Why Am I Depressed When I Should Be Happy?

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

Why Am I Depressed When I Should Be Happy?

by James Hubbard, MD, MPH

What to do about depression was a question not easily answered back when I started practicing. There were really no good medical options. The few drugs available had major side effects. Psychotherapy helped, but good therapists were few and far between where I lived.

And then there was the stigma. Everyone thought any mental problem meant you were weak of mind and body. A strong person just toughed it out and suffered in silence.

The thing is, few people suffer alone. You have family, friends, colleagues who care about you. You affect them with your moods and, in cases of suicide, with your death.

I’ve had at least two dear friends who ended their own lives in times ago. I still mourn them regularly. And the families, well, they’ll never be the same. Until the day they die, they’ll have feelings of guilt mixed with anger and sadness over what they might have done and why it had to happen.

In this post I’m going to discuss what to do about depression using modern medicine and what to do about depression if we have a lengthy disaster or ever have to go back to the bad old days. But first:

Why do some people get depressed when they seem to have everything going for them?

Symptoms of Depression

Feeling blue or down are the obvious ones, but many times you may not feel that way with depression. It can be much more subtle.

You may be depressed if you:

  • Feel fatigued or tired most of the time. Of course, many things can do this, but it’s sometimes the only symptom you have.
  • Are irritable or have mood swings.
  • Have trouble concentrating at home or at work.
  • Eat a lot more or a lot less than you used to.
  • Sleep much more or much less than you used to (not being able to get to sleep or sleeping for a few hours, waking up in the early morning, and not being able to get back to sleep).
  • Don’t enjoy life’s simple pleasures anymore.
  • Have a reduction in sex drive.
  • Have unexplained aches and pains. Yes, I know these need to be thoroughly examined for other causes just like all of the other symptoms I’ve mentioned, but depression can cause physical pain.

Some people know why they’re depressed:

  • Hormone changes: it’s that time of the month, menopause, after a pregnancy, thyroid disease, or just plain old adolescence.
  • Loss of a loved one.
  • Family or financial problems or other extreme stresses.
  • Medications: prescription meds, especially sedatives.
  • Alcohol or marijuana, which are sedatives and can make you depressed.
  • Lack of sunlight. This usually happens in the winter months and is called seasonal affective disorder (SAD).
  • Childhood trauma: physical, mental, or emotional abuse.

But the truth is, your brain, not your external factors, ultimately controls your emotions. External factors can help you be happy or make you sad, but some people have a genetic tendency to be depressed. Then, just the littlest thing can put them over the edge.

One of probably multiple reasons for this seems to be a chemical imbalance. Just a tiny bit can cause a lot of damage. And they’re helpless. What most don’t realize about many depressed people is they don’t know why they’re depressed either. It’s like someone who has a stroke (but much more subtle). Stroke victims can’t just will themselves to start using their hand again.

Fortunately we do have treatments these days that help depression, and with much fewer side effects than in the past.

Conventional Treatments

1. Prescription medications such as the selective-serotonin reuptake inhibitors (SSRIs) and other even newer drugs help balance out the chemicals in your brain that have gone awry. Some people think these drugs (Prozac, etc.) make you a zombie or Stepford wife walking around with a big smile on your face, but I don’t find that at all. Instead, they help you get out of that depressed mode like sometimes nothing else can. They help you think clearer and not fixate on yourself. Then you can take action on some of the family or financial problems that might be part of the external reasons for your depressed state. And there are so many good drugs these days that your doctor can usually find you one with very few side effects. The biggest problem I see with these is that they can take several weeks to work. Be sure to talk to your doctor if you’re planning to or think you might be pregnant so you can get the risks and benefits of individual drugs.

2. Psychotherapy by a counselor or psychologist can help—talking with trained people, trying to work through some of the reasons other than brain chemicals that might be causing depression. Things, again, like family or financial stresses, or childhood physical, mental, or sexual abuse.

3. Regular exercise not only helps burn off stress, but it raises your endorphin level—one of those brain chemicals that makes you feel good.

Books ad4. Sunshine: Open the curtains. Get out more.

5. Meditation: A recent study showed 20 minutes a day of “compassion meditation” might help people who are depressed. Apparently this type of meditation is when you actively think good thoughts about helping people or wishing them well. It sounds a lot like what we Christians call prayer—but for 20 minutes a day. It wasn’t studied, but I’d bet a few minutes less than that would help also.

Alternative Treatments

I would always get expert medical help for depression if at all possible since it’s next to impossible to guess who might go from being mildly to moderately depressed, to suicidal. But during a disaster or anytime you can’t get expert medical help, here are some natural remedies you might consider.

1. St. John’s wort may be the most well-known. It works similar to the prescription SSRIs but may not be as reliable. It can have just as many or more side effects and can take up to eight weeks to work its best. So why take it? I’d say only do so in a long-term disaster when you’ve run out of your prescription meds and can’t get any. A typical dose is 300 mg three times a day. Just like prescription medicines, St. John’s wort can interact with many medicines, including other antidepressants, seizure medicine, and birth control pills. Don’t take if you might be pregnant. If you have episodes of manic moods when you get hyper, maybe feel a little too good, you’re probably bipolar (manic-depressive), and this medicine is not for you since it could make you worse.

2. SAMe (S-adenosy-L-methionine) may work a little faster than St. John’s wort but has the same warnings regarding interactions, side-effects, and pregnancy. The dosage is 400 mg to 1,600 mg on an empty stomach once a day.

