January 19, 2012

Taking the Path From Depression to Wellness

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Joseph V. Madia, MD By:

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Self help for depression from author and psychiatrist

The experience of being depressed is different for everyone, and so is the process of recovery. So how do you know what type of treatment is right for you?

According to Dr. Jesse H. Wright, getting on the right path to recovery is a journey of trial and error for most people with depression. Try going down one road – whether it be medication, therapy, or self-help – and see if it works for you.

Dr. Wright offers up tips and tools for the journey in his new book, Breaking Free from Depression: Pathways to Wellness. The book is co-authored with Dr. Wright's daughter, Dr. Laura McCray.

Dr. Wright is a professor and psychiatrist at the University of Louisville, and Dr. McCray is a family physician at the University of Vermont.

They wrote the book together to provide a resource for people to help themselves, and to discuss the best treatment with their doctors.

Pathways to Wellness

There's no one way to recover from depression, says Dr. Wright. You have to find the path that's right for you.

“When you're looking at depression, it's not one size fits all. The best way is to look at the kind of depression you have, how severe it is, and what kinds of things might have played into it,” he said.

“Has it been problems with getting down on yourself and having self esteem? Have there been some medical problems that played into it? Do you have a strong family history? Depending upon that mix of things, and the interest in things that might help you, you could pick your own path.”

Breaking Free from Depression covers six different paths that people could take, either alone or in combination. Each approach is backed up with scientific evidence, which is important when looking for treatment advice.

The Thoughts-Action Path: Cognitive-behavioral therapy

This is the most widely used type of therapy for depression. Cognitive-behavioral therapy, or CBT, focuses on changing negative thoughts and behavior.

“We all have lots of thoughts that are private thoughts, ones that just go through our minds all day long. In cognitive-behavioral therapy we call those “automatic thoughts” – they just pop into your head,” Dr. Wright explained.

“When you're depressed or anxious, there's a change in those automatic thoughts. they become full of worry, self doubt, and sometimes hopelessness.”

That kind of thinking drags you deeper into depression, Dr. Wright told daily Rx.

“In cognitive-behavioral therapy, you learn how to spot that thinking, write it down in a log, and you begin to check it out, and try to turn it around to thoughts that are going to be more helpful to you.”

The Biology Path: Taking Medication

Dr. Wright calls the biology path the most popular approach to dealing with depression. There are a wide variety of medications on the market used to treat depression.

“There's lots of research that shows that [drugs] are helpful, although I must say that some of the more recent research questions how well people do with antidepressants,” Dr. Wright said. “They're helpful if you have severe depression, or depression that keeps coming back.”

But for people with mild depression, medications might not be the answer, he said. Therapy could be a better approach.

The Relationship Path: Therapy based on dealing with relationships

Relationships can be triggers to cause depression. A major breakup, constant criticism from a partner or close friend or relative, or chronic loneliness can lead to a person slipping into depression.

Therapy focused on relationships – called interpersonal psychotherapy – can help a person cope with common relationship problems.

The Lifestyle Path: Changing lifestyle patterns

Is your lifestyle causing or aggravating your depression? If you're having trouble sleeping, eating unhealthy foods, relying on alcohol or other substances to make you feel better, changing the way you live your life might help.

For example, doctors can help you get more rest either through medication or therapy, and some diets – like the Mediterranean diet – have been shown to alleviate symptoms of depression. Exercise has been proven to increase the chemicals in your brain that make you feel healthy.

But lifestyle changes can't bring you out of depression on their own. Combine a healthier lifestyle with therapy and/or medication.

The Spiritual Path: Lean on your spiritual side

Spirituality and religion often provide people with a sense of purpose and meaning in life. Spiritual resources can be a great tool for combating depression.

Whether it's being involved in your church, or simply reading about how to connect to a higher power, bringing out your spiritual side can give you the strength you need to pull yourself through a difficult time in your life.

However, not much research has been done to quantify the effect that spirituality has on depression. Therefore, the authors recommend combining this approach with therapy and/ or medication.

The Mindfulness Path: Using meditation to ward off negative thinking

“Mindfulness” means staying in the moment and truly experiencing life as it happens. The idea is that mindfulness leads you to appreciate the good things in life.

The mindfulness path combines the ancient tradition of meditation with modern cognitive-behavioral therapy. The book cites one study that found that patients who followed a mindfulness-based therapy had 50 percent fewer episodes of depression than those who did not have the treatment.

This path is recommended for people who have had more than one episode of depression, but not those experiencing severe depression. It's best for people who are already on the way to recovery and want to reduce the risk that they'll fall back into depression.

How to Help Someone with Depression Get on the Road to Wellness

What do you do if you think someone you know might be depressed? The thing you shouldn't do, said Dr. Wright, is tell them that “time will heal” or that they'll “snap out of it.”

“It helps more for someone who is depressed that someone understands, and will stick by them,” he said.

The first step is to talk to a primary care physician about depression symptoms. The person may be able to get treatment just through his regular doctor, or he may choose to see a psychiatrist.

Either way, knowing the different “paths to wellness” is a handy tool to have informed conversations about treatment and take control of your recovery.

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Reviewed by: 
Joseph V. Madia, MD
Review Date: 
January 13, 2012

Last Updated:
September 12, 2012