Episode 384: All About Depression

Hello friends!

In today’s in-depth episode, we embark on a comprehensive exploration of depression, a condition that’s far more complex than the occasional sadness or the transient moods we all experience. Our journey aims to shed light on the multifaceted nature of depression, affecting individuals across the globe in myriad ways. We delve into the clinical aspects, the personal stories, and the common misconceptions surrounding this pervasive mental health condition.

We start by breaking down the very concept of depression, moving beyond the simple definition to uncover its roots and how it impacts the human experience. Through the lens of the DSM-5, we explore the criteria for diagnosing Major Depressive Disorder, highlighting the diversity of symptoms and the profound effect they have on individuals’ lives.

Our discussion takes a personal turn as we examine the experiences of James and Ellie, two hypothetical cases that illustrate the varied manifestations of depression. James, with his outward success masking an internal struggle, and Ellie, facing overt challenges in her transition to college life, offer insights into the silent battles many face.

Addressing common misconceptions, we challenge the stigmas associated with depression, emphasizing its complexity and the fact that it’s not a sign of weakness, nor is it something one can simply “snap out of.” We also touch upon the idea that depression can affect anyone, regardless of how “good” their life may seem.

As we move towards solutions, we discuss the treatability of depression, underscoring the effectiveness of medication, therapy, and lifestyle changes. We emphasize that for those facing this condition, there is hope, and a multitude of resources available to support their journey towards recovery.

In closing, we reaffirm the importance of understanding, empathy, and support in the battle against depression. We encourage our listeners to reach out for help, to engage in conversations about mental health, and to seek the resources necessary to navigate this challenging yet treatable condition.

As always, you can send me questions to duffthepsych@gmail.com and find the full show notes for this episode, including links to resources and further reading, at http://duffthepsych.com/episode384.

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Transcript:

Hey everybody, on this episode of the show I got a listener question asking for more information about depression, and so I use that as a prompt to do a deep dive into the topic. We go through basically everything you need to know, from start to finish. We talk about what is depression, the criteria for it, we talk about some case studies, misconceptions about depression, treatment options, medical things that could look like depression. It’s a very comprehensive episode in a great starting place for anybody who wants to learn more about depression. Or if you’re somebody that does struggle with depression, this would be a great one to send to people that can help them understand more about what you’re going through. So yeah, let’s go ahead and get into it.

It reads: Hi there, thankful for your podcast. I’m trying to find a few that are specifically on depression, even super basic, to share with my boyfriend, who is curious about what he’s feeling and learning more. Can you help guide me to a few of your episodes you suggest to start with on that topic?

So really great question. Um, I do have some previous podcast episodes. Be sure to use the search bar on my website if you’re looking for stuff like that, but I think I can do one better here, so let’s go ahead and just do an entire episode just devoted to the topic. Um, so to the person who asked a question first off, thank you for trying to find resources for your boyfriend. I think that’s awesome. Um, I commonly suggest that people find resources to point their partners toward to help them understand either their own or their partner’s mental health issues. But sometimes, I know it can be hard to find, you know, resources that are a good starting point, resources that are, you know, well informed, comprehensive, not just quick tick talks and things like that. So this is for you and your boyfriend, who are hoping to learn more about his experience. I appreciate both of you and your willingness to learn.

So, starting at the beginning, what is depression? I think one simple way to think about depression is to consider the actual word itself, other situations where, in English, you would use the word depression right. So, outside of mental health, think about what that means. If you are experiencing respiratory depression, that means that you’re having trouble breathing. If you depress a button, that means that you are pushing it down. The Great Depression a lot of us are familiar with that right, it refers to an intense period of a financial slump. Um, a depression on a surface, like you know, a walkway or something like that. A depression on surface means there’s a hollow or sunken in place, and the actual etymology, so the root of the word depression, uh, traces all the way back to the Latin word depremere. I’m not sure if I’m saying that correctly, because I don’t speak Latin. Uh, but that means to press down. So when you apply that to your mood, basically it means that your mood is being pressed down, which is very much what, you know, our depression sounds like.

