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While depression itself is not deadly, it can put a person into such a heavy state of mind that other parts of their life might fall to the wayside. If you’re wondering how emotions can be that powerful, let’s take a step back to understand depression.

As many experts and depressed people have said over the years, depression is not the same thing as being sad.

Sadness is a common symptom of depression, but it’s also not one everyone may experience. Depression, which can be chronic, situation, or acute, is different because of the layers of hopelessness and burden that intensely occupy the mind, for long periods of time.

In 2018, there were an estimated 1.4 million suicide attempts. While depression is the most common illness associated with suicide, it’s not the only illness that can trigger suicidal intention. Nor do all depressed people have suicidal ideation.

This is all to clarify: depression itself is not the only thing that leads to suicide. It’s a mental illness that may limit your ability to cope.

Depression often experienced as a cyclical illness, with stages of ups and downs. The ups can make you believe depression has passed, but if you have chronic or episodic depression, this can cause the next down to feel even more serious or unmanageable.

This feeling of hopelessness can sometimes trigger suicidal ideation.

Lack of motivation is also another symptom of depression. Being unable to perform daily tasks, such as eating, exercise, or socializing, can exacerbate the risk of other conditions, diseases, and mental illnesses

The longer and deeper one leaves depression untreated, the more serious the side effects can be or feel.

If suicidal thoughts are surfacing:

Please seek help — we can’t stress this enough. The following resources exist to support you through this hard time:

  • Call the National Suicide Prevention Lifeline at 800-273-8255 or text “HOME” to 741741 to reach the Crisis Text Line.
  • Ask someone to stay with you until help arrives.
  • Remove any weapons or substances that may cause harm.
  • Call 911, or a community crisis response hotline, if you think someone is in immediate danger and you are unable to reach them. Calling 911 should be used with caution.
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Malnutrition

Losing one’s appetite while depressed is not uncommon. However, what we eat is a delicate balance that can affect how our body regulates depression.

For example, if we’re unable to properly nourish ourselves, our body might not have access to the nutrients it needs to keep our energy levels up for exercise, which is shown to help with depression.

Sometimes it can help to meal-prep or buy frozen meals so eating isn’t so much of a chore. Another trick is to think about foods you loved as a kid. If it’s something you crave, eat that!

Increased anxiety and stress

It seems unfair that depression never seems to stand alone but also does a pretty solid job of making us feel alone. This effect can also feel especially stronger during times of instability, whether it’s economical, personal, or even global, like during COVID-19.

The Centers for Disease Control and Prevention found that during the pandemic, a lot of adults in the United States reported worsening mental health, from increased substance use to suicide ideation.

When anxiety and depression are both weighing on your shoulders, it may help to talk to a professional and figure out if you’re able to tackle them together, or if you need separate strategies.

How you handle depression and anxiety will also depend on how present these disorders were before you felt it became unmanageable.

Substance misuse

For some people, turning to drugs or alcohol can be a type of coping method for severe depression. Alcohol and drugs, such as marijuana, may only temporarily help with feelings of isolation, disconnect, stress, or sadness.

However, if this habit isn’t done mindfully — or if you’re at high-risk for a substance use disorder — this can develop into a dependency during depressive episodes.

Research also shows that substance use increases the risk of suicide or self-inflicted injuries. Alcohol and opioids in particular are more strongly associated with high-risk behavior.

Before turning to alcohol or drugs to manage your mood, take time to consider the factors that may be contributing to your depression and whether or not substance use will improve or further disconnect you from your emotions.

Insomnia

Depression and insomnia may fuel each other. A meta-analysis found that there’s a significant association of depression with insomnia. Interrupted sleeping patterns creates lower quality sleep that can affect how you show up at work, with your friends, and even by yourself.

It’s hard to get excited when you’re completely lacking energy, which can make a person feel even more depressed. During these times, it’s a good idea to listen to your body. Take naps when you need to and can, and if the pattern doesn’t break, talk to a doctor about medication.

Lack of energy or motivation

Sometimes insomnia isn’t the problem and you can still feel sluggish or unmotivated to tackle your day. Untreated depression can often manifest as intense fatigue, making getting out of bed in the morning even harder.

Another sign of depression to keep an eye out for is boredom.

If you notice yourself unable to enjoy activities you used to, instead of dismissing the activity or chalking it up to laziness, consider if you might be entering a depressive episode. If that’s the case, it might be helpful to have a small to-do list that you power through.

Suicidal ideation

As mentioned previously, depression can increase the risk of suicidal ideation — or thinking about suicide. Of course, not everyone who dies by suicide or attempts suicide has depression, but it’s an associated risk.

