The five spokes on a wheel:

Michelle Heward, LCSW

May 1, 2021

A helpful analogy on managing depression symptoms

Managing depression can often feel like a balancing act. Thinking about your depression symptoms in a whole-body way rather than just mood , thoughts, and emotions can be helpful with managing your depression symptoms. A quick way to think about this is to compare it to wheel ( the ones on the very old cars). I like to think of the 5 spokes on a wheel to help remind you about the balance. You could be doing just one of these spokes, or two to three, but if you don’t have all five, your wheel won’t work. If you don’t have all five spokes, you may be off balance and unable to fully ride life the way you would like to. Here are the five suggestions “spokes” to keep your wheel balanced.

girl near bike

# 1 Talk Therapy: During counseling, the therapist will use “talk therapy” to help you understand and work through the issues that are impacting your life in negative ways. Their role is to listen, provide feedback, and work with you to develop strategies to cope. They will also evaluate your progress and adjust the sessions accordingly. You may be asked to do homework that extends the learning from the counseling sessions. Often, this is in the form of tracking moods and feelings. The length and severity of the symptoms and episodes of depression often determine the type of therapy. If you’ve been depressed for a length of time and the symptoms are severe, working with a psychiatrist or psychologist (PsyD) may be necessary since they deal more with issues from the past that may be deeply-rooted in your present feelings. But if the symptoms of depression are more recent or not as severe, working with a therapist in a counseling relationship may be helpful.

# 2 Medication management: Antidepressants work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions. The neurotransmitters serotonin, norepinephrine, and dopamine are associated with depression. How medications affect these neurotransmitters determines the class of antidepressants to which they belong. Medication can be an effective intervention for treating the symptoms of depression. Not all antidepressants, however, work the same way. The antidepressant your doctor will prescribe you often depends on your particular symptoms of depression, potential side effects, and other factors. It is important to communicate regularly with your doctor when you are taking an antidepressant, especially if you are prescribed any other medications. Keep track of your symptoms so that they can find the best medication for your depression, and also keep track of any side effects you experience.

#3 Exercise: Regular exercise may help ease depression by:

· Releasing feel-good endorphins, natural cannabis-like brain chemicals (endogenous cannabinoids) and other natural brain chemicals that can enhance your sense of well-being

· Taking your mind off worries so you can get away from the cycle of negative thoughts that feed depression and anxiety

· Gain confidence. Meeting exercise goals or challenges, even small ones, can boost your self-confidence. Getting in shape can also make you feel better about your appearance.

· Get more social interaction. Exercise and physical activity may give you the chance to meet or socialize with others. Just exchanging a friendly smile or greeting as you walk around your neighborhood can help your mood.

Doing 30 minutes or more of exercise a day for three to five days a week may significantly improve depression or anxiety symptoms. But smaller amounts of physical activity — as little as 10 to 15 minutes at a time — may make a difference. It may take less time exercising to improve your mood when you do more-vigorous activities, such as running or bicycling.

# 4 Diet: Diet is such an important component of mental health that it has inspired an entire field of medicine called nutritional psychiatry. Mind-body medicine specialist Eva Selhub, MD has written a superb summary of what nutritional psychiatry is and what it means for you right here on this blog, and it’s worth reading. There is no specific diet to treat depression, but eating more of some foods and less or none of others can help some people manage their symptoms. An improved diet can focus on fresh and whole foods that are high in nutrients. It also limited processed refined foods, sweets, and fried food, including junk food.

# 5 Limit alcohol and drug use: Because alcohol is a central nervous system depressant, the use of this drug tends to trigger depression symptoms like lethargy, sadness and hopelessness. If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Written by:

Michelle Heward, LCSW

May 1, 2021

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