Depression is a real clinical condition, just like a cold or flu. The key to understanding whether a person is experiencing depression or deep sadness is to know the seriousness and frequency with which the feelings or symptoms occur. Treatment for depression varies from person to person, but there are approaches that are more effective. With proper treatment, you can relieve symptoms of depression and reduce their impact on your quality of life.
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Method 1 of 9: Diagnosing Depression
Step 1. Record and follow the progress of your feelings every day for two weeks
If you're experiencing a low mood, such as sadness, and you lose interest or pleasure in things you used to enjoy, you may be experiencing depression. These symptoms appear most of the day and every day for (at least) two weeks.
- These symptoms may last for two weeks or more, then stop and reappear. Such things are referred to as “recurrent episodes” or “recurrent episodes”. In these conditions, the symptoms of depression are more than just a “bad day.” These symptoms become very significant changes in mood that affect a person's functioning socially or at work. You may not go to school or work. Also, these feelings can make you lose interest in hobbies or activities you enjoy, such as playing sports, crafts, or visiting a friend's house.
- If you have experienced a major life event, such as the loss of a family member, you may exhibit many symptoms of depression, even if you are not clinically depressed. Consult your condition with your doctor or therapist to determine if you are experiencing more depressive symptoms than symptoms during a “normal” grieving process/moment.
Step 2. Watch for other symptoms of depression
In addition to feeling sad and losing interest, people with depression will also show other symptoms most of the day, every day for at least two weeks. Look at your list of feelings over the past two weeks and check to see if you are experiencing three (or more) of the following additional symptoms: These symptoms can include:
- Significant loss of appetite or weight loss
- Disturbances in sleep patterns (eg not being able to sleep or sleeping too long)
- Fatigue or loss of energy
- Increased restlessness or decreased body movement that can be seen by others
- The emergence of feelings of worthlessness or excessive guilt
- Difficulty concentrating or inability to make decisions
- Recurrent thoughts of death or suicide, and attempted or planned suicide
Step 3. Seek help immediately if suicidal thoughts occur
If you or someone you know is contemplating suicide, seek help immediately by calling 119 or going to a hospital emergency department. You should not try to get rid of these thoughts without professional help.
Step 4. Distinguish between depression and “blue” or sad moments
Moments or sadness like this are a real set of feelings and may be brought on by stress, major life changes (both positive and negative), and even the weather. The key to differentiating between depression and sadness is recognizing the seriousness and frequency with which the feelings or symptoms occur. If you experience symptoms of depression nearly every day for two weeks or more, you may be suffering from depression.
A major life event, such as the death of a loved one, can bring on symptoms similar to those of depression. However, a significant difference that you can see in the grieving process is that there are positive memories of the person who passed away, and you can still get pleasure or happiness from certain activities. Meanwhile, people with depression have difficulty getting a sense of happiness when carrying out normal activities
Step 5. Record the activities that have been done in the last few weeks
Make a list of every activity, from going to work or attending class to eating and bathing. Observe whether there is a pattern in the activities undertaken. In addition, pay attention to whether there is a decrease in the frequency of certain activities that you usually do with pleasure or sincerity.
- Use this list to find out if you have exhibited risky behaviors. People who suffer from depression can do risky things because they no longer care about the consequences in life, and need the help of others to care for themselves.
- If you are depressed, this can be a difficult “task” to complete. Don't rush into it, or ask a trusted family member or friend to write your to-do list.
Step 6. Ask if other people notice a difference in your mood
Talk to a trusted family member or friend to see if they notice a difference in your attitude or actions. While a person's personal experience is most important, the opinions or opinions of others who know the person are also important.
Others may feel that you cry easily for no reason or that you are unable to do small things like take a shower
Step 7. Ask your doctor if your physical condition is driving your depression
Several illnesses can cause depressive symptoms, especially those related to the thyroid or other parts of the body's hormone system. Talk to your doctor to see if any medical (physical) conditions you have are influencing or encouraging depression.
