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For reasons both physiological and psychological, depression can be a very real part of coping with Endometriosis. Those of you who feel alone in this, don't! You are among a great many who suffer silently as I did for years and years. Whether you are embarrassed or angry with yourself for not being able to 'snap out of it," don't despair. Depression can have it's hold on you so tightly and it's not your fault!

The definition of depression is, "a state of despondency characterized by feelings of inadequacy, lowered activity and pessimism about the future, and extreme state of unresponsiveness to stimuli, together with self-deprecation, delusions of inadequacy and hopelessness". Sadly, this definition implies a defect of character or weakness because you are suffering. Nothing is further from the truth.

In general, people experiencing depression feel hopeless. They may have feelings of worthlessness and experience a loss of interest in every-day activities such as work, hobbies or sex. Many factors can trigger depression such as: serious illness, divorce or the death of a loved one. Sometimes there is no apparent factor that triggers a depression.

Endometriosis can itself be an indirect trigger for depression as well. Women on hormonal therapies such as Lupron and Synarel experience a state of menopause in which their levels of naturally occurring hormones are dramatically diminished. Neuroendocrine studies have shown a correlation between depression and hormone deficiencies.This would be a biochemical reasons why your depression exists.

In surgery, nerves are cut and this destroys endocrine organs that produce hormones thus eliciting fewer hormones and creating a biological state of depression. The deficiency of tryptophan and beta endorphins plays a large role in depression. Patients treated with antidepressants which include tryptophan have shown an increase in brain endorphin levels. Naturally produced brain endorphins are stifled with hormonal therapies used for endometriosis which can result in depression.

Many times it is the inability to stop the pain that makes a woman become depressed. I know that has been the cause of depression time and time again for me. External factors can also cause depression including living conditions, relationship issues and weight gain to name only a few. In short, many factors can play a part in feeling low and depressed including nutrition, hormones, exercise or lack of thereof, lowered sexual activity, lack of familial or spousal support and lack of faith in your health provider.

If you consistently feel sad or despondent, seek help and talk to others. If you decide to seek professional help, choose a therapist who specializes in either Woman's health or Chronic Pain as these therapists will better understand your struggles. Your knowledgeable therapist will not only reassure you that you are normal, but also explain that there is a medical solution to your depression if need be.

In conjunction with medical therapy I also found that talking to other women who had the same disease helped a great deal. I encourage every woman to look for a support group on or offline in or around your area. You are not alone! Most of all, it is not your fault that you have this disease. You can't help the repercussions from it which include depression. I know that after suffering for many years thinking I could do it on my own I fell into a deep dark depression and I began to rely on my isolation to keep me safe. Whatever you do DON'T isolate! You will only become more depressed! It is a very real contributor to depression and those of us who have debilitating pain understand that it is not as simple as wanting to participate in our own lives. Sometimes or most of the time we feel we can't and that is an awful feeling. Friends go on without us and we begin to look and feel like flakes. No one understands or so it seems. We lose jobs, we're unable to contribute to the family financially or get an important project done or even make love to our partner. When this happens we suffer greatly.

Having said this don't give up! Most depression is treatable and can be successfully treated with anti depressants, life changes or psycho therapy. You and your doctor can decide what is best for you. Make sure to communicate with your friends and family as that is very important. Keep the lines of communication open and that will take you a long way.

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Individual psychotherapy has been around for more than 100 years. But like most everything, it has evolved and changed as therapists learn more about what they are doing. Therapists stopped calling clients "patients" a number of years ago when they started seeing therapy as a journey of discovery through the psyche rather than as a treatment for a medical disorder. The method most are most comfortable with combines a cognitive behavioral therapy within a psychodynamic framework. Many have found it valuable to spend time helping clients use therapy in a practical way to improve their lives. You may already assume that people use individual therapy to help with :

• Anxiety and depression
• Addictions and eating disorders
• Grieving and loss
• Trauma and abuse
• Co-dependency

What is Group Psychotherapy?

Group psychotherapy, like individual psychotherapy, is intended to help people who would like to improve their ability to cope with difficulties and problems in their lives. But, while in individual therapy the patient meets with only one person (the therapist), in group therapy the meeting is with a whole group and one or two therapists. Group therapy focuses on interpersonal interactions, so relationship problems are addressed well in groups. The aim of group psychotherapy is to help with solving the emotional difficulties and to encourage the personal development of the participants in the group. The therapist (called conductor, leader or facilitator) chooses as candidates for the group people who can benefit from this kind of therapy and those who may have a useful influence on other members in the group.

Medical Treatment:

The brain communicates with itself through the use of special chemicals called neurotransmitters such as "serotonin" and "norepinephrine". There is a strong correlation between the amount of these chemicals in the brain and a person's mood. If levels of these chemicals get too low people feel depressed. Doctors elevate these brain chemicals with the use of drugs.

There are many different families of antidepressants available today. The two most common groups are:

- SSRI's (Selective Serotonin Reuptake Inhibitors) These drugs increase the brain's level of serotonin, thus improving mood. SSRI's have also been shown to be useful in the treatment of obsessive-compulsive disorder and some forms of severe shyness. They are generally well tolerated and effective. Some common SSRI side effects include: heartburn, drowsiness and difficulty achieving an orgasm. They can sometimes produce a transient loss of appetite. SSRI medications can have drug interactions. You should consult with your doctor or pharmacist prior to mixing them with other medications.

- Tricyclic Antidepressants get their name from their chemical structure. This class of drugs is very effective in combating depression but is associated with troublesome side effects such as drowsiness, dry mouth and constipation. Tricyclic antidepressant medications can have drug interactions. You should consult with your doctor or pharmacist prior to mixing them with other medications.

Other families of antidepressant drugs include the MAOI's (monoamine oxidase Inhibitors). MAOI's are very effective but have potentially life-threatening drug interactions and food interactions