“Almost Depressed”? Short of a Full-Blown Clinical Diagnosis

Almost Depressed, by psychiatrist Jefferson Prince and psychologist Shelley Carson, is one of the newest additions to the Almost Effect series from Harvard.

As the publisher states, “We all experience unhappiness—but for some, sadness, stress, and negative thoughts can become a regular part of our lives, no matter how good things may be going. There is a place between basic sadness and diagnosed clinical depression called almost depression.”

In a recent CNN.com article Carson states that being “almost depressed” isn’t considered a mental disorder: “It is a state of low mood that can leave you exhausted and de-energized, keeping you from savoring life and working at your peak performance level. It is a gray area of mood problems that lies on a continuum between the ups and downs of normal mood, and full-blown major depression…”

Some of the issues involved include “lower job satisfaction, lower satisfaction with their marriage and other personal relationships, more anxiety issues, less control over their lives and lower overall well-being than people who do not fall into the almost depressed range.”

Interestingly, those with almost depression can actually feel worse regarding some of these life problems than those with full-blown clinical depression. Furthermore, about 75 percent of cases of this lower-grade depression will become a more severe condition if not recognized and treated. And once it becomes clinical depression, or major depression, it’s typically harder to treat and can include such features as serious physical problems, more challenging life issues, and suicidal ideation and attempts.

Steps that are recommended by Carson include the following (presented here verbatim):

Make sure you are getting enough exercise. The minimum amount for treating depression is 30 minutes of continuous aerobic exercise (70% to 85% of maximum heart rate) plus a 10-minute warm-up and cool-down period three times a week.

Integrate activities you have found pleasurable in the past into your weekly calendar. Even if you feel that you no longer enjoy them, such activities will increase the activation of the pleasure centers in your brain. As your symptoms resolve, you will regain pleasurable feelings.

Use creative outlets to express your negative feelings. You don’t need experience or talent to express yourself creatively, so paint, write or play music. Expressive creative work reduces depressive symptoms.

Manage your stress level. Stress has negative effects on both the brain and the body and can be a major source of depressive symptoms.

Challenge the way you think. Our moods are dependent not upon what happens to us in our lives, but in how we interpret what happens. Changing your interpretation has been shown to reduce depressive symptoms.

Increase your level of mindfulness. Mindfulness training and practice is an effective way to keep depression at bay.

Reduce the power you give to your ‘inner critic.’ Often the negative and critical things we say to ourselves lead to feelings of depression and powerlessness.

Increase your social support circle. Having a strong social support system is a known protective factor against depression.

Improve your self-care. Poor nutrition and poor sleep habits can augment feelings of depression. In some cases, specific nutritional supplements can work wonders.

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