Healing Depression: Taking the First Steps You may be worried about depression for many reasons:

You can't stop feeling sad or crying. You often feel angry. You've lost interest in things you love. You're having a hard time dealing with stress.

Depression affects one in 10 -- or nearly 15 million -- adults in the U.S. If you think you might be depressed, don't try to tough it out. Make an appointment with a doctor or therapist. In this step-by-step guide you'll find out how to get the help you need, including:

Finding out more about treatment options Understanding your depression Learning which healthy habits, like exercise, can boost your mood

End the depression cycle tips on breaking the vicious cycle of depression, including how to cope daily. How well do you function when depressed? WebMD Feature By Denise Mann Reviewed By Laura J. Martin, MD You go to work every day and even make time to see your close friends and family on weekends. But for the most part, youre r eally just spinning your wheels. Nothing seems to excite you anymore, and you look forward to climbing back into bed at the end of the day. Sound familiar? Are you or a loved one able to function well every day, despite feeling depressed? These are people who are having symptoms of depression, but are able to get through tasks lifelessly, says Scott Bea, PsyD. He is a psychologist in Cleveland Clinics Center for Behavioral Health in Ohio. You are basically just going through the motions wi thout any enthusiasm. WebMD asked mental health experts to weigh in on how to manage depression proactively in order to thrive -- instead of just survive -each day. If you have severe depression, it can be difficult to get out of bed and you may withdraw from your friends and family. You may even become preoccupied with thoughts of death and dying, but this doesnt happen overnight. Many people with depression are able to work, maintain relationships, and manage their lives for a long time before it catches up with them. How can you tell if your symptoms are related to depression? The first step is to talk with your doctor and get help for depression. Typical symptoms of depression may include: Sleep problems Physical aches and pains, such as headaches or back problems Lack of energy Difficulty concentrating Feelings of guilt or worthlessness Loss of interest in activities you previously enjoyed Eating too much or not enough Depression: This Too Shall Pass? But ongoing symptoms of depression will pass eventually, right? Not necessarily, Bea says. It may be tempting to just write these feelings off, but it doesnt work that way. The first step is t o own what is going on with you and take proactive steps to get out of the funk. Some people ignore continuing depression symptoms and figure theres nothing that can help. We think we must merely endure these feelings and that something will give and we will feel better, he says. It doesnt work that way. It will more likely get worse before it gets better, he adds. What can you do to cope? The next step is to shake things up a bit and make some lifestyle changes, Bea says.

Yes, it can be hard to make changes -- especially positive and healthful ones -- when you are feeling down. It is much easier to settle in on the couch and get lost in mindless TV than to go out for a walk or join a team, but you have to push yourself, he says. Create an obligation, he says. Sign up for a gym with a friend. For further motivation, reward your new habit by doing something that you like afterward. Get plugged back in to life, Bea says. Maybe even revisit something that you loved to do as a child, as a way to kick -start your engine. Be creative. Think about the things that you loved at different times in life, he says. You likely didnt start feeling like this overnight, so it may take a while to get back in the game

Depression: Taking Steps to Feel Better When youre depressed, its OK to behave as if you are enthused and stop saying how difficult everything is, Bea says. Although lifestyle changes and picking up an old hobby can help, sometimes its simply not enough. Medication and counseling are also part of the solution, adds Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital in New York C ity. If you are in therapy and things are getting worse, this is an indication that you should consider medication. Depression: Getting Support You may already be on medication and still not feel like your usual self. If thats the case, talk to your doctor if your current medications and treatment plan arent working. Sometimes more aggressive therapy is needed even if you are on medicine already, says Bruno. Other options to help you cope with depression include: Finding a depression support group. It can help to talk with others who are experiencing similar challenges. Connecting online with other people who have depression. Spending time with friends instead of being isolated and feeling alone. Keeping a journal to help you monitor your moods and sharing it with your doctor. Getting active. If you dread the thought of going to a gym -- and many people who feel depressed do -- consider trying a yoga class or taking a walk in the park to boost endorphins.

You dont have to pretend that you feel good when youre depressed. Talking to your doctor about ways to manage your depression -and being honest about how youre functioning -- can go a long way in feeling better long-term.

Recognizing and Treating Depression Depression: Coping With Anxiety Symptoms Depression and anxiety often go together. WebMD Feature By R. Morgan Griffin Reviewed By Laura J. Martin, MD Depression and anxiety might seem like opposites, but they often go together. More than half of the people diagnosed with depression also have anxiety. Either condition can be disabling on its own. Together, depression and anxiety can be especially hard to live with, hard to diagnose, and hard to treat. When youre in the grip of depression and anxiety, it can feel like the misery will never end, that youll never recover, says Dean F. MacKinnon, MD, an associate professor at the Johns Hopkins Hospital in Baltimore. But people do recover. You just need to fi nd the right treatment. The Symptoms of Depression and Anxiety

Depression can make people feel profoundly discouraged, helpless, and hopeless. Anxiety can make them agitated and overwhelmed by physical symptoms -- a pounding heart, tightness in the chest, and difficulty breathing. People diagnosed with both depression and anxiety tend to have

More severe symptoms More impairment in their day-to-day lives More trouble finding the right treatment A higher risk of suicide

Tips for Depression and Anxiety Treatment Depression and anxiety can be harder to treat than either condition on its own. Getting control might take more intensive treatment and closer monitoring, says Ian A. Cook, MD, the director of the Depression Research Program at UCLA. Here are some tips. 1. Give medicine time to work. Many antidepressants also help with anxiety. You might need other medicines as well. It could take time for the drugs to work -- and time for your doctor to find the ideal medicines for you. In the meantime, stick with your treatment and take your medication as prescribed. Put effort into therapy. Although many types of talk therapy might help, cognitive behavioral therapy has the best evidence for treating anxiety and depression. It helps people identify and then change the thought and behavior patterns that add to their distress. Try to do your part: the benefit youll get from therapy is directly related to the work you put into it. Make some lifestyle changes. As your treatment takes effect, you can do a lot on your own to reinforce it. Breathing exercises, muscle relaxation, and yoga can help. So can the basics, like eating well, getting enough sleep, and exercising. The key is to figure out ways of integrating better habits into your life -- something that you can work on with your therapist. Get a second opinion. When they're combined, depression and anxiety can be hard to diagnose. It's easy for a doctor to miss some of your symptoms -- and as a result, you could wind up with the wrong treatment. If you have any doubts about your care, it's smart to check in with another expert. Focus on small steps. If youre grappling with depression and anxiety, making it through the day is hard enough. Anything beyond that might seem impossible. Changing your behavior can seem overwhelming, Cook says. I encourage people to make small, manageable steps in the right direction. Over time, small changes can give you the confidence to make bigger ones. Be an active partner in your treatment. There are many good ways to treat depression and anxiety. But they all hinge on one thing: a good relationship with your healthcare providers. Whether you see a GP, psychiatrist, psychologist, or social worker -- or a combination -- you need to trust one another and work as a team.

