Is Your Major Depression Treatment Plan Working?

Track your progress with a journal of your clinical depression symptoms.

As you start to overcome major depression (also known as clinical depression, major depressive disorder, or MDD), you can boost your success by being an active member of your own treatment team. Once you’ve worked with your doctor and/or a psychotherapist to put a depression treatment plan in place, the next step is to watch for signs that you’re feeling better. Overcoming depression may take some time, but keeping regular tabs on your progress will help your depression-treatment team fine-tune the right mix of antidepressant medication and psychotherapy for you.

Keep a Depression Symptoms Journal

Day-to-day variations in your depression symptoms can be misleading, so it may be more helpful to assess your progress at the end of each week instead of daily. To keep track of subtle changes in your symptoms, use a depression symptoms journal for at least the first month of treatment. Write in it daily.

Use this checklist to assess your progress around the same time each week:

___I feel more rested in the morning.
___I’m interested at work and able to concentrate.
___My energy level seems to be improving.
___Feelings of lethargy or restlessness were less noticeable.
___I tried to eat regularly and healthfully most days of the week.
___I took my antidepressant medication daily (if applicable).
___I exercised at least 3 times this week.
___Feelings of loss, sadness, guilt, or worthlessness were not distracting.
___I engaged in an activity with friends or family.
___Overall, this week was better than last week.

If you’re taking an antidepressant, take note of the following potential side effects and contact your doctor or therapist right away if you have them:

  • Feelings of worthlessness or thoughts of self-harm
  • Worsening depression
  • Changes in your sexual interest

Modifying Your Depression Treatment Plan

Research shows that a combination of antidepressant medication plus psychotherapy offers the best chance for lasting relief from major depression, says Gerry Neely, MA, LMFT, who works with clients in her Seattle practice. For people who feel a stigma about taking medication, Neely adds, “finding the right medication can serve as a short-term bridge to feeling better and being able to fully engage with life.”

If you don’t see improvement right away, don’t give up hope. Research funded by the National Institutes of Mental Health (NIMH) shows that switching antidepressants or adding a medication to your depression treatment plan can help. If your symptoms persist, your doctor will review your current plan and your overall health to be sure nothing was missed. Your psychotherapist can try a variety of techniques to find the right match.

Top Ways to Get Your Energy Back — Now

February 21, 2010 12:00 AM by Mehmet C. Oz, MD, and Michael F. Roizen, MD

You’re grumpy at the groundhog (who needed extra weeks of winter?) and a little short with your spouse, and you have been spending more time with the mac-and-cheese casserole than the treadmill. Winter can do that. But it doesn’t have to. Use these strategies to cuff the classic energy thieves that are still hanging around this time of year, and get your mojo back before spring hits:

Energy thief #1: Short, dark days.
What happens: Short days can cause seasonal affective disorder (SAD) — neurochemical changes in your brain due to lack of sunlight. This results in depression in up to 6% of Americans (the further north you go, the more likely you are to be a SAD sufferer). From late fall until spring, people with SAD become depressed, sleep too much, withdraw from friends, and battle low energy and relentless carb cravings.
Turn it around: Light therapy — sitting in front of a special box that shines ultra bright lights — has long been considered to be the best way to combat SAD. But a new University of Vermont study reveals that cognitive-behavioral therapy (CBT) may be even better. CBT is a type of psychotherapy that helps people outsmart depression by teaching them to change their negative ways of thinking. In fact, in this study, CBT alone was able to stomp out SAD with a success rate of 81% (compared with 49% for CBT plus light therapy and 32% for light therapy alone). Why wouldn’t more therapies be better? Researchers surmise that trying to balance two therapies was just too confusing, but CBT alone allowed people to focus on the coping skills they needed to banish their winter blues.

Energy thief #2: You can’t get enough comfort.
What happens: When the mercury heads south, we crave calories, carbs (they help our brains make the calming neurotransmitter serotonin), and fat. In fact, a 2006 University of Massachusetts Medical School study found that once the days become shorter, we pack away an average of 86 extra calories a day and weigh more than at any other time of year. We also snarf down more total and artery-clogging saturated fat.
Turn it around: Just cozy up to good-for-you carbs and healthy omega-3 and omega-9 fats that will satisfy your biology and your brain without packing on a gratuitous layer of blubber.

Trade meatloaf and pot roast for hearty whole grains like whole-wheat pasta and brown rice, or try polenta, a veggie burger, or salmon. Or warm up with a satisfying bean-based vegetable chili or Tuscan white bean soup. Since beans and whole grains are digested slowly, they’ll keep you full longer, so you’ll eat less overall. And if it seems like there are slim pickings in the produce department, now is actually the prime time to load up on nutrient-packed starches, including sweet potatoes and winter squash (roast or bake them with a drizzle of olive oil). Finish your feast with seasonal winter fruit (think apples, pears, oranges, grapefruit, and tangerines, or even frozen berries) topped with a sprinkle of heart-healthy walnuts or almonds and you’ll get all the carbs and fats your body craves — but you’ll do it the healthy way.

Energy thief #3: You stay in. On the couch.
What happens: Your workout plan bites the dust. We log less exercise in winter than any other time of year, with a paltry 45% of Americans and 36% of Canadians keeping active. Pretty ironic, since exercise can lift you out of the winter doldrums by boosting energy, improving mood, and helping you sleep better.
Turn it around: Start with your schedule. Make regular exercise appointments on your calendar the same way you’d ink in any other non-negotiable activity. But give yourself a bit of a break: Don’t think exercise needs to be a hard-core trip to the gym. Taking the dog for an extra-long walk or doing crunches and lifting weights in front of the TV count, too. Still uninspired? Try the 10-minute rule. Make a deal with yourself to get moving for at least 10 minutes. Chances are, once you start, you’ll feel so much better that you’ll keep going.