3. Fish oil supplements: Just like for anxiety, they’ve been shown to help depression.

4. Vitamin B6 and folic acid may help.

There have been rare associations of increased depression, even suicide, with the very medicines that make most people better. If any treatment seems to be making the depression worse, stop it immediately, and talk to your health care provider if one is available.

Have you or a loved one ever been depressed? What has helped?

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  • Tammy

    I have suffered with bipolar 1 since I was fifteen years old. I took medications for 17 years. Depakote, Trileptal, Celexa, and countless others. I couldn’t handle the side effects. The biggest one being that it left me emotionless. I was so numb that I couldn’t feel anything anymore. I had done counseling over the years, but I would drop it after awhile. I moved to Alaska in 2001, and shortly thereafter had a massive depression phase that lasted almost two years. The Alaska mental health system is the best I have ever seen or experienced. I finally found the help I needed. I spent four years in intensive therapy. It changed my life. I have been medication free, and in remission for ten glorious years now. They taught me my triggers and how to handle them before they bring on major symptoms. It works. I hope others are able to get the kind of help I got.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Fantastic, Tammy. I so glad you’re better. And thanks for sharing.

  • bob

    I’ve had Bipolar type II for years. I have absolutely no reason for this so I’m a big subscriber to the chemical imbalance theory. I’v been through many medications and find it’s a continuous process to find effective ones and keep up with them as they stop working. I also have fibromyalgia which adds to the confusion.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Bob, thanks for sharing. I wish you continued improvement.

  • annibe11e

    I just happened on this site for the first time. I was looking up stye remedies. I’ve been without insurance for a long time. I managed to stay on my anti-depressants up until about 6 months ago. It was a rough winter (I’m in MN and we still aren’t having much sun). I’ve been diagnosed with a chronic, low level depression (I can’t recall the actual terminology) and I’ve had a lot of success with prescription medication. My main symptom is irritability, which is compounded by hormones. I found a lot of relief in taking hormone based birth control in addition to meds. My saving grace right now is that my experience with depression has taught me that it’s treatable, things are not actually as bad as they seem, and that I can push through (this too shall pass). I do remember a time when I felt completey hopeless all the time and always gave up on everything. I think long term treatment with medication really has helped, and someday I won’t need it.

  • Meera Trivedi

    I am yoga instructor. I teach laughter yoga to depressed people. You can find lots of laughter yoga on you tube.
    It starts with fake laughter but then it becomes natural.
    I have seen improvement in Depressed people.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thanks, Meera. Laughter helps many physical and psychological illnesses.

  • Mariana

    I’ve lived with depression in one form or another since birth. In the ’60′s they would put a pregnant woman on anything in order to not lose the baby when a miscarriage was looming. My mother was such a case. I’ve recently been diagnosed with bipolar II (no manic episodes just a deep, deep depression and loads of irritability), anxiety/panic disorder & social phobia and a slew of other physical ailments (fibromyalgia, chronic migraines, carpel tunnel, bursitis, tendonitis…and I’m only 46!) I started with Zoloft, then Celexa, on to Paxil and now finally Venlafaxine. Additionally, I take Depakote, Clonazopam and Gabapentin(in other words, I’m a walking pharmacy). All of this, coupled with a wonderful therapist, a supportive general practitioner and several other specialists, has given me virtually no relief from the feelings of darkness and hopelessness. I’m detached from the joy of living and fairly numb and indifferent most of the time. It’s got to be all the pharmaceuticals I’m dumping into my body. I’m a tough case and extremely difficult to medicate. At least I don’t have the suicidal ideation plaguing my every day any longer. I’m starting to add fish oil and a hefty dose of vitamin D to my daily handful of meds with the hopes that SOMETHING will work. I live in the rainy Pacific NW so sunshine is virtually non-existant for months on end. My new ‘happy light’ has yet to be implemented, so I’m crossing fingers that there is going to be some form of relief from using it, although it’s recommended to begin with 30 minutes starting as early as September in order to really benefit from it.

    So Doc,got any other ideas you might toss my way? I’m pretty much out of options I think.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Mariana, when you say, specialist, I assume you’re talking about a psychiatrist? If not, I’d try to find a good one. The light is worth a try and does help some people quite a bit. Some other things that have been shown to help somewhat are exercise, B vitamins, yoga, and acupuncture. I have some other suggestions in my post. But, anything you do, you should always run by your doctor first.

  • kimberly

    I have been battling depression and anxiety for 30 years, from something that happened when I was 12 years old. Instead of dealing with it, I put on a happy face and thrust myself into taking care of other people, I figured as long as I was busy I would be okay. I also steadily gained weight until I reached 400lbs, and now I have debilitating osteoarthritis in my knees, I finally started seeing a Psychotherapist a year ago, I still have my symptoms and anxiety, but I have learned better coping mechanisms than to eat my way through it. I strongly urge anyone feeling depressed to get treatment sooner rather than later.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Kimberly,

      Thanks for sharing that. I sure it will help others with similar situations.

  • http://[email protected] Debbie

    Remove my post please??

    • Matt in Oklahoma

      Debbie dunno what the issue was/is but talk to someone. I live with someone who suffers and there is help available and it’s not a bad thing at all. We all have things we need help with and I am the strong silent one and know this to be true

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Done.

  • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

    Debbie, my opinion is you need to see a good psychiatrist. You should ask your family doctor for a referral, maybe, also a support group.

  • Mary

    We do have to take care of our bodies, our minds and relationships. This book demonstrated to me the spiritual component that inspired me to work on everything: http://www.newmessage.org/nmfg/Steps_to_Knowledge.html