Now, as with most mental health issues, depression can be used. The word depression can be used to describe a type of feeling like oh man, that movie was so depressing, or I’m just feeling kind of depressed this week, and it also can mean a specific mental health disorder. So, technically speaking, when we’re talking about disorders, there are several different types of depressive disorders that are categorized in the DSM. There are different sort of medical texts that we use to categorize disorders. The DSM, which is now in its fifth edition, revised, is the one that psychologists and therapists tend to use, and in that they basically describe different flavors of depression, and these include things like major depressive disorder, which we’ll mainly talk about here, but also things like persistent depressive disorder, premenstrual dysphoric disorder, which is PMDD, and other ones as well. So definitely, if you’re ever curious, you can, you can have a look online at some of those criteria.

But you know, rather than talking in the abstract about the features of depression, let’s actually go through the DSM criteria for major depression. So I’m going to read through them and these are somewhat summarized. I took out, you know, some of the language that doesn’t need to be in there for this context, so it’s not verbatim, but this is the gist of it and I’m going to go through all the criteria and then make a few comments afterward. So for major depression or major depressive disorder, you need five or more of these following criteria to be present during the same two week period, and it has to represent a change from previous functioning. Now, importantly, at least one of the symptoms has to be either depressed mood or lost of interest or pleasure from activities. So what are the criteria?

First one depressed mood most of the day, nearly every day, and this can be indicated by your own internal subjective report of feeling sad, hopeless, empty, etc. Or by observations made from others. The next one is a markedly diminished interest or pleasure in all or almost all activities Again, most of the day, nearly every day. So really, really not interested in things that would be pleasurable or any activities really. The next one is significant weight loss, when not dieting, or weight gain, and this could also apply to appetite. So it increase or decrease in appetite.

So some sort of significant fluctuation there insomnia, which is trouble falling asleep, or hypersomnia, meaning oversleeping, nearly every day. Psycho motor agitation or retardation, meaning speeding up or slowing down, so having like really kind of frantic, agitated movements or very slow movements, almost kind of vegetative, again nearly every day. And this is not one that is really judged based on subjective feelings, but what people see from the outside, so observed by others. Next is fatigue or loss of energy nearly every day. Pretty straightforward there Feelings of worthlessness or excessive or inappropriate guilt nearly every day. Diminished ability to think or concentrate or indecisiveness nearly every day. And then the last one is recurrent thoughts of death, recurrent suicidal ideation or a specific plan or attempt to die by suicide. Now, those are the criteria.

There’s a few other things here that it lists. So one is that these symptoms need to cause clinically significant distress, meaning just a lot of subjective distress it’s really really hard for you to deal with, or impairment in social, occupational or other important areas of functioning. So they need to impact your life. The episode can’t be attributable to the physiological effects of a substance or to another medical condition. So there are certainly other things that can mimic this. We’ll talk a little bit about that.

But that wouldn’t count as major depressive disorder if there’s a different reason for it. Again, the major depressive episode is not better explained by another psychological disorder and I would add to that a different neuro type or neuro developmental disorder. For instance, people who are autistic may have a lot of symptoms. Symptoms may even be the wrong word. There are ways that they don’t fit well with the world that neurotypical people live in. That may kind of present as depression, but it wouldn’t exactly fit the frame of that very well because it’s better explained by the fact that they have autism. So you need to be careful about that. And then the last one is that the person can’t ever have had a manic episode or a hypomanic episode, except for when that’s due to a substance right, like taking an upper and having a manic episode. That doesn’t count. But if you have a manic episode or hypomanic episode, then we’re looking at bipolar disorder. So that was a mouthful and that was a lot right. This is kind of how we actually look at these things in the field. So those were all of the technical criteria for major depression.