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You Can Start Feeling Better: 8 Important Things to Do About Depression Is It Depression or Just the Blues? Sooner or later, everyone gets the blues. Feeling sadness, loneliness, or grief when you go through a difficult life experience is part of being human. And most of the time, you can continue to function. You know that in time you will bounce back, and you do. But what if you dont bounce back? What if your feelings of sadness linger, are excessive, or interfere with your work, sleep, or recreation? What if youre feeling fatigue or worthlessness, or experiencing weight changes along with your sadness? You may be experiencing major depression. Also known as clinical depression, major depressive disorder, or unipolar depression, major depression is a medical condition that goes beyond lifes ordinary ups and downs. Almost 18.8 million American adults experience depression each year, and women are near ly twice as likely as men to develop major depression. People with depression cannot simply pull themselves together and get better. Treatment with counseling, medication, or both is key to recovery. Major Depression: What Are the Symptoms? Depression shows itself in different ways. Common depression symptoms are:

Depressed mood, sadness, or an empty feeling, or appearing sad or tearful to others Loss of interest or pleasure in activities you once enjoyed Significant weight loss when not dieting, or significant weight gain (for example, more than 5% of body weight in a month) Inability to sleep or excessive sleeping Restlessness or irritation (irritable mood may be a symptom in children or adolescents too), or feelings of dragging Fatigue or loss of energy

Feelings of worthlessness, or excessive or inappropriate guilt Difficulty thinking or concentrating, or indecisiveness Recurrent thoughts of death or suicide without a specific plan, or a suicide attempt or specific plan for committing suicide

Depression Treatment: When Should You Get Help? If you have five or more of these symptoms for most of the day, nearly every day, for at least two weeks, and the symptoms are severe enough to interfere with your daily activities, you may have major depression. Its important to talk to your doctor about tr eatments to start helping you feel better

Recognizing and Treating Depression Common Causes of Depression If you're depressed, it might not be easy to figure out why. In most cases, depression doesn't have a single cause. Instead, it results from a mix of things -- your genes, events in your past, your current circumstances, and other risk factors. Here are a few of the things that can play a role in depression.

Biology. We still don't know exactly what happens in the brain when people become depressed. But studies show that certain parts of the brain don't seem to be working normally. Depression might also be affected by changes in the levels of certain chemicals in the brain, called neurotransmitters. Genetics. Researchers know that if depression runs in your family, you have a higher chance of becoming depressed. Gender. Studies show that women are about twice as likely as men to become depressed. No one's sure why. The hormonal changes that women go through at different times of their lives may be a factor. Age. People who are elderly are at higher risk of depression. That can be compounded by other factors -- living alone and having a lack of social support. Health conditions. Conditions such as cancer, heart disease, thyroid problems, chronic pain, and many others increase your risk of becoming depressed. Trauma and grief. Trauma, such as violence or physical or emotional abuse -- whether it's early in life or more recent -- can trigger depression. Grief after the death of a friend or loved one is in itself a normal emotion, but like all forms of loss can sometimes lead to depression. Changes and stressful events. It's not surprising that people might become depressed during stressful times -- such as during a divorce or while caring for a sick relative. Yet even positive changes -- like getting married or starting a new job -- can sometimes trigger depression. Medications and substances. Many prescription drugs can cause symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.

Some people have a clear sense of why they become depressed. Others don't. The most important thing to remember is that depression is not your fault. It's not a flaw in your character. It's a disease that can affect anyone -- and regardless of the cause, there are many good ways to treat it.

You Can Start Feeling Better: 8 Important Things to Do About Depression What's Stopping You From Seeing a Doctor About Depression? Common reasons people avoid treatment and expert advice on how to get past them. WebMD Feature By Mary Anne Dunkin Reviewed By Joseph Goldberg, MD

Are you struggling with depression? Are you getting treatment for it? If not, youre not alone. About two -thirds of people with major depression never seek appropriate treatment, and the consequences can be devastating: personal suffering, missed work, broken marriages, health problems and, in the worst cases, death. The World Health Organization ranks depression as one of the worlds most disabling diseases. Yet with treatment, 70% of peop le with clinical depression can improve, often in a matter of weeks. So what keeps us from seeking help? Its hard to find out from folks why they are not coming [for treatment], because if the y are not coming, they cant tell us, says Kate Muller, PsyD. But when they do finally get to our offices, t hey can certainly speak about the things that might have kept them from coming initially. Major Depression: Reasons Why People Avoid Treatment If you feel depressed and are trying to deal with it on your own, see if any of these reasons ring true to you. If they do, then follow the experts advice to get the help you need. If I give it time, Ill snap out of it. Although a case of the blues passes with time, clinical depression may linger indefinitely if not treated, says Erik Nelson, MD. People cant just snap out of being depressed. Sometimes depression has a biological cause. And like other medical conditions, it often requires treatment to control or heal it. Waiting for depression to simply pass can be harmful for a number of reasons. For one, depression that goes untreated may become more severe, Nelson says. The longer the delay in treatment, the more difficult it may be to control, and the more likely it is to recur when treatment is stopped. There also is growing evidence that untreated depression can contribute to or worsen other medical problems. Heart disease is the one that has been most linked to depression, but research also suggests a link between depression and m etabolic issues such as obesity, diabetes, and diseases such as Alzheimers and cancer, Nelson says. Expert advice: Dont allow depression to linger. Speak to your doctor. If you find it difficult to seek treatment for a mental disorder, remember that treatment for it may help prevent serious health conditions like heart disease. I dont want to take antidepressants. Sometimes I think what keeps people from coming in to see us is that theyre afraid theyll have to take a pill, Muller says. They think, I dont want to take a pill for the rest of my life. Although antidepressants are effective against depression, treatment for depression doesnt always involve medication. We have psychotherapies these days that are as effective, so if you are depressed, medication may not be the only option, Muller say s.

