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Dealing with Depression by Gordon Parker

June 30th, 2007

“… an excellent overview of the depressive illnesses, written by one of the leading authorities on the subject.”
Kay Redfield Jamison, Author of “An Unquiet Mind”
Professor of Psychiatry, Johns Hopkins School of Medicine


This excellent book is written from the premise that there are many different forms of depression, rather than the popularly held belief that there is one main type that differs in severity. In a nutshell Gordon Parker explains the different types of depression, and how they should be dealt with differently. He offers suggestions for the most appropriate treatments in each case.

It can’t be overstated how important this approach is. If a correct diagnosis is not made in the first place then treatment may fail. I’ve been there and experienced plenty of what was wrongly called “treatment resistance”. With a correct diagnosis depression will normally be treated successfully.

Something that I find especially helpful is the inclusion of some fictional case histories, so that the reader can understand how each depression type might present itself in terms of its symptoms. When I first read the case histories I tried to guess the specific type of depression that each person was suffering from. I was wrong on all accounts!

While he is first and foremost a psychiatrist, Gordon Parker includes psychotherapies and alternative therapies together with traditional medicine in his discussion of treatment options. This is helpful if you want to actively explore the treatment options.

We have a copy of the first edition and have lent it out countless times to friends and relatives. In fact as I write this review I have no idea where it has gone, it has been handed around so much. The carer of a mentally ill person can gain a lot of help from the book as well. It is easy to read and provides hope that things can get better with appropriate treatment. When the patient, their family and/or friends are educated and moving forward with the treatment being undertaken, there is a much greater chance of success.

“Gordon Parker has style. The second edition of “Dealing with Depression” provides an outstandingly accessible account of how he sees the theory and practice of treating depression. While it is clearly written originally for the non-professional, the story is told from the cutting edge of research and treatment. It exemplifies the modern unifying approach to psychiatry - a synthesis of reliable knowledge and clinical judgment. It is a book both to read and to recommend to one’s patients and their families.”
Guy Goodwin, Professor of Psychiatry, Oxford University.

“This unique book, written by one of the world’s leading authorities on depression, focuses on a way of thinking about the complexity and diversity of the mood disorders that is both easy to understand and ‘rings’ true. Well-written and thought provoking, it is essential reading for all whose lives are affected by depression.”
Michael Thase, Professor of Psychiatry, University of Pittsburgh

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94 Great Resources on Treating Depression

June 28th, 2007

Depression is really a catch-all phrase for a broad spectrum of mood disorders. No two people suffering from depression will experience exactly the same symptoms and they won’t respond in exactly the same way to treatments. It is also a catch-all phrase used to describe different levels of severity in illness, and biological as well as non-biological disorders. This complicates its treatment enormously.

It is important to remember, when working through a resource list like this, that some things may work for you and others may not - a treatment for depression should start with professional help. Irrespective of this, it’s important to be involved in learning about your illness, including the treatments available. It seems that those who actively participate in their treatments have the most success in maintaining good health. Good luck!

THE BIG PICTURE

Large Website Resources
National Institute of Mental Health
National Alliance on Mental Illness
Medline Plus
MayoClinic.com
Blackdog Institute

Comprehensive PDF publications
National Institute of Mental Health
Mental Health Foundation - Dealing with Depression

HereToHelp - Depression Toolkit
Understanding Major Depression and Recovery

PDF Fact Sheets
Mind (National Association for Mental Health)
National Institute of Mental Health
SANE Australia
Black Dog Institute
Beyond Blue

Staying Well Plans
National Mental Health Information Center - Self-Help Guide
SANE Australia - Mental Illness and Keeping Well
Black Dog Institute - Ways of Staying Well
Sarah Russell - “Staying well with bipolar disorder”
(5th article from the top. Very applicable to depression.)

EVERYDAY LIFE

Exercise
MayoClinic.com - Depression and Exercise
Better Health - Depression and Exercise
MIND - The Mind Guide to Physical Activity
Mental Health Foundation UK - Up and Running!