A few things to point out here. One of the most important aspects to recognize in the criteria is that the symptoms need to be present for at least two weeks straight and they represent a change from previous functioning. All right, so that’s a pretty significant amount of time two weeks straight at least. And then when we say previous functioning, it means that there’s definitely a change here. I will also point out that there are kind of different categories of symptoms here. You have the more overtly emotional ones, so things like feelings of sadness, feelings of worthlessness and potentially, you know, thoughts of death in some cases. And then you have ones that are maybe a little bit more on the physiological side, like the psychomotor changes, fatigue, weight fluctuation and sleep changes.

And what all that means is that depression can look pretty different from one person to another. For one person, they might be crying constantly and just feeling like they’re a failure. Maybe they’re avoiding social interactions, activities they used to do, and they just feel like the world may be better off without them, whereas another person might not even be super aware of their feelings. They just might feel like everything is blank and blah. They’re not even sad, they just don’t feel much of anything, they don’t want to do anything and they’re so lethargic that every day feels like torture to them and they’re just sleeping their days away.

You know, either way, depression is more than just being blue. It’s more than just having moments of sadness. You know, we all have moments of sadness, we all have situations that suck and make us feel down at the dumps. That’s not what we’re talking about here. With major depression. We’re talking about a persistent pattern of these symptoms that lasts over time and really interferes with your life. For most people with depression, they do tend to have recurrent episodes, meaning you’ll have an episode Maybe, you know, months or years down online It’ll kind of come back and it and it ebbs and flows. But it is possible as well to have just a single isolated major depressive episode. But the length of that can vary pretty significantly. For some people it’s just a matter of months, for some people it might be a whole year.

Okay, so jumping back into it, with all mental health disorders, it’s understood that they are at that level of being considered a disorder when they interfere with functioning. For people with depression, it’s common for symptoms to cause difficulty with work or school. For example, some people end up missing a lot of class and having poor grades because they can’t motivate themselves to complete work or study. It can also cause social impairment, in that you might pull away from other people, which is damaging to romantic Relationships or friendships, even relationships with family, and in this way it can really perpetuate this sort of self-reinforcing cycle where you pull away from people because you’re depressed and then you feel sad at being isolated, which then makes you more depressed and it kind of again just perpetuates that cycle. So that, in a nutshell, is major depression.

I also quickly want to point out the other disorder that I talked about persistent depressive disorder. This is also commonly called dysthymia, which I’m going to call it because it’s easier, but basically this is depression that can be less intense than major depression. So not always, but it tends to last a long time. So, technically speaking, the person who has dysthymia needs to be with Significant depression symptoms for at least a two-year period, with no more than two months of relief at a time, right? So if you think about that, over the course of a year you have to be basically depressed almost all the time with no more than just two months of relief at a time. So it’s very persistent, which is why it’s called persistent depressive disorder, and sometimes people think of this, you know, think of dysthymia as a less severe form of depression. But that’s really underplaying how much it can impact you, because even if the threshold for symptoms is lower, meaning you need, you know, just a few criteria instead of all of those criteria, or five of them at least you know you don’t have as many symptoms, or maybe not as severe symptoms, but the fact that it just never lets up can be totally maddening. It can. It can really mess with you and impact your life in the long run. So you know, even if you’re not meeting that full criteria for you know, major depressive disorder, if you’re in the realm of dysthymia, this persistent depressive disorder, you really still need to take it seriously because it can impact things for you.

So, getting back to you know depression in general, let’s look at a couple case studies. I wrote out a couple case studies of what this might look like, okay, so first one we’re going to talk about is James. James is a 30 year old web developer and he’s been quietly struggling with depression for years. On the surface, he seems to be successful. He has a good job, he talks to his parents on the phone once a week and generally he’s engaged in conversations and meetings at work. However, under the surface, he battles feelings of emptiness and worthlessness. He doesn’t feel like his life has any meaning and he can’t find motivation to do any activities Outside of work that might he bring him pleasure. When he’s not working, he tends to drink alone while feeling disgusted with himself about, you know, wasting his life. And While his work related appearance seems fairly typical, james struggles with insomnia and his apartment is extremely messy due to low motivation. If you were to ask James how he is, he’d probably just say I’m good, how are you? But this is really just a daily mask that James puts on while thinking quite thoughts about how meaningless his life is. So that’s one version of what depression can look like.

