Friday, March 1, 2013

How Well Do You Function When Depressed?

WebMD Feature
By Denise Mann

You go to work every day and even make time to see your close friends and family on weekends. But for the most part, you’re really just spinning your wheels. Nothing seems to excite you anymore, and you look forward to climbing back into bed at the end of the day.

Sound familiar? Are you or a loved one able to function well every day, despite feeling depressed?

“These are people who are having symptoms of depression, but are able to get through tasks lifelessly,” says Scott Bea, PsyD. He is a psychologist in Cleveland Clinic’s Center for Behavioral Health in Ohio. “You are basically just going through the motions without any enthusiasm.”

WebMD asked mental health experts to weigh in on how to manage depression proactively in order to thrive -- instead of just survive -- each day.

If you have severe depression, it can be difficult to get out of bed and you may withdraw from your friends and family. You may even become preoccupied with thoughts of death and dying, but this doesn’t happen overnight.

Many people with depression are able to work, maintain relationships, and manage their lives for a long time before it catches up with them. How can you tell if your symptoms are related to depression? The first step is to talk with your doctor and get help for depression.

Typical symptoms of depression may include:

Sleep problems
Physical aches and pains, such as headaches or back problems
Lack of energy
Difficulty concentrating
Feelings of guilt or worthlessness
Loss of interest in activities you previously enjoyed
Eating too much or not enough
Depression: This Too Shall Pass?

But ongoing symptoms of depression will pass eventually, right?

Not necessarily, Bea says. It may be tempting to just write these feelings off, but it doesn’t work that way. The first step is to own what is going on with you and take proactive steps to get out of the “funk.”

Some people ignore continuing depression symptoms and figure there’s nothing that can help. “We think we must merely endure these feelings and that something will give and we will feel better,” he says. It doesn’t work that way. “It will more likely get worse before it gets better,” he adds.

What can you do to cope? The next step is to shake things up a bit and make some lifestyle changes, Bea says.

Yes, it can be hard to make changes -- especially positive and healthful ones -- when you are feeling down. It is much easier to settle in on the couch and get lost in mindless TV than to go out for a walk or join a team, but you have to push yourself, he says.

“Create an obligation,” he says. “Sign up for a gym with a friend.”

For further motivation, reward your new habit by doing something that you like afterward.

“Get plugged back in to life,” Bea says. “Maybe even revisit something that you loved to do as a child, as a way to kick-start your engine.”

Be creative. “Think about the things that you loved at different times in life,” he says. You likely didn’t start feeling like this overnight, so it may take a while to get back in the game.

Depression: Taking Steps to Feel Better

When you’re depressed, it’s OK to “behave as if you are enthused and stop saying how difficult everything is,” Bea says.

Although lifestyle changes and picking up an old hobby can help, sometimes it’s simply not enough. Medication and counseling are also part of the solution, adds Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital in New York City. “If you are in therapy and things are getting worse, this is an indication that you should consider medication.”

Depression: Getting Support

You may already be on medication and still not feel like your usual self. If that’s the case, talk to your doctor if your current medications and treatment plan aren’t working.

“Sometimes more aggressive therapy is needed even if you are on medicine already,” says Bruno. Other options to help you cope with depression include:

Finding a depression support group. It can help to talk with others who are experiencing similar challenges.
Connecting online with other people who have depression.
Spending time with friends instead of being isolated and feeling alone.
Keeping a journal to help you monitor your moods and sharing it with your doctor.
Getting active. If you dread the thought of going to a gym -- and many people who feel depressed do -- consider trying a yoga class or taking a walk in the park to boost endorphins.
You don’t have to pretend that you feel good when you’re depressed. Talking to your doctor about ways to manage your depression -- and being honest about how you’re functioning -- can go a long way in feeling better long-term.

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