correct dose and then re-assessing the decision every year or so.

[bikebum]

Vigorous exercise is best for me. And it's gotta be tough. Sprints, fast bike ride, heavy weights, non-stop body-weight exercise circuits, anything that makes me feel beat. Totally mellows me out and resets my brain.

Sorry you are down; I hope you feel better soon :)

[oldladystache]

For me it's definitely seasonal. Every morning I make sure to go outside and take a walk or do some other exercise for at least a half hour. That sure helps me.

[Cassie]

See a professional & let them make a diagnosis. Then discuss & try various options to see what helps. Ask friends that you trust for referrals since that can often be the best way to find a great MH professional.   good luck:))

[Anatidae V]

When you see the professional, do due diligence there too. They need to be a registered clinical psychologist, who does cognitive behavior therapy or similar. If they're "nice but not helping, ask  to try someone else.

My SO's depression has a situational component, we haven't worked out the degree of the seasonal and chemical components yet.

[aj_yooper]

Seeing a counselor is a good idea, especially if they use CBT approaches.  Exercise is definitely helpful, especially if it is outdoors.

When low mood occurs, we frequently refrain from activities that we would normally do.  This decreases our net positive reinforcement which dampens mood.  Encourage yourself to do things that give you pleasure or feelings of mastery.   Stay in motion.

[jba302]

All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.

Example - Anti-depressant Cymbalta makes it difficult, if not impossible, to have orgasms. If you want to talk about a useless profit-only drug, there ya go.

[Jenga]

It sounds to me like you are being really proactive, and taking all the steps you can.  Good for you, it can be really hard to manage that when you are depressed!  The therapist (especially, as several people have mentioned, one that uses CBT) will help;  but don't be too alarmed if you don't see a big difference right away. 

I find that mindfulness meditation is really helpful for me.  You don't need a quiet room or special equipment, just a few minutes to refocus on the here and now.  There are some excellent books out there that can help you use this in context of depression.  I really liked "The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness."  It had a lot of interesting information about the ways our usual problem-solving skills actually make things worse.  It's a bit of a perspective-shift. :)

Maybe the most important thing I've learned through experience with Depression is that there is no "one right way" or magic bullet.  The things that will help you will be a combination of different ideas and methodologies, and will be unique to you.  Maybe a couple CBT ideas will help, + Yoga, + a short term course of medication.  Maybe it'll be something else.  But it will get better!

[Bettis]

Good job being proactive.  I had/have the same situation.  I didn't want to take pills and I didn't like the high cost of therapy.  What I did was try out talk therapy in June-July last year(7 sessions total).  It helped and it didn't.  It made me realize I know myself better than they do so why am I spending $85 a session?  It actually empowered me to believe that no one can help me better than helping myself.  Every therapist is different of course but never underestimate your own ability to snap out of a funk.

Be as active as possible, yoga, running, biking, whatever.  Don't be intimidated, depression did that to me(I'm shy in nature so it just made that worse) but I got mad at it.  Maybe I'm not cured and maybe there is no "cure" but keep moving and find any way you can to enjoy life.  If it doesn't work, try other things but don't quit and accept depression as a constant in your life because you only have one life.

[Iconoclast]

Some years ago I was sent abroad for work and suffered from a serious bout of depression there. There were various causes: I did not like the work there, I had to put in insane hours, and the office was a pretty non-fun place. It was almost impossible to exercise there. Looking back, that was probably one of the major (chemical) causes. The other reasons were situational.

A doctor gave me some pills, but as others have mentioned, they have side effects. Me, I had weird dreams and during the day I would suddenly remember parts of those dreams, as you usually only do right after waking up. Also, it takes a couple of weeks before your body adjusts to the chemicals. When I came back, I continued the pills for a while but quickly stopped when I continually felt euphoric. I also had a couple of sessions with a therapist to put a number of things that happened there in the right perspective.

My 2 cents: pills are like a spare tire. Use it to bring you home, but don't continue driving around with it if you can avoid it. What's more important is that in the future, you recognize the symptoms and can act before you start sliding down the black hole. You posting this means that you are already aware, which is a good thing. Good luck.

[brewer12345]

I suppose that this will make me the skunk at the garden party, but before you start popping any recommended pills be sure to do a bit of research, understand what the side effects are and make sure you can live with them.  All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.  Medicine man speak with forked tongue (to say nothing of drug companies).

It is always good to hear a variety of viewpoints, so thank you for including yours. Personally, I would only use medication as an absolute last resort. I would radically change my life before taking the pill approach.

Why is that? Would you feel the same way if you had to take antibiotics? Or birth control?  The anti-medication sentiment feeds into the stigma of mental illness.  Mental illness is not a weakness, it's an illness like any other.  All medications have side effects that can be serious, including aspirin.  Yet I don't see posters here or in real life advising people strongly against taking aspirin for a headache.

It's not bias-- it's just due diligence and getting a second opinion. 

