Self-Management of Depression

Although we have all heard the medical profession touting the health benefits of physical activity and exercise, most of us don’t regularly engage in this inexpensive health-promoting behavior. In addition to preventing chronic medical conditions, growing evidence demonstrates that physical activity and exercise improve mental well-being and have a buffering effect on depression. A review of the literature showed that a higher level of baseline physical activity was associated with decreased risk of developing depression in the future (Mammen & Faulkner, 2013). Even low levels of physical activity, such as walking less than 150 minutes per week, can prevent future depression. Another study demonstrated that individuals who engaged in physical activity for more than 30 minutes a day had a 48% lower risk of being depressed at follow-up compared to individuals who didn’t engage in physical activity (van Gool et al., 2006). Interestingly, the same study also showed that each minute of ...

What is Measurement-based Care? Measurement-based care is extensively used in medical conditions and involves matching treatment interventions with the outcomes for those treatments. For example, a provider would periodically measure fasting blood glucose or glycosylated hemoglobin in an individual with diabetes to make adjustments to the treatment plan, including medication and lifestyle changes. Measurement-based care fosters self-management by making the individual aware if they are on the right treatment plan or if they need to modify it in collaboration with their provider. While measurement-based care has been proven to improve outcomes for medical conditions, mental health, unfortunately, has lagged behind in adopting it as a regular practice. Measurement-based care in depression is an algorithmic application of published, accepted, clinical guidelines and consists of four steps (Morris et al., 2012): Step 1: Screening: Your provider may use one of the several available tools ...

A right match between you and your mental health professional is key to your wellness and recovery from depression. If you are looking for a therapist, the most important thing to inquire about is whether they use evidence-based psychotherapy to treat depression. Cognitive-behavioral therapy (CBT) and Interpersonal psychotherapy (IPT) are two modalities of psychotherapy that have the most evidence to support their first-line use for treating acute depression (Parikh et al., 2009). There is some evidence to suggest that CBT may be more effective than IPT in individuals with severe depression, but the two are comparable for treating mild and moderate depression (Luty et al., 2007). Questions to ask yourself during your first visit with the mental health professional “How did you get your training in CBT (or other therapy modality)?” “How much experience do you have with these approaches?” “What are your professional credentials?” “What kind of methods would be used during the therapy?”...

With strategies such as Transcranial Magnetic Stimulation (TMS), Ketamine, and psychedelics becoming more prevalent for treatment-resistant depression, it is helpful to take a look at what this entity really means. Not everyone who is being referred for either TMS or treatment with Ketamine may have "true" treatment-resistant depression, and then there is what is called "pseudo-resistance." In simple terms, treatment-resistant depression implies that depression has not reached sufficient remission after adequate treatment. Remission is defined as clinical improvement with few signs of depression still remaining and a lower likelihood of subsequent exacerbations. About 15% of people with depression may eventually develop treatment-resistant depression (Berlim & Turecki, 2007). Treatment-resistant depression has been variously defined, but the most commonly accepted definition is as follows (Souery et al., 2007): A person with depression is considered ...