(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.
