What is the reverse of the coin? There isn’t any! The abundant evidence of research activities have shown that exercises, which improve oxygen exchange (dancing, basketball, jogging, cycling, swimming, walking, etc.), as well as exercises which do not belong to this category (such as weightlifting), can relieve depression, if it is determined as mild or middle. They also can reinforce treatment rates by heavy depression. Even such inoffensive activity like walking does its part. The observance of stable regime in case of melancholy may be a powerful restorative remedy. It is not inconceivable that it is all that need a person.

The exercises are so efficacious, that if person will do them in combination with psychotherapy or/and with medication taking, he rather approaches his recovery, than if he restricts himself with only course of treatment.

Exercise’s effects may be long-term. One research, that included among 5 000 college students in course of mental health, has shown that students who regularly did morning exercises (even during seven years after course ending), had weak depression and anxiety. The exercises, along with others methods, may be a powerful weapon in arms of your beloved.

Why are these exercises so efficient?

There are some theories which can explain this phenomenon. On the psychological level these exercises divert person from pains and bereavement. Winning round in tennis he may become sensation of reached mastery, which can help to conquer a feeling of hopelessness and despair. Exercises which are realized in the form of playing kinds of sports, like dancing or aerobics, may also slacken the feeling of solitude. Moreover, we should remember, that with the purpose of exercises like walking, skiing or jogging, we go to the open air, that is important for our soul.

Positive effects may also come from biological sources. The scientists have discovered that strenuous activity releases in brain chemical agents called endorphins. They act like morphine – they relieve sensations of pain and
revive our spirits. Besides, physical activity improves effect and metabolism of mediators, such as noradrenaline and serotonin. They are very important to regulate our spirits.

How many exercises should be enough?

Do a complex of aerobic exercises just 2-5 times a week by 30-40 minutes. Provide 5-10 minutes at the beginning for warming-up and at the end for relaxation. These exercises should demand efforts, but they must not be too difficult. The person should be able to perform them and be sure that they are not doomed to failure. No one set of exercises will not work if person believes that they are too difficult for him. In this case it is better to start with simple exercises and while its development to increase the load.

The failures may be a reason of psychological stresses and may intensify the feeling of inferiority. That is why he must see his goals. A friendly game in tennis, which does not contain competition, may be more useful than game on points. If person likes it, he will probably want to play more.

It stands to reason that no one combined movements will not be effective if person does not want to do it. The person suffering from depression may be of sluggish disposition. That is why it will be better to start with joint short walks. As they say, half a loaf is better than no bread. Concentrate on little steps which approach you to the aim. In addition, the person will be disposed to exercises, if they are convenient for him and do not disturb the daily routine.

There is only one insignificant risk by physical exercises: some people may be too accustomed to the changes of their state. The sign of such adaptation is a necessity to increase the «dose» of exercises in order to achieve positive effect. The training becomes the main thing. The family relations pale into insignificance. Furthermore, the person is disposed to put such well-doing before all else. That is a bit too thick. Sometimes excessive keenness on exercises may be a sign of impulsive obsession. Such circumstances must be discussed with a doctor. In old time, a Greek philosopher Aristotle advised us be moderate in everything. It includes exercises which help us to cope with depression.

There are some sleep cycles in 90 minutes for one night by normal sleep structure. Every cycle consists of four phases plus REM (rapid eye movement sleep), which is the most aroused phase and where we have dreams. Most of us have deep sleep at the beginning of the night. The REM phase takes only a small part of the first 90-minutes cycle. During the night the phases of deep sleep are getting shorter with every cycle. Whereas REM phases are more evident.

By people suffering from depression this structure is functioning in opposite succession. They can have prolonged REM phases at the beginning of the night, which decrease to the morning. The action of this altered order consists in the fact that depressed person, on top of everything else, is deficient in a deep sleep, which best of all can recuperate. Perhaps that is why depressed person can sleep for a long time, but waking up he feels tired and emaciated.

