Depression, Symptoms and Treatment
People often use the word ‘depression’ to describe when someone is feeling miserable, low or ‘in a bad mood’. It can be difficult to tell the difference between a depressive illness and someone feeling low. The diagnosis of depression can be made after the patient has been assessed for the severity of the low mood and other related factors.
Depression is a common, treatable problem that anyone can develop. Although many people may assume that a person suffering from depression simply needs to ‘snap out of it’, this is not the case! There are things that can be done by the individual or their peers to alleviate the symptoms and aid the road to recovery.
The causes of depression are not fully understood, but early life experiences or genetics may be contributing factors. Other events that may trigger an episode of depression may include the loss of a job or a loved one, a relationship ending or other stressful experiences. It may also be caused by the use of recreational drugs or through drug treatments, or even because of a physical illness.
Some of the symptoms include the loss of interest in normal activities, having no energy and feeling tired all of the time, waking up early in the morning or difficulty sleeping, lack of appetite, loss of sexual appetite, irritability, restlessness and anxiety, the lack of self-confidence and the avoidance of other people.
Unfortunately there is no real test for depression and it can only be diagnosed by the symptoms. Once diagnosed, a person can be treated by a Doctor, a counsellor, a psychiatrist, a psychologist or a psychotherapist.
Depression can be treated in different ways, depending on the severity of the condition. If a person has a mild condition, psychotherapies are offered and can be as effective as medication. If the condition is more severe, medication will probably be needed, but psychotherapy may be used as a supplement.
Your physician will choose which medication is suitable for you, depending on the side effects of the drug and your symptoms. Unfortunately not everyone responds to the medication and as a result a higher dose or a different medication may be required, or even a combination of psychotherapy and medication may be needed.
Some people need more specialised help, so may be referred to a psychiatrist. The psychiatrist will want to find out about background information, including work and home life, what problems a person is suffering and if there are any emotional or health problems. The psychiatrist will also need to know what current medication you are on.
If you are suffering from depression the last thing you should do is bottle things up. You should start by talking to people about your problems, then get help from your physician. Lying in bed all day or locking yourself away from the world will only compound the problem. Getting regular exercise can often help and can keep your mind off things. This is often easier said than done when suffering from depression, as you may not feel like doing anything, but you should try to be as active as you can. Try not to drink excessive amounts of alcohol as it will only make the symptoms worse and harder to treat. It is also important to remember that you are suffering from an illness and it is treatable. Do not suffer alone!
Depression is a medical illness that needs to be given attention. It affects a lot of people and they are not treated because they do not know that what they are suffering is depression. Education regarding clinical depression is very important so that there will no more misconceptions about it and can be treated accordingly.
“Every time a person gets depressed, the connections in the brain between mood, thoughts, the body, and behavior get stronger, making it easier for depression to be triggered again.”
- J. Mark G. Williams, John Teasdale, Jon Kabat-Zinn, Zindel Segal, The Mindful Way Through Depression
Very recently I had the opportunity to answer a quiz regarding depression, and I was happy to know that I could differentiate the truth and the myths about depression. But, answering the quiz also made me realize that there are still people (including me) out there who may not know what the truth is about depression, not able to differentiate the myths from the truths and thus, not able to get the necessary diagnosis and help from professionals and family.
Here are some of the most common misconceptions about depression:
Depression although hurtful is not a major medical condition.
Definitely not true. Depression isn’t something that happens for a day or two and will leave you as if you willed it to. Depression is a common and serious medical condition that can disrupt the daily functioning of a person. According to medical studies, the brains of people with depression functions differently from those non-depresses people. The brain imaging research shows that the brain areas that regulate behavior, mood, appetite, sleep and thinking function abnormally for depressed people compared to non-depressed people. Also there are different neurotransmitters that can go awry causing the communication between nerve cells to not function properly. And so again we clarify that depression is a very serious medical condition that needs to be diagnosed properly.
Only emotionally disturbed persons get depressed.
Not true. Depression can affect people from all walks of life. It does not choose only the emotionally disturbed people or those with previous traumas and psychological problems. It does not choose the poor or the rich, the unemployed or the professionals in their work uniforms. Although we can say that it can start or strike one when he or she is at a weak point, after a trauma or a loss of a loved one. Other stressful situations or changes can also trigger depression but there are also other factors considered. When we say changes it does not only mean the stressful times but there are case that even positive changes like getting married or getting a new job can trigger depression.
If your parent and grandparents had depression, you are sure to get it in the long run.
Definitely not true. Although experts suspect that genes play a role in the cause of depression, it doesn’t necessarily run true. Researchers believes that if depression runs in your family, there is a greater risk of you having one if compared to those who do not have a family history of depression. But, it is not inevitable because scientists believe that depression is caused by a combination of biological, genetics, biochemical, environmental and psychological factors. Some have even said that gender and age are also factors.
