Strategies to manage depression

Accurate and effective management of depression requires a combination of medication and long-term psycho-therapy. Many psychotherapists begin treatment with their patients' feelings of being ‘trapped’ in their depression, more than 90% of clinically depressed patients describe some form of emotional paralysis. Medication controls the patient's biochemistry, addressing the source that triggers episodes of sadness, withdrawal,
hopelessness, psychological fatigue, and emotional paralysis.

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One frequent advertisement for an anti-depressant medication represents this feeling with a wind-up doll, the voice-over saying, "I have to wind myself up to get going every day, and I have to wind myself up to keep going through the day." Patients agree that the wind-up toy and narration represent their experience accurately. Some say, "It takes every ounce of my energy just to reach out for my coffee mug and lift it to my lips." To an untrained ear, the complaint may seem melodramatic, for the patient however, the complaint represents a very
simple, straightforward statement of fact.

Psychotherapists, therefore, frequently supplement their prescriptions with a command, a mandate: Get moving and Keep moving! Many Doctors essentially prescribe exercise regimes to get their patients up and moving and many health plans will compensate patients for gym memberships as part of their treatment for depression. After approximately twenty minutes of repetitive motion such as walking, jogging, swimming, or cycling the brain releases a flood of endorphins commonly known as ‘the runner's high’. These endorphins work as the bodies own perfect antidote to the excess serotonin that deepens depression. Just as importantly, depressed patients develop positive addictions to exercise, because their bodies become habituated to the endorphins, and because they derive satisfaction and self-esteem from the activities.

Psychotherapists who specialize in treatment of depression also express grave concern about patients' consummate self-absorption. One researcher explains, "In cases of acute depression, patients' attention turns completely inward, and they become so completely self-conscious they barely can attend to anything outside of themselves." The researcher attributes this behavior to patients' conviction that no one cares about them, so that they begin obsessively to care for themselves. Aggressively treating the condition by treating the symptom, the researcher requires patients to complete community service, become involved in the community, attend social meetings or join a cause.
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