Aches and pains

You name it in terms of aches, depression can exacerbate it. Studies have found a direct link between depression and back aches, as well as headaches and depression. Other physical problems you might feel include:

Rest is super important, but it can also be helpful to incorporate some gentle movement when possible.

Digestion issues

Not only can depression make that sinking feeling in your stomach worse, it can actually have real-life effects on your digestive system. Constipation is one common symptom that occurs alongside depression.

Research also shows that the gut microbiome can affect the way we think. It might not be literal, in the sense that a working gut will change our minds, for everyone. For you, it may be more in a symptoms sense, where less physical discomfort frees up brain space for focus. Scientists don’t refer to the gut as a “second brain” for nothing.

Heart attack and cardiovascular disease

Heart disease and depression are comorbid both ways, meaning depression can be closely linked to heart disease and heart disease can cause depression.

This has to do with our fight or flight response and the release of stress hormones. Being in a perpetual state of mental stress can cause someone to develop heart disease over time.

Because this is a condition that develops over time, taking measures to treat depression daily with mindfulness or meditative breathing can be helpful.

Chronic pain

If you already have a chronic pain condition, it might be worsened by depression. For example, the fatigue from depression may prevent you from doing a lot of movement that could be helpful for the alleviation of your chronic pain.

You can treat both depression and your comorbidity at the same time but medical treatments may also depend on what condition or disease you have.

Don’t chalk up any unwanted feelings as “it will pass.” It’s better to talk about them first so you can receive care for your physical and mental well-being before symptoms escalate.

Research shows that people who have physical disorders and chronic illnesses have a higher risk of depression. These illness include:

  • cancer
  • diabetes
  • epilepsy
  • stroke
  • Alzheimer’s disease
  • HIV/AIDS
  • Parkinson’s disease
  • Rheumatoid arthritis

An overlap in conditions and depression can make managing intense feelings of loneliness, lack of motivation, and suicidal ideation more difficult. Depression alone needs a lot of support!

This is all to say, don’t be too hard on yourself if you’re struggling. There are many factors out of our control, and sometimes accepting the feelings as they come can be extremely helpful.

On the worst days, depression can feel a slow drag toward nothing.

Because of that, it’s important to seek help or maintain practices that make us feel better. Similar to an old-school film camera or a rusty but trusty car, sometimes we need to put in a lot of work before we see results. That’s OK, because once we get there it’ll be much more smooth sailing.

Luckily, there are a ton of options for dealing with depression. You’ll want to curate your own self-care kit based on the type of depression, the cause, and your symptoms.

Try self-care

Day to day, you can prioritize self-care — not just skin care and bubble baths (though those count, too) — but also allowing yourself time to rest and recover when feeling burnt out.

Some ideas include:

Ask for help or support from your friends

Loneliness is a prevalent emotion during a depressive episode. During this time, it’s important to reach out and ask for help. Don’t get caught up in the myth that “if people care about you, you don’t have to ask.”

It’s by asking that you start to develop a strong bond where your friends can help you in the way you need it. Think of it this way: the more you ask, eventually, the less you’ll also have to ask.

A simple “Hey, I’m feeling like crap right now. Do you have some time to talk?” could work. You could also reach out first with a “how are you” and then slowly open up as the conversation goes on.

Integrate movement

On the hardest days, exercise can feel like A LOT. Instead of thinking about the intensity of the movement, integrate exercise in a way that brings you joy. This can be small things like taking a mindful walk around the block or dancing it out to a favorite song.

Or aim for tolerable, like doing stretches while you have Netflix on. You could also consider creative movement, such as baking or knitting. Sometimes, just putting your hands to work can be cathartic.

Getting professional help

If you have the ability to, seek therapy for your depression. While therapy can be expensive, there are providers who may offer a sliding scale or group therapy options.

Talk to your doctor about other treatment options. Cognitive behavioral therapy (CBT) and talk therapy are common strategies a therapist will us to teach you how to manage your symptoms and identify triggers, like stress, anxiety, or certain behaviors.

In addition to talk therapy, medication may also be a useful treatment option. A psychiatrist or nurse practitioner can help you figure out what kind of prescription could alleviate some of your symptoms.

If you have existing comorbities, your health care provider will also want to make sure that your antidepressants don’t affect your other medications.

It can take a month or 2 to find the right dosage or combination, but the results can really level out emotions in a way that makes it easier to prioritize self-care and healthy social interaction.

Regardless of the coping technique you choose, it’s important to break the cycle of depression for your health and wellness. It won’t happen overnight but finding something to anchor onto can help you get better day by day.

Be patient with yourself and give yourself grace on the hard days. It’s not about being perfect, it’s just about working toward a place that feels manageable, where life feels more easeful.