Cognitive-behavioral therapy is a form of talk therapy that focuses on the here and now -- helping you look at your emotions, thoughts, and behaviors to try to improve your quality of life and reduce your depression, she says. We know that it may work as well as medications in the short term, but may also last longer. Expert advice: See a therapist (psychologist, psychiatrist, or social worker) as well as your regular doctor. If you do need a medication, it most likely wont be for life. Learn all you can and dont rely on stories you have heard from others who have taken antidepressants, Muller says. Every person reacts a little differently to them. I don't feel sad all the time. Why do I need treatment for depression? You dont need to feel sad or cry all day to be clinically depressed. Often people with depression see their primary care doctors for problems such as muscle pain, sleeping problems, or fatigue, not knowing those are signs of depression, Nelson says. Sometimes these symptoms accompany sadness; other times they dont. There is also so-called masked depression -- when, for whatever reason, people dont feel in touch with a sense of sadness or abnormal mood, he says. They may be more likely to report something like apathy, blunted mood, or not feeling like themselves. In these cases, a doctor may diagnose depression based on other symptoms, particularly decreased interest in or loss of pleasure from favorite activities. Expert advice: If you are having symptoms such as fatigue, muscle pain, or loss of interest in activities you love, dont rule out depression as a cause. See your doctor. Im embarrassed to talk to my doctor about it. The shame of having a mental health problem keeps folks from seeking help or even talking about suffering from depression, says Bob Livingstone, author of The Body Mind Soul Solution: Healing Emotional Pain

Through Exercise. But depression is nothing to be ashamed of. It is a medical condition, much like diabetes or high cholesterol, which requires treatment. It is also a very common condition. Depressive disorders affect nearly 19 million people in the U.S. every year -- regardless of gender, age, race, religion, sexuality, income, or education. So theres a good chance your doctor wont hear anything from you that she hasnt heard many times before. Expert advice: Remember that virtually everyone experiences depression at some point, and your doctor will not repeat anything that you share during an office visit. Still, if speaking to your own doctor is embarrassing, find out if your health insurance has someone you can speak with first by phone. If you dont have insurance coverage for mental health, check out mental health services in your c ommunity. Im afraid of having to talk about painful subjects in therapy. Depressed people avoid treatment for fear of having to undergo a probing examination of their psychological pain, says Joe Wegmann, a licensed clinical social worker in Metairie, La. They have a fear of opening it all up -- I dont want to go there, Kate Muller says. Unfortunately, in some cases, getting into painful discussions is necessary for healing, she says. But in other cases, it doesnt have to be as deep or scary as you might thin k. A good therapist understands what is like for someone to open up to a stranger and will guide you through that process. He wont push you to open up too quickly or at a level you are not comfortable with. Expert advice: Find a therapist you feel comfortable with and ask him as many questions as he asks you, Muller says. Find out what therapy will be like. Although painful discussions may be necessary in time, your therapist cannot force you. What you reveal is up to you. Breaking the Depression Cycle Next Article:

Your Depression Triggers How to manage situations that trigger your depression and feel good every day.

Understanding Depression Disguises Many people think of depression as an intolerable sadness or a deep gloom that just won't go away. Yet depression can also be sneaky, disguised in symptoms that can be hard to identify. If you've had unexplained aches or pains, often feel irritable or angry for no reason, or cry at the drop of a hat -- you could be depressed. Fortunately, you can be proactive with depression. Learn how these less obvious symptoms can reveal themselves and when you should seek out depression treatment. Common Depression Symptoms Common symptoms of depression include feeling sad, hopeless, or empty or having lost interest in the things that previously gave you pleasure. But other, less obvious symptoms also may signal depression, including:

Anger, irritability, and impatience. You may feel irritated and angry at family, friends, or co-workers, or overreact to small things. Sleep problems. You may have trouble sleeping, or you may wake up very early in the morning. Or you may sleep too much and find it hard to get up in the morning. Anxiety. You may have symptoms such as anxiety, worry, restlessness, and tension. Anxiety and depression often occur together, even though they are two separate problems. Crying. Crying spells, crying over nothing at all, or crying about small things that normally wouldn't bother you may be signs of depression. Inability to concentrate. If you are depressed, you may be forgetful, have trouble making decisions, or find it hard to concentrate. Pain. If you have aches and pains that don't respond to treatment, including joint pain, back pain, limb pain, or stomach pain, they could be signs of depression. Many people with depression go to their doctor because of these types of physical symptoms, and don't even realize that they are depressed. Substance abuse. Having a drug or alcohol problem may hide an underlying problem with depression. Substance abuse and depression often go hand in hand. Appetite changes. You may have no desire to eat, or you may overeat in an effort to feel better. Isolation. You may feel withdrawn from friends and family -- right when you need their support the most.

Depression Symptoms: Men and Women May Differ Not everyone has the same signs and symptoms of depression. In fact, men and women may experience depression differently. Women more often describe feeling sad, guilty, or worthless when they are depressed. Men are more likely to feel tired, angry, irritable, and frustrated, and they often have more sleep problems. A man may feel less interested in hobbies, activities, and even sex. He may focus excessively on work in order to avoid talking with friends and family about how he feels. Men also may be more likely to behave recklessly and use drugs or alcohol to deal with depression. Some men with depression can become abusive. More women attempt suicide than men do, but men are more likely to succeed -- almost four times as many men die from suicide as do women. Many men do not acknowledge feelings or symptoms of depression. They don't want to admit that something may be wrong or talk about their feelings. But men and women can both feel better with treatment. Depression Symptoms: When to Seek Treatment It can be hard to admit to yourself that you may be depressed, let alone ask for help. Here are two good reasons why you should consider depression treatment:

Treatment works. Even people with severe depression can find relief, and so can you. Early treatment is better. As with many other health problems, getting treatment early on can ease symptoms more quickly. If you wait to get help, your depression can become more severe and harder to treat.

