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Major Depressive Disorder and Stress

Stress can trigger clinical depression, but taking steps to reduce stress is an important part of getting better.

Without some stress, we'd be little more than slugs (minus the motivation to do the things that enrich our lives), but too much stress can affect our health and even contribute to major depression (also known as clinical depression, major depressive disorder, or MDD). "If prolonged, stress can lead to headaches, muscle aches, fatigue, and gastrointestinal problems," says Simon Rego, PsyD, director of psychology training at Montefiore Medical Center and assistant professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine in the Bronx, N.Y. "It can also affect appetite, sleep, and mood, generating anxiety and depression."

For people predisposed to depression -- especially major depression -- or who are already depressed, stress can be overwhelming, triggering a downward slide. "Depression is like kindling on the forest floor," says Daniel Buccino, MSW, clinical supervisor and assistant professor of psychiatry at Johns Hopkins University. "Stressors can sometimes be the spark that ignites the vulnerability to depression."

In part that's because chronic stress may change behavior in ways that fuel clinical depression, Rego says. "For example, people who are stressed tend not to go out as much or sleep as well, or they may overeat or drink too much. Those things can generate symptoms of depression."

Try these strategies to help reduce stress and overcome major depression:

  • Recognize what causes your stress. "Each person needs to know [his or her] particular vulnerabilities to certain kinds of stress," Buccino says. Maybe too little sleep or too many commitments at work put you over the edge. "Figure out your limits and then try to manage them," Buccino says.
  • Exercise. Moderate-intensity exercise, such as walking at talking speed, can help lift people out of anxiety, stress, and depression, Rego says. Exercise isn't a substitute for medical treatment for major depression, but it can help support your recovery.
  • Tap into social support. "People who are stressed and depressed tend not to use social support networks," Rego says. "Reaching out to friends or trusted colleagues can buffer stress and offer an outside opinion on stressors, and connections can create a sense of belonging, which lessens depression." Connections don't always have to be in person: Start out with a text or an e-mail, or Skype.
  • Challenge your perspective. "When people stress, they tend to see only threatening information," Rego says. "Examine your thoughts to see if they're as negative as you think. For instance, if you're stuck in a traffic jam, instead of thinking you'll never arrive on time, ask yourself, 'What's the worst that can happen if I'm late?'"
  • Sign up for therapy. If you have clinical depression, psychotherapy is probably part of your treatment. It's a great tool to treat major depression and address stress, Buccino says. "You're forming a useful working alliance with another person, whether to gain insight or make changes."

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