Some medical conditions, especially chronic or incurable conditions, carry a risk of depressive symptoms. In situations like these, the goal of medical professionals is basically to help the sufferer understand the source of depressive symptoms and how to relieve them
Method 2 of 9: Seek Professional Help
Step 1. Choose a mental health expert/expert
There are different categories of therapists and each category offers a different skill or specialization. This category includes counseling psychologists, clinical psychologists, and psychiatrists. You may need to see one or more therapists from different categories.
- Counseling psychologist: Counseling psychology is a field of therapy that focuses on developing skills and helping sufferers get through difficult times in their lives. This type of therapy can be short or long term, and is often problem-specific and goal-directed. In general, the counselor will ask you to talk through careful questions, and listen to what you have to say. The counselor will objectively help you identify significant ideas and phrases. He or she will discuss these ideas with you in more detail to help deal with the emotional and environmental issues that are driving or contributing to your depression.
- Clinical psychologist: Clinical psychologists are trained to give tests to check the diagnosis. Therefore, clinical psychologists tend to focus on psychopathology or the study of behavior and mental disorders.
- Psychiatrist: Psychiatrists can use psychotherapy and scales or tests in its implementation. However, usually a psychiatrist is used as a reference when treatment becomes an option that the patient wants to try. In most countries, only a psychiatrist can prescribe medication, although some countries or regions allow psychologists to prescribe medication.
Step 2. Get referrals
To find a counselor, try asking friends or family for recommendations, religious group leaders, community mental health centers, employee mentoring programs (if your company offers this service), or personal doctors.
Other professional associations such as the Indonesian Psychological Association or the American Psychological Association offer search services to find members who live or practice in your city/area
Step 3. Find out and choose a therapist
Find someone who makes you feel “accepted” and comfortable. A bad counseling experience can keep you from going to counseling for years and so you miss out on valuable therapeutic opportunities/moments. Remember that not all mental health professionals are the same. Find an expert you like and stay in counseling sessions with him.
Therapists will generally ask you to talk through carefully designed questions, then listen to your answers. At first, you may feel nervous about opening up and telling a story, but most people find it difficult to stop talking after a few minutes
Step 4. Make sure your therapist is licensed
Mental health professionals must be licensed or licensed to practice in your city/area. The Association of State and Provincial Psychology Boards website provides basic information on how to choose a therapist, licensing requirements in certain cities/regions, and how to find out if a particular therapist is licensed or not.
Step 5. Check health insurance
Although the cost of treating mental disorders can be officially covered just like physical illnesses, the type or category of insurance you have can still affect the type and amount of therapy you receive. Make sure you seek information about this with the insurance company or service provider before starting treatment. Apart from this, it can also ensure that you can get the services of a therapist at a cost that your insurance can cover.
Step 6. Ask the therapist about different types of therapy
There are three main therapies that most consistently show benefit to patients. These therapies are cognitive behavioral therapy, interpersonal therapy, and behavioral psychotherapy. In addition, there are various approaches that can be taken. The therapist can determine the best course of action for you.
- Cognitive behavioral therapy (CBT): The goal of this therapy is to challenge and change the views, behaviors, and prejudices that are thought to trigger depressive symptoms, as well as implement changes to maladaptive behavior.
- Interpersonal therapy or interpersonal therapy (IPT): This therapy focuses on life changes, social isolation, decreased social skills, and other interpersonal problems that drive depressive symptoms. IPT is especially effective when a recent “episode” or depressive moment was prompted by a specific event (eg someone's death).
- Behavioral psychotherapyBehavioral therapy aims to schedule pleasurable activities while reducing bad experiences through techniques such as activity scheduling, self-control therapy, social skills training, and problem solving.
Step 7. Be patient
The effects of counseling appear gradually. You will need to attend regular counseling sessions for at least a few months before seeing some permanent effects. Don't give up before the effects start to feel.
Method 3 of 9: Talking to a Psychiatrist About Medication
Step 1. Ask a psychiatrist about antidepressants
Antidepressant products affect the neurotransmitter system in the brain to fight problems in the production and/or use of neurotransmitters by the brain. Antidepressants are categorized according to the neurotransmitters they affect.
- Some types of antidepressants that are quite common are SSRIs, SNRIs, MAOIs, and tricyclics. You can find the names of some of the most commonly used antidepressants by searching the internet. The psychiatrist also knows the best type of medication for the situation / condition you are experiencing.
