Categorized | Depression

About Clinical Depression: Treatment Tips From A Professional

“If you stop thinking about your problems, your depression will go away; you’d be happier.” “Think about positive things; you’ll feel better.”  “You like feeling bad.” “It’s all in the mind; make up your mind to be happy, and you will be.”

Oh, if it were only this simple to turn a clinical depression around, a whole lot of people would be relieved. So many clinically depressed people have to cope with their difficult condition while dealing with family members and friends who misunderstand the cause of major depression. Unfortunately, clinical depression is one of those illnesses that you have to experience first-hand, in order to really know what a terrible burden with which it is to live. However, we can come to understand it much better, so that we can give our loved ones the empathy, care, and support that they need to get better.

My post today is a tribute to all of you who have struggled with clinical depression or who have a loved one who has struggled with this problem. I give you a three-tier treatment approach that research shows will help you to get better. But, I know this first-hand too, as I, also, have struggled with a clinical depression. I use the treatment approach that I provide to you today. Thus, I know it works to relieve your symptoms greatly.

Needless to say, as a therapist, I’ve treated many clinically depressed people throughout the years. Indeed, their depression is a huge physical and mental assault on their well-being. Even so, one of the most hurtful assaults that they have to endure is the misunderstanding of their condition by family members and friends. By clarifying the source of clinical depression, today, and its effects upon those who are afflicted with it, I hope to increase your understanding, awareness and sensitivity as to its source and cause.

Clinical depression, a.k.a. major depression, is not a personal weakness or a character flaw. You cannot will it away or shake yourself out of it, to get better. It’s not a temporary bad mood or sad feeling that lasts for a few days. And, it persists, whether or not good or bad things happen to you.

Clinical depression is a serious medical illness that alters brain chemistry and affects physical and mental health, behavior, and spiritual well being. It negatively influences how you feel, the way you think and act, and even your will to live. Although, you may have inherited depression, psychological and environmental stressors, like loss, chronic illness, personality and relationship problems, work stress, and stressful life changes can trigger a depressive episode, even in people without a family history or genetic contribution. These problems can cause wear and tear on your body that eventually depletes the chemicals that keep your brain and body running smoothly. For example, if you rack up more miles on your car than its structure can handle, its parts will wear out sooner than it is expected to last.

You can’t use your intellect or will to deal with clinical depression, without medical intervention. Depression undermines motivation and will, as it’s a dysfunction in the chemistry of the brain that is linked to the brain’s nerve transmitters (serotonin, norepinephrine, and dopamine). The effectiveness of antidepressants validate the biological basis to a person’s depression. One of the ways mental health professionals know that a person’s depression is a problem in brain chemistry, rather than a personality disorder, is by the capacity of an antidepressant to relieve symptoms. But, make no mistake; a relief in symptoms is not the same as taking the clinical depression completely away. It simply improves a person’s functioning. The degree of functionality depends upon the person’s level of personality development.

Depression does seem to run in families, suggestive of its biological source. Most clinically depressed persons can name a family member or two who struggle with the same condition. This is certainly the case with bipolar depression (BD) that is characterized by periods of depression that alternate with periods of elation and increased activity, known as mania. In fact, the rate of occurrence of bipolar disorder amongst family members is strong (Offspring of parents with BD is 10.6% in contrast to .8% in people who have no parents with the disorder. This increases to 29% when both parents have BD). 76% of these offspring experienced childhood-onset bipolar disorder before the 12-years of age. However, having a biological vulnerability to clinical depression does not mean you are destined to become depressed. Depression can occur in one family member and not the other, and also skip generations of family members. This suggests that other factors are involved. Additionally, depression can occur in persons who have no family history of depression.

