Depression manifests and exhibits as: feelings of hopelessness, low self-worth, memory impairment, difficulty concentrating and experiencing pleasure (anhedonia), plus anxiety.

I want to emphasize the impact of negative thoughts in depression. These negative thoughts can seem to come from outside of your mind as if they existed in some cosmic, quantum soup of consciousness. They are like foreign invaders -- successfully penetrating your defenses and finding a safe and secure home inside your brain, causing all kinds of hell-like thoughts and feelings. (In part two of the Depression newsletter, I will talk more about dealing with your negative thoughts.)

Many depressed people will seek out their primary care physician with somatic complaints, while not recognizing what role the body and the brain plays in depression and other physical problems. The same mistake occurs with marriage, relationship and work problems. Usually there are complaints about fatigue, lack of energy, low motivation, sleep disorders, backaches, headaches and gastrointestinal problems. Also, there are a host of other physical ailments that are directly related to depression, but the connections are not recognized. Some of these ailments can be quite serious, even life-threatening.

Relationship problems will also become part of the clinical picture as personality problems complicate treatment and diagnosis. Sexual issues will certainly surface as well as self-destructive attempts to self-medicate with drugs, cigarettes, alcohol and various acting out behaviors. It is very important to connect seemingly unrelated problems to depression and the repression of affect.

In my therapy program, you will learn the interacting and inner looping connections between life, relationships, marriage, physical problems, work, mood, sexual problems and the brain itself. You will also learn how to develop a lifetime strategy for coping with and maintaining a healthy, happy lifestyle with improved brain functioning. But ... be ready to work hard and commit yourself!

I have many people ask me when is it possible to stop taking medication and discontinue treatment strategies. This question arises for many disorders treated by psychotherapy and psychiatry. It is a mistake to believe that you can can cease using very effective therapeutic methods during periods of remission ... because of the illusion that the alleviation of personal problems will last a lifetime.

I'm sorry to inform you that no matter how hard you work on yourself and eventually reach a very solid and happy state of existence, certain tendencies will, in all probability return, given the right circumstances. Therefore, I am stressing that you begin to formulate a long-term, permanent, lifetime view of your personal tendencies and vulnerabilities towards depression.

Warning: just because you have gotten over the hump, does not mean that you should suspend using the methods and techniques that helped transform your life for the better. Think in terms of lifetime personal growth and maintenance. Depression is a nasty visitor and once it's gone, that does not mean that it won't come back again!

Be prepared.... A vigilant, watchful patrol of your thoughts and physical symptoms must be a hallmark for your personal care and optimum well-being.

Depression - like obesity, personality, mood and anxiety disorders, and a host of other problematic occurrences - must be seen within the framework offrequency. You will need to be treated to full and complete remission, otherwise you will fall into an ever enlarging pool of people who chronically suffer from the emotional, relationship and physical dilemmas of this disorder.

Another word of warning: Do not allow yourself to believe that depression will just pass or that you can handle it all by yourself. Most people who suffer from depression do not seek professional help. Primary care physicians may not be fully trained and aware of how to assess and properly diagnose the complete and complex spectrum of problems that make up depression. Only 1 in 10 persons gets the proper treatment ... this includes looking at and dealing with the physical, interpersonal as well as the emotional demands of the disorder. Depression is far more costly when it is not substantially and adequately treated physically, emotionally and mentally.

If you are suffering from depression, it is imperative that you be fully treated into total remission and kept there. Only one out of three people treated for depression fully achieves this objective.

If you, someone you know or a loved one suffers from a form of depression, seek immediate treatment (contact me at PsychotherapyHELP or call 818 882-7404) . If you fail to heed this message, things will only get worse!

Don't let depression rob you or a loved one of life itself!

Stay tuned for Part 2 of Depression ... until next time,

Paul J. Hannig, Ph.D. MFCC