By Mehmet C. Oz, M.D., F.A.C.S. and Norman E. Rosenthal, M.D.

Depression is generally defined by a feeling of sadness and disinterest in everyday life, and it can range from mild to severe.

To be classified as clinical depression, the feelings of sadness must go on for more than two weeks. According to LLuminari expert and cardiologist, Mehmet Oz, M.D., depression stems from both a chemical imbalance in the brain and a psychological or emotional component. “We’re often asked how much of depression comes from psychological factors and how much from brain chemistry.  Many doctors answer, ‘one hundred percent of both,’” said Oz.

Caregivers are particularly vulnerable to depression. You are responsible for the care of an individual you love and in many cases, your loved one is not expected to improve significantly. With terminal cancer, Alzheimer’s, and old age, your loved one is not expected to recover at all. You may be looking ahead to days, weeks, months, or even years of endless responsibilities. Estimates of caregiver depression vary. One study found that 23% of spousal caregivers had symptoms of depressive disorders, and very few of these had any prior history of depression (Haley, 1997). Several studies indicated that from 30 to 55% of Alzheimer’s caregivers had clinically significant depression.
(Schulz et al., 1995; Haley et al., 1995). 

Recognize the Symptoms

Depression manifests itself in many ways: problems sleeping (either being unable to sleep or feeling that no amount of sleep is adequate), changes in appetite (either decreased or increased appetite), feeling lethargic, hopeless about the future, and having difficulty concentrating. Other symptoms include: persistent sadness, anxiety or feeling of emptiness; loss of interest or pleasure in ordinary activities, family or friends; excessive crying without reason; recurring aches and pains such as headaches and backaches that don’t respond to treatment.

Depression Damages Your Body

Don’t let depression affect your overall health—not only will you suffer, your family will feel the effects too. One study showed that men and women who had both heart disease and depression had a 69% higher death rate than those who only had heart disease. 

Another study showed women with depression have lower bone density than those who weren’t depressed. Depression leads to behaviors that accelerate the aging process. Depressed people are less likely to eat well, exercise, or even care about healthy habits.  Depression impacts your immune system, making you more vulnerable to infections and serious illnesses.

Fighting Depression

Take action against depression. LLuminari expert Norman Rosenthal, M.D. offers some suggestions for a caregiver. Adjust your expectations so that you can begin to appreciate small victories, for example, your loved one enjoying a meal or going on an outing.  Think quality time, not quantity of time. Delegate some of the menial tasks and spend time doing things the patient appreciates most like cooking a favorite meal or watching a favorite sports event on TV.  Don’t take responsibility for your patient’s worsening condition and be mindful that at some point, you may have to seek long-term care for your loved one.   

Other Depression Fighters

Exercise options are endless. Start slowly and build to whatever level feels right for you.  But know that exercise can always have a positive impact on your emotions. Be creative by setting priorities, so you have more control over your life; changing your daily routine so you don’t feel like you’re in a rut. Talk to friends. Plan special outings.

Talk to Your Doctor

If you feel your best efforts aren’t working for you, make an appointment to see your primary care physician or a psychiatrist. Recent research on depression has shown that the combination of appropriate medication as well as cognitive behavior therapy (short term therapy, usually 6-8 sessions, to reframe automatic thought patterns) brings the most effective relief. However, if you’re feeling desperate, it is perfectly acceptable to ask your doctor for medication to get you feeling better quickly. Be prepared to try a few different medicines until you find the one that brings you the most relief.

Coping Questions to Ask Yourself

Look at what you know about yourself to examine how your beliefs create thought patterns and behaviors that might add to your depression. Ask yourself:

• What are the emotional and physical effects you usually have when stressed?
• Do you believe you are able to solve most problems?
• Can other people be helpful even though they cannot provide help like you? 
• If you are having trouble managing a problem, who would you ask for help? 
• What would your most trusted confidant do in your current situation? 

There are no easy answers, but you must seek knowledge about yourself, your situation and the resources available to you, to discover the best way to combat depression.