managing depression


More than sad or blue?

Depression can be serious, so I want to help you recognize its symptoms. This information is in no way complete - it does not include every type of depression or everything that you can do to manage depression. There is a lot more you can learn that will help you live beyond the effects of depression.

Everyone will feel sad or blue from time to time. It is important to recognize when sad feelings and behaviors become part of depression. If five or more of the Keys to Recognizing Depression describe how you have been feeling for more than two weeks, you could be clinically depressed.  

If you are having trouble with depression, please call your doctor or make a call to someone. Withdrawal into isolation and suffering is a symptom of depression.

Reaching out is part of the cure.

Notice, too, the symptoms you don’t have. You will probably discover that you are already doing some of the suggestions below. Congratulate yourself.  

For an appointment call



Considering Suicide?

Keep it a question and call someone.

National Mental Health 

Information  1.800.969.6642

National Mental Health Hotline  1.800.784.2433

MHMR 24 HR Crisis Line  214.828.1000

NTBHA Mobile Crisis Hotline (ACS):  1-866-260-8000

Crisis Text Line:  Please text HOME to 741741

 from your mobile device

Suicide and Crisis Center of North Texas:  


National Suicide Prevention Lifeline:  


24/7/365 Crisis Hotline: 

Call 775-784-8090 

or Text ANSWER to 839863

Benefits of the crisis lines

Available 24 hours a day - 7 days a week


Caller remains in control of the call

Only tell what you want to tell them

Only talk about what you want to talk about

Can call as often as you want or need to call

Volunteers and professionals trained and willing to listen  to just about anything

Volunteers and professionals are not interested preaching,  condemning, or telling you what to do

Dial 911 to report risk of imminent harm 

to yourself or others.


Recognizing Depression

Keys to Recognizing Depression

Feeling sad, empty, or tearful most of the day.  Someone telling you that you seem sad or down often.  Children and adolescents could be in an irritable mood most of the time.

You no longer enjoy or have much interest in daily activities.

A significant change in your weight and appetite without deliberate effort. Children might not be gaining weight as expected for growth.

You are sleeping or wanting to sleep all the time. Or it is difficult to sleep at all.

People tell you that you seem physically agitated/restless/slow almost every day. Children may become disruptive or have sudden outbursts of anger. 

You feel physically tired most of the time. You have lost your usual energy.

You have strong feelings of guilt and worthlessness almost every day even though you know you have done nothing wrong.

You have trouble concentrating and making decisions almost every day. People tell you that you look like you are in a daze/fog/lost.

Children may become increasingly fearful and preoccupied with thoughts of death with no apparent cause.  

You have frequent thoughts about suicide, have developed a suicide plan, or have attempted suicide.


latest phone help

Just heard -in addition to the 10 digit numbers listed above there is a new quicker easier number - 

   988 National Emergency Hotline 

recent advancements in treatment


Pharmacogenetics - Drug-Gene Testing

Gene testing  can provide useful information to guide medication selection. Gene testing includes screening for possible interactions,  best compatibility and effective dosing.  

 Pharmacodynamic - what the Rx does to the body - how a medication can contribute to the treatment of a condition.

Pharmacokinetics - what the body does to the Rx - how the body actually manages a treatment medication.

It may be worth having a conversation with your prescribing  physician to see if gene testing would assist in selecting the right  medication(s) for you.



A healthy diet and regular exercise can make us healthier in many ways. This advice has  not changed.


Metabolic research is providing a more explicit  understanding in how nutritional deficits may actually be contributing to mental health distress. The National Institutes of Health has comprehensive resources about complimentary alternative medications. For example - B-complex (B3, B6, B12) deficits are being linked to a range of mental health concerns - anxiety, tension, stress, depression, and more specifically PMS, fatigue, moodiness, and irritability. 

Again, worth a conversation with your treating physician to see what they suggest adding to your nutritional supplements.

living beyond depression


  • Repeat as many times as necessary: depression is a medical illness that is common and treatable.  
  • Repeat as many times as necessary: negative thoughts are a symptom of depression.
  • Become informed about the effects, side effects, and the requirements of taking the antidepressant prescribed by your doctor. 
  • Believe you have the strength to get help treating and managing depression. 
  • It is wise to avoid or postpone making any major decisions (quitting work/school, ending a relationship, moving, etc.) until the symptoms of depression have been significantly reduced.
  • Looking for WHY you are experiencing the symptoms of depression usually deepens the depression; why/blame is not the cure.
  • Keep goals realistic. Prioritize and dedicate your time and energy to the goals that directly affect shelter, food, and healing the depression.
  • Keep tasks and responsibilities in line with your current abilities.
  • Grant yourself the patience to recover.


  • Keep a journal in a way that is most comfortable for you and include notes of hope to yourself.
  • Spend a small amount of time with people in a casual or social environment every day.
  • Do a mild physical activity that you have enjoyed in the past and will enjoy again when you feel better. 
  • Repeat as often as necessary: it took awhile to become depressed and it will take some time to feel better.
  • Have a complete physical to determine if any chronic “aches and pains” are a part of depression or require separate medical treatment.
  • Revise your diet, including vitamin supplements, to include more healthy and energizing food. 
  • Avoid or at least minimize sugar, caffeine, white flour and alcohol since they all can contribute to depression. 
  • Stand tall, sit up straight, walk erect. All help you breathe and feel better.
  • Invite humor back into your life by reading the comics or watching a favorite movie.
  • When saying “yes” or “no” - say the one you mean.

suggested reading

My blog post - Self-Help Books offers suggestions to select useful books.

Just a few suggested readings: 

Hand Me Down Blues

is one of several useful books 

by Michael Yapko

How to Heal Depression

By Harold H. Bloomfield, MD & Peter McWilliams

Feeling Good: The New Mood Therapy

By David D. Burns, MD

Necessary Losses

By Judith Viorst

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