Depression

Depression can have a variety of causes. You can choose from the strategies listed here to feel better.

Exercise can improve your mood as well as your health.

Peer support groups can provide information, understanding and friendship.

What Is Depression?

Depression is a condition of feeling sad, low, or lonely. Everyone has depression from time to time, especially when we experience a loss (of a spouse, friend, or a job, for example). Chronic (ongoing) or clinical depression happens when these feelings continue for a long time. Clinical depression means that feelings of sadness are so severe that they interfere with activities and relationships. People who are chronically or clinically depressed may not want to get out of bed in the morning, may feel lifeless and unable to join in their usual activities, and may have thoughts of suicide. Symptoms of clinical depression include: 

• Fatigue or loss of energy almost every day
• Feeling worthless or guilty almost every day
• Inability to concentrate or focus on a task or make decisions
• Either being unable to sleep or sleeping all the time
• Either feeling overly restless or sluggish
• Either loss of appetite or eating too much – resulting in a 5% or more change in body weight in just a month
• Thoughts about suicide or death

Why Do People with Physical Disabilities Have Depression?

People with physical disabilities tend to have chronic depression more than the general population. Studies have found that the prevalence of depression may range from 25% to 80% for people with different disabilities, including Parkinson’s disease, spina bifida, multiple sclerosis, spinal cord injury, and post-polio syndrome. This is true for a number of reasons: 

• The chronic pain and fatigue that are part of certain types of disabilities can quite understandably lead to depression if the person with a disability is isolated and lonely or unable to do normal activities of daily living. This may especially be true if the pain happens at unpredictable times, leading the person to feel that it is out of control.

• Some types of physical disabilities may produce chemicals that have a depressive effect on the brain.

• There is evidence that some people are genetically predisposed to chronic depression, due to chemical imbalances in the brain or other factors. If depression runs in the family, chronic depression could occur before, during, or after the person acquires a physical disability. 

• Some kinds of medication for a disability, such as steroids, may have side effects leading to depression.

• Some of the symptoms of depression, such as sleep disturbance, fatigue, and low energy, are also symptoms of a person’s physical disability. This may lead some health care providers to overlook the possibility that the person might also be depressed. 

How Do People with Disabilities Successfully Deal with Depression?

If you think you are depressed, you need to talk to your health care provider. Depression is something you CAN deal with! Things to consider to help overcome depression may include:

• Understand your depression.  Keep a journal for at least a month to figure out your “depression triggers.” Are there times of day when you feel more depressed? Do certain people or events that make you feel sad? Certain foods (maybe you experience “sugar crashes” or caffeine jitters) that trigger depression? Look for patterns. Talk it over with your health care provider.

• Decide whether you need medications. Anti-depressant medications can be very effective in relieving feelings of depression. You might take medication to get over a rough time in life, or it may be something you will need for the long term (especially if depression runs in your family). Learn about the different types of medication and talk with your health care provider. Understand the side effects.

• Decide whether you need counseling. Psychiatrists who prescribe anti-depressant medications may often insist that they be paired with counseling. A counselor, psychologist, or social worker trained to provide therapy may be able to give you a number of coping strategies to deal with your depression, as well as provide a fresh perspective to your challenges. You may be able to get free or low-cost counseling through a Community Mental Health Center.   

• Exercise. People who exercise regularly produce oxytocin, which is a brain chemical that helps induce feelings of well-being. Therefore, exercise is not only good for a variety of physical reasons, it can also improve your mood.

• Consider what you eat and drink. Look at your journal to see if there are foods you eat that trigger your depression. Likewise, consider what you drink. Alcohol is a depressant, for example. Talk these over with your health care provider.

• Take action. People who are depressed often feel their lives are out of control and there is nothing they can do about it. You can fight feelings of helplessness by starting out with simple goals that you know you can accomplish in a day or a week, like walking or wheeling around the block or working on a jigsaw puzzle. You can build up to bigger goals as you feel stronger. 

• Get out and about. Even if you don’t feel like it and it takes great effort to round up transportation, go somewhere – preferably with someone. Go shopping, to a movie, to a ballgame, or just to a park that has a peaceful setting. 

• Join a group. There are numerous support groups that are related to almost every type of physical disability. You may find them online or you may find them through your local Center for Independent Living. Or, you may be able to join a group of people who are also coping with depression. If none of these options is appealing, you may be able to be part of a group with your religious organization, or a political advocacy group, or even a book club. The point is finding like-minded people who can become a natural part of your social circle and, in the process, provide some support.

• Volunteer. Volunteering or engaging in some kind of advocacy is similar to getting involved with other people. It has the added benefit of making you feel like you are making a difference in the world.

• Do something for somebody else. People who are overcoming depression often talk about “getting outside of myself,” meaning that when they think about others, their own challenges feel a little less overwhelming. Small acts of kindness directed toward other people not only make the other person feel good – they make you feel good. 

NOTE: This fact sheet is for informational purposes and is not meant to take the place of health care services you may need. Please see your health care provider about any health concerns.