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Ask the Mental Health Expert Archives 2001-2004

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Avoiding Depression

Q. I have been diagnosed and treated for depression in the past. It got so bad that I started having delusions and was hospitalized for three weeks. I never want to go through that again. It has been 5 years since that episode in my life and lately I have been under a great deal of stress. What are my options to help keep myself from slipping into that pit of darkness and hopelessness again?

A. First off, there's no reason to assume you will slip back into that type of severe depression simply because you are under a great deal of stress. However, I think it's wise of you to do your best to stay well, and there are some fairly straightforward things you can do to bolster your resistance to depression.

First is to maintain your overall physical and mental health by ensuring that your diet, sleep, and physical activity are all optimal. Basically, this means eating a healthy diet that contains adequate vitamins, minerals, and omega-3-fatty acids, which are known to be involved in maintaining mood. (Tuna and salmon are good sources of omega-3s).

Maintaining good sleep hygiene is also important; e.g., avoiding caffeine in the evening, and trying to keep regular sleep hours throughout the week. If medically feasible and safe for you (your family physician would need to advise you on this), a regular, moderate program of aerobic fitness can be helpful in reducing stress and mild depression.

Finally, it's important to maintain your emotional and spiritual resources by becoming creatively involved in activities you find rewarding and restorative; e.g., joining a support group, doing some volunteer work, taking an interesting course, etc.

All of these common-sense measures will help boost your overall resilience, but can't necessarily prevent a recurrence of major depression. Therefore, if you are not already seeing a mental health professional on an ongoing basis, I would recommend considering doing so. This would be especially important if you began to notice major changes in your sleep, appetite, energy level, or interest in life.

For individuals who have had three or more bouts of severe depression, many clinicians recommend indefinite maintenance on an antidepressant. (For those with bipolar or manic-depressive disorder, a mood stabilizer is the preferred treatment). Psychotherapy may also help stave off recurrences of depression. Certainly, if you have any doubts, I would consult with a mental health professional--particularly if you expect this level of stress to continue. I wish you well!

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December 2002

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