Think about it for a moment, what I just said, and see if you notice any of the criteria that we talked about. Definitely, I think that there’s some hopelessness in there. Right, there’s a lack of interest in activities, sleep changes, interference in social activities, and we can infer from you know, talking to him or hearing about him. At least it’s something that we would want to probe further about. So that’s one example. Let’s talk about another case study to just show a different perspective. So let’s talk about Ellie.

Ellie is a 22-year-old college student. She struggled with symptoms of depression on and off throughout high school, but this was thought to be more of a reaction to the fact that her parents were going through a contentious divorce at that same time. Now the transition to college was also difficult. She had trouble making friends, trouble being away from home for the first time, and this led to feelings of isolation and sadness. But unfortunately, these feelings didn’t fade throughout her first semester of school and now she’s experiencing significant disruptions in her life.

Unlike James, ellie isn’t able to push through and focus her attention into work, and she’s actually getting Cs and Ds in most of her classes. When some of her professors have asked to meet with her because she’s struggling, she’s avoided these one-on-one meetings because she can barely look at somebody in the eye without bursting into tears. All of this makes her feel very, very guilty, as her parents are helping pay for her tuition and she feels like she’s wasting it. And when she’s not in class, she tends to keep to herself in her dorm room with her headphones in watching the same comfort shows on repeat, rather than gaining the freshman 15 pounds that you might see in a lot of people. She’s actually lost 20 pounds since coming to college and she’s constantly feeling fatigued. So routine activity is like doing laundry or starting to feel like torture for her. Although she’s not close with her roommate, jordan, jordan’s asked Ellie if she’s okay and if there’s anything she can do to help, because it’s so obvious that she’s just not having a good time.

So, yeah, this highlights a different type of depression which is a little more overt. Ellie spends a lot of time crying, feeling sorrowful. She has a hard time masking, whereas James is able to hide behind his work. But no one of those is more important or more severe than the other. There are just different flavors of it. There are many different ways that depression can look, and so hopefully these examples illustrate some of that variety. Now, just need to throw this out there. Those case studies. These are not real people, these are not individuals. It’s more of kind of an amalgamation based on various people that I’ve experienced and what I know, but I think they’re pretty realistic pictures of what that could look like.

So, now that we’ve talked about what depression is, let’s talk about five common misconceptions that are related to depression. I already talked a bit about the first misconception, which is that depression isn’t just feeling sad or feeling the blues. We also often don’t diagnose major depressive disorder when you’re just reacting to something devastating. If you lost your dog and your house in a fire, with all of your other most prized possessions, you know we’d be more worried if you didn’t show signs of depression, right? That’s a normal reaction to these really intense circumstances. So you know, major depression isn’t just feelings of sadness, but it’s also not, you know, a normal reaction to a really bad situation.

The second misconception is that depression is a sign of weakness. Some people that are out there that you consider the strongest people you can think of, have struggled with depression, and you didn’t even know it. Some estimates say that about 8% of adults in the United States, which is 21 million people, have had at least one major depressive episode in their life. Right, and it can truly impact anybody, regardless of your background. Depression is a complex interaction between brain chemistry, genetics, environmental factors. It is not a character flaw or a sign of weakness.

The third misconception is that you can just snap yourself out of depression if you try hard enough. That’s really dumb, right, like if you think about it. Just being able to will yourself out of depression probably means that you don’t actually have depression, because lacking hope and motivation is often part of depression, so the disorder itself keeps you from pulling yourself out. This doesn’t mean that depression can’t resolve on its own and it often does with time but it commonly requires treatment, and we’ll talk about that more in a bit. But it’s not as simple as snapping your fingers and just going okay, you know what I’m done with this no more depression. It’d be nice, but not how it works out.