Talk to someone. There are many people willing to help you overcome depression, but the first step you have to take on your own is to let someone know how you are feeling. It may help to start by talking to a close friend or family member. Ask them for support in finding depression treatment. The sooner you get treatment, the sooner you will start to feel better. Don't hesitate -- call your doctor or a medical health professional if:

You think you may be depressed You notice symptoms of depression such as sadness, hopelessness, or emptiness, or if you have less obvious symptoms such as trouble sleeping or vague aches and pains Depression symptoms make it hard to function

If you have thoughts about dying or committing suicide, seek immediate medical help. You may feel hopeless now, but treatment will give you hope -- and help you see that life is worth living. Depression Treatment: Give it Time to Work Certain medications and medical conditions such as thyroid problems can cause symptoms of depression, so your doctor may want to rule them out. If your doctor thinks you may be depressed, he or she can refer you to a mental health professional. Depression treatment involves either antidepressant medication, psychotherapy, or both. People with mild to moderate depression can benefit from therapy alone. People with more severe depression usually do better with medication and therapy. Note that once you start treatment, you may notice improvements in symptoms such as sleep or appetite before begin to you feel less depressed. Antidepressants work by affecting brain chemicals called neurotransmitters that regulate mood. Antidepressants effectively treat depression in most people who take them. However, they can take four to six weeks to notice an effect, so it's important to be patient. Antidepressants can also have side effects, including weight gain and sexual problems. So it may take some time to find the right medication that works best for you with the fewest side effects. Psychotherapy treats depression by helping you:

Learn new, more positive ways of thinking Change habits or behaviors that may make your depression worse Work through relationship problems at home or work Help you see things in a more realistic way and face your fears Help you feel hopeful, positive, and more in control of your life

It can take time to break old patterns of thinking and behavior, so give therapy some time to work.

Depression Treatment: How to Help Yourself In addition to the help and support you get from your therapist and/or doctor, there are a few things you can do on your own that will help you feel better:

Stay physically active. Exercise helps boost your mood, and research has shown that it may also help ease depression. Get a good night's sleep. Sleep helps us heal from many health problems, including depression. Getting the right amount of sleep, but not too much, helps you have more energy. Try to go to sleep and get up at the same time every day. Make your bedroom a comfortable place for sleeping and sex only -- banish TV and use curtains to keep out bright outdoor light. Stay connected. Spending time with supportive friends or family will make you feel better -- even if you don't feel like it will. It may help to choose low-key ways to connect. Go to a light-hearted movie, meet for a coffee and some people watching, or take a walk in a nearby park. The contact you get from others, along with depression treatment, can help bring you out of the dark and back into the light.

How Well Do You Function When Depressed? (continued) Depression: Taking Steps to Feel Better When youre depressed, its OK to behave as if you are enthused and stop saying how difficult everything is, Bea says. Although lifestyle changes and picking up an old hobby can help, sometimes its simply not enough. Medication and counseling are also part of the solution, adds Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital in New York City. If you are in therapy and things are getting worse, this is an indication that you should consider medication. Depression: Getting Support You may already be on medication and still not feel like your usual self. If thats the case, talk to your doctor if your cur rent medications and treatment plan arent working. Sometimes more aggressive therapy is needed even if you are on medicine already, says Bruno. Other options to help you cope with depression include:

Finding a depression support group. It can help to talk with others who are experiencing similar challenges. Connecting online with other people who have depression. Spending time with friends instead of being isolated and feeling alone. Keeping a journal to help you monitor your moods and sharing it with your doctor. Getting active. If you dread the thought of going to a gym -- and many people who feel depressed do -- consider trying a yoga class or taking a walk in the park to boost endorphins.

You dont have to pretend that you feel good when youre depressed. Talking to your doctor about ways to man age your depression -and being honest about how youre functioning -- can go a long way in feeling better long-term. Let Your Pet Nuzzle Blues Away Sometimes your pet really can be your best friend -- and that's good therapy. When you play with your pet, you take your mind off your problems. Also, when you take care of your pet you're fulfilling a commitment to something outside yourself. Caring for others can be very therapeutic. Eat Smart to Lift Mind and Body There's a connection between mind and body. Although there is no specific diet that works for depression, a healthy diet can be part of an overall treatment plan. Build your diet around plenty of fruits, vegetables, and whole grains to help boost your physical and emotional health. Choose Foods to Boost Your Mood

Some studies suggest omega-3 fatty acids and vitamin B12 -- especially for people for may not get enough of these nutrients -- may ease the mood changes that are part of depression. Fatty fish such as salmon, tuna, and mackerel contain omega-3 fatty acids. So do flaxseed, nuts, soybeans, and dark green vegetables. Seafood and low-fat dairy products are sources of B12. Vegetarians who eat no meat or fish can get B12 in fortified cereals, dairy products, and supplements. Try Low-Fat Carbs for a Pick-Me-Up Serotonin is a brain chemical that enhances your sense of well-being. Carbohydrates raise the level of serotonin in your brain. Low-fat carbs such as popcorn, a baked potato, graham crackers, or pasta are options. Vegetables, fruit, and whole grain options also provide fiber. Drink Less Caffeine to Improve Mood Do you really need that third cup of coffee? Anxiety can accompany depression. And too much caffeine can make you nervous, jittery, or anxious. While possible links between caffeine and depression haven't been definitively established, cutting back on caffeinated drinks may help lower your risk of depression and improve sleep. Treat Your Aches and Pains Feelings of depression can be related to pain. Work with your health care team to treat your depression and your pain. Exercise to Change the Way You Feel For some people, exercise works as well or even better than antidepressants. And you don't have to run a marathon. Just take a walk with a friend. As time goes on, increase activity until you exercise on most days. You'll feel better physically, sleep better at night, and improve your mood. Choose an Exercise You Enjoy If you dont like to run, you won't last long training for a marathon. But you will stay with a moderate exercise you en joy. For instance, try walking, golfing without a cart, riding a bike, working in your garden, playing tennis, or swimming. The important thing is to pick something you like. Then you'll look forward to it and feel better when you do it. Exercise With Others for Support Staying connected with other people helps overcome the lethargy, exhaustion, and loneliness of depression. Join an exercise group or exercise with a friend. You'll stay connected. And you'll have support to help you stay on track! Be Sure You Get Enough Sunlight Do you feel more depressed during darker, cold months? You may have seasonal affective disorder, or SAD. SAD is most common in the winter, when there's less sunlight. SAD can be treated with light therapy or exposure to artificial sunlight, antidepressants, and psychotherapy. Explore Your Creativity Painting, photography, music, knitting, or writing in a journal: These are all ways people explore their feelings and express what's on their mind. Being creative can help you feel better. The goal isn't to create a masterpiece. Do something that gives you pleasure. It may help you better understand who you are and how you feel. Make Time for Mindful Relaxation Stress and anxiety can increase your depression symptoms and make it harder to recover. Learning to mentally relax can help restore a sense of calm and control. You might consider a yoga or meditation class. Or you could simply listen to soothing music while you take a long, hot bath Become Actively Involved