Depression is more common in the elderly people than in the younger ones.
Again, not true. Research has shown that people from ages 40 to 59 have the highest rates of depression. We often assume that depression is a normal part of growing old and so make the mistake of thinking elderly people are more prone to depression. If they do get depressed it is more likely triggered by a combination of several factors such as social isolation or living alone and having lack of social support, financial troubles, side effects of some medication, and ill health. The one problem that makes it worse for the elderly is the fact that they feel ashamed admitting feelings of sadness and grief while others do not want to be a burden to their family. Unfortunately, not getting the necessary professional help can worsen especially because white men 85 and up have the highest suicide rate in the US.
More than 50% of people with depression do not seek medical help.
It is a fact that only 39% of people with depression seek a mental health professional. This is because people think that depression is not really a serious disease and that they can treat it themselves. Some people who suffer from depression does not want to admit it is depression because they feel it is a personal weakness rather that a serious medical illness. It is not a personal weakness nor is it a step towards insanity and should not have a stigma on it. What we do not know is that there is no single cause for depression. It is a combination of so many factors and they are not the same for two persons. The same way that the symptoms may be different for each person with depression the cause will also be different. While some people may figure out why they become depressed, others do not. What is important to remember is that it is a disease that can affect anyone and that the same you see a doctor in medical uniforms for any wound or illness or a dentist for your toothache, it is crucial to see a mental health professional for your depression. It is not something that can be cured with simple talk or positive thinking because if the cause is an imbalance in the brain chemicals then medication is very much needed.
It is a fact that about 70% of individuals with depression who seek medical attention get a full remission with effective treatment. But again, only a few consider this a disease that needs medical attention so only a few see their doctors or a qualified medical health professional for it. They will be the ones to talk with you for the choice of treatment that is more applicable to the pattern, severity, history of the illness and persistence of depressive symptoms. The treatment for one individual may be different for another because they might be experiencing different symptoms and/ or causes of depression
Another misconception about depression is that its symptoms are only mental and emotional symptoms which include anxiety, persistent sad mood, hopelessness, and irritability. What we don’t know is that it can also cause physical pain. Some of the persistent physical symptoms include chronic pain, digestive disorders, queasy or nauseated, reduced appetite and weight loss, or increased appetite and weight gain, exhaustion, sleeping too much or too little and may worsen joint pains, muscle aches and back pain. According to the experts, if you are experiencing 4 or 5 of these symptoms for two weeks or more, it would be best to see your doctor or a qualified medical health professional. Just like any other illness, early treatment is still the most effective and will prevent possible serious recurrences.
Sure, everybody feels sad or blue now and then. But if you’re sad most of the time, and it’s giving you problems with
• your grades or attendance at school
• your relationships with your family and friends
• alcohol, drugs, or sex
• controlling your behavior in other ways
the problem may be DEPRESSION.
The good news is that you can get treatment and feel better soon. Approximately 4% of adolescents get seriously depressed each year. Clinical depression is a serious illness that can affect anybody, including teenagers. It can affect your thoughts, feelings, behavior, and overall health.
Most people with depression can be helped with treatment. But a majority of depressed people never get the help they need. And, when depression isn’t treated, it can get worse, last longer, and prevent you from getting the most out of this important time in your life.
So….Listen Up:
Here’s how to tell if you or a friend might be depressed.
First, there are two kinds of depressive illness: the sad kind, called major depression, and manic-depression or bipolar disorder, when feeling down and depressed alternates with being speeded-up and sometimes reckless.
You should get evaluated by a professional if you’ve had five or more of the following symptoms for more than two weeks or if any of these symptoms cause such a big change that you can’t keep up your usual routine…..
When You’re Depressed…
• You feel sad or cry a lot and it doesn’t go away.
• You feel guilty for no reason; you feel like you’re no good; you’ve lost your confidence.
• Life seems meaningless or like nothing good is ever going to happen again. You have a negative attitude a lot of the time, or it seems like you have no feelings.
• You don’t feel like doing a lot of the things you used to like – like music, sports, being with friends, going out – and you want to be left alone most of the time.
• It’s hard to make up your mind. You forget lots of things, and it’s hard to concentrate.
• You get irritated often. Little things make you lose your temper; you over-react.
• Your sleep pattern changes; you start sleeping a lot more or you have trouble falling asleep at night. Or you wake up really early most mornings and can’t get back to sleep.
• Your eating pattern changes; you’ve lost your appetite or you eat a lot more.
• You feel restless and tired most of the time.
• You think about death, or feel like you’re dying, or have thoughts about committing suicide.
