Dealing with Depression

Depression is an extremely common disorder in the United States, and Dinner Table Doctor has become quite the expert in helping patients with depression. Through the years many friends, acquaintances, family members and even strangers have told me how he has helped them deal with this condition.

The topic of uncertainties and feelings of isolation leading to depression due to this pandemic has come up during many recent dinners, and DTD’s general advice for dealing with depression is worth sharing. Most recently, we talked about this while enjoying a fabulous and simple meal of ribollita, a Tuscan bean soup. The recipe I’ll share is part of an entire Italian theme night which was a definite mood-booster for us. First, our medical discussion:

DTD sees patients suffering from depression every single day he’s working. Sometimes these people recognize that they are feeling sad or depressed, but some initially make an appointment for other reasons. They could be experiencing physical symptoms or maybe aren’t sure what the problem is; they just know that something is wrong.

Unfortunately there is no blood test to diagnose clinical depression, but there are certain criteria a doctor looks for in a patient to make this diagnosis.

If for a period of at least two weeks:

A person experiences a depressed mood or a loss of interest or pleasure in daily activities,

AND has a majority of specific symptoms, such as issues with sleep, eating, energy, concentration, or self-worth,

AND these symptoms are not the result of substance abuse or a recent catastrophic event,

THEN they should probably be treated for depression.

DTD stresses to patients that diagnosing depression is not always easy. Sometimes simultaneous life events are so horrible – job loss, death of a loved-one, illness, a pandemic, etc. that anyone would be depressed. Sometimes everything is going well, but you feel sad. Life and health are full of nuances, but a good doctor should be able to figure out your problem.

DTD typically explains depression to patients by drawing a Venn Diagram like this:

One circle is LIFE, meaning stress due to circumstances like job, marriage, money, etc. The second is COPING SKILLS, which include your personal coping methods, good or bad. These might include exercise, prayer, talking to someone, or drinking or drugs. The third is BIOCHEMISTRY. When all three circles are not balanced, they could combine to create depression, and treatment may be necessary.

DTD explains that medicine for depression is not a “happy pill.” It is used to correct your biochemistry. The analogy he uses is, if your car won’t start because you need gas, when you fill the tank it works normally – not faster or better but just as it should. If the car wouldn’t start because of the battery, then gas won’t make a difference. Medicines for depression are the same. They can help if that’s your problem, but they won’t do anything for you if not. If you are clinically depressed, medications won’t make you suddenly happy or able to avoid stress in life. Instead they correct your biochemistry to put you on a level playing field. Then you work with your doctor to find positive coping skills and to try and address the life stressors you’re dealing with. When all three circles are in balance, you should begin to feel better.

Medications used to treat depression are not habit-forming or addictive in any way. Although they have side effects, like all medications do, they are not high-risk. If you think you might be suffering from depression, talk to your doctor. DTD says there is absolutely no reason you have to live your life feeling like this when you can be treated. Don’t assume you can just necessarily “fix” yourself by eating a healthy diet or exercising or just trying to be upbeat or even using chemicals like alcohol or drugs. Coping skills alone will not fix depression. It is a very common medical problem, and just like asthma or high cholesterol, you can and should seek treatment from a doctor. If your biochemistry is off, you can’t fix it without medical treatment.

Medicines for depression aren’t a quick fix. Depending on your biochemistry, one medicine or a combination of medicines will be necessary. It may take time to figure out what’s best for you. Most people who present with clinical depression for the first time benefit from medication taken for 9-12 months, and if they stop too early they may experience more frequent bouts of depression. All of these factors are topics your doctor can explain more thoroughly in designing a care plan to fit your personal needs.

As you must know from reading my blog, one of my personal coping skills is definitely cooking. A really good meal brings me much joy. I am so happy to share not only a wonderful, healthy, and simple recipe with you, but also an entire experience that provides great distraction and entertainment during these difficult times of isolation. This is courtesy of my friend Cheri Passell, whose blog is a favorite of mine. In her post “Missing Italy? Try this!” she shows you how to create a taste of Italy with mood music from her personal play list, a recipe, some suggestions of Italian movies, and a link to study the language if you’re really feeling motivated! You could have a lovely theme night, on your own or with others in your pandemic pod.

DTD and I had a great time with this. We listened to her playlist while cooking ribollita, which is perfect comfort food on a cold night. She shares an excellent recipe from the New York Times. We enjoyed the soup with a Tuscan red blend, which I highly recommend. Then we capped off the night with one of the movies we discovered on her blog –Io Sono Tempesta. We felt like we were in Italy! Everything you need to create the same experience can be found by linking to her blog. Plus, you’ll enjoy getting to know her and reading her movie reviews and learning where you can watch all these Italian movies. She has had many experiences in Italy attending the Venice Film Festival and interviewing several Italian actors and directors.

I think theme nights are going to be our new activity during this pandemic. I look forward to branching out with several international recipes in future posts. DTD and I love to try new foods and miss traveling. If you have music or recipes or wine or movies to go along with a theme, feel free to share them! Of course, I’ll be sure to bring up some interesting medical topics with DTD during these meals.

If you are feeling sad or depressed and it has been affecting your health or life in general, a theme night probably isn’t going to help – please see your doctor. You can and should get treatment. And if you’re feeling like giving up entirely or think you might hurt yourself, please seek help immediately. ❤️

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