(cellphone beeping)
What is minor depression?
How is it different from major depression
and what does it look like if you have it?
That's what I'm talking about today.
I'm Dr. Tracey Marks, a psychiatrist
and I make mental health education videos.
The term depression can be confusing
because it's used to describe an emotion.
"I feel depressed today,
but I wasn't depressed yesterday."
Or "Thinking about the holidays
since my dad died is depressing."
The term also describes a psychiatric disorder
where you experience several symptoms
that are a part of the illness.
Major to depression is the name
of the illness that's defined
by the Diagnostic Manual of Mental Disorders.
The manual lists nine symptoms that are typical
of someone who is depressed and you must have five out
of the nine symptoms for at least two weeks occurring all
at the same time.
Here's a handy mnemonic to remember the symptoms.
It's the word depression.
Depression has 10 letters and with the mnemonic,
the I and the O are combined to form one
of the criterion that's used in the manual.
Let's take a look.
D is for depressed mood.
E is for energy loss or fatigue.
P is for pleasure lost, and this is referred to
as anhedonia, where you don't experience pleasure
in anything or things that were previously pleasurable.
R is for retardation or excitation,
and this refers to your activity level.
Depression can make you slowed or agitated.
E is for eating changed.
And your appetite either increases
or you can lose your appetite completely or just eat less.
S is for sleep changed and this can be sleeping less
than your usual, tossing and turning throughout the night,
or sleeping more than 10 hours and still not feeling rested.
S is for suicidal thoughts.
I is for I'm a failure or loss of confidence,
and you can also feel hopeless.
O is only me to blame, which is guilt,
also known as guilty ruminations.
And so again, the I and the O are one criterion
that includes all of these negative ways of thinking.
And N is for no concentration.
As you can see, these are a lot of symptoms
and more than just feeling sad.
Also for the diagnosis, one of the five things has
to be a depressed mood or an inability
to experience pleasure in anything.
What would you do if you had all of these things going on?
Some people suffer through without getting treatment,
but it's a struggle.
A major depressive episode causes you
to have trouble fulfilling obligations or completing tasks.
You may not be eating or you may be binging on junk food.
You could miss work or school because you can't wake up.
If someone forces you out of bed,
you may be so drowsy and foggy-headed
that you're stuck in zombie mode for another hour or two.
You're awake,
but you're just a shell going through the motions,
and you can't work like that.
Most times, a person in this type
of depression needs treatment in the form of therapy
and/or medication.
Often major depressive episodes are self-limited,
meaning they come and they go away
on their own after three to 12 months,
whether or not you get treatment.
Some people have symptoms that persist for longer than this,
but the usual is
that major depression is an episodic illness that comes,
stays for a while, then goes away, but comes back.
If you're not on any medication,
it can come back months later or even years later.
If you have a first time episode, there's a 50% chance
that it won't come back at all.
But once it comes back,
there's a greater chance it will come back again
at some point down the road.
So that's major depression.
What's minor depression?
Minor depression isn't an official term or illness,
it's more of a description of a milder form of depression.
With minor or mild depression,
you have two to four of the depression symptoms.
So for example, you may feel sad and have fitful sleep.
That's two symptoms.
And you may be thinking how is that different
from having a bad day where something made you sad
and then you didn't sleep well that night?
With mild depression symptoms, they still also last
at least two weeks and often last much longer than that.
The closest diagnostic term
for mild depression is persistent depressive disorder.
This used to be referred to dysthymic disorder.
With persistent depressive disorder, you can have a few
of these symptoms for a couple of years.
It's like this low hanging cloud of low-grade depression
that affects how you feel but doesn't keep you
from fulfilling your normal duties like work, school,
or managing your home, cleaning, paying bills, et cetera.
You can still do these things,
but it's like you're limping along
and not operating at optimal efficiency.
Another way you can experience mild depressive symptoms is
if you're burned out.
Burnout, like minor depression,
is not an official diagnosis,
but it's a real entity nonetheless.
It happens when you put in a lot of work
with little reward for that effort
and the reward doesn't have to be monetary.
