Stephen J. Schueler, M.D.

Depression Home Care

Home care for depression includes:

  • Take prescribed medications as directed:
    • Do not stop antidepressant medications without talking to your doctor.
  • Do not miss counseling sessions:
    • Counseling sessions help reduce the symptoms of depression.
    • Counseling helps you understand life situations that make your depression worse.
    • Counseling also teaches you effective ways to cope with the illness.
    • If your depression is under control, regular counseling can reduce the risk that symptoms will return.
    • Be aware of the common side effects that may be caused by your medication.
  • Do not drink alcohol.
  • Get help for drug abuse.
  • Do not smoke.
  • Get regular exercise.
  • Consider joining a depression support group.
  • Discuss your feeling with your family and friends.
  • Focus on activities that make you feel better.
  • Take part in activities with others. Do not isolate yourself.
  • Maintain a regular sleep schedule.
  • Avoid the use of alcohol and illicit substances.
  • Anxiety and stress can make your depression harder to control:
  • Ask your doctor about relaxation therapy or physical therapy.
  • Eat a healthy diet that is low in fat.
  • Talk to your doctor about taking B vitamin supplements:

For more information:

Depression Diet

Strategies for a healthy diet include:

  • Limit your intake of fat to 30% of your total calories.
  • 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil and peanut oil.
  • Consume only unsaturated fats that are low in cholesterol.
  • Consume less than 300 milligrams of cholesterol a day.
  • Eat dietary fiber: whole grains are best.
  • Avoid fad diets.
  • Check with your doctor about B vitamin supplements. Some people may benefit from B vitamins.

Key Dietary Recommendations for Chronic Disease Prevention
Energy (calories)to maintain BMI < 25
Total fats< or = to 30% of total daily calories
Saturated fats< 7% of total daily calories
Polyunsaturated fats< 10% of total daily calories
Monounsaturated fats< 13% of total daily calories
Cholesterol< or = to 300 mg per day
Dietary fiber25-30 grams per day
Fiber type3:1 insoluble to soluble fiber
Sodium< or = to 1,500 mg per day
Calcium 9-24 yrs1,200-1,500 mg per day
Calcium 25-50 yrs1,000 mg per day
Calcium 51-65 yrs1,200 mg per day
Calcium >65 yrs1,500 mg per day
Vitamin D 9-50 yrs200 IU per day
Vitamin D 51-70 yrs400 IU per day
Vitamin D >70 yrs600 IU per day
Folic acid400 micrograms (ug) per day
Fruits & vegetables5-7 servings per day

Depression Insomnia

Home care measures for insomnia in someone with depression include:

  • Avoid heavy meals, smoking, alcohol, caffeine, and colas prior to sleep. A light snack prior to bedtime may be effective.
  • Avoid naps: daytime napping can make it hard to fall asleep at night.
  • Avoid watching your clock: this can cause anxiety.
  • Do not drink fluids before bedtime: this may cause you to awaken to urinate.
  • Do not go to bed too early: sleep when you are sleepy. Find a way to relax before trying to sleep: read, watch TV, or take a warm bath. Do not read or watch TV in bed.
  • Keep the lights as dim as possible if you must get out of bed. Bright lights reset your brain's sleep clock. Do not watch TV because the light is too bright.
  • Limit stress whenever possible.
  • Make sure your bedroom is a comfortable temperature. A room that is cool and well ventilated is best.
  • Regular exercise can benefit sleep, but heavy exercise close to bedtime can delay sleep. Exercise prior to dinner may make you sleepy when its bedtime.
  • Sleeping pills should only be used for short-term insomnia. Long-term use of these drugs can cause more problems.
  • Try to follow a regular bedtime and sleep cycle. Remain in bed, with the lights out and your eyes closed if you awaken during the night. This will help sleep return and will not affect your normal sleep-wake cycle

Depression Stress

Tips to manage stress in someone with depression:

  • Accept what you cannot change.
  • Ask for help if you need it.
  • Associate with people you enjoy and who treat you well.
  • Consider life as challenges to seek not obstacles to avoid.
  • Do not be dominated by one thing such as work or relationships.
  • Do not feel guilty when you have to say "no" to extra duties or tasks. Respect your limitations.
  • Energize your body with regular exercise.
  • Engage in hobbies.
  • Find the joy in giving.
  • Fuel your body with healthy foods and avoid drugs and alcohol.
  • Get a regular fresh air and sunshine.
  • Have the courage to be imperfect.
  • Keep your sleep habits regular.
  • Make a list of all the stresses that cause you distress. Dispose of the ones you can and reduce your exposure to the others as much as possible.
  • Pamper yourself with simple pleasures that give you joy.
  • Practice relaxation and meditation.
  • Realize that you are responsible for how you feel.
  • Reevaluate and rearrange your priorities.
  • Schedule time for fun. Laughter dissolves tension.
  • Seek professional help with overwhelming hard to solve problems.
  • Take a few minutes of quiet time each day just for you to rejuvenate.
  • Talking with someone you trust can be the best medicine.
  • Try new experiences.
  • Strictly avoiding stimulants may help many people. This includes substances such as:

Depression Taking Control

The successful treatment of depression requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared. Think about what has made your problem better or worse. Most doctors ask many questions about "unrelated" symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects and drug interactions.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Depression Warning Signs

Notify your doctor if you have depression and any of the following:

  • Thoughts of harming yourself
  • Thoughts of harming someone else
  • Inability to function at home or work
  • Inability to take prescribed medications
  • Worsening symptoms of depression
  • Hallucinations:

Continue to Depression Complications

Last Updated: Dec 9, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed Depression References
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  2. Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003 Nov 10;163(20):2433-45. [14609780]
  3. Barrett B, Byford S, Knapp M. Evidence of cost-effective treatments for depression: a systematic review. J Affect Disord. 2005 Jan;84(1):1-13. [15620380]
  4. Neumeyer-Gromen A, Lampert T, Stark K, Kallischnigg G. Disease management programs for depression: a systematic review and meta-analysis of randomized controlled trials. Med Care. 2004 Dec;42(12):1211-21. [15550801]
  5. Remick RA. Diagnosis and management of depression in primary care: a clinical update and review. CMAJ. 2002 Nov 26;167(11):1253-60. [1245108]
  6. Wulsin LR. Is depression a major risk factor for coronary disease? A systematic review of the epidemiologic evidence. Harv Rev Psychiatry. 2004 Mar-Apr;12(2):79-93. [15204803]
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