Being involved with others can help you regain a sense of purpose. And it doesn't take much to get started. Try volunteering with a charity. Or join a discussion group at the library or at church. Meeting new people and doing new things will help you feel good about yourself. Keep Friends and Family in Your Life The people who love you want to support you. If you shut them out, they can't. If you let them in, you'll feel a lot better. Call a friend and go for a walk. Have a cup of coffee with your partner. You may find it helps to talk about your depression. It feels good to have someone listen. Get the Healthy Sleep You Need Depression interferes with healthy sleep. Some people with depression sleep too much. Others can't fall asleep easily. As you recover from depression, relearn good sleep habits. Start by going to bed and getting up the same time each day. Use relaxation techniques to help you fall asleep. Healthy sleep makes you feel better physically and mentally. Avoid Alcohol and Drugs Alcohol and drugs can slow or prevent recovery from depression. They can also make your depression worse and interfere with the medicines you take for depression. If you have a problem with substance abuse, ask for help now. You'll have a far better chance of recovering from depression. Continue Your Treatment The steps outlined in these slides may help you feel positive about your life. But alone, they're not enough. They won't replace medical treatment or talk therapy. Depression is a serious illness, and it carries a risk of suicide. If you are thinking about suicide, seek help immediately. And never stop or change treatment without discussing it carefully with your doctor. How Can Diet Affect Depression?

Here are 10 tips for eating if you or a loved one is recovering from clinical depression. 1. Eat a Diet High in Nutrients

Nutrients in foods support the body's repair, growth, and wellness. Nutrients we all need include vitamins, minerals, carbohydrates, protein, and even a small amount of fat. A deficiency in any of these nutrients lead to our bodies not working at full capacity -- and can even cause illness. 2. Fill Your Plate With Essential Antioxidants

Damaging molecules called free radicals are produced in our bodies during normal body functions -- and these free radicals contribute to aging and dysfunction. Antioxidants such as beta-carotene and vitamins C and E combat the effects of free radicals. Antioxidants have been shown to tie up these free radicals and take away their destructive power.

Studies show that the brain is particularly at risk for free radical damage. Although there's no way to stop free radicals completely, we can reduce their destructive effect on the body by eating foods rich in antioxidants as part of a healthy diet, including:

Sources of beta-carotene: apricots, broccoli, cantaloupe, carrots, collards, peaches, pumpkin, spinach, sweet potato.

Sources of vitamin C: blueberries, broccoli, grapefruit, kiwi, oranges, peppers, potatoes, strawberries, tomato. Sources of vitamin E: margarine, nuts and seeds, vegetable oils, wheat germ.

3. Eat "Smart" Carbs for a Calming Effect

The connection between carbohydrates and mood is linked to the mood-boosting brain chemical, serotonin. Carbohydrate craving may be related to decreased serotonin activity, although experts are not sure if there is a link.

So don't shun carbs -- just make smart choices. Limit sugary foods and opt for smart carbs, such as whole grains, fruits, vegetables, and legumes, which all contribute healthy carbs as well as fiber. 4. Eat Protein-Rich Foods to Boost Alertness

Foods rich in protein, like turkey, tuna, or chicken, are rich in an amino acid called tyrosine. Tyrosine may help boost levels of the brain chemicals dopamine and norepinephrine. This boost helps you feel alert and makes it easier to concentrate. Try to include a protein source in your diet several times a day, especially when you need to clear your mind and boost your energy.

Good sources of healthy proteins: beans and peas, lean beef, low-fat cheese, fish, milk, poultry, soy products, yogurt. 5. Eat a Mediterranean-Type Diet The Mediterranean diet is a balanced, healthy eating pattern that includes plenty of fruits, nuts, vegetables, cereals, legumes, and fish. A Spanish study, using data from 4,211 men and 5,459 women, found that rates of depression tended to increase in men -- especially smokers -- as folate intake decreased. The same increase occurred for women -- especially those who smoked or were physically active -but with a decreased intake of another B-vitamin: B12. This wasn't the first study to discover an association between these two vitamins and depression. Researchers wonder whether poor nutrient intake leads to depression or whether depression leads people to eat a poor diet. Folate is found in Mediterranean diet staples like legumes, nuts, many fruits, and particularly dark green vegetables. B12 can be found in all lean and low-fat animal products, such as fish and low-fat dairy products.

6. Get Plenty of Vitamin D A 2010 national study found that the likelihood of having depression is higher in people with deficiency in vitamin D compared to people who are sufficient in vitamin D. In another study, researchers from the University of Toronto noticed that people who were suffering from depression, particularly those with seasonal affective disorder, tended to improve as their levels of vitamin D in the body increased over the normal course of a year. Vitamin D receptors are found in the brain. Researchers, though, are unsure how much vitamin D is ideal. 7. Select Selenium-Rich Foods Selenium is a mineral that is essential to good health. Studies have reported an association between low selenium intake and poorer moods, although evidence isn't conclusive on whether supplementation can help.

It is possible to take in too much selenium so that it becomes toxic. But this is unlikely if you're getting it from foods rather than supplements, and it can't hurt to make sure you're eating foods that help you meet the recommended intake for selenium, which is 55 micrograms a day for adults. The good news is that foods rich in selenium are foods we should be eating anyway. They include:

Beans and legumes Lean meat (lean pork and beef, skinless chicken and turkey) Low-fat dairy products Nuts and seeds (particularly brazil nuts) Seafood (oysters, clams, sardines, crab, saltwater fish, and freshwater fish) Whole grains (whole-grain pasta, brown rice, oatmeal, etc.)

8. Include Omega-3 Fatty Acids in Your Diet We know that omega-3 fatty acids have innumerable health benefits. Recently, scientists have revealed that a deficit of omega-3 fatty acids is associated with depression. In one study, researchers determined that societies that eat a small amount of omega-3 fatty acids have a higher prevalence of major depressive disorder than societies that get ample omega-3 fatty acids. Other studies show that people who infrequently eat fish, which is a rich source of omega-3 fatty acids, are more likely to suffer from depression.