When You’re Manic…
• You feel high as a kite…like you’re “on top of the world.”
• You get unreal ideas about the great things you can do…things that you really can’t do.
• Thoughts go racing through your head, you jump from one subject to another, and you talk a lot.
• You’re a non-stop party, constantly running around.
• You do too many wild or risky things: with driving, with spending money, with sex, etc.
• You’re so “up” that you don’t need much sleep.
• You’re rebellious or irritable and can’t get along at home or school, or with your friends.
Talk to Someone
If you are concerned about depression in yourself or a friend, TALK TO SOMEONE about it. There are people who can help you get treatment:
• a professional at a mental health center or Mental Health Association
• a trusted family member
• your family doctor
• your clergy
• a school counselor or nurse
• a social worker
• a responsible adult
Or, if you don’t know where to turn, the telephone directory or information operator should have phone numbers for a local hotline or mental health services or referrals.
Depression can affect people of any age, race, ethnic or economic group.
Let’s Get Serious Here
Having depression doesn’t mean that a person is weak, or a failure, or isn’t really trying…it means they need treatment.
Most people with depression can be helped with psychotherapy, medicine, or both together.
Short-term psychotherapy, means talking about feelings with a trained professional who can help you change the relationships, thoughts, or behaviors that contribute to depression.
Medication has been developed that effectively treats depression that is severe or disabling. Antidepressant medications are not “uppers” and are not addictive. Sometimes, several types may have to be tried before you and your doctor find the one that works best.
Treatment can help most depressed people start to feel better in just a few weeks.
So remember, when your problems seem too big and you’re feeling low for too long, YOU ARE NOT ALONE. There’s help out there and you can ask for help. And if you know someone who you think is depressed, you can help: Listen and encourage your friend to ask a parent or responsible adult about treatment. If your friend doesn’t ask for help soon, talk to an adult you trust and respect — especially if your friend mentions suicide.
What You Need to Know About Suicide…
Most people who are depressed do not commit suicide. But depression increases the risk for suicide or suicide attempts. It is not true that people who talk about suicide do not attempt it. Suicidal thoughts, remarks, or attempts are ALWAYS SERIOUS…if any of these happen to you or a friend, you must tell a responsible adult IMMEDIATELY…it’s better to be safe than sorry….
Why Do People Get Depressed?
Sometimes people get seriously depressed after something like a divorce in the family, major financial problems, someone you love dying, a messed up home life, or breaking up with a boyfriend or girlfriend.
Other times – like with other illnesses – depression just happens. Often teenagers react to the pain of depression by getting into trouble: trouble with alcohol, drugs, or sex; trouble with school or bad grades; problems with family or friends. This is another reason why it’s important to get treatment for depression before it leads to other trouble.
Depression and Alcohol and Other Drugs
A lot of depressed people, especially teenagers, also have problems with alcohol or other drugs. (Alcohol is a drug, too.) Sometimes the depression comes first and people try drugs as a way to escape it. (In the long run, drugs or alcohol just make things worse!) Other times, the alcohol or other drug use comes first, and depression is caused by:
• the drug itself, or
• withdrawal from it, or
• the problems that substance use causes.
And sometimes you can’t tell which came first…the important point is that when you have both of these problems, the sooner you get treatment, the better. Either problem can make the other worse and lead to bigger trouble, like addiction or flunking school. You need to be honest about both problems — first with yourself and then with someone who can help you get into treatment…it’s the only way to really get better and stay better.
Depression is a real medical illness and it’s treatable.
Be Able to Tell Fact From Fiction
Myths about depression often prevent people from doing the right thing. Some common myths are:
Myth: It’s normal for teenagers to be moody; teens dont suffer from real depression.
FACT: Depression is more than just being moody, and it can affect people at any age, including teenagers.
Myth: Telling an adult that a friend might be depressed is betraying a trust. If someone wants help, he or she will get it.
FACT: Depression, which saps energy and self-esteem, interferes with a person’s ability or wish to get help. It is an act of true friendship to share your concerns with an adult who can help.
Myth: Talking about depression only makes it worse.
FACT: Talking through feelings with a good friend is often a helpful first step. Friendship, concern, and support can provide the encouragement to talk to a parent or other trusted adult about getting evaluated for depression.
There has been some recent press about the long speculated correlation between one’s weight and depression, or state of mind. Well, new studies are showing that overweight or obese people are significantly more prone to depression and mood disorders, which is contrary to the popular myth of the “fat and jolly” individual.
This newest study, which consisted of more than 9,000 adults of both male and female sex, found that obese individuals were approximately 25 percent more likely to suffer from depression than their slimmer counterparts.