Food
Mental Health Foundation - Healthy Eating and Depression
MIND - The Mind Guide to Food and Mood
MyPyramid.gov - Healthy Diet Plan

Stress Management and Relaxation
MIND - The Mind Guide to Managing Stress
MIND - The Mind Guide to Relaxation
Families for Depression Awareness - Coping With Stress

Sleep
HelpGuide - Tips for a Good Night Sleep
National Sleep Foundation - All About Sleep

TRUSTED BOOKS (links to Amazon)

Dealing with Depression: A Commonsense Guide to Mood Disorders

Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You…That You Need to Know (Living Well)

The Relaxation & Stress Reduction Workbook

A Lifelong Journey: Staying Well With Manic Depression/bipolar Disorder

Loving Someone With Bipolar Disorder

PHYSICAL TREATMENTS

Medicines
National Alliance on Mental Illness - Information on Specific Medicines
Drug Digest - Information on Specific Medicines
National Institute of Mental Health - Detailed Information on Types of Medicines

Beyond Blue - Brief Introduction to Types of Medicines
MayoClinic - Brief but Helpful video on Understanding Antidepressants

Electroconvulsive therapy
MayoClinic.com Overview
MayoClinic.com Video
infrapsych

Vagus Nerve Stimulation
MayoClinic.com - VNS: A New Depression Treatment Option

Transcranial magnetic stimulation
National Alliance on Mental Illness - TMS
MayoClinic.com - TMS: An experimental depression treatment

PSYCHOLOGICAL TREATMENTS

Overview
APA - How Psychotherapy Helps People Recover From Depression
APA - How to Find Help Through Psychotherapy
Mental Health Foundation - We Need to Talk PDF

Cognitive Behavior Therapy (CBT)
National Alliance on Mental Illness - About CBT Treatments
National Association of Cognitive-Behavioral Therapists
MoodGym program - free online CBT course
Living Life to the Full - free online CBT course
liveandworkwell.com - Steps to Change: free online CBT course

ALTERNATIVE, COMPLEMENTARY AND SELF-HELP TREATMENTS

Overview
Healthy Place
National Mental Health Information Center
New Hope - Natural Remedies for Depression
Introduction to Dietary Supplements

Bibliotherapy
Holistic Online - Bibliotherapy

Omega-3
Medline Plus
Black Dog Institute - The Role of Omega-3 Fatty Acids as a Treatment for Bipolar Disorder
(Online presentation also applicable to unipolar depression)

Vitamin B6
National Institute of Health - Dietary Supplement Fact Sheet
Medline Plus

Vitamin B12
National Institute of Health - Dietary Supplement Fact Sheet
Medline Plus

SAMe
Drug Digest - Article on SAM-e

DHEA
Medline Plus - DHEA Overview
MedPage Today - DHEA Effective for Midlife-Onset Depression

Ginkgo Biloba
Medline Plus - Ginkgo Overview
NCCAM - Herbs at a Glance: Ginkgo

St John’s Wort
National Center for Complementary and Alternative Medicine - St John’s Wort
Drug Digest - St John’s Wort

Light therapy
MayoClinic - Seasonal Affective Disorder
PsychEducation.org - Light Therapies for Depression

Yoga
Better Health Channel - General Article on Yoga
The MIND Guide to Yoga

Aromatherapy
Holistic Online - Depression Remedies
Wavelengths Natural Therapy - How to use Aromatherapy for Depression
depression-guide.com - Depression and Aromatherapy

Massage therapy
National Center for Complementary and Alternative Medicine
Medline Massage Therapy Interactive Tutorials

Spirituality
Mental Health Foundation - The Impact of Spirituality on Mental Health

Creative Therapies
American Art Therapy Association
American Music Therapy Association
American Dance Therapy Association

Acupuncture
National Center for Complementary and Alternative Medicine
Acupuncture.com - Depression and the Five Elements

Meditation and Relaxation
National Center for Complementary and Alternative Medicine
MayoClinic online meditation video
MayoClinic Relaxation Techniques

Progressive Relaxation, Guided Imagery and Autogenic Relaxation
Calming.org
McMaster University - Relaxation: Physical and Mental

Ecotherapy
Mind (National Association for Mental Health)

Keep this list expanding! If you have another resource that you’d like to share please add it in the comments.

8 Tips to Get Off the Couch and Into Action

June 25th, 2007

This is the 2nd of 4 articles on exercise, to be posted over 4 weeks. The first article is “The Exercise and Mental Health Link“.