In fact, you can do something that pays very well,
but the money doesn't make up for the fact
that you put your heart and soul into your work,
but it feels senseless, or you may be criticized
for it no matter how hard you work, or some person
or entity puts unreasonable demands
on you to keep churning out work with little regard
for the toll it takes on you.
And you can feel like the system will just chew you up,
spit you out, and move on
to the next juicy worker who's ready to serve.
With burnout, there's a cynicism that sets in,
that affects your motivation.
You also feel exhausted and even small tasks that were easy
for you to do before, now feel overwhelming.
Sometimes burnout can feel like or look like depression,
but instead of having all of those symptoms,
you may have a few of them like exhaustion, appetite changes
or trouble enjoying pleasurable activities.
I mentioned that major depression usually requires some kind
of treatment like therapy or medication.
This is not necessarily the case
for minor depressive symptoms, so what do you do about it?
A natural approach to treating mild depressive symptoms is
getting 150 minutes a week of aerobic exercise
and that's moderate aerobic exercise like brisk walking.
This kind of movement helps depression,
even mild symptoms, through chemical changes in the brain.
I talk about this in detail in my video
on exercise and depression.
The next thing you can do is change your diet.
The Mediterranean diet has been shown
to treat depression independent of medication or therapy.
I also have a video on that
and I'll link to that video in the description.
In short though,
eating Mediterranean involves eating less meat,
like only one meat meal a day, eating unlimited fish,
eating more vegetables,
and healthy fats like nuts and avocado.
Mediterranean also includes whole grains
instead of processed grains like white bread and white rice.
People with special dietary needs can modify this
to address those needs like making it gluten free
or nut free.
The last thing I'll mention
that you can do is optimize your sleep.
Chronic sleep deprivation, which would be getting less
than six hours of sleep a night for the majority of the week
and for the majority of the month can worsen depression
or even cause you to have depression symptoms.
And there are lots of things you can do
to improve your sleep hygiene, but one thing
that I'll mention is wearing blue light blocking glasses
two hours before bedtime.
Blue light is emitted by sunlight,
but you can also get exposed to it from electronic devices
and the modern compact fluorescent bulbs
that you use to light your home.
This blue light exposure can delay
or decrease melatonin release.
Melatonin is a sleep hormone.
And I've talked about using the glasses to block blue light
for people with sleep disorders or in dark therapy
for bipolar disorder, but here you would use the glasses
to help keep your sleep regular.
I wear them every night as part of my sleep routine.
Sleeping pills like Ambien, Lunesta
or the newer medicine, Dayvigo,
can help you log some good restorative sleep
if you took them for a couple of weeks.
Filling the void of sleep loss can make a difference
in your mood when you have mild depression with sleep loss.
You want to think of using them as a short-term solution
so that you don't become dependent on needing something
to help you sleep every night.
And short-term would be one to three months.
If your sleep problem is partly due to poor sleep habits,
like not having a regular bedtime, staying up late,
or using alcohol to fall asleep, just to name a few things,
sleeping pills can help you establish a sleep routine.
For example, if you don't fall asleep until 1:00 AM
but you need to get up at 7:00 AM,
it's going to be very hard, if not impossible,
to start falling asleep at 10:00 PM on your own.
You can push your sleep back,
but you need help bringing it forward.
Taking something that makes you fall asleep earlier
can help you reset your body clock to fall asleep earlier
and have that be your new bedtime.
Using the blue light blocking glasses two hours beforehand
and sleeping with eye covers to block the light
in the room can further help you fall asleep
at your desired time.
So these are natural solutions for mild depressive symptoms.
Does this mean that you can't take medication?
No.
Antidepressants may help mild depressive symptoms,
but you have to weigh the risks of side effects
from the medication against the benefits of taking them.
It may not be worth it to take medication
if natural interventions make you feel better.
Also, it's important to know that what we call recovery
from depression does not mean zero symptoms.
You can still have a few things like appetite changes
or sleep troubles and still be considered to be
in remission from depression with medication.
So if you start out with three symptoms,
you may not want to add in a medication
if that medication only relieves you
of one of those three symptoms.
For more on what it means to recover from depression,
watch this video.
And there's also the video on exercise and depression.
Thanks for watching.
See you next time.