You wouldn't advise the headache sufferer to take Percocet for that headache either.  It's no different than paying fees to a financial advisor who's earning a commission to invest you in high-cost funds, or to hand your credit card over to the car dealer and say "How much of a monthly payment can I afford?"

There's a balance between those perspectives, and it's worth taking the time to decide whether medication is appropriate-- just as it's worth titrating to the correct dose and then re-assessing the decision every year or so.

Well, to be fair I do generally take a dim view of counseling, antidepressants, etc. for all but the most severe cases of mental illness.

[secondcor521]

Lots of good responses here already, will just add a few things not yet mentioned:

1.  I've been on various SSRI's for 10-15 years.  For me, and for some percentage of the population that takes them, my body gets accustomed to the meds and so I have to up my dose periodically and then switch to another one when my dose gets too high.  Most of the ones I've been on have "dampening" sexual side effects.  Other than that, they have all worked for me and have had few side effects.

2.  IIRC you're about to get engaged?  If that's right, I encourage you to make sure your fiance understands what's happening (or that you're OK with keeping him in the dark).  Also, those side effects mentioned in (1) may be relevant to him.

3.  Aerobic exercise and sunlight / being outside help for me.

4.  "Deciding to just feel better" has never worked for me.

5.  Introspection, for me, has been what I needed.  It's sort of like talk therapy by myself for myself.  I haven't had good luck with counseling / CBT, but maybe that's just because I'm usually not very trusting and I can be very stubborn.

6.  Also, the ability to sort of "watch" myself and see what works, what doesn't, what patterns there are, has slowly over the years helped me cope and/or figure out more coping mechanisms.  My depression has a seasonal aspect to it as well, and part of my mechanism is just knowing that from December through March it's going to be a little tougher.

7.  If you're averse to prescription meds but OK with OTC/herbal stuff, I used St John's Wort for a while.  It's weak compared to prescription stuff, but it is helpful.

Good luck!!!  Feel free to PM me any time if I can help at all.

[MarcherLady]

+1 for St John's Wort, but be cautious if you are on the Pill. SJW can reduce the contraceptive cover of oral contraceptives.

[Anatidae V]

Another line of enquiry is to get your iron and vitamin D levels checked. Both have been found to cause low energy levels when their levels are low.

[Self-employed-swami]

All drugs have trade-offs and stuff prescribed for depression can have particularly nasty side effects.

Example - Anti-depressant Cymbalta makes it difficult, if not impossible, to have orgasms. If you want to talk about a useless profit-only drug, there ya go.

And for me, Cymbalta was a godsend. It helped my overwhelming anxiety, and it got me to a point where I could do the CBT that I needed, to end my depression.

I would recommend CBT in conjunction with medication (if deemed necessary by a doctor). Without the CBT, I wouldn't have had the results I did, but I needed the medication as well, so I could get out of bed in the morning, and be semi-functional.

[Freedom2016]

I've had 3-4 bouts of serious depression in my life, all triggered by specific situations but it was clear that there was a chemical component to at least 2 of them. In those two really bad situation, I *could not shake* the deep melancholy/hopelessness to even get myself out the door to exercise or do other self-care.

The combination of talk therapy with two brief stints taking Effexor, made a world of difference to me. Effexor "took the edge off" in that the blanket of sorrow lifted enough for me to have the ability to take better care of myself through exercise, diet, socializing... plus I was better able to process what I was discussing in therapy.

Good luck to you. You sound much more able to cope than I was at my lowest moments.

[Flaneur]

Example - Anti-depressant Cymbalta makes it difficult, if not impossible, to have orgasms. If you want to talk about a useless profit-only drug, there ya go.

Considering there's only about a 50% chance of sexual disfunction when taking duloxetine and the drug has one of the higher positive response rates among patients with depression it's presumptuous to claim it's a "useless, profit-only drug", isn't it? I doubt many people suffering from the kind of depression duloxetine treats care if they can orgasm or not; restoring the desire to live is probably a little higher on the totem pole.

[jba302]

Example - Anti-depressant Cymbalta makes it difficult, if not impossible, to have orgasms. If you want to talk about a useless profit-only drug, there ya go.

Considering there's only about a 50% chance of sexual disfunction when taking duloxetine and the drug has one of the higher positive response rates among patients with depression it's presumptuous to claim it's a "useless, profit-only drug", isn't it? I doubt many people suffering from the kind of depression duloxetine treats care if they can orgasm or not; restoring the desire to live is probably a little higher on the totem pole.

Oh jeez, you know what, I was supposed to say for me in that line. I did not mean to downplay the entire drug class for EVERYONE based on my own experience!

[Squirrel away]

I have long term sexual dysfunction (problems with arousal) from taking psychiatric meds and I've been off them for a few years now. If you go on any mental health forum you will find it's quite a common problem with some people that doesn't go away when you stop taking the meds. It's pretty shitty honestly as I used to have a high sex drive.

[snyder66]

This may sound crazy, but, try changing your diet.  Eat more plant based whole foods.  Cut out the dairy.