In contrast to what some people believe, depressed people don’t like being depressed. In fact, they’d try almost anything to rid themselves of this personal burden that robs them of time, energy, joy, and the motivation to participate in life. Medication, talk therapy, yoga and mindfulness therapies, light-therapy, thought restructuring therapies, acupuncture and massage, spiritual healers, and vitamins and herbs are just some of the treatments they try to jumpstart their biology and return them back to life. While these treatments make some better, some people get little relief and can end up taking their own lives. Take, for example, the recent suicide of 58-year-old Mary Kennedy. She suffered from a life-long clinical depression. And, years of alcoholism did little to help her condition. Robert Kennedy Jr. told the New York Times: ‘A lot of times I don’t know how Mary made it through the day. She was in a lot of agony for a lot of her life.’ Sister-in-law Kerry Kennedy said Mary – a lifelong friend -had been sober for five months, but was still battling depression.

Depression can ravage your body, mind, heart and soul. It takes a lot of energy to manage depression. Energy that many depressed persons do not have to give. Nonetheless, many clinically depressed persons are able to do what is needed to function the very best they can. They have relationships, jobs, and raise children. Their days are like yours and mine, only so much harder, as their depression is a high maintenance condition. What makes the difference? They do all that is needed to do more than just survive. They take medications, go to therapy, get the nutrition and exercise they need to stay well, and abstain from alcohol and drugs and any other habit that worsens their depression. But, there are factors that science still doesn’t fully understand that permit some clinically depressed people to do what they need to get better and others to fall victim to the condition. To be sure, it is a mistake to blame some depressed persons failure to thrive on them personally.

A Three-Tier Approach to The Treatment of a Clinical Depression


No matter if you inherited your depression or came by it through loss or a psychological or environmental stressor, you need an antidepressant to treat the chemical imbalance in the brain’s nerve transmitters. However, some people resist medication wanting to try vitamins or herbs, and exercise or psychotherapy, before they go with the antidepressant route. I appreciate why people do not want to take antidepressants. It usually takes a period of trial and error to get you on the right medication. Also, antidepressants have side-effects. But, most clinically depressed people find the side-effects of antidepressants to be much more tolerable than their depressive symptoms.

We are a society that tends to over-medicate. Thus, you are wise to use caution when deciding upon your choice of antidepressant. Nonetheless, medication is the way to jumpstart your biology, so that you can benefit from psychotherapy treatment. Really, there’s no better way to get your brain chemistry right. And, although vitamins, herbs, and exercise may give you some relief, they are not enough to adequately treat a clinical depression.

Don’t be shy when it comes to selecting the psychiatrist who will treat you. Do not let a general practitioner, internist, or physician’s assistant medicate your clinical depression. As competent as they are, they are not trained to diagnose, understand, and treat clinical depression. You have a serious medical illness that requires a mental health professional. That being said–no two mental health professionals are alike. Like any profession, there are competent professionals and there are quacks. There’s a general rule of thumb you should keep in mind when considering antidepressant medication. If you are on the right medication, you will not need several others to treat your symptoms. Thus, if your doctor wants to immediately put you on two to three medications to treat your depression, or goes for the most powerful medications first, please question his/her reasoning. You may be going to the wrong psychiatrist. The more medications you take, the more toxic they become on your body. The benefits of antidepressant treatment can quickly go awry when you are taking so many that you can’t function well.  Your therapist can direct you to psychiatrists whom he or she knows and trusts.


Today, most practicing clinicians believe that depression is caused by an equal combination of biological (including genetics), social, and psychological factors. A treatment approach that focuses exclusively on one of these factors is not likely to be as beneficial as when treating the depression on three-levels. Therapy is critical to getting better. Remember, research clearly shows that psychotherapy and medication together are more effective than either treatment alone. Therapy educates and informs, treat the symptoms and emotional problems that contribute to depression, and returns you to mental health.