Research shows that one of the most popular treatments for depression - according to clinicians, researchers and patients - is exercise. The problem with exercise is that it’s very hard to start, or once started, very hard to continue to form a habit. If you’re like me you have a treadmill, a bike, or some kind of gym apparatus collecting dust in a corner of your house.

Here are some ideas to help.

1. Start slowly and set small goals. Aim for things that you can achieve, like walking for 10 minutes each day. If you go for a complete training program straight away then you are more likely to fail. I make this mistake all the time. I plan an elite-style exercise regime, then quietly concede a few weeks later that it never got off the ground.

2. Make exercise a habit. If you start slowly you are more likely to continue. Once you’re over the “exercise hump” - say the first couple of weeks - you will be well on the way to a healthy habit.

3. Do something you enjoy. This will help to associate exercise with positive feelings. Shoot baskets, go for a swim, or walk laps of the local mall. (But remember that ecotherapy is better than shopping center exercise). A symptom of depression and other mood disorders is a loss of pleasure in things that you once enjoyed. If you start and persist with an exercise that you used to enjoy, the pleasure is likely to return.

4. Exercise with other people. Exercise is very hard to start and then continue on your own. Especially if you have a strong gravitational force that prevents you from getting up. You are much more likely to succeed if there is a commitment involved, like a set of expensive aerobics classes, walking with a friend once a week, or hiring a personal trainer to cheer you on.

5. Rethink your attitude to exercise. Exercise is essential for keeping your body and mind healthy. It provides huge benefits to you, that can make a vast difference to your mental well-being. Exercise can also be enjoyable and bring a great sense of achievement or satisfaction. If you develop a positive attitude towards exercise you will find it easier to commit time to it.

6. Is anything else stopping you? Many of us have other barriers to activity, like self-consciousness. There are many different ways to exercise, so find one that you’re comfortable with. Don’t use it as an excuse that just prevents better health.

7. Build your exercise into a task. On the weekend I surprised myself by pulling down a fence (intentionally). Actually I only pulled down most of it - if I finished it in one day my wife would have been suspicious. Anyway, it was a lot of effort to pull it down. A lot of exercise. It is also exercise to walk the dog, or mow the lawn, or wash the car. If you combine your exercise with a task then you will have twice the satisfaction when it’s over.

8. Be reasonable. Exercise and depression don’t seem to go together, just as swimming against the tide doesn’t really work. Don’t be hard on yourself when things don’t go to plan. Give yourself full credit for your successes and keep persevering to form a strong habit.

“I have to exercise in the morning before my brain figures out what I’m doing.”
Marsha Doble

“I gotta work out. I keep saying it all the time. I keep saying I gotta start working out. It’s been about two months since I’ve worked out. And I just don’t have the time. Which uh..is odd. Because I have the time to go out to dinner. And uh..and watch tv. And get a bone density test. And uh.. try to figure out what my phone number spells in words.”
Ellen DeGeneres

“The trouble with jogging is that the ice falls out of your glass”
Martin Mull

My Mind Doesn’t Clock On Until 1pm

June 23rd, 2007

A common symptom of biological depression is a steady improvement in mood during the day. Worst mood in the morning, best in the evening, or thereabouts. I experience this symptom like clockwork.

I’ve been expanding my “stay-well plan” to include more of the things that I’ve blogged about. Taking my own medicine, so to speak. One of them is going outside, or getting light into my eyes, as soon as I wake up. (See the earlier post “Dim Bulb or Bright Light“.)

Over the last few weeks I’ve been opening the curtains first thing in the morning, then going back to bed for “just another 10 minutes”. Instead of sleeping I look out the window, at the winter sun streaming into our bedroom. (Australia.) I do the same thing in the family room. I eat breakfast facing the window and looking outside. (I had to swipe my 3 year-old daughter’s spot).

There has been a big improvement in my mood in the mornings. I’ve actually been civil at work, and I’ve maintained an awful lot of eye contact. Yesterday when I arrived at work I coated the insides of my car with a large espresso, and I actually laughed.

If light isn’t the reason for my newfound regularity then it must be the arrival of a modern mattress. We’ve been out of the mattress market for about 10 years, and had never even heard of a “comfort layer”. Comfort it is. I don’t think it’s helped my health an awful lot, except now I sleep for 5 or 6 hours, instead of 4 or 5.