Not only that, but contrary to earlier theories that obese women may have been more prone to depression than overweight men, the newest findings show that both men and women suffering weight problems are equally as likely to battle depression. But the question still remains, why is depression more common in the obese segment of the population, and what are some of the theories as to why this is the case?
While these new studies provide almost irrefutable evidence that obesity is strongly linked to depression and other mood disorders, there are unfortunately no definite answers as to why exactly this is true. There are theories of course, and there are also many documented cases of patients who are obese or simply over a healthy weight standard that are also suffering from depression and mood swings.
I’m sure if you think about it, you may be able to come up with someone in your life who you can make this correlation with. It may even be you. As I previously mentioned, there are a number of theories as to why depression occurs so much more often in people who are obese or overweight. One common sense theory is the simple fact that an individual may feel inferior or out of control if they have lost control over their weight.
They may emotionally beat themselves up over and over because they view themselves as “fat”, which has a direct impact on their every day interactions with people, their self esteem, and therefore leads to depression and feelings of sadness, lethargy and hopelessness. This may seem the most obvious of all theories, and it is, but it nonetheless is a very valid theory.
Another theory, which has been discussed in numerous diet and health books is the link between depression and weight through blood sugar and other key chemicals in the body and the brain which can be upset by the presence of obesity and a poor diet. The blood sugar link is the one I believe is most likely to be true, as I know from a personal perspective for me, when my blood sugar is bottoming out, I am the last person you’d want to be around.
Not only am I unpleasant, but I start to have feelings of despair, anxiety and anger for no apparent reason. Then, once my blood sugar is regulated again through means of “healthy” food, I’m back to my pleasant self, and those much-needed feelings of well being. This is not to discount other theories, as I think they all kind of work together. Weight and depression can become a vicious cycle for many of us.
When we’re thinner, we tend to feel better about ourselves, which produces more endorphins and feelings of happiness, which happens to also suppress our appetite, which in turn keeps us on the “thin track”, and vice versa. When we feel down or depressed, we may tend to overeat or binge on comfort foods as a temporary means of feeling good again, which in turn makes our weight balloon, which in turn makes us feel bad about our body image…. and so on and so forth.
You get the picture. Weight and depression in itself can become a vicious cycle, if we don’t learn to harness the power of our mind and take control of our bodies and our health. Not only will it lead to a more slender, heart healthy and longer-living you, but chances are, it will also lead to a much happier, mentally alert and content you. And that’s worth more than any size five jeans in my book.
We accept that illness is part of our daily lives. Colds and flu, cuts and bruises. All these are taken within our stride. Curative potions, prescribed and otherwise, are taken and within a few days we are all back to normal ready to face the world. We have this acceptance because it is something that is tangible. Life is nice and simple as we look at these minor ailments. Everyone has had them at one time or another so it’s part of life.
What about depression? The word itself, particularly when used with regard to an illness, sends a shudder down the spines of most folk. Some would say that it is a disease of the 90s, something that television and the like, too much this, not enough of that and perhaps only confined to those in our community who have – what shall we say – some mental problem. It is so easy to dismiss this illness. We can then forget it and think of things a little more pleasant. What we don’t understand can certainly make us feel that way.
It’s all very easy to dismiss this very harrowing and distressing illness, for it is an illness, not a condition. Some of our community, although seeming physically fit, appear to be carrying the worries of the world on their shoulders. They find it impossible to cope with the normal pressures that the rest of us comfortably deal with in the course of our daily lives.
It is not meant to be patronising to call them poor people. It is merely gratitude for one not having the illness and pity, yes pity, that fellow human beings have to suffer such torment. Luckily nowadays there is some relief with medication that is available. It is however small compensation for the anguish that must be caused by this awful malady.
It is quite easy to remember the days when someone had an “off day” – due to what we now know as depression – to hear their close ones say “Buck yourself up – you’ll be OK tomorrow”. That was the diagnosis and cure for depression principally because not enough was known about the reason why it happens. We read of a blackness and inner torment that travels with it, unfortunately encouraging self harm in some cases.
Society now appears to be much more tolerant. It seems that a little knowledge does go a long way. People, who before seemed aloof and rude at times, with medical help and the correct medication, can now live a content and peaceful life, free from the demons that depression inevitably brings.
Depression hasn’t just happened in the last 15 years though. It surely must have been around for an incredible number of years. Does that mean that it has increased in intensity because of the type of lifestyle we lead, or does it mean that we simply shunned our lesser fortunate acquaintances because we felt there was something “odd” about them?
It is more likely to be the latter. It was far easier to think of someone as not quite the same as everyone else and reject them accordingly, which is what we normally do with things or people we don’t understand, than approach them and try to help them conquer their personal battles.