The fourth misconception is that you can’t be depressed if you have a good life. This is a tough one, right? Depression is not always a reaction to difficulties in life. You can absolutely have depression even if you’re in a position of privilege and, in fact, shame about the fact that you have depression, even though you have it easy. It can be a compounding factor for some people because they may be less likely to seek help, because they feel foolish or embarrassed, like what do I have to be depressed about? But that’s not what it’s about. It’s not about how good your life is. It’s a separate thing.

The fifth and final misconception that I’ll mention is the idea that talking about depression just makes it worse. Now, this is just straight up not true. Avoiding the issue doesn’t make it go away and in fact, talking about it openly is one of the best things that you can do. I always say that depression wants to hide itself, it wants to preserve itself, it wants to be your deep, dark secret and not let anybody else in. But when you take it out and just drag it out into the light and openly talk about it, it really helps to take away some of its power over you. Now, talking about depression, and only depression, and not talking about anything else in your life, can certainly draw a lot of attention to it, and in some cases that can be detrimental, but the concept of talking about it doesn’t make it worse. So if you can talk about it and take some action, that’s going to be the best case.

Okay, so we’ve talked a bit about what depression is. We’ve talked about some case studies, some common misconceptions. Now let’s talk about what can be done about depression. If you’ve been listening to this episode and it seems like either yourself or a loved one may actually have major depression, I have some good news for you Depression is treatable. However, due to the nature of depression, many people don’t get treatment for it. I’m not going to dive deep into the statistics and all of the clinical research right now, but I will say that they’ve done several large meta-analyses, meaning studies that group together a bunch of other studies with thousands of participants, and they’ve consistently found that both medication and therapy are effective in treating depression. The research also suggests that the combined approach is probably better than just medication alone. There’s some question as to whether the combined approach is significantly better than just therapy, but if you can do both, that’s great. I also want to mention that there are lifestyle changes that can be very helpful in reducing depression. For example, it’s been shown in the research that consistent, moderate exercise, especially cardiovascular exercise, can have a similar effect size to medication when it comes to reducing depression.

The awesome thing is you can do any or all of them. The way I often see it working out is that medication is sometimes required for people first not always, but sometimes because depression is very paradoxical. Like I mentioned earlier, the symptoms of depression make it hard for you to find the will to claw your way out of depression, so getting a boost from medication is often what’s called for to help relieve you of some of those depression symptoms, so that you can put in some of that work and make changes for yourself. To be clear, not everybody needs medication, but if you’ve been stuck in depressive symptoms and can’t seem to benefit from other things that you’re doing, it’s definitely something to consider. There’s nothing wrong with whatever you do regarding medication. If you decide to just jump straight to medication as a first line, that’s okay. If you want to hold off and see what you can do without it, for whatever reason, that’s also okay.

But I just want to tell you. It’s not weak to take medication. I take medication. I am on a low dose of an SSRI called Lexapro or Escitalopram. I’ve been on it for quite some time now and it makes a huge difference in my life, even if it’s a low dose, and I’m really happy to continue taking it. So it’s not a weak thing to do.

But there are various types of medications that can help you with depression. I’m not going to dive into all of the specific types. There are lots of resources out there you can look at, but broadly speaking, for depression, no-transcript Most medications that you’re going to take are ones that you take every day and those help you to gradually change the balance of the neurotransmitters in your brain Neurotransmitters I’ve talked about on the show before, but these are the chemical messengers in your brain, such as serotonin or dopamine. Now, unlike medications for anxiety, for depression you don’t typically have medications that are taken on an as needed basis. For emergencies. For anxiety, you might have things like, say, xanax, which is a sedative to help you when you’re feeling panicky. It’s not something you’re supposed to take every day if you can avoid it, but when the need arises and you need that help in the moment, you have something you can rely on. With depression, we don’t necessarily have the same thing, although depression and anxiety do often go together but instead, mostly, we have these medications that you take it every day, and it tries to relieve some of that burden and make you feel a bit lighter, a little bit better, a little less hopeless.

