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By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Depression is a mental illness that appears by persistent blues, decreased lust, interest, energy and increased fatigue. Many people are briefly ‘depressed’ in short periods of their life but only 10-20% experience an actual depression. Once you have had a depression, there is higher risk of having another depression later on. Depression is most effectively treated with a combination of conversations and medication.

Depression is a mental illness that appears by persistent blues, decreased lust and interest in all aspects of life, decreased energy and increased fatigue. It is a unhealthy condition without the feeling of joy for the partner, spouse, work, friends or leisure interest. Those things that previously could make you feel good are now indifferent and meaningless. Nothing has anything to it.

Before doctors classify it as a depression you have at least 2 core symptoms and at least 2 accompanying symptoms. Core symptoms are the blues, decreased lust or interest and decreased energy or increased tendency of fatigue. Accompanying symptoms are decreased confidence or self-esteem, self-approach or guilt, thoughts about death or suicide, difficulties with thinking or concentrating, inner uneasiness, sleep disorders, change in appetite or weight.

During the course of a lifetime most of us encounter opposition, illness and loss that leads to sadness. However, depression is completely different. It lasts longer, has a deeper effect and is not always triggered by a certain cause. It is estimated that 20% of all women and 10% of all men have a depression requiring treatment at some point in their lives. At least half of the patients with a depression have more episodes of depression during their life.

Depressions arise following a traumatic experience (death, illness, divorce) and increased vulnerability. Some people are robust – others are fragile. Fragile people may develop a depression after a lightly testing experience. Especially robust people can go through anything without having a depression.

What can you do?

It is important to seek help if you have the symptoms of depression. It is not enough to pull yourself together. A depression does not go away by itself and the faster you are treated the better a result.

Besides from following the doctor’s treatment it is important to live a regular life with healthy diet and no excessive use of alcohol. Hard physical training and treatment with light have some impact and is completely without any side effects.

Recent research has shown that hard physical training can better your mood if you are lightly to moderately depressed. It is not enough with a few walks. The physical training must be intensive and regular. There are several reasons why hard physical training can better your mood. Regular exercise brings acknowledgement from friends and family and increased self-esteem. Besides from that, hard physical training moves your attention from the negative thoughts and finally, hard physical training increases the amount of different pleasure-inducing hormones.

Treatment with light in the form of natural sunlight has been used for depression since Antiquity. Research has shown that treatment with light on younger and middle-aged for depression is effective and not just for the so-called seasonal affective disorder during the winter. The effect of treatment with light for older people is uncertain. To make it work you need a luminous intensity of 10,000 lux with treatment duration of 30 to 60 minutes every morning.

It is important that you do not end the medical treatment your doctor has prescribed for your depression. If you experience side effects or feel that the medication does not work, you must make a plan together with your doctor for scaling down. A sudden stop of taking antidepressant medication lead to about a third feeling very bad. The most common symptoms are flu-like symptoms (headache, tiredness and muscle pain), sleep disorder, nausea, gait disturbance and dizziness, the feeling of electric shock, visual disturbances and irritability.

What can your doctor do?

If you have at least 2 core symptoms and at least 2 accompanying symptoms for a period longer than 2 weeks, you should contact your doctor.

All suffering from a depression should be offered conversation treatment. Some general practitioners with a special further education can provide the conversation treatment themselves while other doctors refer to a psychiatrist or a psychologist.

Some, but far from everybody suffering from a depression, will benefit from medicinal treatment. Assessed after a treatment lasting 3 months, around 1/3 of the patients suffering from a depression have recovered.

The most effective treatment of depression consists of both conversations and medication. 3 out of 4 patients get a lot better after 6 weeks treatment with conversations and medication.

What can a specialist doctor do?

Patients with serious contemplations about suicide (suicide attempts, thinking about the method), young people less than 18 years old, severe serious depression, pregnant and patients with both decreased and increased mood level are particularly difficult to treat and should therefore be treated by a psychiatrist.

Patients who after 6 weeks treatment with conversations and medication with the general practitioner are still depressed should be referred to a psychiatrist.

A psychiatrist uses – like the general practitioner – conversations and medication for treatment of especially difficult cases of depression.