Depression is a serious medical condition. In contrast to the normal emotional experiences of sadness, loss, or passing mood states, clinical depression is persistent and can interfere significantly with an individual’s ability to function. There are three main types of depressive disorders: major depressive disorder, dysthymic disorder, and bipolar disorder (manic-depressive illness).
Symptoms and Types of Depression
Symptoms of depression include sad mood, loss of interest or pleasure in activities that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping, physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt, difficulty thinking or concentrating, and recurrent thoughts of death or suicide. A diagnosis of major depressive disorder is made if a person has 5 or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15 to 30 but also can appear in children. 1 Episodes typically recur.
Some people have a chronic but less severe form of depression, called dysthymic disorder, which is diagnosed when depressed mood persists for at least 2 years (1 year in children) and is accompanied by at least 2 other symptoms of depression. Many people with dysthymia develop major depressive episodes.
Episodes of depression also occur in people with bipolar disorder. In this disorder, depression alternates with mania, which is characterized by abnormally and persistently elevated mood or irritability and symptoms including overly-inflated self-esteem, decreased need for sleep, increased talkativeness, racing thoughts, distractibility, physical agitation, and excessive risk taking. Because bipolar disorder requires different treatment than major depressive disorder or dysthymia, obtaining an accurate diagnosis is extremely important.
Facts About Depression
Major depression is the leading cause of disability in the U.S. and worldwide. 2 Depressive disorders affect an estimated 9.5 percent of adult Americans ages 18 and over in a given year, 3 or about 18.8 million people in 1998. Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive disorder each year.
Depression can be devastating to family relationships, friendships, and the ability to work or go to school. Many people still believe that the emotional symptoms caused by depression are “not real,” and that a person should be able to shake off the symptoms. Because of these inaccurate beliefs, people with depression either may not recognize that they have a treatable disorder or may be discouraged from seeking or staying on treatment due to feelings of shame and stigma. Too often, untreated or inadequately treated depression is associated with suicide.
Treatments
Antidepressant medications are widely used, effective treatments for depression. Existing antidepressants influence the functioning of certain chemicals in the brain called neurotransmitters. The newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), tend to have fewer side effects than the older drugs, which include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). Although both generations of medications are effective in relieving depression, some people will respond to one type of drug, but not another. Other types of antidepressants are now in development.
Certain types of psychotherapy, specifically cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been found helpful for depression. Research indicates that mild to moderate depression often can be treated successfully with either therapy alone; however, severe depression appears more likely to respond to a combination of psychotherapy and medication. 7 More than 80 percent of people with depressive disorders improve when they receive appropriate treatment.
In situations where medication, psychotherapy, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms such as psychosis (e.g., hallucinations, delusional thinking) or suicidality, electroconvulsive therapy (ECT) may be considered. ECT is a highly effective treatment for severe depressive episodes.
The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.
One herbal supplement, hypericum or St. John’s wort, has been promoted as having antidepressant properties. Results from the first large-scale, controlled study of St. John’s wort for major depression, which was funded in part by NIMH, are expected in 2001. Note: There is evidence that St. John’s wort can reduce the effectiveness of certain medications. Use of any herbal or natural supplements should always be discussed with your doctor before they are tried.
Research Findings
Brain imaging research is revealing that in depression, neural circuits responsible for moods, thinking, sleep, appetite, and behavior fail to function properly, and that the regulation of critical neurotransmitters is impaired. Genetics research, including studies of twins, indicates that genes play a role in depression. Vulnerability to depression appears to result from the influence of multiple genes acting together with environmental factors.
Other research has shown that stressful life events, particularly in the form of loss such as the death of a close family member, may trigger major depression in susceptible individuals. The hypothalamic-pituitary-adrenal (HPA) axis, the hormonal system that regulates the body’s response to stress, is overactive in many people with depression. Research findings suggest that persistent overactivation of this system may lay the groundwork for depression.
Studies of brain chemistry, mechanisms of action of antidepressant medications, and the cognitive distortions and disturbed interpersonal relationships commonly associated with depression, continue to inform the development of new and better treatments.
Depression is a serious medical condition that can affect anyone. Men, women and children are all susceptible to this disease which can have devastating effects on someone’s daily life. Depression can come on suddenly, for no reason, or it might follow a traumatic experience such as a death or some other traumatic experience.
Symptoms of depression can interfere with a person’s ability to work, sleep, study and enjoy life in a fruitful way. If you find that these symptoms persist for more than a few weeks you should discuss it with your doctor. The symptoms to look for include: sadness, irritability, no interest in hobbies and activities which once were loved, hopelessness, problems sleeping, fatigue, thoughts of suicide or death, feelings of guilt and significant weight change.