Sources of omega-3 fatty acids: fatty fish (anchovy, mackerel, salmon, sardines, shad, and tuna), flaxseed, and nuts. Sources alpha-linolenic acid (another type of omega-3 fatty acid): flaxseed, canola oil, soybean oil, walnuts, and dark green leafy vegetable 9. Watch Your Lifestyle Habits Many people who are depressed also have problems with alcohol and/or drugs. Not only can alcohol and drugs interfere with mood, sleep, and motivation, they can also affect the effectiveness of your depression medications. In addition, drinks and foods containing caffeine can trigger anxiety and make it difficult to sleep at night. Cutting out caffeine or stopping caffeine after noon each day can also help you get a better night's sleep. 10. Stay at a Healthy Weight Findings published in the journal of Clinical Psychology: Science and Practice, show a link between obesity and depression, indicating that people who are obese may be more likely to become depressed. In addition, according to this study, people who are depressed are more likely to become obese. Researchers believe the link between obesity and depression may result from physiological changes that occur in the immune system and hormones with depression. If you have a weight problem, talk with your doctor about healthy ways to manage it with diet and exercise.

HIPRICO - HIERBA DE SAN JUAN - PERICN - CORAZONCILLO FRANCS: Millepertuis ALEMN: Johanniskraut INGLS: St. John's wort ITALIANO: Iperico Latn: Hypericum perforatum L. (Hipericceas) CARACTERSTICAS DE LA HIERBA DE SAN JUAN: Planta herbcea de base leoso con ramas erectas de 25-60 cm. Hojas opuestas, pequeas, oblongas provistas de numerosas glndulas fcilmente observables al trasluz. Flores vistosas, amarillas, reunidos en panculas densas, con numerosos estambres ramificados reunidos en tres fascculos. Fruto en cpsula ovoide con tres valvas. ORIGEN Y DISTRIBUCIN DE LA HIERBA DE SAN JUAN: Euroasitica y norteafricana, en mrgenes y bordes de caminos. Naturalizado en la mayor parte del mundo templado. DROGA: Sumidad florida. PRINCIPIOS ACTIVOS DE LA HIERBA DE SAN JUAN:

Aceite esencial (0,1-0,5 %): Monoterpenos. Sesquiterpenos.

Hidrocarburos. Alcohole. xidos terpnicos. Cetonas Flavonoides. Flavanoles. Xantonas. Acidos fenil-carboxlicos: cafico, clorognico, gentsico, ferlico. Carotenoides. Derivados del floroglucinol. Taninos catquicos (10-12 %). 1

EFECTOS DE LA HIERBA DE SAN JUAN:

Cicatrizante en uso externo. Antimicrobiana. Fotosensibilizante (hipericina). Antiviral (naftodiantronas, aceite esencial). Antidepresivo, inhibidor de la MAO, ligeramente sedante. Vasoprotector capilarotropo (flavonoles). Vasodilatador perifrico y coronario (procianidinas). Hidrocolertico (aceite esencial, cidos fenlicos.

APLICACIONES DE LA HIERBA DE SAN JUAN: Ansiedad, insomnio, depresiones ligeras y moderadas, sndrome del intestino irritable, enuresis nocturna infantil, terrores nocturnos. Heridas, llagas, quemaduras, grietas mamarias, infecciones dermatolgicas (acn) y ORL. CONTRAINDICACIONES DE LA HIERBA DE SAN JUAN: Embarazo, por su ligera accin tero-tnica. USO TERAPETICO Y DOSIS DE LA HIERBA DE SAN JUAN:

Infuso al 3%, 3 tazas al da. Extracto fluido: 20-40 gotas, 3 veces al da. Extracto seco (5:1): 300-800 mg/da, repartidos en 2-3 tomas. Uso tpico: oleato ol 20 %, extractos hidrogliclicos (entre el 5-10%), aplicados en forma de toques, cremas, gel, lociones etc.

EFECTO TXICO DE LA HIERBA DE SAN JUAN: Debe manejarse con precaucin por su contenido en principios fito fotosensibilizantes: La exposicin al sol de las zonas tratadas puede originar quemaduras, ya que lo hipericina es un potente agente fototxico. OBSERVACIONES: El extracto hidroalcohlico de hiprico produjo, en estudio a doble ciego, un importante efecto hipotensor ante hipertensiones moderadas o severas. La accin antibacteriana es especialmente activa frente a Stophylococcus aureus, Bordetello pertussis, Escherichio coli y Shigello sp. pl. Se comprob que lo hipericina, in vitro, inactiva el virus VIH-1, pero este efecto slo se manifiesta en presencia de luz, o a dosis altas, prximas a las citotxicas. Los extractos de hiprico confieren un efecto radioprotector frente a los rayos X

Causes of Depression Have you ever wondered what causes clinical depression? Perhaps you have been diagnosed with major depression, and that's made you question why some people get depressed while others don't.

Depression is an extremely complex disease. It occurs for a variety of reasons. Some people experience depression during a serious medical illness. Others may have depression with life changes such as a move or the death of a loved one. Still others have a family history of depression. Those who do may experience depression and feel overwhelmed with sadness and loneliness for no known reason. What Are the Main Causes of Depression?

There are a number of factors that may increase the chance of depression, including the following:

Abuse. Past physical, sexual, or emotional abuse can cause depression later in life. Certain medications. For example, some drugs used to treat high blood pressure, such as beta-blockers or reserpine, can increase your risk of depression. Conflict. Depression may result from personal conflicts or disputes with family members or friends. Death or a loss. Sadness or grief from the death or loss of a loved one, though natural, can also increase the risk of depression. Genetics. A family history of depression may increase the risk. It's thought that depression is passed genetically from one generation to the next. The exact way this happens, though, is not known. Major events. Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring. Other personal problems. Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression. Serious illnesses. Sometimes depression co-exists with a major illness or is a reaction to the illness. Substance abuse. Nearly 30% of people with substance abuse problems also have major or clinical depression.