Sleep disturbance – is a sign of broken biological clock, its workings or diurnal rhythm.
The treatment with antidepressants returns these structures in normal state. But we can recommend one simple method – do not sleep during 24 hours. It may restore biological clock and help to cope with depression.

Other methods which regulate incorrect functioning of biological clocks, include following:

• melatonin intake, under the care of a physician;
• the change of sack time in 5-6 hours earlier than usual;
• gradual restitution to habitual time; exact time observance of down-lying and awakening;
• coffee and alcohol refusal;
• medicines refusal, for example such as no-dos or nitol, as well as other stimulants and depressants
• relaxing and breathing exercises

The most influence on our mood has carbohydrates. Getting into the body, they start a range of chemical reactions, at which point a great number of tryptophan gets the brain. The tryptophan turns to serotonin, which improves our mood. But not all carbohydrates have the same effect. For example fruit does not have such influence. The fructose does not start a range of chemical reactions, which lead to serotonin development.

What has an influence?

Household bread. Imagine yourselves sportsmen who want to win a relay race. The most foodstuffs have one or more amino acids which molecules contain in animal or vegetable albumens. They are necessary for our health. Like sportsmen, amino acids engage in competition with each other, trying as fast as possible getting a brain. Here tryptophan makes serotonin level more active. This substance assuages and improves the cerebration. But you should eat bread before meat or cheese, which are enriched with albumen. That allows the tryptophan getting into the brain before it will be filled with other amino acids.

The turkey meat is reach in tyrosine. The tyrosine – is an amino acid which increases a level of dopamine and noradrenaline in the brain that in its turn raises energy and rate of a reaction. The good substitutes are meat of tunny-fish and chicken.

Beef. The people, who keep to a diet and have a low cholesterol level, may have an iron deficit. It can cause a sensation of weariness and bad mood. The iron supports the saturation of cells with an oxygen and in such a way inspires with energy.

Water. By dehydration we have decreased blood supply to body organs and slowed body working. If you will drink enough water every day, it helps you to get rid of drowse. The adults should drink 8-10 glasses of water every day. The drinks which contain caffeine can not be replaced by water. They usually act as diuretic and redouble the dehydration.

Bananas. The magnesium deficit and stress are interdependent. That is why some doctors and dietitians advise people, who is leading intensive life, add to their food ration such products like bananas. The scientists have also determined that increased magnesium consumption decreases excitability and promotes sleep improvement. If you do not like bananas, remember, that another magnesium source you can find in nuts, haricots, greens, germinated wheat grains.

Oranges and grapefruits. Lack of vitamin C reduces body’s capacity to iron assimilation, which is necessary for struggle against tiredness.

Chocolate. Some specialists believe that, like many sweet carbohydrates, chocolate can benefit our moods. Other think that caffeine and similar to it substances, play a part of stimulants.

Hot pepper. Capsaicin, is a substance which gives a pepper spicy taste and stimulates nerve endings, provoking a burning sensation. In response, brain excretes endorphins – natural substances, which elevate mood.

It has been found experimentally that a change in biological rhythms in the human body occurs by its source of heightened intensity light. It were some attempts to prevent the seasonal exacerbation of depression by means of “lengthening day” with the help of lightage and sleep deprivation.

It is supposed that bright and long effecting light affects circadian rhythm, oppresses in epiphysis (endocrine gland which regulates other organs of endocrine system) melatonin secretion, causes changes of cortisol concentration as well as ACTH in patient’s blood. It also changes the catecholamines synthesis and has sympathicotonic and parasympathetic (at the expense of calorific effect) effect. In the end, these changes lead to treatment of depression.

For therapeutic action it is necessary to have room lighting at least 2600 and no more than 8000 luxes.

Necessary lighting is achieved with a help of incandescent lamps, located on the ceiling chamber at a height of 2.5 meters. Usually are used 27 incandescent lamps of 200 Watts. It was noted that the effectiveness of treatment with light increases by coloring the therapy rooms in the white or green, as well as by maximum (25%) naked body. Before a light therapy the patient is carefully examined. The treatment of depression with light can be conducted at any time of day, also with two-day or three-day intervals. During the conversation, patients who are only asked not to shut their eyes can freely move around the room.

