By Clinton Sims, Psy. D.

As reported by The National Institute of Mental Health, major depressive disorder is the leading cause of disability in the United States for ages 15-44. The condition affects approximately 14.8 million American adults, or about 6.7 percent of the population age 18 and older, in a given year. While major depressive disorder can develop at any age, the median age at onset is 32. Major depressive disorder is more prevalent in women than in men.

More Americans suffer from depression than coronary heart disease, cancer, and AIDS combined. Depression ranges from the functionally depressed, who are primarily sad and unhappy with life, to the debilitating depressed, who isolate, are withdrawn, and experience limited interpersonal relationships, to the emotionally unstable depressed, who are a threat to themselves.

The functionally depressed are frequently seen in therapy. For example, I provided service to a client whose depression intensified due to feelings of inadequacy about job performance. A debilitating depressed client presented as unable to look for employment and found the usually friendly gathering as unsatisfying. [Not sure what this sentence in bold is supposed to say.] The emotionally depressed client felt hopeless and unable to change the circumstances in his life, resulting in self-mutilation and thoughts of suicide.

My primary focus with the depressed client is to make gradual steps toward a more active lifestyle, as well as helping the client to gain better self-perception of his or her accomplishments. I emphasize remembering the things that used to bring enjoyment, or identifying unfulfilled desires and personal pursuits. These don’t have to be big things. They can be as simple as exercising, taking a walk in the park, having a “girls’ night out,” etc. Also, a hairstyle change or refreshing your wardrobe can create feelings of pleasure.

Because financial concerns tend to be associated with depression, creating the freedom to treat yourself can do wonders for enhancing positive feelings. For instance, a relative who teaches biblical finances suggested saving at least one $5 bill every day. They can be accumulated and used for entertaining activities such as the movies or dinners, or even gasoline. I have personally adopted this strategy. The number of $5 bills I save each week fluctuates between 10 and 20, and they provide the occasional moment of enjoyment.

When dealing with depression, major decisions should be avoided until your mental health improves, even if you believe that someone else, such as your job or spouse, is causing the depression. It is my belief that depression is caused by your reaction to situations and others. A change in your perception and doing more of the things you like can help reduce the depression.

Finally, significant life events leave residue that can negatively affect relationships. Although some people can “get over” them, the best results seem to occur when you “work through” them with the guidance of the clergy, a therapist, a self-help group, or the like. Depression does not have to be a life sentence.