Depression and the anxiety that often accompanies it can cause sufferers to experience feelings of isolation, but in reality, they have lots of company. The National Institute of Mental Health reports that in a given year, 18.8 million American adults will experience depression. According to the World Health Organization, the total is 350 million worldwide. Women are twice as likely as men to have depression, and the average onset age is 32. 
The CDC reports that the states with the highest levels of depression are Alabama, Mississippi and West Virginia. Those with the lowest are North Dakota, Minnesota, Alaska and Iowa.
What are the causes?
It’s not known what exactly causes depression and anxiety, though they can be triggered by many different risk factors, such as: 
Death of a loved one    
Divorce or a breakup 
Pregnancy or infertility
Change (even positive changes like a new job, work relocation, graduation or retirement) 
Caring for a sick loved one
Holidays or seasons
Physical, sexual or emotional abuse
Family history of depression and anxiety
What are the symptoms?
How do you tell the difference between expected sadness over life events and serious depression? During the normal stages of grief following a death or the end of a marriage, a person can be distracted from their pain temporarily, but in clinical depression, sadness lingers on and on without letting up. Depression is insidious, creeping in slowly like a fog until the sufferer can’t see past their illness or even remember what it was like to feel well. WebMD suggests that five or more symptoms like these, persisting for most of the day, every day, for at least two weeks could indicate depression, especially if they interfere with day-to-day activities: 
Loss of interest or pleasure in former activities, relationships and hobbies
Emptiness, sadness, guilt and anxiety
Pessimism, hopelessness, helplessness, worthlessness (particularly in the mornings upon waking)
Excessive sleeping or inability to sleep, resulting in fatigue
Drop in job performance
Forgetfulness, loss of memory
Restlessness, irritability, excessive crying
Loss of appetite and inability to keep food down 
Significant weight loss or gain (amounting to more than 5% body weight in a month)
Loss of ability to concentrate or make decisions
Recurring thoughts of death or suicide
Sexual dysfunction
Excessive and compulsive drinking, drug use, gambling or even shopping
Men and women experience depression differently. In men, depression manifests itself more often in anger and irritability, and men are more likely to deal with their feelings through alcohol, recreational drugs or infidelity rather than seeking help. 13-14% of mothers and 10% of men experience postpartum depression after the birth of their child, says the Huffington Post. Celebrity moms Brooke Shields, Marie Osmond, and Diana, Princess of Wales have all spoken publicly about their histories of postpartum depression. 
If left untreated, depression and anxiety can linger for months, years or never go away. During that time, they can undermine relationships, sabotage careers, lead to drug or alcohol abuse, inhibit ability to recover from other illnesses and even lead to suicide. Anxiety manifests itself with unpleasant physical symptoms like chronic back pain, severe headaches, indigestion, trembling, profuse sweating, dizziness and panic attacks. 
There is no one procedure or laboratory test to treat depression and anxiety. The first step is to see your primary doctor right away. They may run medical tests in order to rule out a physical condition that replicates depression symptoms, like hypothyroidism. You could then be referred to a psychiatrist, psychologist or counselor for further treatment. For many, a combination of medication, talk therapy, and lifestyle changes is the most effective. 
Treatments and coping
Medication - Brain scans of depressed individuals show biological evidence of abnormal activity levels, and key brain chemicals that carry signals between nerves may be out of balance. Medications can help correct this imbalance. In most states, only psychiatrists and medical doctors can prescribe antidepressant medications. Every medication is different and comes with its own risks and side effects. Antidepressants can take weeks or months to gain their full effects, and you may need to try different ones or vary doses to find the treatment that’s right for you. 
Talk therapy – Support groups can be a safe and comfortable place to share your feelings with others who uniquely understand what you’re going through. Group members can give you support, encouragement and share personal coping strategies and tips. Online groups can be a useful supplement to group meetings or take the place of them if it’s not possible for you to attend in person. Ask your doctor, church, HR representative or local mental health organization to help you find a support group in your area. 
Exercise – Exercise boosts endorphins, the “feel good” chemical produced by our bodies that also helps improve mood and reduce pain sensitivity. Exercise also increases energy and helps promote better natural sleep. Start in 20-30 minute intervals and build your program gradually as your energy level permits. Working out with friends, such as taking a yoga class, brings the added benefit of social support and can help you stick with it. 
Light Therapy – It’s most commonly used for seasonal affected disorder (SAD), depression experienced during winter months, when there is less natural sunlight. However, light therapy can benefit other types of depression as well. It involves sitting in front of a specially designed light box for a set amount of time each day to help elevate mood. 
Get involved – Regain your sense of purpose through volunteering and helping others. Your church or favorite charity can help connect you where you’re needed. 
Limit or eliminate caffeine – Caffeine may boost your energy temporarily, but it can also increase anxiety and nervousness, and undermine healthy sleep patterns. Raise energy levels naturally through exercise and getting the proper amount of deep, healthy sleep. 
Diet – No matter what you read on the Internet, no specific diet can be used to cure depression or anxiety. However, a healthy diet with regular meals including whole grains, fruits and vegetables can help build up physical strength, and omega-3 fatty acids and vitamin B12 are thought to ease mood changes. The carbs in lowfat foods like whole-grain pasta and sweet potatoes raise the level of serotonin, a mood-enhancing chemical in the brain.  
Find new interests – If former hobbies have associations with past events or people that cause you to feel sad, find different ones that have no unhappy associations. Taking up a new sport or creative pursuit like needlework or home improvement builds a sense of accomplishment. Explore new ways to express your feelings through music and the arts.
Avoid alcohol and drugs – Alcohol and drugs may make you feel better temporarily, but in the long run they can increase depression and anxiety. They could also interfere with prescription antidepressants. Even over-the-counter medications and natural supplements can affect your condition, so share anything you’re taking with your doctor before and during treatment. 
Alternative treatments – Explore yoga, meditation, massage, acupuncture, herbal remedies, aromatherapy, vitamins, saunas and steam rooms for their relaxing and therapeutic properties. 
Pets – A pet’s affection can serve as a reminder that you’re loved, and looking after pets helps you fulfill your responsibility to those outside of yourself. 
Keep friends and family close – How you’re feeling may cause you to withdraw from others, but you need loved ones now more than ever. Just having someone listen and try to understand is therapeutic and will remind you that you matter to those in your life, and that people care about you and will not abandon you.
Guard against relapses – Once you experience a significant bout of depression, you are at an increased risk of having another. The best way to avoid it is by staying on top of the triggers that caused your initial condition and addressing recurrent symptoms with your doctor or therapist. Do not stop taking medication you’ve been prescribed unless instructed by your doctor, even if your symptoms have disappeared and you are feeling better. 
Focus on the Future – Healthline reports that the number of patients diagnosed with depression increases by approximately 20% per year, but over 80% of people with symptoms of clinical depression aren’t getting treated. That is existing, not living. If you suffer from depression, you can develop and execute a treatment plan for overcoming it. Be patient - it doesn’t happen overnight, nor will it go away as quickly. Set realistic goals and stay focused on moving forward. Eventually, more positive thinking gradually replaces negative thoughts. Sleep and appetite improve as the depressed mood lifts. Exploring talk therapy and counseling will equip you with better coping skills to deal with prospective triggers. As the fog of depression slowly clears, you’ll be able to finally see the future you deserve.  

Posted on 2015-07-08 by Barbara Meyer