“I’ve been struggling to get out of bed in the morning.” “I just can’t shake this low mood.” “I’ve lost my appetite, and I can’t sleep.” — If you’ve been experiencing feelings like these for more than two weeks, it may be your mind and body sending out a call for help.
Depression is an illness characterized by persistent low mood and loss of motivation. It is not “all in your head,” nor is it a sign of weakness. With appropriate treatment, improvement can be expected.
Keldsen Family Clinic is a family-oriented clinic offering both Psychosomatic Medicine and Internal Medicine, a 1-minute walk from ‘Oizumi Yubinkyoku’ bus stop, accessible by Seibu Bus from Oizumi-Gakuen Station. We are open on weekends and holidays and also offer telemedicine. “Going to a clinic feels a little scary” — we’d love to help you take that first step.
About Mood Disorders
Mood disorders are a group of conditions in which emotional highs and lows go beyond the normal range and persist long enough to interfere with daily life. The most well-known examples are Depression and Bipolar Disorder (manic-depressive illness).
Mood disorders are by no means rare — many people experience them at some point in their lives. We discuss Depression in more detail in the section below.
The word “depressed” is often used casually to describe a temporary low mood, but clinical Depression is something different. It affects not only your mood but also your appetite, sleep, physical health, thinking patterns, and behavior — reaching a point where willpower alone is not enough to regain control.
Mood disorders are believed to be related to imbalances in neurotransmitters that affect brain function. Just like a physical illness, they can be treated with a medical approach. Recognizing the signs early and receiving proper care is the quickest path to recovery.
What Is Depression?
Depression is a condition in which low mood and a loss of interest or pleasure persist nearly every day for two weeks or more, significantly impairing daily life. It is characterized by both emotional symptoms — such as “feeling down all day” or “being unable to enjoy anything” — and physical symptoms — such as “can’t sleep,” “no appetite,” or “constant fatigue.”
Depression is thought to be related to imbalances in neurotransmitters — primarily serotonin and norepinephrine — that regulate both emotional and physical functioning in the brain. When these systems are disrupted, the condition becomes difficult to improve through effort or positive thinking alone.
The triggers for depression vary from person to person. It’s not only stressful events like work pressure, relationship difficulties, or the loss of a loved one — seemingly positive changes such as marriage, starting school, or moving to a new home can also be a trigger. In some cases, physical conditions such as hypothyroidism, or certain medications, may cause depressive symptoms.
According to a survey by Japan’s Ministry of Health, Labour and Welfare, approximately 6 in 100 people in Japan will experience Depression during their lifetime, and the rate among women is about 1.6 times higher than among men. It is far from uncommon, and it is not a matter of “willpower” or “personal weakness.” Depression is an illness from which recovery can be expected with proper treatment.
At Keldsen Family Clinic, we offer both Psychosomatic Medicine and Internal Medicine under one roof, so we can provide comprehensive care even when physical symptoms like headaches or stomach problems have an underlying emotional cause. If something is bothering you, please don’t hesitate to reach out.
Symptoms and Characteristics of Depression
The symptoms of Depression appear across three dimensions: emotional, physical, and changes noticeable to those around you. If even one symptom has been persisting for an extended period, consider consulting a specialist.
Specific Symptom Examples
Emotional Symptoms
- Feeling depressed, with a low mood that lasts all day
- Unable to enjoy anything, including activities you once loved
- Viewing things negatively and blaming yourself
- Strong irritability or restlessness
- Difficulty concentrating or remembering things
- Thoughts of “wanting to disappear” or “wanting to die”
Physical Symptoms
- Can’t sleep, waking up too early, or feeling sleepy all day
- Loss of appetite, or overeating
- Persistent fatigue and exhaustion
- Headaches, shoulder and neck tension, palpitations
- Stomach problems, constipation, diarrhea
- Dizziness, dry mouth, decreased libido
Changes Noticeable to Others
- Looking withdrawn and speaking less
- Neglecting personal appearance
- Becoming tearful easily
- Slower reactions or restlessness
- Increased alcohol consumption
- Feeling especially bad in the morning, with slight improvement in the afternoon
Depression often involves a pattern called diurnal variation, where symptoms are most severe in the morning and gradually ease toward the afternoon and evening. When someone can’t get up in the morning and is repeatedly late, yet seems fine by the afternoon, others may mistakenly see them as “lazy” — but this is actually one of the signs of the illness.