We learn to talk on mobile phones brief and to the point: only about important things, “on business“. Even our rest is quite often planned beforehand, and it also has a schedule. We rush in a breakneck speed, winning the right for rest and happiness, sometimes losing their meaning, depriving ourselves of live. At one time or another, “sweets of life” have become a prize, which are available only at the cost of enormous efforts and unswerving determination.

We deny ourselves everything, full out with work, fearing not be in time. The success of our career is growing rapidly, external achievements often amaze with magnitude, but more often we feel inferiority complex and anxious dissatisfaction. But if the system has failed? And clue to pleasure – is its receiving? In our everyday language the words “hedonism” and “pleasure” have become almost vituperative. Meantime, the ancients (who were very likely wiser than we are) could enjoy life and appreciate its pleasures.

Also some people suffering from difficulties and depressions are disposed to some ways of relax. But it is important that the minutes of pleasure will not be overloaded with unrealistic expectations or provoked with a feeling of despair, as they aggravate the matter, leading to sense of guilt and low self-esteem. You also should not expose your organism to excessive load (it is impossible fasting for a month, and then eat at once a whole cake). So you should measure out a dose, practice it regularly, make them a rule of your life, rather than try to squeeze in the time-table week-long “vacation”.

And if you want to make the first step, some very simple and even free things are quite available:

• Find a bench in the park, sit down and watch the life
• Lie in the hammock and contemplate starry sky.
• Dance on the waves in the ocean
• Walk without purpose, wander forth
• Read a book in a complete silence
• Take a nap in the sun
• Take a bath with candles
• Sleep, sleep and sleep to the point of exhaustion
• Watch a film of French director
• Massage feet
• Make love in the rain
• Dance dirty dances
• Seat in a silence
• Cachinnate

According to recent researches, new-born children, whose mothers have taken antidepressants in the second half of the pregnancy, had more often life-threatening complications from the direction of lungs. These medicines include selective serotonin reuptake inhibitors (SSRIs) – Prozac, Paxil and Zoloft. It is not the first information about harmful influence of these antidepressants on the fetal. Earlier these medicines were connected with the advent by new-born children of excess nervousness, irritability, low blood sugar, respiratory affection.

Last year FDA has warned that taking Paxil by future mothers can lead to heart’s defects by fetuses. In the quoted researches by new-born children there were discovered the persistent pulmonary hypertension. In this case child can not adapt quickly for independent breathing and experience oxygen deprivation. From 1000 new-born children there were only one or two with such symptoms. And although the risk of such complications is not important, in any single case it turned into a tragedy for the family.

According to statistics, about 15% of Americans suffer from one or another form of depression, and it costs the nation 89 billion dollars every year (it includes not only cost for treatment and medicines, but also production loss, work absences and suicidal thoughts). Each year in the U.S. occur about 30 thousand attempted suicides, resulting in the death of a considerable number of people. Depression – is one of the main reasons of employability’s lost among people aged 15-44. Doctors called it «emotional cancer», the same malignant disease disposed to relapses.

Nowadays they used more than two tens of antidepressants with different mechanisms of action. Some of them are not so efficacious as it was expected. Others had tendency to suicidal actions by teenagers, and perhaps by adults.

Today the most popular are medicines which belong to the group of selective serotonin reuptake inhibitor (SSRI). The reason – is simplicity of application (one pill per day).

Some time ago, with a help of government budgeting, there was a wide trial after the medicine called Celexa (citalopram). The studies included 3 thousands of patients suffering from depression, from which this antidepressant has helped only a third people, despite the fact that they were given in higher doses than usual.

The next stage of research were conducted with those people who are not helped Celexa. Among those patients were people who suffered from depression more than one year. These patients were prescribed other antidepressants of different classes – Zoloft (from the same group as Celexa), Wellbutrin (other class than SSRI), or Effexor (which has another point of application in brain). It turned out that such simple medicine change has helped at least a quarter of patients do not experience depression attacks during 3-4 months.