- Your psychiatrist may ask you to try several different types of medication to determine which one is the most effective. Some antidepressants are contraindicated in some people so it is very important that you stay in touch with your doctor/practitioner and immediately take note of any negative or unwanted changes in mood. Usually, switching to a different class of drugs can solve this problem.
Step 2. Ask a psychiatrist about antipsychotics
If antidepressants alone aren't effective, your therapist may suggest antipsychotics. There are three types of antipsychotics, namely aripiprazole, quetiapine (seroquel), and risperidone. In addition, there is also antidepressant/antipsychotic combination therapy (fluoxetine/olanzapine) which has been approved for use with regular antidepressants. This combination can treat depression when antidepressant products alone are not enough.
Step 3. Combine medication with psychotherapy
To maximize the effects of the medication, keep making regular visits to a mental health professional while taking your medication.
Step 4. Take medication regularly
Antidepressants take time to work because these products slowly and “carefully” alter the chemical balance in the brain. In general, it takes at least three months to see a lasting effect from an antidepressant.
Method 4 of 9: Journal Writing
Step 1. Write down the mood pattern
Use a journal to record patterns that affect mood, energy, health, and sleep habits. Journaling also helps you process emotions and get an idea of why some things make you feel certain emotions.
If you need more "structure," there are people or books that teach journaling techniques, and even websites for keeping journals online
Step 2. Try journaling every day
Get into the habit of writing every day, even for a few minutes. Sometimes you want to write more, and other days you lack energy or inspiration. Writing will become easier when you do it more often. Therefore, keep writing to find out the benefits that can be obtained.
Step 3. Have a pen and paper ready at all times
Always carry a journal or notebook and a pen so you can easily write whenever there is a moment that needs to be noted. Alternatively, you can use a notes app on your phone, tablet computer, or other device you carry around frequently.
Step 4. Write down whatever you want
Just let the words flow and don't worry if what you write doesn't make sense. Don't care about spelling, grammar, or writing style, and don't think about what other people think.
Step 5. Share posts only if you want
You can keep the journal to yourself if you want. You can also share your story with family, friends, or a therapist if you find it helpful. Apart from that, you can also create a blog to share all your stories with the public. This decision rests with you and your level of comfort regarding the use of the journal.
Method 5 of 9: Changing Your Diet
Step 1. Cut down on the types of foods that promote depression
Processed foods such as processed meats, chocolate, sugary desserts, fried foods, processed cereals, and high-fat dairy products are known to be associated with more symptoms of depression.
Step 2. Eat more types of foods that can reduce depression
Several types of foods are associated with a decrease in symptoms of depression, including fruits, vegetables, and fish. Increase the intake of these types of food so that the body gets more nutrients and nutrients that make the body healthier.
Step 3. Try Mediterranean types of food
The Mediterranean diet (referring to the region of the world from which this type of food originates) emphasizes the consumption of fruits, vegetables, fish, nuts, legumes, and olive oil.
This type of food also does not include alcohol which is a depressant substance
Step 4. Increase your intake of omega three fatty acids and folate
Although there is no evidence to suggest that increasing intake of omega-3 fatty acids and folate alone is sufficient to treat depression, these two substances have an effect on treating depression when used in combination with other types of therapy.
Step 5. Observe the impact of diet on mood
Pay attention to your mood a few hours after eating certain types of food. If you're in a good or bad mood, think about the food you've just eaten. Do you see patterns in some types of food?
You do not need to record every nutrient intake in detail. However, it is important for you to pay attention to the food you eat and its impact on your mood so you don't fall back into the "snare" of depression
Method 6 of 9: Focusing on Fitness
Step 1. Check with a medical doctor or personal trainer
Before trying a new exercise routine, it's important to know the sport that best matches your interests, size/strength, and injury history (if any). Consult your body condition with a medical doctor or personal trainer to evaluate your level of fitness.