Once these symptoms start affecting the way you live your life, it’s time to seek help. M.I., who has had depression on and off for many years says, “I never really knew what was wrong with me. I would have these bouts with trying to cope with life, but all I would end up doing is staying sad and crying all the time. I couldn’t see any way out of what I was dealing with in my life, but I’m glad I hung in there. Being able to find out what was wrong with me and knowing that I could get treatment for it changed my life.”
Depression an also affect the physical health of a person, which is a symptom that is often overlooked. I. A., a depression sufferer shares, “I would get these pains in my arms, shoulder and hands. My doctor told me that he couldn’t find anything wrong. Nothing wrong with my bones or my joints, but the pains never seemed to go away. Now I know it was related to the depression.”
No one knows what exactly causes depression, but some believe it might be caused by an imbalance of certain chemicals in the brain, and in that instance you and your doctor might decide that you need to take antidepressants. One form of depression called “Seasonal Affective Disorder” (SAD) uses light therapy as treatment since it’s thought that a lack of sunlight during certain times of the year could be a cause.
If you think depression might be entering your life, don’t wait to get help. There is nothing wrong with asking questions and trying to get help. Many people are too afraid or feel guilty about asking for help for depression. A lot of the world still thinks that depression is “just the blues” or just a person feeling down. Depression is a very real medical condition that is just as valid as having a broken bone that would need to be treated.
“A reluctance to get help can lead to years of disability and not having a good and happy life,” says B.D., “I could have gotten help a long time ago, but I waited for about ten years before taking action. I thought I should have been a person strong enough to beat depression on my own. I sure wish I had made the move toward help instead of waiting.”
Remember, depression is a treatable condition that can get better. You need to take the steps to get the help you need.
People often use the word ‘depression’ to describe when someone is feeling miserable, low or ‘in a bad mood’. It can be difficult to tell the difference between a depressive illness and someone feeling low. The diagnosis of depression can be made after the patient has been assessed for the severity of the low mood and other related factors.
Depression is a common, treatable problem that anyone can develop. Although many people may assume that a person suffering from depression simply needs to ‘snap out of it’, this is not the case! There are things that can be done by the individual or their peers to alleviate the symptoms and aid the road to recovery.
The causes of depression are not fully understood, but early life experiences or genetics may be contributing factors. Other events that may trigger an episode of depression may include the loss of a job or a loved one, a relationship ending or other stressful experiences. It may also be caused by the use of recreational drugs or through drug treatments, or even because of a physical illness.
Some of the symptoms include the loss of interest in normal activities, having no energy and feeling tired all of the time, waking up early in the morning or difficulty sleeping, lack of appetite, loss of sexual appetite, irritability, restlessness and anxiety, the lack of self-confidence and the avoidance of other people.
Unfortunately there is no real test for depression and it can only be diagnosed by the symptoms. Once diagnosed, a person can be treated by a Doctor, a counsellor, a psychiatrist, a psychologist or a psychotherapist.
Depression can be treated in different ways, depending on the severity of the condition. If a person has a mild condition, psychotherapies are offered and can be as effective as medication. If the condition is more severe, medication will probably be needed, but psychotherapy may be used as a supplement.
Your physician will choose which medication is suitable for you, depending on the side effects of the drug and your symptoms. Unfortunately not everyone responds to the medication and as a result a higher dose or a different medication may be required, or even a combination of psychotherapy and medication may be needed.
Some people need more specialised help, so may be referred to a psychiatrist. The psychiatrist will want to find out about background information, including work and home life, what problems a person is suffering and if there are any emotional or health problems. The psychiatrist will also need to know what current medication you are on.
If you are suffering from depression the last thing you should do is bottle things up. You should start by talking to people about your problems, then get help from your physician. Lying in bed all day or locking yourself away from the world will only compound the problem. Getting regular exercise can often help and can keep your mind off things. This is often easier said than done when suffering from depression, as you may not feel like doing anything, but you should try to be as active as you can. Try not to drink excessive amounts of alcohol as it will only make the symptoms worse and harder to treat. It is also important to remember that you are suffering from an illness and it is treatable. Do not suffer alone!
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Common Misconceptions About Depression
“Every time a person gets depressed, the connections in the brain between mood, thoughts, the body, and behavior get stronger, making it easier for depression to be triggered again.”
- J. Mark G. Williams, John Teasdale, Jon Kabat-Zinn, Zindel Segal, The Mindful Way Through Depression
Very recently I had the opportunity to answer a quiz regarding depression, and I was happy to know that I could differentiate the truth and the myths about depression. But, answering the quiz also made me realize that there are still people (including me) out there who may not know what the truth is about depression, not able to differentiate the myths from the truths and thus, not able to get the necessary diagnosis and help from professionals and family.