Not every person reacts the same way to medication and it can take some trial and error. People have side effects at times. There are various side effects for different medications. They can include things like dry mouth or headaches. They can include things like weight gain or changes to sexual functioning, but it’s not the same for everybody. There’s no free lunch. You’re always going to have some degree of side effects. But when you’re doing the balancing act, a lot of people find that the primary effect of the medication is well worth any of the minor side effects that they have.

And when you’re able to find a medication that works for you, it can really help to ease that crushing pressure of the depression. I like to think of it as you’re wearing a backpack with 100 pounds in it, and if you could even take out 50 of those pounds? Life still isn’t easy walking around the 50 pound backpack, but it’s a whole hell of a lot easier than a 100 pound one. So if you can lift out some of those weights from your backpack, suddenly it frees you up to put more effort forward, to be able to actually even care about feeling better or think that you’re going to be able to benefit from things like therapy or other lifestyle changes. So sometimes it’s a combination approach because you need to take that first layer off so that you can do anything about it.

Now, speaking of therapy, there are many types of therapy that are helpful. Psychodynamic behavioral therapy, or CBT, is one of the most commonly studied and it is very effective for depression. But please know CBT is not everyone’s cup of tea and there are plenty of other research supported approaches. If you’re looking for a hands-on approach that digs into your thinking patterns and gives you practical coping tools, cbt may be great for you. If you find that your depression stems more from relational patterns, maybe something like psychodynamic therapy or internal family systems might be a better fit. There are also people who are more solution focused and immediate versus those who are more oriented toward looking for insight, talking about your history and your past, even just supportive therapy, being very humanistic and hearing what someone has to say and being empathetic toward them can be very helpful for depression. So don’t get too hung up on this specific approach, as long as it’s not something that’s a wackadoodle and not actually a supported therapeutic approach. There’s a lot of things that can help with depression and everybody has a certain approach that they tend to benefit more from.

Both medication and therapy are often covered by insurance. So be sure to look there first so you don’t end up paying an arm and a leg when you don’t have to, especially for medication, right? If you’re seeing a psychiatrist and paying out of pocket for medication management, you might have very short appointments and have quick check-ins and then realize you’re paying $250,000, $300,000. I heard today from somebody that lives near me that I was giving some feedback to $400 a session, which is like damn right, I can’t pay $400 a session for psychiatry. So be sure to check in with your insurance. There are various options and for the depression medication, a lot of times your primary care doctor can also start with those. If it becomes more complicated and it needs a little bit more nuance, definitely I’d say a psychiatrist, meaning a specialist, is called for. But if you’re like me and what you’re looking for is just a little bit of help with a low dose of an SSRI like a basic medication. There’s no reason you can’t do that through primary care if you have a primary care that you trust.

But in addition to therapy, in addition to medications, there are also so many awesome self-help resources out there that can make a big difference. One thing I would suggest to you guys is finding online communities. If you go to Facebook and search hardcore self-help, we have a private Facebook group that you can ask to join and that’s a great resource if you’re trying to look for, say, a book or an area online where you can find support groups or anything like that, just throwing it out there and seeing what other people have found. But yeah, not to toot my own horn, I also wrote an awesome and comprehensive book about depression. It’s called Hardcore Self-Help Fuck Depression. It’s my second book that I wrote and I think honestly, that book doesn’t quite get the recognition it deserves.

My anxiety book is a lot more popular and it’s for a good reason. The anxiety book was hard out of the gate. It’s short, it’s very digestible. A lot of people find it very actionable. For that reason, the depression book isn’t long, but it’s a bit longer, but it’s also, in my opinion, a lot better and it’s a little bit more mature and it balances my characteristic approach with also some really solid information and it goes through all the tools and information that you need to do a lot of the work that you would actually do in therapy on your own.