These two practitioners can help you determine which exercise is safe and enjoyable for you, as well as provide motivation to start exercising
Step 2. Start exercising
Exercise helps improve mood and prevent depression "relapses." In a randomized controlled trial, exercise was shown to be as effective as medication. Experts argue that exercise increases the body's release of neurotransmitters and hormones, and regulates sleep patterns.
The positive impact of exercise as a form of dealing with depression is that activities such as running do not spend a lot of money
Step 3. Use the SMART system to set goals
Set goals based on SMART which stands for Specific (specific), Measurable (measured), Attainable (affordable, in the context of achievement), Realistic (realistic), and Timely (on time). This guide helps you get the “rewards” and reinforcements associated with achieving your sporting goals.
Start with the “A” aspect of SMART to set goals. Set easy goals first because achievements can give you early success. In addition, achievement also gives you the confidence to set your next goal. If you feel like you can't push yourself any further (eg.walk for 10 minutes), challenge yourself to do it more often (eg walk for 10 minutes every day for a week, a month, and then a whole year). Pay attention to how long you can maintain the achievement
Step 4. Think of each exercise session as a step forward
View exercise as a mood handler and a positive reflection of your desire to improve. Even walking for five minutes at a moderate pace is better than no exercise at all. By looking at each achievement with pride, no matter how small it is, you can still feel like you're progressing and recuperating.
Step 5. Try cardiovascular exercise
These types of exercise, such as swimming, running, or cycling, are ideal primary exercises for treating depression. Choose cardiovascular exercises that are easy and suitable for the joints as much as possible, such as swimming back and forth or cycling.
Step 6. Work out with friends
Invite a friend or family member to exercise together. They can motivate you to get out of the house and go to the gym to work out. Explain that it may be difficult for them to motivate you, but any help they provide you will sincerely appreciate.
Method 7 of 9: Trying Other Strategies
Step 1. Increase exposure to sunlight
Several studies have shown that increased exposure to sunlight can have a positive effect on mood. This is due to the effect of vitamin D which can be obtained from various sources (not only sunlight). You don't need to do specific activities when you're outside. Sitting on a bench and enjoying the sun is also beneficial.
- Some counselors prescribe ultraviolet lamps (sun lamps) for people with depression who live in areas with little sun exposure in winter. Using these lights has the same effect as going outside and standing in the sun.
- If you plan to go outside and be out in the sun for more than a few minutes, take precautions by applying sunscreen to your skin and wearing sunglasses.
Step 2. Enjoy outdoor activities
Gardening, walking, and other outdoor activities can have a beneficial effect. Although some of these activities are related to sports, the activities you do don't have to focus on sports. Exposure to fresh air and nature can relax the mind and relax the body.
Step 3. Find a creative “vent”
There has long been speculation that creativity and depression are related because some people feel that depression is the “price” one has to pay to be creative. However, depression is more common when creative people find it difficult to find an outlet for their expression. Find creative outlets by writing, painting, dancing, or engaging in other creative activities on a regular basis.
Method 8 of 9: Try Alternative Medicine
Step 1. Try using St. John's Wort. St. John's Wort is an alternative medicine that is effective in treating mild depression. However, this product was less effective than placebo pills in large-scale studies. This remedy can be purchased at a food store or natural health product store.
- Make sure you follow the directions on the package for the correct dosage and frequency of use.
- Make sure you buy herbal supplements from a trusted store or seller. In some countries, the production of supplements is not strictly controlled by food and drug regulatory agencies so that the purity and quality varies between manufacturers.
- Don't use St. John's Wort along with medications such as SSRIs. Its use can cause the body to excess serotonin so that it threatens your life.
- St. John's Wort may reduce the effectiveness of other medicines if used at the same time. Drugs that may be affected include oral contraceptives, antiretroviral drugs (eg HIV medications), anticoagulants (eg Warfarin), hormone replacement therapy, and immunosuppressant drugs. Talk to your doctor first if you are taking other medications.
- Due to the lack of evidence supporting the effectiveness of St. John's Wort, the American Psychiatric Association or the American Psychiatric Association do not recommend this product for general use.
- The United States National Center for Alternative and Complementary Medicine calls for caution when using homeopathic medicines and encourages open discussion with health care providers for safe and coordinated treatment.