How Is Biology Related to Depression? Researchers have noted differences in the brains of people who are depressed as compared to people who are not. For instance, the hippocampus, a small part of the brain that is vital to the storage of memories, appears to be smaller in people with a history of depression than in those who've never been depressed. A smaller hippocampus has fewer serotonin receptors. Serotonin is a calming brain chemical known as a neurotransmitter that allows communication between nerves in the brain and the body. It's also thought that the neurotransmitter norepinephrine may be involved in depression. Scientists do not know why the hippocampus is smaller in those with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or poisonous effect on the hippocampus. Some experts theorize that depressed people are simply born with a smaller hippocampus and are therefore inclined to suffer from depression. One thing is certain -- depression is a complex illness with many contributing factors. The latest scans and studies of brain chemistry that show the effects of antidepressants help broaden our understanding of the biochemical processes involved in depression. As scientistsgain

a better understanding of the cause(s) of depression, health professionals will be able to make better "tailored" diagnoses and, in turn, prescribe more effective treatment plan How Is Genetics Linked to the Risk of Depression? We know that depression seems to run in families. This suggests that there's a genetic link to depression. Children, siblings, and parents of people with severe depression are much more likely to suffer from depression than are members of the general population. Multiple genes interacting with one another in special ways probably contribute to the various types of depression that run in families. Yet despite all the evidence of a family link to depression, scientists still have not been able to identify a "depression" gene. Depression, the Thyroid, and Hormones The thyroid gland produces and regulates hormones. These hormones can affect energy levels, mood, even weight. They can also be factors in depression. Read on to find out what causes thyroid-related depression and how it's treated. What Are Hormones? Hormones are substances produced by the endocrine glands that have a tremendous effect on bodily processes. The glands in the endocrine system influence growth and development, mood, sexual function, reproduction, and metabolism. What Do Hormones Have to Do With Depression? Levels of hormones, such as those produced by the thyroid gland, can be factors in depression. In addition, some symptoms of depression are associated with thyroid conditions. The same is true about conditions related to the menstrual cycle, such as premenstrual syndrome (PMS), perimenopause, and menopause. Because there is this connection between depression symptoms and other medical conditions, blood tests are often ordered to avoid a misdiagnosis. It is important to note that you can have both depression and thyroid conditions at the same time. It is also possible to have depression and menstruation-related symptoms. What Are Some Types of Thyroid Conditions? Thyroid gland hormones can affect food metabolism, mood, and sexual function. When the thyroid produces too much hormone, the body uses energy faster than it should. This condition, overactive thyroid, is called hyperthyroidism. Symptoms that may indicate hyperthyroidism include:

enlarged thyroid gland inability to tolerate heat infrequent, scant menstrual periods irritability or nervousness muscle weakness or tremors sleep disturbances vision problems or eye irritation weight loss When the thyroid gland does not produce enough hormone, the body uses energy at a slower pace than it should. This condition, underactive thyroid, is called hypothyroidism. Symptoms that may indicate hypothyroidism include:

dry, coarse skin and hair fatigue forgetfulness frequent, heavy menstrual periods hoarse voice inability to tolerate cold weight gain enlargement of the thyroid gland (goiter) Some of these symptoms -- fatigue, irritability, weight changes, and sleep problems -- are symptoms that may also indicate depression. Your doctor may order blood tests to determine levels of certain hormones, including: thyroid stimulating hormone (TSH, which is released by the pituitary gland) triiodothyronine (T3) thyroxine (T4) What Causes Thyroid Disease? There are many different reasons why either hyperthyroidism or hypothyroidism might develop. Currently, about 20 million Americans have some form of thyroid disease. People of all ages and races can get thyroid disease. Some babies born with a non-functioning thyroid gland may have thyroid disease from the beginning of life. Women are five to eight times more likely than men to have thyroid problems. Hypothyroidism may be caused by: thyroiditis, an inflammation of the thyroid gland that can affect the level of thyroid hormone production Hashimoto's thyroiditis, a painless and hereditary immune system disease post-partum thyroiditis, which occurs in five to nine percent of women who have given birth and is usually temporary Hypothyroidism can also be a side effect of certain drugs, such as lithium and amiodarone, and by iodine deficiency. The thyroid gland uses iodine to make hormones. Iodine deficiency is not a problem in the United States because of the use of iodized salt. However, iodine deficiency is a problem worldwide. Hyperthyroidism may be caused by: Graves' disease, an enlarged thyroid gland (also called diffuse toxic goiter) nodules that may form in the thyroid and may cause it to be overactive thyroiditis, an inflammation of the thyroid gland that can cause the release of stored hormones (If thyroiditis causes all the hormones to be released, hypothyroidism can follow.) excessive iodine, which might be found in certain drugs and some cough syrups How Is Thyroid Disease Treated? The goal of treatment for any thyroid disorder is to restore normal blood levels of thyroid hormone. Hypothyroidism is treated with the drug levothyroxine or triiodothyronine. Brand names for levothyroxine are Synthroid, Unithroid, Levoxyl, and Levothroid. Levothyroxine is a synthetic hormone that replaces missing thyroid hormone in the body. The brand name for triiodothyronine is Cytomel.

Sometimes the combination of levothyroxine and triiodothyronine is prescribed as two separate pills or, more rarely, as a single pill called liotrix (brand name Thyrolar). Hyperthyroidism is generally more difficult to treat. That's because it requires the normalization of thyroid hormone production. Treatment might involve drug therapy to block hormone output. Or it might involve radioactive iodine treatment to disable the thyroid. Surgery may be used to remove some or all of the thyroid gland. Treatment with radioactive iodine, the most common therapy, often causes hypothyroidism. So levothyroxine is used following treatment in order to normalize hormone levels. What Other Hormone-Related Conditions Are Associated With Depression? First, as noted earlier, women are more likely than men to develop thyroid conditions. Women are also more likely than men to be diagnosed with depression. Because of biology, women are more vulnerable to hormone-induced depression. The process of menstruation involves fluctuations in the levels of estrogen and other hormones. Some women experience depressionrelated symptoms such as sadness, irritability, and fatigue prior to menstruation. These symptoms are part of the premenstrual syndrome, or PMS. A more severe case of emotional problems related to menstruation is known as premenstrual dysphoric disorder (PMDD). When pregnant, women are subject to physical and emotional changes caused in part by changes in hormones. After pregnancy, women experience a huge shift in hormone levels. This shift is a likely cause of the "baby blues," a mild type of depression that immediately follows childbirth and resolves quickly. A more severe form of depression -- post-partum depression -- could also result. When women get older and move out of child-bearing years, they experience changes in hormone levels. These changes happen during perimenopause and menopause. Symptoms that occur during this time of life could include fatigue, sleep disturbances, weight gain, and skin changes. Women who experience symptoms of depression need treatment. Treating depression in mothers is important for both mothers and children. Treatment of hormone-related depression may include the same things that work for depression in general -- talk therapy, strong support networks, and antidepressant medications Alternative Treatments for Depression If you prefer natural therapies, then you might be searching for home remedies for depression. There is no conclusive evidence that any complementary and alternative treatment or home remedy is effective for moderate to severe depression. However, some people with depression may feel that home remedies help cope with the condition. If you have depression and are considering using a complementary and alternative form of therapy, it is important to seek the advice of your health care provider. What Is an Alternative Therapy? A health treatment that is not classified as standard Western medical practice is referred to as complementary and alternative medicine (CAM). CAM encompasses a variety of approaches. They include everything from diet and exercise to mental conditioning and lifestyle changes. Examples of CAM therapies include: Acupuncture Aromatherapy Biofeedback Chiropractic treatments Guided imagery Dietary supplements Hypnosis Massage therapy Meditation Relaxation Yoga Which Herbal Supplements Can Help Depression? There is a wide variety of herbal supplements that people believe can treat many illnesses. For depression, St. John's wort is a common herbal supplement that is used. St. John's wort has been used for medical purposes in other parts of the world for thousands of years. But research findings have been mixed. Using an herbal supplement requires caution and should be taken only after consulting your doctor. This is because supplements could interact with medicines that you are also taking, and use could be dangerous for people with certain conditions. Your doctor can help you weigh the risks and potential benefits. That way, you can make an informed decision. Is Meditation or Yoga Helpful for Depression?

