The following article appeared in the March 2009 issue of Christianity Today.  Many of you who come to this site are probably not subscribers.  The article is useful for its insights and advice and I thought it worthy to be a part of TheHealingsite.Us

                            When you’re Depressed

                                    Three Questions to Ask–five ways to respond
                                                  By Mark R. McMinn

       I was mistaken for a real doctor once and invited to a seminar for physicians on the topic of depression. Instead of admitting to be a psychologists with a Ph.D. rather than an M.D., I decided to attend the seminar and find out what physicians were being told about depression.
After procuring my doughnut and fruit medley, I sat with 250 physicians and listened to a simple message. “Depression can be disagnosed quickly and reliably by observing a patients facial features, and the only effective treatment is medication.” I left with an attractive pen bearing the sponsoring pharmaceutical company’s name–and deep discomfort with what I had just witnessed. Medications can be useful in treating depressions, but it is only one tool.
       If we view depression through the medical model, we may easily begin thinking of it as something one “gets” or even “catches,” and that the only treatment is to take medicine to make it go away. While it is true that depression often has biological markers, such as depletion of the neurotransmitters serotonin and norepinephrine, the medical model fails to capture the complexity of a problem that is also related to past trauma, current social support, cultural milieu, spiritual and religious concerns, recent losses, guilt and shame, medical problems, and more.

Detecting Depression
Here are three questions to consider if you think you or a loved one may be struggling with depression.
       First, ask the beyond sadness question. Life in our sin-stained world can be tough, and everyone feels the wear and tear of it at various points in life. With depression, sadness progresses to a point of persistent and deep emotional pain, often coupled with hopelessness, irrational feeling of guilt, and sometimes thoughts about suicide.
       Second, ask the physical symptom question. For many adults, depression is associated with early morning waking, poor appetite, unintentional weight loss, irritability, crying bouts, difficulty concentrating , and memory lapses. To make matters worse, depression interferes with motivation, so a depressed person is inclined to withdraw from the activities and relationships that once brought happiness and joy to his or her life.
       Third, ask the impaired functioning question. A person struggling with depression is likely to have difficulty functioning in everyday life. Depression can lead to lost productivity at work, strained relationships at home, and declining passion for ministry.
For those who answer yes to one or more of these questions it is time to seek help.

Getting Help
Here are some practical steps for those facing depression.
       First, resist the temptation to isolate. A few years ago, I was doing assessments of depressed inpatients at a local hospital and found myself writing in almost every report, “This patient needs a better social support system.” After writing dozens of these reports, I shifted my professional attention to how churches and psychologists can partner with each other. Church communities can provide the social support and spiritual meaning that depressed individuals desperately need. Attend services, consider becoming part of a weekly small group wheree you can be honest about the struggle, find men’s or women’s groups to join and get to know your pastor or peer helper at church. Many churches also have Stephen Ministries programs that can provide social and spiritual support for those who are depressed.
       Second, establish an exercise routine. This can be difficult for those experiencing depression because motivation is at an all-time low. But if you can push yourself into a moderate exercise regimen, it is likely to help, especially if your depression is relatively mild.
       Third, reclaim the pleasant events that have ceased because of the depression. In a depressed state, people stop the activities that bring them pleasure. They stop socializing with their good friends, strolling in the woods, enjoying sex with their spouse, eating their favorite foods and so on. Remember the goodness of God’s creation, and find ways to re-engage in living fully.
       Fourth, make an appointment with a psychologist. The most effective treatment for mild depression is a form of therapy known as cognitive therapy, and the best treatment for serious depression is a combination of medication and therapy.
       Fifth, talk to your physician. It won’t solve everything, but medication can help.
Here’s a bit of good news: People recover from depression. Treatments are effective and widely available. A Christian colleague of mine–a dear soul who struggled with depression–used to say, “As Christians, we have no right to give up hope.” There may be a time to take Prozac, and a time to give it up, but there is never a time to give up hope.

(Mark R. McMinn is professor of psychology at George Fox University and author of Sin and Grace in Christian Counseling (InterVarsity Press, 2008)

        In addition to the above article  a longer article was written by  Dan G. Blazer called  The Depression Epidemic.  Blazer quotes the American Pssychaitric Association's diagnoticc criteria:

        Major depression is disgnosed when an adult exhibits one or both of two core sysmptoms (depressed mood and lack of interest), along with four or more of the following symptoms.  for at least two weeks: feelings of worthlessness or inappropriate guilt, diminished ability to concentrate or make decisions, fatigues, psychomotor agitation (cannot sit still) or retardation (just sitting around), insomnia or hypersomnia (sleeping too much) significant  decrease or increase in weight or appetite; and recurrent thoughts of death or suicidal ideation.