[Thegoblinchief]

Like bikebum, vigorous exercise is the key for me. Something more intense than walking.

I've been on SSRI meds for a while. They help, but to be honest the main "benefit" I get from them is increased sexual endurance. Without them, I have a hard time satisfying my wife. YMMV. Hopefully that's not oversharing :P

[Dr. Doom]

I periodically go through periods where I'm not just "feeling down" and it's something more.  Usually during the winter, and usually something else is bothering me as well.

You can't just decide to feel better.  Your mind and mood is directly connected to your body and if body's chemistry is out of whack because it's missing something, you're going to feel down.  When I feel down I definitely get into that "I hate everything" mindset that you've mentioned, hyper-critical of everything (mostly myself, of course.)  I've come to recognize that when I'm being super-negative, it's a chemical thing and not "the real me."

I'll repeat things that others have already mentioned that have had some benefit.

• Heavy cardio.  Walking can be marginally helpful but heavy cardio, the kind where your heartrate gets up to at least 125 for 30-40 minutes, is much better.  Trust me, I know it's really difficult to ramp yourself up to work out intensely when you're already feeling low-energy and depressed.  I typically drink a cup and a half of coffee 30 minutes prior to light the fire a little bit, and also walk for 10 minutes at a brisk pace to warm up and prep.  Doesn't matter what you do, bike, elliptical, jogging, even aerobics, but get that heartrate up and keep it up.   Listing this first because it's the most important for me.
• Get outside for a couple of times a day, for at least 15 minutes.  Do it even though you don't want to.   Make time for it like you make time for other important body-maintenance activities, like eating lunch.  Or combine the two if the weather's nice enough...
• Diet.  Foods that are high in fat and sugar/carbs make people sluggish and that equates with depression.  This can include staples like bread and potatoes.  I switched to eating more fruits and vegetables -- and also eating smaller portions of stuff -- and this definitely helped. 
• If you're drinking -- at all -- seriously consider stopping it entirely until this gets sorted.  Even one drink close to bed can mess with your sleep cycles, and poor sleep is a major contributor to depression because it's tied to your energy levels.

On the mental side:

• Journaling can help to figure out if there is another issue that's weighing on you that needs attention.  IMO this is most effective right at the start of the day before my brain has fully woken up.  That's when it's most likely to be truthful. 
• Therapy can definitely help too, especially if you can find someone that's a good match for your personality.  I went through something more serious about 3 years ago and finally reached out ... took a few months but I'll be damned, having someone else poke around my brain wasn't such a bad thing. 
• Introverts need time alone to sort things out.  If you're not getting enough, it can be an issue.  But be sure that your time alone is good time and you're not just staring at a wall or playing candy crush. 

I don't have any personal experience with prescription drugs but they have been effective for some other members of my family. 

[stripey]

When you see the professional, do due diligence there too. They need to be a registered clinical psychologist, who does cognitive behavior therapy or similar. If they're "nice but not helping, ask  to try someone else.

My SO's depression has a situational component, we haven't worked out the degree of the seasonal and chemical components yet.

+1. I don't suffer from depression (fortunate me!) but am surrounded by people who do. SO's longstanding clinical depression has a situational component, although family history has a big part to play. All up he manages pretty well in my opinion.

One of the things SO's always said is to view counsellors or psychologists like any other health professional--  If you don't gel or feel comfortable for whatever  reason then find someone else. He said some of the best people who worked with SO said in the first session 'so what's worked well in the past?'.  Just something to keep in mind.

[golden1]

There are a lot of good tips in this thread.

It is always good to hear a variety of viewpoints, so thank you for including yours. Personally, I would only use medication as an absolute last resort. I would radically change my life before taking the pill approach.

While I understand this, and I get trying everything first, (I did this for years) sometimes the medication gives you the boost you need to be able to practice the other maintenance parts of treating depression more successfully.  I have dysthymia - a milder form that is very easily treatable by non-medication methods, but it has slipped into depression and that I can't dig out of without some sort of medication.  I use multiple approaches to try to avoid slipping into full blown depression:

1) Exercising and getting outside everyday - I take a 20 minute walk at lunch minimum and I am starting my running program this spring - 3X a week.  In the winter I use a small elliptical which isn't ideal for getting the heart rate up but it is better than nothing.

2) Mindfulness practice - this has been a life changer for me.  I did therapy for a year with a mindfulness therapist and it was wonderful.  Just pulling your focus from the crap going on inside of you to the present moment is a beautiful thing and it stops the negative chatter cold before it sets in and leads to anxiety and depression. 

3) CBT - when I have a really persistent negative thought - I diagram it out using the methods in "Feeling Good" by David Burns - a good read on the basics of CBT. 

4) Getting adequate sleep and a good diet. 

I have taken a low dose of Prozac in the past, and it definitely helps me shake the more serious episodes when I am only borderline functional as a parent and at my job.
The side effects are minimal and worth the benefit - lighter sleep, occasional twitches and decreased sex drive.  Plus it is only $4.50 a month for the prescription.  :p