Depression

• Identify the things that make you feel worse—for example, sleep deprivation, a recent loss, substance use, relationship problems, lack of sunlight, stress, diet or medications. Change what you can, and if you get stuck, talk to a health care provider or counselor.
• If you notice one particular trigger outweighs any others, find a self-help or support group that specializes in that issue. Research shows that connecting with a like-minded community can help you heal.
• Pay attention to your self-talk. If your inner voice is negative or critical, respond kindly and firmly, as a loving parent would (“Thank you for your perspective, but it isn’t helpful right now.”). Or push back with questions (“Is that true? How do you know?”).
• Keep a journal. Write down your thoughts and feelings, without a filter or judgment. Get to know your feelings, and name them: “Today, I’m feeling resentful” or “Today, I feel uneasy.” Accept your feelings for what they are instead of trying to deny, change or mask them.

• Avoid alcohol. It can interfere with sleep and mood, and acts as a nervous system depressant.
• Avoid substances that might serve as “quick fixes,” like caffeine or sugar. These can do more harm than good.
• Take a vitamin D supplement. Most of us don’t get enough vitamin D, especially in the winter, and it can be hard to obtain from food.

• Exercise for at least 30 minutes three times per week. Choose activities you normally enjoy or that you’ve always wanted to try. If you have trouble finding motivation or sticking to a schedule, take a class or find an exercise buddy.
• Exercise outside when you can. Spending time outdoors can ease stress and improve mood, and exposure to sunlight can help relieve symptoms of seasonal affective disorder (SAD).

Get adequate sleep—at least seven to eight hours a night. Try going to bed at roughly the same time every night and getting up at roughly the same time every morning.

• Make time for yourself to rest and recharge. This is especially important at busy times, like during the holidays or when you’re preparing for a presentation at work.
• Delegate. Let family and friends help with tasks you don’t enjoy or don’t have time to complete.

• Antidepressants – Treat depression by balancing chemicals in your brain; common types include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and aminoketone antidepressants.
• Estrogen therapy – Relieve symptoms of menopause, such as irritability, mood swings and night sweats.

• Cognitive behavioral therapy (CBT) – Helps you identify and change distorted perceptions of the world and yourself.
• Behavioral activation (BA) therapy – Helps you change what you do so you can change how you feel.
• Interpersonal therapy (IPT) – Focuses on symptoms and current issues that may cause problems, especially in relationships.

• Phototherapy – Uses a light box or special mask that gives of bright light that’s similar to natural outdoor light.
• St. John’s Wort (Hypericum perforatum) – May help relieve mild to moderate depression.

Depression is caused by abnormally low levels of chemicals called neurotransmitters, including serotonin, dopamine and norepinephrine. Other things that may contribute to depression include genetics, low levels of B vitamin folate, burnout, chronic stress, difficult life transitions, grief and loss, certain medical conditions and traumatic events.

You may have a higher risk for depression if you:

Depression can happen to anyone, but is diagnosed slightly more often in women. 

Depression often occurs with conditions like chronic pain and diabetes, and after a heart attack or stroke. It also can be triggered by perimenopause and menopause. 

Once you experience depression, there’s a 50% chance you’ll become depressed again. If you’ve experienced two episodes, there’s a 70% chance you’ll become depressed again.

If left untreated, depression can be devastating. An estimated 1% of women with a lifetime history of depression will eventually commit suicide. What’s more, depression is a risk factor for other medical conditions, such as heart disease and osteoporosis. It may also affect the immune system.