Step 2. Try a SAMe supplement
Another alternative supplement that you can try is S-adenosyl methionine or S-adenosyl methionine (SAMe). SAMe is a naturally occurring molecule. Low levels of SAMe in the body have been linked to depression. To increase SAMe levels in your body, you can take or inject SAMe supplements into your veins or muscles.
- The manufacture or production of SAMe supplements in some countries is not regulated. In addition, each manufacturer produces products with different strengths and basic ingredients.
- Make sure you follow the directions on the package to find out the correct dosage and frequency of use.
Step 3. Seek acupuncture treatment
Acupuncture is a part of traditional Chinese medicine in which needles are inserted into certain parts of the body to correct energy blocks or imbalances in organs. Find an acupuncturist by searching the internet for information or asking a doctor for a referral.
- Contact your insurance provider to find out if your acupuncture treatment costs can be covered by your insurance.
- The effectiveness of acupuncture has mixed evidence. A study demonstrated an association between acupuncture and the normalization of neuroprotective proteins with effects similar to those of Prozac. Meanwhile, other studies show the effectiveness of acupuncture that can be compared with psychotherapy. These studies give credibility to acupuncture as a treatment for depression, although more research is needed in this regard.
Method 9 of 9: Attempting Treatment Using a Medical Device
Step 1. Ask the therapist to administer electroconvulsive therapy
Electroconvulsive therapy (ECT) may be given for very severe depression, people with acute suicidal ideation, people with psychosis or catatonia (other than depression), or those who don't show a positive reaction or change to other medications. This therapy begins with a light anesthetic, followed by several electric shocks delivered to the brain.
- ECT has the highest response rate of any other antidepressant therapy (about 70-90% of people with depression respond to this therapy).
- Some of the limitations of using ECT include the stigma associated with the practice, as well as possible side effects, such as cardiovascular and cognitive effects (eg short-term memory loss).
Step 2. Try transcranial magnetic stimulation
Transcranial magnetic stimulation (TMS) uses magnetic coils to stimulate the brain. This practice has been authorized by the United States Food and Drug Administration for people with major depressive disorder who cannot show a positive response or change to usual medication.,
This treatment needs to be done every day so it may be difficult for people with middle economic ability
Step 3. Try vagus nerve stimulation
Vagus nerve stimulation (VNS) is a relatively new treatment and requires implantation of a device to induce the vagus nerve, a component of the autonomic nervous system. This practice can be applied to people with depression who do not show a positive response or change to usual medication.,
Data regarding the effectiveness of this stimulation are still limited. In addition, there are potential side effects associated with implanting medical devices in the body, including interference with other medical devices.,
Step 4. Try deep brain stimulation
Deep-brain stimulation (DBS) is an experimental treatment and has not been approved by the US Food and Drug Administration. In this practice, a medical device is implanted in the patient's body to push the part of the brain called "Area 25".
Information regarding the effectiveness of this practice is limited. As an experimental treatment, DBS can only be used if other treatments fail or cannot be used as options
Step 5. Try neurofeedback
Neurofeedback aims to "retrain" the brain when people with depression show certain patterns of brain activity. New forms of neurofeedback are being developed using functional magnetic resonance imaging (fMRI) techniques.
Neurofeedback is expensive and time consuming. Your insurance company may not be able to cover the cost of this procedure
Additional Resources
| Organization | Phone Number or Contact |
|---|---|
| Counseling hotline for the Directorate of Mental Health Services, Ministry of Health, RI | 500-454 |
| Emergency service numbers (cell and satellite) | 112 |
| Suicide prevention services | 021-7256526 or 021-7257826 |
| International Wellbeing Center | 021-80657670 or 081290529034 (WhatsApp) |
| Bipolar Care Indonesia | Facebook Group |
| Into The Light Indonesia | Official Facebook page |
Tips
- The selection of a particular treatment option can be a trial and error process. When working with a mental health professional, don't be discouraged if the first or second treatment doesn't work. This means you need to try another type of treatment.
- Do not abuse drugs or use other addictive substances to fight pain. Also, use antidepressants only as prescribed by a licensed expert.
- Never hold back your feelings when you are depressed.