Here are some of the most common misconceptions about depression:
Depression although hurtful is not a major medical condition.
Definitely not true. Depression isn’t something that happens for a day or two and will leave you as if you willed it to. Depression is a common and serious medical condition that can disrupt the daily functioning of a person. According to medical studies, the brains of people with depression functions differently from those non-depresses people. The brain imaging research shows that the brain areas that regulate behavior, mood, appetite, sleep and thinking function abnormally for depressed people compared to non-depressed people. Also there are different neurotransmitters that can go awry causing the communication between nerve cells to not function properly. And so again we clarify that depression is a very serious medical condition that needs to be diagnosed properly.
Only emotionally disturbed persons get depressed.
Not true. Depression can affect people from all walks of life. It does not choose only the emotionally disturbed people or those with previous traumas and psychological problems. It does not choose the poor or the rich, the unemployed or the professionals in their work uniforms. Although we can say that it can start or strike one when he or she is at a weak point, after a trauma or a loss of a loved one. Other stressful situations or changes can also trigger depression but there are also other factors considered. When we say changes it does not only mean the stressful times but there are case that even positive changes like getting married or getting a new job can trigger depression.
If your parent and grandparents had depression, you are sure to get it in the long run.
Definitely not true. Although experts suspect that genes play a role in the cause of depression, it doesn’t necessarily run true. Researchers believes that if depression runs in your family, there is a greater risk of you having one if compared to those who do not have a family history of depression. But, it is not inevitable because scientists believe that depression is caused by a combination of biological, genetics, biochemical, environmental and psychological factors. Some have even said that gender and age are also factors.
Depression is more common in the elderly people than in the younger ones.
Again, not true. Research has shown that people from ages 40 to 59 have the highest rates of depression. We often assume that depression is a normal part of growing old and so make the mistake of thinking elderly people are more prone to depression. If they do get depressed it is more likely triggered by a combination of several factors such as social isolation or living alone and having lack of social support, financial troubles, side effects of some medication, and ill health. The one problem that makes it worse for the elderly is the fact that they feel ashamed admitting feelings of sadness and grief while others do not want to be a burden to their family. Unfortunately, not getting the necessary professional help can worsen especially because white men 85 and up have the highest suicide rate in the US.
More than 50% of people with depression do not seek medical help.
It is a fact that only 39% of people with depression seek a mental health professional. This is because people think that depression is not really a serious disease and that they can treat it themselves. Some people who suffer from depression does not want to admit it is depression because they feel it is a personal weakness rather that a serious medical illness. It is not a personal weakness nor is it a step towards insanity and should not have a stigma on it. What we do not know is that there is no single cause for depression. It is a combination of so many factors and they are not the same for two persons. The same way that the symptoms may be different for each person with depression the cause will also be different. While some people may figure out why they become depressed, others do not. What is important to remember is that it is a disease that can affect anyone and that the same you see a doctor in medical uniforms for any wound or illness or a dentist for your toothache, it is crucial to see a mental health professional for your depression. It is not something that can be cured with simple talk or positive thinking because if the cause is an imbalance in the brain chemicals then medication is very much needed.
It is a fact that about 70% of individuals with depression who seek medical attention get a full remission with effective treatment. But again, only a few consider this a disease that needs medical attention so only a few see their doctors or a qualified medical health professional for it. They will be the ones to talk with you for the choice of treatment that is more applicable to the pattern, severity, history of the illness and persistence of depressive symptoms. The treatment for one individual may be different for another because they might be experiencing different symptoms and/ or causes of depression
Another misconception about depression is that its symptoms are only mental and emotional symptoms which include anxiety, persistent sad mood, hopelessness, and irritability. What we don’t know is that it can also cause physical pain. Some of the persistent physical symptoms include chronic pain, digestive disorders, queasy or nauseated, reduced appetite and weight loss, or increased appetite and weight gain, exhaustion, sleeping too much or too little and may worsen joint pains, muscle aches and back pain. According to the experts, if you are experiencing 4 or 5 of these symptoms for two weeks or more, it would be best to see your doctor or a qualified medical health professional. Just like any other illness, early treatment is still the most effective and will prevent possible serious recurrences.
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Let’s Talk About Depression
• your grades or attendance at school
• your relationships with your family and friends
• alcohol, drugs, or sex
• controlling your behavior in other ways
the problem may be DEPRESSION.
The good news is that you can get treatment and feel better soon. Approximately 4% of adolescents get seriously depressed each year. Clinical depression is a serious illness that can affect anybody, including teenagers. It can affect your thoughts, feelings, behavior, and overall health.
