Five things to do when you’re depressed

Depression is on the rise in the US. Chances are, if you don’t struggle with the condition, you almost certainly know someone who does.

Nearly 18% of US adults — more than 1 in 6 — said they were currently depressed or receiving treatment for depression, according to a 2023 Gallup poll.

In 2015, when Gallup first began collecting data on the topic, that number was below 11%.

Gallup’s data shows that clinical depression was rising slowly in the country before the epidemic, but that social isolation, loneliness, fear of contagion, psychological exhaustion, substance abuse and mental health disorders have risen faster in its wake. Rates are rising fastest among women, young adults, and black and Hispanic adults.

The statistics for teenagers aged 12 to 17 are also dire. According to the US Centers for Disease Control and Prevention, 5 million children in that age group, just over 20%, experienced an episode of major depression in 2021 (the most recent year available), with 3.7 million experiencing severe impairment.

Psychiatrist Charles Reason, a professor of human ecology and psychiatry at the University of Wisconsin-Madison, said he struggled with depression.

Reason, who is also the director of the Vail Health Behavioral Health Innovation Center and a former CNN Health mental health expert, described the state of mental health in the United States in one word: “bad.”

“There’s no doubt that depression and anxiety and suicide and substance abuse have been on the rise in the United States … for probably 20, 25 years, maybe longer,” Reason told CNN’s chief medical correspondent Dr. Sanjay Gupta on a recent podcast. Pursuit of life.

“But they’ve really grown over the last 10 years, and the data is really consistent.

“Growth is not equal across all age groups,” Raison said.

“The people who are really suffering are young people. So people between the ages of 15 and 35, that’s where you’re seeing this really, really disturbing growth.”

While the rise in depression among Americans is alarming, what is also troubling is the difficulty in identifying the cause.

We can’t see it on a brain scan. We don’t have a blood test for that. We cannot accurately measure its severity.

Reason compared depression to the antiquated term for “drops,” which can be caused by a variety of underlying conditions or factors.

“It could be… heart failure. It could be pneumonia. It could be cancer. There are (are) different reasons for causing these symptoms,” he said.

“Will we ever find a test to diagnose depression? No, because depression is like dropsy…,” he said, pointing to various possible underlying causes. “Depression is not the only thing that can be tested.”

And that may be one of the reasons why depression is so difficult to treat.

Take an antidepressant such as Prozac, also known as fluoxetine. It was launched in the country 35 years ago as the first in a new class of drugs called selective serotonin reuptake inhibitors, or SSRIs.

The idea was that depression was caused by a chemical imbalance in the brain, and the imbalance could be corrected by targeting the neurotransmitter serotonin. Serotonin-norepinephrine reuptake inhibitors, or SNRIs, which target both neurotransmitters, followed in 1993.

But antidepressants don’t work for everyone.

“The question of the use of antidepressants, which are the first-line treatment for depression in the United States, is incredibly complex,” Reason said, noting that they are “lifesavers for some people.”

“But over the past 20 years, we’ve had to digest, as a field, some very hard truths about antidepressants and their effectiveness,” he said.

“One hard truth, and the most obvious one, is that they don’t work nearly as well as we thought 30 years ago,” estimating that only 30% of patients “get a complete response.”

So what can you do to help yourself if you’re depressed? Raison has these five tips:

Make an appointment with a mental health professional.

“If you’re constantly depressed, if you’ve lost interest in life, if your sleep and your appetite have changed, if you feel hopeless, if you think about hurting yourself, things like that, that’s what depression is. Reason said.

Getting help is especially important if you have had these symptoms for several months.

“All of us who struggle with depression know that having a clinician … can help you, either through psychotherapy or medication … or both,” she said.

It turns out that what is good for the body is also good for the brain.

“Really try to do things that you would do for your physical health,” Raison said. “I often tell people. “Think about what you would do if you wanted to take care of your heart health and do the same thing.”

All of those things are also antidepressants. So manage body weight, eat healthy food, get enough sleep, get enough exercise, get sunlight.”

Try to maintain a close relationship.

“(Tip) #3 is sometimes very difficult when you’re depressed. … But it’s probably the single most important thing, trying to maximize our interpersonal connections with other people,” Raison said.

“If you have caring, small, supportive relationships with other people, that’s a big protective factor against depression. It’s also a factor that can really help you overcome depression.”

Be persistent in seeking help.

“The way people, especially in the United States, respond to antidepressant medications tends to be very dichotomous,” Raison said.

“There’s a smaller group of people who just start an antidepressant and they feel better within a few weeks and … and the depression goes away,” while others struggle with chronic depression.

So if one antidepressant doesn’t work, he said. “Try another one.”

But don’t be afraid to go ahead.

“We’ve known for a long time, for example, that people who don’t respond to a series of antidepressants in a row are less likely to respond to the next one, but no less likely to respond to psychotherapy,” he said.

Create a state of gratitude.

“Work on developing an attitude of gratitude,” Raison said.

Raison admits that’s not always easy to do when you’re depressed.

“If you can make it a habit, it can be very powerful in both preventing depression and feeling better when you’re depressed,” she said.