Meditation is sometimes described as an altered state of consciousness. Meditation can help promote relaxation, which has been found to be helpful for depression. There is some evidence to suggest that yoga may be helpful for depression, but the evidence is not conclusive. Yoga involves meditation with physical postures, breathing techniques, and relaxation. Yoga practices vary, and some may not be recommended to people with certain medical conditions. In addition to meditation and yoga, you can use a number of other approaches such as progressive muscle relaxation, guided imagery, or music therapy. How Does Massage Therapy Boost Relaxation? Massage uses touch to help provide relaxation. Most touch therapies are based on the premises that the mind and body are interconnected and that physical health and emotional well-being are closely linked. The belief is that, when the body is relaxed, the mind contributes to better health, less depression, and overall well-being. There are also reports that mind/body exercises used with various types of bodywork can boost feelings of calmness. How Does Exercise Help Ease Depression? Different forms of exercise can lower stress, relax you, and help reduce symptoms of depression. Exercise can also increase your energy, balance, and flexibility. In general, exercise is a safe, effective, and easy way to improve your well-being. Check with your doctor before starting a new program What Is Guided Imagery? Guided imagery is also called visualization. It is a method of communication between body and mind that utilizes perception -- vision, smell, taste, touch -- along with position and movement to produce a relaxation response. Guided imagery involves mentally seeing pictures of relaxing situations, such as a sunset on the beach, a flowing mountain waterfall, or a brilliant mountain sunrise. As you use all your senses during imagery, you will actually make an effort to: Smell the flowers and trees. Feel the breeze or temperature. Feel the texture of the surface under your feet. Hear all the sounds in nature. While some people are better at imagining than others, anyone can master this simple relaxation technique. You can use guided imagery during massage or another touch therapy to boost your relaxation and your feelings of serenity and peacefulness. Much like learning to play the piano or tennis, becoming skilled at guided imagery involves time, patience, and practice. It is one relaxation skill that cannot be rushed or hurried. Can Music Therapy Lift Moods? Music therapy has been shown to be an effective non-drug approach for people of all ages that assists in reducing fear, anxiety, stress, or grief. Music can be thought of as a natural tranquilizer for the human spirit. Pythagoras, the sixth century B.C. philosopher and mathematician, is thought to have been the founder of music therapy. During World War II, the Veterans' Hospitals had volunteers who played their music for the wounded soldiers. The results were so positive that the VA added music therapy programs. In its simplest form, all you need to incorporate music therapy is a CD player or mp3 player with headphones. Then choose music -- from New Age "mood" music to rock to classical -- that matches your personal needs, moods, and tastes. What Is Guided Imagery? Guided imagery is also called visualization. It is a method of communication between body and mind that utilizes perception -- vision, smell, taste, touch -- along with position and movement to produce a relaxation response. Guided imagery involves mentally seeing pictures of relaxing situations, such as a sunset on the beach, a flowing mountain waterfall, or a brilliant mountain sunrise. As you use all your senses during imagery, you will actually make an effort to: Smell the flowers and trees. Feel the breeze or temperature. Feel the texture of the surface under your feet. Hear all the sounds in nature. While some people are better at imagining than others, anyone can master this simple relaxation technique. You can use guided imagery during massage or another touch therapy to boost your relaxation and your feelings of serenity and peacefulness. Much like learning to play the piano or tennis, becoming skilled at guided imagery involves time, patience, and practice. It is one relaxation skill that cannot be rushed or hurried. Can Music Therapy Lift Moods?

Music therapy has been shown to be an effective non-drug approach for people of all ages that assists in reducing fear, anxiety, stress, or grief. Music can be thought of as a natural tranquilizer for the human spirit. Pythagoras, the sixth century B.C. philosopher and mathematician, is thought to have been the founder of music therapy. During World War II, the Veterans' Hospitals had volunteers who played their music for the wounded soldiers. The results were so positive that the VA added music therapy programs. In its simplest form, all you need to incorporate music therapy is a CD player or mp3 player with headphones. Then choose music -- from New Age "mood" music to rock to classical -- that matches your personal needs, moods, and tastes. How Often Should I Exercise to Ease Depression? Try to exercise at least 20 to 30 minutes, three times a week. Studies indicate that exercising four or five times a week is even better. Take it easy if you are just beginning. Start exercising for 20 minutes. Then you can build up to 30 minutes. What Are Some Tips for Getting Started Exercising? When you first start your exercise program, you should plan a routine that is easy to follow and maintain. When you start feeling comfortable with your routine, then you can start varying your exercise times and activities. Here are some tips to help you get started: Choose an activity you enjoy. Exercising should be fun. Put your exercise routine into your schedule. If you need reminding, put it on your calendar. Variety is the spice of life. Make sure you vary your exercises so that you don't get bored. Check your local gymnasium or community center for an assortment of exercise programs. Don't let exercise programs break the bank. Unless you are going to be using them regularly, avoid buying health club memberships or expensive equipment. Stick with it. If you exercise regularly, it will soon become part of your lifestyle and will help reduce your depression. What Should I Do if Exercise Is Painful? Never ignore pain. You may cause stress and damage to your joints and muscles if you continue exercising through pain. If you still feel pain a couple hours after exercising, you have probably overexerted yourself and need to decrease your activity level. If your pain persists or is severe, or if you suspect you have injured yourself, contact your doctor. If you are unable to regularly participate in exercise or athletics, you can also try other tools to help boost your mood. Studies of meditation and massage therapy have demonstrated that these techniques can stimulate endorphin secretion, increase relaxation, and aid in boosting mood