Never Delay Dealing With Depression

By Len Lantz, M.D.



I know this question sounds ridiculous, but you might be surprised how often I find myself asking it of my patients. Some people have had depression for so long and feel so stuck that they are not sure what they want. So, I make sure to ask.

It’s worthwhile to point out that for many people with depression, it’s not their first time. They may have tried many things to get their depression better, only to see a temporary benefit and slip back into the depression. It’s demoralizing and sometimes people give up trying. If that sounds like you, please consider reading my article, “The Dangers of Freedom from Depression.” It may help you dig deep and find the resolve to try again, because it is my genuine desire that your answer to the question, “Do you want to be happy?” is to stand up and shout, “Yes! Of course, I want to be happy!” and then do something effective for your depression. There are many reasons to set an intention to do something about your depression today.



The majority of people I know with depression hate it tremendously and want nothing more than to feel normal and start enjoying life again. While many frustrating symptoms occur with depression, rather than focusing on what’s wrong, people often find it far more motivating to focus on the positive outcomes they want for themselves in order to act immediately and with unwavering commitment in getting their depression to remission (full freedom from depression). Examples of positive outcomes to focus on include:

Getting your memory and concentration back to normal

Regaining your confidence

Enjoying yourself when you are with the people you care about

Feeling the dark cloud of depression lift from your mind and body

 + Laughing again and no longer feeling numb

Experiencing your normal energy level and procrastinating less

Being physically and emotionally present with your kids and partner again

Ending negative or suicidal thoughts



Some people hope they can sleep off depression or simply ignore it until it gets better. The problem when you try to sleep off depression or avoid dealing with it is that those very behaviors can make depression much worse. When you are depressed and in bed all day instead of living life, the depression is right there in bed with you.

One of the most effective interventions for depression is called behavioral activation. Behavioral activation involves filling your entire day with activities that are in alignment with your values. That might involve regular exercise, getting together with your friends or simply opening up your mail. You can read more about this strategy in my article, “Behavioral Activation for Depression.”

One of the problems of depression is that it steals motivation and energy and sends you into a vicious downward spiral. As you give up activities due to low motivation and energy, it fuels the depression to repeat the cycle until the depression becomes severe or even extreme. Just waiting for things to get better without a plan or intervention does not usually work. More often, it allows the depression to sink its claws in deeper.



If you hate feeling anxious, you might consider improving your depression so that you feel less anxious. Anxiety is one of the worst parts of depression. In the deepest part of depression, not only can people feel hopeless about ever getting better, but they can also become overwhelmed by anxiety. For some of the depressed people I help, depression can lead to an unsafe chain reaction due to anxiety and panic. Depression fuels anxiety which, in turn, fuels thoughts of suicide as a means of escape from the anxiety. Deciding to deal with depression can also be a decision to improve your anxiety and safety.



Are you familiar with the term slippery slope? If you have ever tried to inch your way down a very steep and/or slippery slope, then you know what I mean. Once you reach a critical point on the slope, you cannot get back up the same way you came. And in many cases, you will slide all the way to the bottom before you can turn around and find another, longer route back to the top. The farther you slide, the longer the journey.

How long will it take a person trying to get severe depression to remission compared to someone who has mild depression? I treat severe depression for a living. I can tell you that in most cases, it takes much longer to improve severe depression than mild depression.



Once established, it’s harder to change long-established brain patterns. The longer you are depressed, the more you set up the depressed brain pattern. If you stay in your depression, you are essentially training your brain to be depressed. Brain research supports this assertion. Both adult and pediatric depression research studies show that the faster depression is improved, the better the outcomes. Dealing with depression as quickly and effectively as possible reduces the odds that a person will end up with chronic, low-grade depression or relapse again into severe depression.



Bill was a 37-year-old computer programmer with an eight-year history of depression. He didn’t know why it started and didn’t really think there was a negative life event or problem that had caused the depression to start. He just seemed to slip into it. The depression had been bad for about the last five years and his life was feeling increasingly meaningless to him. His mood usually improved a little bit in the spring and summer, but last winter he developed severe pneumonia. He was in the hospital for a week before the doctors got the infection under control. After pneumonia, his depression became the worst he’d ever experienced, and he decided to talk with his primary care doctor about it.

“Bill,” said his doctor, “the last time I saw you in the clinic was a few years ago. At that time, your depression rating scale showed moderate depression. Wow. Your depression is really severe now. After we met the last time, did you get a chance to do any of the things we talked about?”

“Not really,” Bill admitted. “I called the therapist you recommended, but they were full at the time and not taking on new patients. I kept hoping the depression would get better on its own. I just lost all motivation and things kept sliding downhill. All I can do now is get myself to work and sleep. That’s it. I sleep at least 12 hours a day now and I’m still exhausted.”

“I hear you,” the doctor replied. “I can help you. We’ve got a great depression program right here in our clinic. I can get you in with one of our therapists who is good at short-term therapy. And I want you to start an antidepressant. You shared that you’ve been feeling suicidal and that you’re barely functioning. We need to implement everything we can to get your depression better as quickly as possible. Our depression program is called Collaborative Care, which means that we work as a team – that means you, me and a case manager. The program also allows me to consult with a psychiatrist to make sure you are getting the best care possible. The case manager is going to join us in a minute and she’ll set up times to meet with you once a week to make sure you are getting better and taking care of yourself. If you are not making progress in our program, I also can get you in quickly with an excellent psychiatrist who is affiliated with our program. Are you up for this?”

Bill agreed that he wanted help and liked that he could get the best treatment under the direction of a doctor he already trusted. He agreed that it was time to try an antidepressant, especially if it meant that it could accelerate his improvement. He appreciated his meetings with the case manager and therapist. Through their encouragement and with a gradual improvement in his motivation and energy, he was able to start doing the things – like exercising and engaging in more activities – that would help his depression get better and stay better.



Are you convinced to do something about your depression? There are many things that you can do to help your depression, and the best time to deal with your depression is right now. Start by simply making a commitment to yourself to do something about it. The next thing to do is to meet with a primary care physician or other advanced medical practitioner to talk about your options. In addition to their ability to start an antidepressant, they often have relationships with therapists and psychiatrists in your community, if you desire to work with specialists in your mental healthcare. Your depression can get much better, and it starts with your decision to no longer delay. Feel happier, get your joy back, improve your energy and motivation and start loving life again. Imagine how awesome that will feel!


Leave a Reply

Your email address will not be published. Required fields are marked *