Symptom-based psychotherapies are the most popular and commonly used therapy for the effective treatment of depression. Symptom-based therapies treat the symptoms that you have today, rather than go back to your past to find the emotional conflicts that may be causing your depression. Cognitive-behavioral treatments (thought restructuring, assertiveness and social-skills training, and stress-management) emphasize changing thoughts and beliefs that worsen depression and increase attitudes and behaviors that make you more functional. Mindfulness therapies teach you how to stop patterns of thinking that take you out of the present moment and into personal dramas that keep you unhappy and stuck in the past. And, the insight-based talk therapies focus on past conflicts that contribute to your depression. Each of these therapies can be helpful to relieving your depressive symptoms.


Depression left untreated can cause brain damage. It suppresses levels of a key nerve growth hormone called an eicosanoid that preserves the integrity and elasticity of brain cells. Suppression of this super-hormone eventually leads to the death of neurons in critical memory and reasoning areas of the brain, including the hippocampus and prefrontal cortex. Additionally, it increases brain inflammation that may worsen depression, or be one of its main causes. (Inflammation, Glutamate, and Glia in Depression).

Thus, what you drink and eat can reduce or increase brain and body inflammation and worsen your depression. It’s been observed that many depressed people get symptom relief through diets that emphasize an increase in protein and decrease in carbohydrate intake. Lowering sugar and other products that increase body inflammation activates the body’s anti-inflammatory eicosanoids that preserve brain cells.

Eight Tips to Treating Your Clinical Depression

  1. Accept that clinical depression is a high-maintenance condition. The extent to which you get better parallels the areas you clean up, so to speak, to treat your depression. Thus, please, be good to yourself; treat your depression with a three-tier approach. You’ll be happy you did. As you get better, you may, overtime, be able to take less medication to feel well.
  2. Examine your misconceptions about antidepressant treatment. Many people have many misconceptions about antidepressant treatment for depression. Know that when you get your brain chemistry right, you actually reduce some of the damaging effects of untreated depression  (Inflammation, Glutamate, and Glia in Depression). Remember, some of the findings that I cited for you in this post today. Consider any resistances you have toward prescribed medication for your depression. I have had many patients worry about brain damage from antidepressants, even though they drink alcohol regularly, and some have smoked marijuana for years. This reasoning has always fascinated me. But, denial can be very effective. So, challenge your reasoning as to any misconceptions or resistances you may have about treating your depression at the biochemical level.
  3. Get the therapy you need. If you have suffered from depression for a long time, you may have developed social fears, coping difficulties, and have problems managing stress. These problems often accompany depression. Treating your thinking and behavior is vital to your well-being. And, perhaps, even more, talking with a professional about the years of your suffering, the impact on your life, and the feelings you have about having to live your life with this particular burden will go a long way toward helping you to recover.
  4. Eat a balanced diet and one that helps with depression. I can’t stress enough how important nutrition is to managing your depression. I can attest professionally and personally to how much diet affects your well being (Inflammation, Glutamate, and Glia in Depression; Anxiety and Omega-Three Fatty Acids). If you have not taken care of this area in your life yet, it will be worth your effort to start today.
  5. Exercise daily. Research shows that exercise definitely improves mood. Regularity is more important than duration or intensity (National Institute of Mental Health; Depression and Exercise).
  6. Become your own scientist.When you have a serious illness like clinical depression, you have to arm yourself with the right knowledge, so that you can work collaboratively with professionals. If you don’t, you may be led to treatment approaches that are not right for you. A good psychiatrist and psychologist should keep their egos in check, if you question them about their treatment suggestions. If you don’t get the answers you need to feel secure, try another professional.
  7. Do not be ashamed of your depression. Clinical depression is no different than being a diabetic or having any other physical illness or mental health condition. Of course, you need to choose the right people, time and place to share this with other people. This is your choice. It’s more important that you feel okay about it. This will help you to get the information and help that you need to get better.
  8. Keep the faith. I can’t stress enough how much faith can help you to deal with your depression. Clinical depression can rob you of hope. Activate the principles of your faith; just don’t think about them. Practice what you believe, so that you have enough courage and energy to go for the help that you need.

