relieve depression

Currently, there is no universal solution that can “radically cure” depression 100% in the global clinical field. However, the three-dimensional combination of “standardized medical intervention + individualized adjustment + social support” that has been proven for decades can enable more than 80% of mild to moderate patients to achieve long-term symptom relief and return to normal life. Severe patients can also significantly reduce the risk of self-injury and improve their quality of life through systematic intervention.

I worked as a volunteer escort at the Municipal Mental Health Center for the past two years. The first patient I met was a 17-year-old high school sophomore named Xiao Nan. Before she was diagnosed with severe depression, she had seen too many posts about "relieve depression through exercise" and "just don't think too much". She refused to seek medical treatment for three months. When she was finally pulled down by a passerby while standing by the river, she still had a scrap of paper in her pocket written "Am I too useless?"

When many people hear that they need to take antidepressants, their first reaction is, "Will it be stupid?" Will it be dependent? ”, this concern is too common. I have seen too many patients secretly reduce their medication and eventually relapse. From the perspective of a psychiatrist, during a moderate to severe depression, there is a pathological imbalance in the neurotransmitters such as serotonin and dopamine in the brain. Just like a diabetic who needs to replenish insulin secretion due to insufficient secretion, it is useless to ask him to "drink more hot water and try to prescribe more" at this time. Standardized medication is the highest priority intervention method. Side effects such as nausea and drowsiness that most people say will only appear in the first two weeks of taking the medication. They will basically disappear after getting used to it, and there will be no addiction problem. Of course, there are also different opinions. Many patients with mild to moderate symptoms are not sensitive to drugs themselves, or do not want to take drugs due to work or pregnancy preparation needs. At this time, the effect of evidence-based psychological intervention has also been widely recognized. For example, the commonly used cognitive behavioral therapy (CBT), by adjusting the patient's automatic Many people can feel significant changes after doing 8 to 12 times of negative thinking patterns. Even a 2022 study in The Lancet Psychiatry showed that 30 minutes of moderate-intensity exercise three times a week has an intervention effect on mild to moderate depression that is basically the same as low-dose antidepressants.

To be honest, I rarely read those "three steps to cure depression" posts on the Internet. Many of the suggestions do not take into account the state of the person during the attack. For example, when many people give advice to patients with depression, they first start by saying, "Go out for a walk more often" or "Talk to friends." But anyone who has actually experienced a depressive episode knows that at that time, let alone going out, even getting up from bed to drink water was like carrying dozens of kilograms of stuff, and it was impossible to do. Many clinical counselors I have contacted never set the first goal for patients suffering from seizures to "be happy", but "to be able to walk to the door to get takeout today" and "to stand up and brush my teeth today." Such micro-goals that are so small that they are almost impossible to fail are much more useful than shouting big slogans. When Xiaonan first started consulting, the consultant assigned her a task for the first week: "Sit for 30 seconds every day when you want to sit up."

There is another misunderstanding that many family members tend to fall into: "I hang around him every day, why is he still not well? ”In fact, many times excessive attention is actually stress. One of the most poignant scenes I have ever seen was a 28-year-old boy who was depressed and stayed home from school. His mother would never ask him, "Are you feeling better today?" If you don’t want to move, I’ll leave the food at your door later.” There was no preaching or urging, just telling him “You can do whatever you want.” Half a year later, the boy took the initiative to tell his mother that he wanted to go back to school to complete the remaining credits. Of course, this does not mean that all family members must reach this level. Many family members themselves are also under emotional stress. At this time, seeking professional family counseling to intervene will be more effective than trying to deal with it yourself.

Of course, there are situations that don't make sense. I once met a 35-year-old programmer who insisted on taking medication and consulting for two years, but his symptoms continued to recur. Later, he picked up a stray cat with a broken leg downstairs. He gave the cat medicine, shoveled poop, and played with the cat every day. Within half a year, his depression score actually dropped to the normal range. He himself couldn't explain why. He just felt that "there is someone else who needs me, and I am not completely useless." There is no standardized solution to depression. What works for others may not work for you. It is perfectly normal. There is no need to blame yourself for it.

In fact, many people have a misunderstanding about "relieving depression". They think that they must return to their previous lively and cheerful self, and they must be able to go to work and school normally, but this is not the case. Just like you have a runny nose when you have a cold, or you need to use crutches when you have a broken bone, you don't want to do anything when you are depressed, it is just a normal reaction to being sick. There is no need to force yourself to get better immediately. Allow yourself to lie down for a while and rest for a while. If you can't bear it anymore, go to the doctor. There is really no shame in it.