It is not uncommon for Depression to be discovered when someone visits an internist for physical symptoms such as headaches or stomach problems. At Keldsen Family Clinic, we offer both Psychosomatic Medicine and Internal Medicine, allowing us to take a broad view of the factors behind your symptoms.
Treatment and Recovery from Depression
Treatment for Depression is typically a combination of medication, psychosocial support, environmental adjustments, and self-care. The specific approach is tailored step by step based on the severity and context of the symptoms. The key is not to rush — work with your doctor to find the approach that’s right for you.
1. Medication
Medication for Depression works by regulating neurotransmitter activity in the brain. The current first-line options include SSRI (Selective Serotonin Reuptake Inhibitor), SNRI (Serotonin-Norepinephrine Reuptake Inhibitor), and NaSSA (Noradrenergic and Specific Serotonergic Antidepressant). Compared to the older tricyclic antidepressants (TCAs), these tend to have fewer side effects, and your doctor will choose the best option based on your individual symptoms and condition.
Antidepressants do not work immediately — they generally take about 2 to 4 weeks to take effect. Stopping medication on your own can lead to discontinuation symptoms or a relapse, so please always adjust your medication in consultation with your doctor.
2. Psychosocial Support
Alongside medication, psychological care is an equally important pillar of treatment.
- Cognitive Behavioral Therapy (CBT): A method that helps you gradually identify and reshape patterns of negative thinking and behavior to improve your mood.
- Interpersonal Therapy (IPT): A method that focuses on relationships with those close to you and changes in your roles, aiming to reduce the burden of stress.
- Supportive Psychotherapy: A process of talking about your current state with your doctor, feeling heard and accepted, and gradually regaining a sense of security.
At Keldsen Family Clinic, we listen carefully during each consultation and provide guidance on psychotherapy options as needed.
3. Adjustments at Work or School
In treating Depression, rest itself is an important part of the medicine. Taking time away from work or school to allow your mind and body to recover is one of the most effective steps toward getting better.
- Discuss the possibility of a leave of absence with your doctor
- When returning, request a gradual transition (reduced hours, lighter workload, etc.)
- Coordinate with your occupational health physician or school health office
Pushing yourself because you “don’t want to be a burden” can actually prolong recovery. A medical certificate from your doctor can be a valuable tool for communicating your situation to your workplace or school.
4. Support at Home
The way family members engage can make a big difference in recovery.
- Encouragement like “just try harder” or “toughen up” can often do more harm than good
- Respect the person’s own pace and celebrate small changes together
- Help maintain daily basics — meals, sleep, and medical appointments
- Don’t bear the weight alone — make sure family members also have someone to talk to
The greatest support a family can provide is to be patient, be kind, and simply be there.
5. Self-Care in Everyday Life
Self-care practiced alongside treatment plays an important supporting role in recovery.
- Exercise: Light aerobic activities like walking or yoga are recommended. They have been shown to promote the release of serotonin and norepinephrine, which can help improve mood.
- Sleep: Establish a regular routine — wake up at the same time each day, get morning sunlight, and avoid caffeine and alcohol before bed.
- Diet: Eating three balanced meals a day helps stabilize both your body and your emotions.
- Stress management: Don’t bottle things up — talk to someone you trust, find a hobby for a change of pace, and gradually build a toolkit of coping strategies that work for you.
- Time to rest your mind: Even a few minutes each day, step away from your phone and social media, take a deep breath, and reconnect with your own pace. Many people are finding mindfulness — the practice of paying attention to your breath and sensations in the present moment — to be helpful.
What matters most is continuing at a pace that feels manageable. Don’t aim for perfection from the start — give yourself credit for what you accomplished today.
Depression is an illness from which recovery can be expected with the right treatment and support. You don’t have to face it alone — please feel free to reach out to Keldsen Family Clinic. We are a 1-minute walk from ‘Oizumi Yubinkyoku’ bus stop, accessible by Seibu Bus from Oizumi-Gakuen Station, open on weekends and holidays, and telemedicine is also available.