Depression is a personal burden that many people have to deal with for a lifetime. I hope my post today has helped you or a loved one to understand your depression better. If you liked my post today, please say so by selecting the Like icon below. Your feedback helps me to know the kind of posts you want to read on Psychology In Everyday  Thank you for your ongoing support and friendship. Warm regards always, Deborah!




19 Responses to “About Clinical Depression: Treatment Tips From A Professional”

  1. Dr. K – this was so well-written. Very clear, candid, and comprehensive. This will surely help many many people. I really like that you talked about diet being such a critical component. It is often overlooked. I also really liked this:
    Do not be ashamed of your depression. Clinical depression is no different than being a diabetic or having any other physical illness or mental health condition


    A good psychiatrist and psychologist should keep their egos in check!

    • avatar Dr. Deborah Khoshaba says:

      Thank you Stefanie, thank you for your thoughtful comments. True, so many times we forget that good self-care can go a long way toward helping depression. And, yes, my friend, education and training, some times, does little to humanize a person. Only self-exploration and spirituality can do this. Warmly, Deborah.

  2. avatar Jim Romano says:

    Great article Deb. Our family, like most, has dealt with depression issues. Great read.

    • avatar Dr. Deborah Khoshaba says:

      Thank you so much Jim. I hoped that the importance of the topic outweighed the article’s length. Hope all is well. Deb.

  3. avatar Todd says:

    Perhaps you should pen an article for the millions of middle class Americans that can’t afford the first two tiers.

    • avatar Dr. Deborah Khoshaba says:

      Hi Todd, you are so right. There are resources that can help people with medication and psychotherapy. First, if a person is indigent, most every city has a Behavioral Health Care Agency for the Indigent. This is government funded and there are mental health professionals who evaluate, diagnose and treat for no fee, if a person qualifies for indigent status. In orange County, California where I reside, for example, Westminster, California has a Health Care Agency for the Indigent. I have directed many of my patients throughout the years to this agency. And, I have found them to be very concerned and quite helpful. Psychiatrists visits are very expensive as well as some Psychologists. There are mental health care professionals that have two year degrees and are try skilled to do therapy and to make appropriate referrals. Most psychologists and licensed social workers and marriage and family therapists do therapy for lower fees. If you check your state psychological association, they can provide you with a list of professionals who will see people on a sliding scale. And, many of these professionals are excellent. That being said, I would turn to a general practitioner (HMO/PPO) to get evaluated, if this is the best financial route for me.

      I hope that helps. I will pen an article in the near future on this topic. It is very important. I did sliding scale therapy for years Todd. Most of us do. We just can’t afford to do it across the board. It is more difficult finding a psychiatrist who does sliding scale fees, but they are out there.

      Please know that I highly value medical professionals and if this is the route one has to take, by all means get the help that is needed. This is better than nothing. Todd, don’t hesitate to write me back. I am happy to answer your questions and appreciate the opportunity to share this with you and others. Warm regards, Deborah.

  4. avatar Todd says:

    Unfortunately Dr. the middle class doesn’t qualify as indigent.

    As to myself, I’m healthy but do know someone that, due to the lack of universal health care and the distortion in the price equilibrium curve created by health insurance can not afford help and self medicates with alcohol(typical). I fear she will have to go from being a contributing member of society to someone qualifying for help as a indigent.

    For me it only reinforces the notion that despite the highest cost in the world we do deserve the ranking of 36th in outcomes.

    • avatar Dr. Deborah Khoshaba says:

      Hi Todd, you are right. Unfortunately, the economy and insurance industry has negatively affected mental health care and its consumers, like so many industries today. I believe the middle class suffers because they are not wealthy enough to afford services, like mental health that is a luxury item for the middle class and do not qualify for indigent status, as you rightly say. I started Psychology in Everyday Life to bring mental health to the millions of people all over the world who cannot afford services. And, unfortunately, some of the self-help guidance involves getting the services one needs. The only thing I can think of at this point is contacting city and state psychological services and present the problem. They may know clinicians who treat on a sliding fee scale. Also, Universities and institutions that train therapists have mental health clinics. They are manned with graduate students in the field who are talented. But, more importantly, those graduate students are supervised by mental health professionals who have years of expertise. This is another route that your friend can try. Best to you and to her Todd. Please stop by again. Warmly, Deborah.