           Blazer then says, "This clinical definition is sterile, however, and fails to capture  the unique quality of the severaly depressed person's suffering.  Deep depression is embodied emotional suffering. It is not simply a state of mind or a negative view of life but something that affects our physical being as well.  Signs of a severe episode of depression include unfounded negative evaluations of friends, family, and oneself, emotional "pain," physical problems such as lethargy, difficulty getting  one's thoughts together, and virtually  no interest in one's surroundings.  Though most of us know at least an acquaintance who has committed suicide, this tragic act baffles us perhaps as much as it pains us.  "I don't understand," we say.  The irony is that surviveors of serious suicide attempts frequently reflect on those attempts with similar attitude: "I have no idea what came over me."  The pain and mental dysfunction of major depression are deep.

      (Christianity Today, March, 2009. Dan Blazer is Professor of Psychiatry and Behavior Sciences at Duke University Medical Center and author of The Age of Melancoly,(Routlege, 2005))

                                         Topeka Capital Journal

LAWRENCE — Five years ago, Ivan Pancic couldn't sleep for more than an hour at a time. The smallest problem would overwhelm him. It was a struggle to get out of bed and navigate through the day. His back muscles were so tight he saw a chiropractor every week.

Pancic, a triathlon athlete and long-distance runner, had been diagnosed with clinical depression. Various anti-depressant medications and counseling, however, didn't seem to have any long-lasting effect.
"I had been trying to deal with depression for years," he said. "I'd have brief periods of improvement."

Pancic, 38, who works in the information technology field, said he began to research depression on the Internet and discovered a book, "The Depression Cure," that said making changes to one's lifestyle could successfully treat depression.

He contacted the book's author, University of Kansas associate professor of psychology Steve Ilardi, to see if he qualified for the 14-week Therapeutic Lifestyle Change treatment program, which focuses on a balanced diet, exercise, sunlight, sleep and social support. The treatment program is part of a research study being conducted by Ilardi and others at the university.
"It was the most freeing experience I've had," Pancic said. "I have been depression free for 21/2 years. It's very hard to describe, but it's a completely different life."

Ilardi said the research study has been ongoing for about five years.
"The most recent preliminary data analysis shows more than 70 percent of the people who completed the TLC program experienced a favorable response, which is defined as a 50 percent or greater reduction in their depressive symptoms," he said.

The idea for the TLC program came to Ilardi about seven years ago while he was teaching a graduate seminar in psychopathology at KU and realized the treatment of depression was unsatisfactory.
"We have an epidemic of depressive illness despite the increase in anti-depressant medications and other forms of treatment, and it's only getting worse," he said. "This is baffling."

Over the past 20 years, he said, there has been a 300 percent increase in the use of anti-depressant medications in the United States, he said. One in every nine adults currently take such medications, and about 23 percent of Americans will battle an episode of depressive illness by age 75.

To better understand why depressive illnesses are so prevalent in modern industrialized nations, Ilardi studied evolutionary medicine and examined research on an aboriginal group in Papua, New Guinea, where depression is rare despite high infant mortality rates and often violent deaths.

"In the two centuries since the Industrial Revolution, our world and our way of life have been radically changed, and yet we're still walking around with exactly the same genes," he said. "When our predominantly Stone Age genes collide with the modern post-industrial way of life, the consequences for our physical and mental health are often disastrous."

Ilardi said this mismatch can result in depression, diabetes, allergies, obesity, asthma, common cancers and heart disease — ailments rare in aboriginal groups. "What we're coming to realize about heart disease, the most serious epidemic of lifestyle, is that medications have a place,” he said. “They can be helpful in slowing the progression of the disease, but the sad reality is a large percentage of patients who simply take their medications and make no change to lifestyle will still eventually die of heart disease."

"It's analogous with depression, where the clear majority of patients who faithfully take their medications but make no changes in how they live will not experience a long-term cure of their depression,” Ilardi said. “It's not a problem we can simply throw medications at."

The Therapeutic Lifestyle Change treatment program includes:
■ Thirty minutes of brisk walking three times a week, with the support of an exercise consultant.
■ Daily fish oil supplements to provide essential Omega-3 fatty acids that have disappeared from the typical U.S. diet.
■ The use of a light box to simulate the intensity of sunlight, which is critical in setting the body's clock and synthesis of vitamin D.
■ Insuring healthy sleep. 
■ Maintaining social connections. "Having just one emotionally supportive contact cuts the risk of depression by more than one-half when stressful events crop up," he said. Participants in the TLC program meet with six to eight other people for 1 1/2 hours a week for shared activity.
■ Avoiding rumination, or dwelling on negative thoughts. "Rumination is psychologically toxic, and it has the tendency to pull other people into that world," he said. "It doesn't help anyone."
Still, Ilardi said, the TLC treatment program isn't a cure for everyone's depression.
"But we've had very good success with those who didn't respond to traditional therapies," he said.