In a recent post, we discussed common stress complaints from real patients in our clinic (see Top 10 Ways Stress Can Hurt You).  Over half of our stressed patients admitted to depression as one of their problems. 

But, contrary to what the Prescription Drug Cartel would like us to believe, not everything is caused by the lack of a brand-name drug.  On the other hand, drugs certainly do belong on the overall menu.  Let’s take a look at the big picture of what might make us depressed. 

1.  External Stress:   This is depressing (the adjective).  The rescuer could come from many disciplines.  A wardrobe makeover could be the key.  A lawyer could spring for bail, a trucker could pull one’s stranded car out of a snowbank.  If sadness comes from winter darkness (see  Seasonal Effective Disorder ) then a travel agent could offer just the cure.  If the stresses are financial, a financial planner could solve the problems, albeit much more slowly.  In any event, this is not a disease unto itself, but simply a normal reaction to unhappy circumstances. 

2.Internal Stress: This is depression (the noun).  Nothing in the external world makes any difference.  For example a person could be financially secure, in good health, and have good relations with family and friends.  But they could also be feeling a crushing daily sadness.  This is the chemical imbalance inside the brain that deserves full consideration of medical science. The rescue menu here is much different, involving a medical work-up, councelling, and often medications.   

The problem arises when the public assumes that all who are depressed should start with drug therapy.

Here are a few areas to review before seeking medication:

1. Diet: Depression is made worse by the inappropriately named “comfort” foods.  It would be counterproductive to have an antidepressant pill in one hand, and a bag of cookies or a soda in the other.

2. Sleep: Rest is a weapon for the next day’s battles.  Insomnia can be beaten (see Insomnia: Is It Worth Losing Sleep Over?).

3. Exercise: Runners speak of the endorphin “high” that comes with their daily exercise, and of feeling depressed when they stop for a few days.  Exercise in any form is excellent for mood elevation. 

4. Time management: If you are feeling overwhelmed and depressed by today’s time “famine”, then get a grip on your time management.  Start writing things down in one trusted place (organizer book or cell phone).  Learn to prioritize, and be selective about which of tomorrow’s activities are really important.  The lesser items could be put off, or done if time emerges.  Then when you do get a ten minute gap, you won’t fritter it away. 

If you are feeling depressed, don’t assume that relief is only a pill away.  Take a look at your circumstances, and consider your responses to diet, sleep and exercise.  If you are still blue, by all means see your doctor for further advice.