Another group of similar patients have continued to give Celexa, but in addition was appointed a Wellbutrin or sedative BuSpar. Among these patients, one third had a calm period during the same term, however, the combination with Wellbutrin was more effective.

The doctors were very interested in these studies, consider it as a new hope for people suffering from depression. Indeed, such a simple procedure, like substitution one medicine with another or addition of a new therapeutic agent allows you to help more patients, especially with severe and long-term recurrent forms of depression. But it is known that the suicidal inducements often occur with a medicine change, so patients and their surroundings should be especially attentive during these periods, to avoid trouble.

Very often depression is accompanied by chronic diseases. It is considered, that one third of all patients with serious medical problems suffers from a depression. Thus after infarction it is observed by 40 – 65% of the patients, by ischemic disease – 20%, after the stroke – from 10 to 27%, by diabetes and rheumatoid arthritis – from 20 to 30 %.

It is natural, that chronic diseases cause the disturbance of daily routine, especially if there is no possibility to continue the work. In this case symptoms` appearance may be imperceptible for others and patient itself, that’s why it is necessary to know such symptoms in order to take appropriate measures. There are some of them.

• The constant state of depression, sadness, anxiety, nervousness or indifference.
• The inability to enjoy life or its positive moments.
• Loss of weight and appetite
• Insomnia, early awakening or on the contrary, drowse in the morning
• Impatience
• Reduction of vital power and chronic tiredness
• Feeling of helplessness and pessimism
• Feeling of own otioseness and unjustified guilt
• Difficulties with concentration, memory and with taking decisions
• Recurrent suicidal thoughts

If you notice some of these symptoms by your relatives, discuss with a doctor what measures can be taken. The specialist in fundamental illness (for example in diabetes or arthritis) can not often to diagnose the depression himself, but he should connect the patient with a psychiatrist. In many cases qualified treatment of depression can relieve clinical the course of arthritis or recover health after infarction.

In case of unimportant depression doctors recommend psychotherapy like a first stage of the treatment. Among them the most efficient is Cognitive Behavioral Therapy, CBT. It helps the patient to recognize negative ideas and some behavioral reactions and replace them with positive. Usually the course of treatment is not very long – about 10-20 weeks, and is defrayed by medical insurance. Quite often psychotherapy goes with drug therapy, which yields tangible results, especially by acute form of a depression.

The most commonly are used the class of selective serotonin reuptake inhibitors (SSRI). This group includes:

• citalopram (Celexa)
• escitalopram (Lexapro)
• fluvoxamine (Luvox)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• sertraline (Zoloft)

An other class of antidepressants (SNRI) is also connected with a heightened content of serotonin and norepinephrine in the brain – venlafaxine (Effexor) and duloxetine (Cymbalta). So-called tricyclic antidepressant, previously widely used for depression treatment, now are not recommended for people elder 65 because of their side effects, particularly their abilities to cause cardiac arrhythmias.

There are two main proven ways to treat depression: medical therapy and psychotherapy. The most effect gives the combination of 2 these methods. The application only of pharmaceutical substances, according to controlled studies in the field of pharmacotherapy of depressions, leads to expressed improvement only in 60-65% of cases. It means that by 35-40% of depressed patients should be used various methods of psychotherapy.

But for achievement of that expressed improvement is required the long-term taking of antidepressants in quite high doses. Despite the relative safety of modern drugs it would be better to reduce the duration of their intake and dose as low as practicable, thereby minimizing side effects (sleepiness, lethargy, liver and stomach failure, etc.)

The optimum alternative for treating depression is a combination of antidepressants with a course of cognitive psychotherapy. In this case the improvement would be faster and perceptible, and most importantly – it will be received persistent effect of the treatment. Thanks to psychotherapy, the patient gets “powerful weapons” – with a help of psychotherapy he learns how to control his own negative emotions, to perceive the approaching of depression, to take necessary measures and even to prevent the return of the disease. In this case, the percentage of resistant cure is achieved in 98-99% of cases (according to reliable sources).