  5. Your article on depression is just great! You make it so much clearer than it usually is taken to be. As usual, you are so helpful to all of us. Thanks so much.
    Sal Maddi

    • avatar Dr. Deborah Khoshaba says:

      Thank you so much Sal, I enjoy helping people. Your feedback means a lot to me. Warm regards, Deborah.

  6. avatar Dr. Ashwini Lal says:

    Hi Debbie, I wanted to ask you about a recent study that I found out about through epocrates. Often times we hear about how antidepressants are only effective for the more severe depressions. However, a recently published large study disputes that thinking stating that severity of the depression does not matter. What are your thoughts on the issue? The article can be found at: Gibbons RD et al. Benefits from antidepressants: synthesis of a 6 week patient level outcomes from double blind placebo controlled randomized trials of fluoxetine and venlaflaxine.

    • avatar Dr. Deborah Khoshaba says:

      Hi Dr. Lal, thank you for directing me to this interesting study. I have several thoughts with regard to their findings that antidepressants work regardless of the severity of the depression. I’ve seen many people benefit from antidepressant medication who did not meet the criteria for Major Depression (MDD). Antidepressant medication can help people who have a low-grade, chronic depression (Dysthymia). I think the distinction between people who can forgo antidepressants and try the other treatments alone are those who have a lower grade depression. If a loss hits and they go into Major Depression (called Double Depression) then they most likely will benefit from antidepressant treatment. One of the first things I did after I read the findings of the article was look at who funded the study and of course, part of the study was funded by a pharmaceutical company. I can’t help but think that they want more people taking antidepressants. Just a thought! Thank you again. Great question. What do you think? Warmly, Deborah.

  7. avatar Dr. Ashwini Lal says:

    Hi Dr Deb! Thank you for your response! I think it’s important for it to be known that antidepressants CAN be effective for those with lower grade depression, however, I feel if someone has a low grade depression they would benefit more by individual psychotherapy. This is not to say that someone may not benefit from being on an antidepressant as well as involved in psychotherapy but if the depression is less severe in nature and is not impacting one’s overall functioning, psychotherapy may be a better option initially. I actually did not check who was involved in the funding of the study so you make an excellent point about the pharmaceutical industry’s desire(s) for their medications to be utilized more often. I wonder if any studies about this particular issue have been done without funding from a pharmaceutical company. I need to look into this! 🙂

  8. avatar najma shaheen says:

    thank u for nice writing.which kind of food is helpful for depression rather than protein diet, want to know.i have heard that safron is good for it true doc Deb?warm regards.Najma

  9. avatar Prof. Raja Habib says:

    hi !
    Dr. D.K
    I am fine & hope that you will be the same and when i read your post today i felt very happy becouse one of my brother is saying that he has deprssion. so i think now i can help him by your tips.
    thanks for such great jobs

    • avatar Dr. Deborah Khoshaba says:

      Hello Prof. I’m so glad that what you found in this post will help you to guide your brother. This is what it is all about. Let me know if you need anything else. And, I very much look forward to you visiting again. Warmly Deborah.

  10. avatar saba says:

    hi im saba hope ur good…i hve no family i feel alone waana die imiss my mom but cant do anything im not hapy i hate life tel me what will i do?

    • avatar Dr. Deborah Khoshaba says:

      Hello Saba, I am well. I’m sorry to hear how hard life is going for you. I recommend that you talk to a professional who can guide you. You deserve a happy life. Believe me, life will get better for you. Take the steps to get the help you need so that you can get closer to the good life that you deserve. Warm regards to you, Take good care of yourself, please. Deborah.


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