But there are also amazing YouTube videos out there online courses, apps, books, other podcasts. I would say it’s important to just try to triangulate your information and vet your sources. Anybody can put out a video. Anybody can put out a TikTok. Anybody can put out an online course and say that they’re a coach in something. It doesn’t mean they know what the hell they’re talking about, right, but sometimes you just need to hear the information that maybe you even already know in a voice that resonates with you, just to knock something loose and start making a difference for yourself. So there’s a lot of opportunities for that out there online and there are a lot of amazing clinicians out there, lots of therapists, lots of psychiatrists and doctors people that are putting out good information that’s clinically sound. So definitely have a look if you’re looking for that type of resource.

I also want to take a moment, since we’re talking about doctors to mention, you should always talk to your doctor when you’re considering whether you may have depression, because there are other physical health issues that can cause similar symptoms. For example, hormonal issues, things like low testosterone, a poor diet or even a diet that just doesn’t jive with you for whatever reason. Maybe you have an allergy you didn’t know about or some sort of sensitivity. Those things can definitely cause behavioral changes. End deficiencies that’s a big one. People may not realize that they’re deficient in a certain type of vitamin and that’s causing changes. And a very common one that I’ve talked about before is hypothyroidism. If you’re low in your thyroid hormone, that can cause symptoms that very similarly mimic depression. So it’s important to at least do the leg work, get some lab work done. Make sure there’s not an obvious answer to what’s going on with you before diving into the possibility that you might have major depressive disorder.

Now let’s say that you’ve tried everything under the sun to treat your depression, but nothing seems to work. You’ve tried medication, therapy, support groups, all of it. There are other options as well. This is what we might refer to as treatment resistant depression, meaning depression that doesn’t respond to medication very well, that doesn’t really shake, even though you’re trying other approaches and there are also other options for that. I’ve done different episodes on these approaches. So there’s episode 346. You would just do http://duffthepsych.com/episode346. In that episode I compare and contrast two common treatments which are ECT. Electroconvulsive therapy Sounds scarier than it is. Go listen to the episode. I compare and contrast ECT with ketamine infusions. And then, way back in episode 107, I do kind of a comprehensive breakdown of all the different treatment options, including ECT, including TMS, which is transcranial magnetic stimulation treatment therapy. In the future I’m sure we will be much more able to include psychedelic assisted therapy to the list, because that’s a huge area of research right now. That shows a lot of promise. But yeah, there are approaches that can help you if nothing else helps as well.

So I hope that all of this gives you a good overview of depression and a place to start if you feel like you may be experiencing it. Please reach out. If you think that you might be struggling with depression. Even if you have a lot of information about the disorder, you really can’t diagnose yourself and it’s important to establish care with a qualified provider to help you navigate it, even if that’s just starting with your primary care. That’s okay. You are the expert on yourself, but you don’t have to figure it out all on your own. In a lot of cases, you can’t. So try to get some help. And if you’d like to learn more about topics related to coping with depression, specific skills or topics like supporting a partner with depression, be sure to head over to my website, duffthepsych.com, and use the search bar. Look for relevant topics. You can just type in partner or you can type in depression.

I put out a lot of episodes in the course of this podcast that are related to it, and even if you’re not personally impacted by depression, a lot of the tips and tricks are going to be great for anybody to improve their life, and it may come in handy if you happen to have a loved one that finds themselves in the throes of depression at some point in their life.

So that’s the episode, guys. Thank you so much for listening. If you want to find the show notes for this, go to http://duffthepsych.com/episode384. And please take really good care of yourselves. I appreciate you. Thank you so much for joining me in this episode. If you would like to send a question or a topic for a future episode. Please email me at duffthepsych@gmail.com. If you like my approach and would like to learn more about my books, online course or other resources. Please head over to my website at duffthesightcom. And lastly, it would mean so much to me if you would leave a review for the podcast wherever you listen to it or share an episode with a friend, until next time you got this.

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