Cognitive therapy has proved itself in depression treatment, anxiety, phobias and panic attacks. At the heart of cognitive approach is the assertion: “Emotions and human behavior are determined by his world-view”. It means if a person in his subconsciousness has the conviction of “unfriendly world”, then his behavior and emotions will be the same: how can you feel good and comfortable in the place where you are beforehand treated badly?

But there are not a lot of people who can admit the existence of such conviction, and meanwhile just this opinion leads to development of anxiety and depression. The revelation of these basic facilities, its correction and developing of a new mode of thought is an aim which can achieve both psychotherapist and patient.

At the beginning of the treatment the patient is talked about the correlation of thoughts, emotions, behavior, by the example of his own experience. Next, he is learned to identify, track and fix his negative thoughts in a special “Diary of automatic thoughts.” After that, together with the therapist, the thoughts are analyzed and identified, irrational (incorrect and illogical). The special techniques with automatic thoughts are revealed as basic views: in our example it was conviction of «unfriendly world». The next stage – is a correction of irrational basic conviction and formulation of a new one, adequate and realistic.

During this work, the responsibility for own condition is gradually passed into patient’s hands. And by the end of the therapy the patient begins to play the role of the psychotherapist in relation to himself, calling in question own prognosis or conclusions, and skilfully propose an amendments.

As a rule, the course of cognitive psychotherapy consists of 15-25 sessions in the range from 1-2 times per week in an infant state, once a week in following stages, and around the bend it is possible to have meetings once in every week. After completion of the course is required a “booster therapy” – a psychotherapy appointment necessarily 3-4 times per year, in order to observe the situation and get further precise definitions and homework.

For many people the question of adaptation is quite important. Will not organism insist on usual dose even after depression recovery? We can answer more than uniquely – medications, which are taking today from depression, do not addict an adaptation independence from duration treatment. They only help the body to restore those mechanisms which were disturbed by depression.

People, whose work is creative, are usually interested, if medications will not disturb processes answering for creative abilities. In most cases depression has not a very good influence upon creative work, more often it makes it impossible. Antidepressants are able to renew unbalanced inner life and return to the person creation ability, because mental health more often promotes creative activity.

Psychiatrist’s task – is to choose the right medications. Only half of patients feel improvement after the first course of therapy. So the choice of drugs can be called by trial and error. A doctor can prescribe several medications before he find out the most efficacious.

The preparation’s effect doesn’t show immediately – usually it takes no less than 2-3 weeks between beginning of the drug and appearance of positive effect. Sometimes positive changes can appear already in a week. For some people medications are like panacea, and person who for several months unsuccessfully was trying to get out of depression, come to life just in presence. But there are people who do not feel any affect of drug therapy. Do not hurry to identify yourself to this category – everything is very individual, and in some cases a stable result may appear only in several months.

Often drugs are prescribed with others treatment modes. Antidepressants most often are not able to fill inner life with a light and completely relieve from depressed feelings. They can give the feeling of stability and weaken depression symptoms.

In practice I have had some people who suffer from depression already not a year, and often in the acute form, but they have never taken the course of treatment with antidepressants.
A lot of them have a stereotype, like «still I hold out without drugs, I am quite normal person, but once only to start… ». And what next, I wonder? Look, what is happening right now with your lives. I repeat, medications are nonaddictive, and at any moment you may give up therapy even if you have taken them for several years, without detriment to your health.
Frequently, just depression does not allow use some methods from this section, because in order to try something, you need strength and stability. Depression takes away all this things. Medications are able to give necessary conditions, to change your perception, to relieve depression, and only then you can run, go to the psychotherapist, practice sleep’s derivation and do a lot of other things.
I myself for many years took antidepressants, and they played an important role in the treatment of my depression, and after a year when I was able to deal with depression and its symptoms have become much weaker, I just stopped taking them. You see? It is quite easy.