Dear Dr. Garner,

I really need your help. For the past few weeks, I have been feeling sad all the time.
Nothing makes me happy.

I have a wonderful husband and beautiful children, yet I feel as though something is not right.
I don’t want to go anywhere and prefer to stay in bed in my house and not even get dressed.
My family is starting to suffer but I am so tired I don’t feel I can help them.

I just cannot snap out of it.

Thanksgiving and Christmas are coming up and I have no desire to make any preparations.
I am writing to you out of desperation. I am not sure what to do.

Sad in Sheepshead Bay

Dear Sad,

Thank you for writing to me. It is important that you have recognized your problem and want to do something to deal with it.

I hope that talking about your condition will help others out there who find themselves in the same predicament, particularly at this “most wonderful time of the year.”

Depression is a medical illness, similar to other disorders, such as diabetes, in which there is an imbalance of chemicals — in this case, in the brain. You cannot just snap out of it.

You need medical help consisting of medication and counseling to overcome the problem. It will not be a one-time treatment, but a lifelong process.

The good news is that you can be helped and you have made the biggest step — recognizing that you have a problem and being willing to seek help.

There are different types of depression, both mild and major.   Feeling sad when someone close dies is a natural occurrence, but not leaving the house for a month or not being able to function in your everyday life requires help.

Symptoms of Major Depression
How can you tell if you have this serious form of the disease?

If you experience five of the symptoms below, every day for almost the entire day over a two-week period, you are suffering from major depression.

1. You have a sad mood.
2. You have diminished interest and feel no pleasure at all.
3. You have significant weight loss without dieting.
4. You have insomnia/increased desire to sleep.
5. You have restless/slowed behavior that is observed by someone else.
6. You have fatigue or loss of energy.
7. You feel worthless or have excessive guilt.
8. You have trouble making decisions or concentrating.
9. You have repeated thoughts of death or suicide.

Remember, the above symptoms must be present almost every day for two weeks without being due to the effects of medication or a medical condition like low thyroid activity.

People who are depressed often have an alteration in their brains with abnormal amounts of certain chemicals produced.

It appears to be inherited and affects women twice as often as men.

It may be related to an early childhood trauma, either physical or mental.

There is help available in the form of medications and counseling. In addition, a treatment that might sound barbaric is actually quite innocuous and helpful — shock therapy, or ECT.  It produces improvement almost immediately.

It is sometimes necessary to admit a depressed person to the hospital as there is an increased risk of suicide in the first few weeks after starting antidepressant medications, particularly in young adults.

You must seek help immediately. Please contact me if you have any problems getting help.

Benefits of Religious Services
A new study published last week demonstrated a connection between happiness and optimism in women   who attended religious services at least once a month.

These people had as much as a 30% decreased chance of being depressed. They were also 20% less likely to die during the course of the study.

While there is no guarantee that you will live longer or be less depressed, the study concluded that the benefits of attending religious services might include calming effects in stressful times, improved social relationships, and discouraging harmful habits.

Beating the Holiday Blues
For those who are anxious about the Thanksgiving and Christmas blues, I would like to leave you with some tips which may help.

1. If you are lonely, seek out church or other community groups and volunteer.
2. Stick to a budget — money is the number one source of stress this time of year.
3. Take a time out and treat yourself to a spa, a massage, or even a quiet walk or time alone.
4. Make a schedule that allows for enough sleep and exercise.
5. Be realistic — not all holidays have to be perfect. And even with the best of plans, something inevitably goes awry.
6. Acknowledge and respect your feelings. It is okay to be sad if your loved ones have recently died and will not be there to celebrate with you this year.

Please keep me updated on your progress.
Until next week, be well.[hr] Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.

Battling Depression
Fast Facts:
• Depression is a  medical illness caused by a chemical imbalance in the brain.
• There are two types — mild and major.
• Recognition of your condition and willingness to get help are the biggest steps on the road to recovery.
• Treatment is available.