7 Evidence-Based Strategies for the Treatment of Depression

“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds. ~ Laurell K. Hamilton

“In three words, I can sum up everything I’ve learned about life. It goes on.” Robert Frost

Major Depression is one of the most common mental health conditions in the United States, with roughly 21.0 million adults having experienced at least one major depressive episode (National Institute of Mental Health, July 2023). Major depression is diagnosed when an individual experiences either depressed mood or loss of interest for a period of at least 2 weeks, more days than not. It is accompanied by other symptoms which can include sleep disturbances, changes in appetite, fatigue, excessive feelings of guilt or worthlessness, indecisiveness, and recurrent thoughts of suicide.

Researchers suggest that depression is correlated with many changes in the brain. These can include reduced volumes of gray matter which forms the outer layer of the brain, changes in neurotransmitters including serotonin, dopamine, and noradrenaline, and elevated levels of brain inflammation (Rees, M., 2023).

Cognitive-Behavioral Therapy is an evidence-based practice often used for the treatment of depression. While there are some common features, it manifests differently for each client. Together with the client, I work with them to help identify triggers, thoughts, emotions, physical sensations, and behaviors associated with their depression.

People who are depressed often engage in behaviors that make their condition worse. These can include sleeping for long periods of time or not enough, eating excessively or skipping meals, engaging in high levels of passive activities such as watching television or scrolling social media, and isolating from others. Many people with depression worry about being around others who may notice the change in their mood. It can feel extremely difficult to interact or articulate one’s thoughts when depressed. Therefore, it can feel easier to isolate. Below, I have listed some of the most common strategies I recommend to clients to help manage depressive symptoms.

Tending to basic needs

One of the first issues to address is regulation of sleep and eating habits. Aiming for about 7 to 8 hours of sleep per night is essential. Getting an appropriate amount of sleep can help restore the brain and allow for optimal functioning. It is also important to improve overall nutrition. Limiting processed foods, alcohol, and caffeine as well as eating plenty of protein, fruits and vegetables can decrease inflammation and improve brain health.

 Exercising

Many studies have demonstrated that exercise is highly effective for reducing symptoms of depression (Craft and Perna, 2004). Incorporating regular walking, jogging or light weight training can help improve mood. There are several theories on why exercise is so effective for reducing depression. Researchers have suggested that exercise helps increase endorphins (mood-boosting neurotransmitters), provides healthy distraction, and increases feelings of self-efficacy. While the exact mechanisms may be unclear, exercise tends to have a powerful antidepressant effect, and therefore, it is often recommended.

Identifying and challenging distorted thoughts

When people experience depression, it clouds their thinking and judgment. They often struggle with negative thoughts about themselves, other people, and the world. A significant part of treatment for depression involves teaching people how to recognize and challenge distorted thoughts. People with depression often think in extreme, black- and- white terms which is referred to as “All or Nothing” thinking. One mistake can be seen as a complete failure. A bad day or increase in symptoms can lead to thoughts like “I’ll never get better” or “It will always be this way.” Clients are taught to recognize these distorted thoughts when they occur and to think in a more balanced and realistic way.

“There is hope, even when your brain tells you there isn’t.” John Green

Listening to Music

Research has shown that music tends to boost mood by positively affecting neurotransmitters like dopamine and serotonin (Hoffer, et. al 2022). Important aspects of daily functioning such as sleep, focus, memory, motivation, and mood are impacted by dopamine and serotonin levels. Studies have shown that classical music, specifically, has a positive effect on the cardiovascular system, with 83% of subjects reporting that they experienced fast music as uplifting (Darki et.al. 2004).

Self-compassion

As mentioned previously, people with depression tend to have negative thoughts about themselves. Depression can be viewed as a defect which increases frustration. When we are struggling, we tend to be hard on ourselves with thoughts such as “Snap out of it” or “What’s wrong with me.” Practicing self-compassion involves learning to treat oneself with love and kindness. I encourage clients to think of someone they love and imagine what they would say or do to encourage them and to apply this approach to their own struggles. Depression does not represent a failure and it is not an identity. It is a mental health condition that can be managed effectively.

Engaging in creative projects

Developing a creative hobby can be an excellent way to manage depression. I encourage clients to consider activities such as journaling, photography, drawing, painting, or crocheting. Creative expression can increase feelings of enjoyment and self-efficacy. Csíkszentmihályi, M. (2009) argued that when people are fully immersed in an activity, it can produce an optimal experience of enjoyment and performance which he described as “flow.” Working on something creative provides something positive to focus on and leaves less room for unhelpful thoughts and worries.

Increasing social support

While it is understandable that people with depression may have the urge to be alone, this is likely to increase rumination. It can also further distort thinking about self and relationships. Instead of isolating, it is crucial during these times to try to be with others, even if only for a short period of time. It can be helpful to be aware of what people in our social circles can provide. While some family and friends may be good problem-solvers, others may be more adept at talking about and understanding emotions. Understanding the strengths and limitations of others can help us make better choices about whom to spend time with when depressed. If it feels too challenging to spend time with friends and family, a good starting point is to be in environments where others are present, such as browsing a store or sitting in a local coffee shop.

Dealing with depression can feel daunting and isolating. However, it is a very common and treatable condition.

If you or someone you know is struggling with depression, I’d love to help. Feel free to contact me at 630-570-0095 or email at drpamheilman@heilmanps.com.

References:

Craft, L. J. and Perna, F.M. (2004). The Benefits of Exercise for the Clinically Depressed. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC474733/

Csíkszentmihályi, M. (2009). Flow: The psychology of optimal experience. Harper Row.

Darki, C., Riley, J., Dadabhoy, D.P., Darki, A., & Garetto, J. (2022, July 27). The Effect of Classical Music on Heart Rate, Blood Pressure, and Mood. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9417331/

Hoffer, M., Avirett, J., Bocharski, K., & Da Costa, J. (2022, December 2). How Music Affects Your Mind, Mood, and Body. Tallahassee Memorial Healthcare. https://www.tmh.org/healthy-living/blogs/healthy-living/how-music-affects-your-mind-mood-and-body

National Institute of Mental Health (July 2023). Major Depression. Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression

Rees, M. (2023, October 9). What to Know about Depression and the Brain. Medical News Today. https://www.medicalnewstoday.com/articles/howd-does-depression-affect-the-brain

 If you experience a life-threatening emergency or become concerned about the ability to keep yourself or others safe, visit your nearest emergency room or call 9-1-1. If you are experiencing suicidal thoughts, you may call the Suicide Prevention Hotline at 9-8-8 to talk to a trained professional.

The content on this website is meant for informational purposes only and is not intended to take the place of mental health diagnosis and treatment. All information is provided on an "as is" basis. Heilman Psychological Services, PLLC does not assume responsibility or liability for any errors or omissions that may occur.