Overview

Depression is a common mood disorder. Sometimes it can be very serious even life-threatening. If you have depression, you may feel sad, anxious, hopeless, or even want to kill yourself.

Globally it’s estimated that 5% of adults suffer from the disorder.  Major depression is the second leading cause of years living with disability in the world.

Depression is also one of the greatest mental health challenges facing Americans today: about 45,000 people die by suicide each year in the United States. About 500,000 people visit a hospital each year for self-harm related injuries.

Having depression can make people likely to get more severely ill from other diseases including COVID-19.  People who have depression and another illness tend to have more severe symptom of both illnesses.

Causes of Depression

Depression can happen for many different reasons and have diverse triggers.

Main causes of depression are:

  1. If your family members have had depression, you are more likely to experience too. It may be because of genetic vulnerability, or the learned behavior from the environment.
  2. Injuries and health issues can have a significant impact on your mental health.
  3. Medication, drugs, and alcohol may cause or worsen depression.
  4. Certain personalities are not apt enough to hold worries and stress.

Some negative life events like stress at work or even losing job, dysfunctional relationship (breakup or divorce), isolation, grieving a loved one, etc. may also factors for depression.

Brain chemicals imbalance or/and issues inside or outside nerve cells may also contribute to depression.  

Signs and Symptoms of Depression

Some people experience only a few symptoms while others may experience many:

  1. Enduring sad, anxious, or “empty” mood feelings
  2. Pessimism or hopelessness feelings
  3. Guilt, worthlessness, or helplessness feelings
  4. No interest or no pleasure in hobbies or even anything
  5. Fatigue, less or no interest in studies or work
  6. Difficult to concentrate, remember, or make decisions
  7. Insomnia, awake early, or oversleep
  8. Eating disorder or unplanned weight changes
  9. Suicide attempts or thoughts of death


Types of Depression

  1. Major depressive disorder: very severe systems persist for periods longer than two weeks. If untreated, episodes of major depression may last from 6 to 18 month, and becomes increasingly vulnerable.
  2. Persistent depressive disorder, or dysthymia: lasts persistently for at least two years.
  3. Psychotic depression: with hallucinations and delusions.
  4. Seasonal depressive disorder: related to the absence of sunlight, prevalent during winter time in Northern Hemisphere.
  5. Premenstrual dysphoric disorder: a form of premenstrual syndrome with monthly depressive cycles.
  6. Peripartum and postpartum depression: depression that some pregnant women and new mothers experience.

Treatment and Therapies of Depression

Depression can be treated. The earlier, the better.

Medications: Antidepressants including SSRIs, SNRIs, TCAs, and MAOIs.

Try several different antidepressant medicines and find the one that works well and has less side effects. It takes time, so as a patient, be patient.   

Medications, Natural products like St. John’s wort or Vitamin D for mild depression, psychotherapy (talk therapy or counselling), brain stimulation therapy (electroconvulsive therapy for very severe depression, repetitive transcranial magnetic stimulation and vagus nerve stimulation), light therapy, massage therapy may be considered.   

Massage Therapy for Clients with Depression?

There is no specific physical risks for a person with depression who wants to receive massage therapy.

“Some research data suggest that massage may be associated with a decrease in hypothalamic-pituitary-adrenal activation and possibly with an increase in oxytocin levels, which can lower depression and anxiety.”[4]

Researches also found that “the brain circuitry stimulated by C fibers is associated with feelings of positive affect and wellbeing. Massage also stimulates brain circuits involved in the control of sympathetic and parasympathetic activity, with an enhancement of parasympathetic tone. These effects could in turn lead to a decrease in stress response as well as modulation of certain aspects of immune function, such as a decrease in inflammatory response.” [4]

“Studies have also suggested that massage interventions may decrease anxiety and enhance mood in nursing home residents with cognitive impairment.” [4]

Massage therapy used to be considered a complementary and alternative medicine (CAM).  After researches validated its effectiveness in treating depression, now massage therapy can be integrated within the medical mainstream under the type “complementary and integrative medicine” (CIM). That’s why National Institutes of Health renamed the center addressing CAM therapies the National Center for Complementary and Integrative Health.

So, massage therapy is very helpful to improve mood, reduce anxiety, and alleviate depression.

Massage therapist cannot diagnose. No matter how effective massage therapy may be, it does not replace traditional medicine.  Massage therapy may be so well received, that some depression patients may want to reduce or even completely abandon medications. Massage therapist please advise the clients that this would not happen without the oversight of the prescribing physician.

Resources

[1] Werner, R. (2019). A Massage Therapist’s Guide to Pathology, 207-210

[2] National Institute of Mental Health: Depression
https://www.nimh.nih.gov/health/topics/depression

[3] Harvard Medical School: What Causes Depression? (January 10, 2022)
https://www.health.harvard.edu/mind-and-mood/what-causes-depression

[4] NIH: Massage Therapy for Psychiatric Disorders
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519566/

[5] Marieb, E.N. & Keller, S.M. (2018) Essentials of Human Anatomy & Physiology, 225-277