If Antidepressants Don't Work, What Can You Do?

A recent study from the Journal of the American Medical Association has indicated that certain antidepressants are not effective for people with milder cases of depression. Before seeking medication for sad feelings, it may be appropriate to determine if you have clinical depression, seasonal affective disorder, or just a case of the blues and if there are lifestyle changes you can make to help with relief from the symptoms.

Clinical depression is an illness that causs sadness, loss of interest in enjoyable activities, social withdrawal, and fatigue or low energy levels. Sad and hopeless feelings occur every day for at least 2 weeks. The terms mild, moderate, and severe describe the level of symptoms and length of episodes. Clinical depression is a result of an imbalance of neurotransmitters in the brain, particularly serotonin and dopamine. According to the National Institute of Mental Health, clinical depression affects approximately 14.8 million American adults, or about 6.7% of the population.

Seasonal Affective Disorder (SAD) is a form of depression that typically occurs in the winter when people receive less ambient light and are indoors for extended periods of time. It corelates with mild depression, and as the weather turns warmer and days get longer, symptoms usually resolve. Like other forms of depression, it is typically more prominent in women than in men.

No matter the cause or form of depression, it is important to seek appropriate help to ensure that it does not progress into a more serious situation. Counseling, psychotherapy, support groups and other mental health professionals can help you decide if medication is an appropriate avenue. Should symptoms be manageable without medication, here are some tips for helping break the depression cycle.

First, understand that depression is not a character flaw or something you can just “get over”. Accept yourself and your current situation and seek attention, not blame. Talk with trusted family or friends for emotional support.

Second, take care of yourself and your health. Ensure that depression is not being caused by another health condition, such as diabetes or heart disease or that your depression is not doing the reverse, and causing stress that exacerbates these conditions. Eat a healthy diet rich in whole grains, fruits, vegetables, and lean protein. Some foods may be beneficial to include in the diet, such as omega-3 fatty acids, which may have mood-lifting effects. Avoid drugs, including caffeine, and alcohol which can make symptoms worse.

Some dietary supplements have been marketed as relief from depression or to improve mood. Some of these supplements have been shown to be beneficial for mild depression and seasonal affective disorder, and some are simply unfounded.

St. John’s Wort is the most studied alternative remedy for depression and in many studies has been shown to be beneficial in the relief of mild to moderate depression. S-adenosylmethionine (SAMe) has been sold over the counter as a mood enhancer since 1998. It is a compound that affects neurotransmitters such as serotonin and dopamine. A 2002 review of the available research on SAMe found that it was more effective than a placebo in the treatment of mild depression. Among the supplements that are not shown to have any clinical benefit are Gamma-aminobutyric acid (GABA), Inositol, and tryptophan.

Although you may feel fatigued or low in energy, getting regular exercise is a key factor in relief of depression symptoms. One study found that depressed patients who worked out for 30 minutes a day reduced severity of symptoms by as much as 50%. Getting outside in the winter for a walk when the weather is mild is also beneficial for seasonal affective disorder.

Maintaining a daily routine, trying to reduce stress levels, and getting at least 7 hours of sleep each night are also beneficial for symptom relief.