Most people with depression can be helped with treatment. But a majority of depressed people never get the help they need. And, when depression isn’t treated, it can get worse, last longer, and prevent you from getting the most out of this important time in your life.
So….Listen Up:
Here’s how to tell if you or a friend might be depressed.
First, there are two kinds of depressive illness: the sad kind, called major depression, and manic-depression or bipolar disorder, when feeling down and depressed alternates with being speeded-up and sometimes reckless.
You should get evaluated by a professional if you’ve had five or more of the following symptoms for more than two weeks or if any of these symptoms cause such a big change that you can’t keep up your usual routine…..
When You’re Depressed…
• You feel sad or cry a lot and it doesn’t go away.
• You feel guilty for no reason; you feel like you’re no good; you’ve lost your confidence.
• Life seems meaningless or like nothing good is ever going to happen again. You have a negative attitude a lot of the time, or it seems like you have no feelings.
• You don’t feel like doing a lot of the things you used to like – like music, sports, being with friends, going out – and you want to be left alone most of the time.
• It’s hard to make up your mind. You forget lots of things, and it’s hard to concentrate.
• You get irritated often. Little things make you lose your temper; you over-react.
• Your sleep pattern changes; you start sleeping a lot more or you have trouble falling asleep at night. Or you wake up really early most mornings and can’t get back to sleep.
• Your eating pattern changes; you’ve lost your appetite or you eat a lot more.
• You feel restless and tired most of the time.
• You think about death, or feel like you’re dying, or have thoughts about committing suicide.
When You’re Manic…
• You feel high as a kite…like you’re “on top of the world.”
• You get unreal ideas about the great things you can do…things that you really can’t do.
• Thoughts go racing through your head, you jump from one subject to another, and you talk a lot.
• You’re a non-stop party, constantly running around.
• You do too many wild or risky things: with driving, with spending money, with sex, etc.
• You’re so “up” that you don’t need much sleep.
• You’re rebellious or irritable and can’t get along at home or school, or with your friends.
Talk to Someone
If you are concerned about depression in yourself or a friend, TALK TO SOMEONE about it. There are people who can help you get treatment:
• a professional at a mental health center or Mental Health Association
• a trusted family member
• your family doctor
• your clergy
• a school counselor or nurse
• a social worker
• a responsible adult
Or, if you don’t know where to turn, the telephone directory or information operator should have phone numbers for a local hotline or mental health services or referrals.
Depression can affect people of any age, race, ethnic or economic group.
Let’s Get Serious Here
Having depression doesn’t mean that a person is weak, or a failure, or isn’t really trying…it means they need treatment.
Most people with depression can be helped with psychotherapy, medicine, or both together.
Short-term psychotherapy, means talking about feelings with a trained professional who can help you change the relationships, thoughts, or behaviors that contribute to depression.
Medication has been developed that effectively treats depression that is severe or disabling. Antidepressant medications are not “uppers” and are not addictive. Sometimes, several types may have to be tried before you and your doctor find the one that works best.
Treatment can help most depressed people start to feel better in just a few weeks.
So remember, when your problems seem too big and you’re feeling low for too long, YOU ARE NOT ALONE. There’s help out there and you can ask for help. And if you know someone who you think is depressed, you can help: Listen and encourage your friend to ask a parent or responsible adult about treatment. If your friend doesn’t ask for help soon, talk to an adult you trust and respect — especially if your friend mentions suicide.
What You Need to Know About Suicide…
Most people who are depressed do not commit suicide. But depression increases the risk for suicide or suicide attempts. It is not true that people who talk about suicide do not attempt it. Suicidal thoughts, remarks, or attempts are ALWAYS SERIOUS…if any of these happen to you or a friend, you must tell a responsible adult IMMEDIATELY…it’s better to be safe than sorry….
Why Do People Get Depressed?
Sometimes people get seriously depressed after something like a divorce in the family, major financial problems, someone you love dying, a messed up home life, or breaking up with a boyfriend or girlfriend.
Other times – like with other illnesses – depression just happens. Often teenagers react to the pain of depression by getting into trouble: trouble with alcohol, drugs, or sex; trouble with school or bad grades; problems with family or friends. This is another reason why it’s important to get treatment for depression before it leads to other trouble.
Depression and Alcohol and Other Drugs
A lot of depressed people, especially teenagers, also have problems with alcohol or other drugs. (Alcohol is a drug, too.) Sometimes the depression comes first and people try drugs as a way to escape it. (In the long run, drugs or alcohol just make things worse!) Other times, the alcohol or other drug use comes first, and depression is caused by:
• the drug itself, or
• withdrawal from it, or
• the problems that substance use causes.
And sometimes you can’t tell which came first…the important point is that when you have both of these problems, the sooner you get treatment, the better. Either problem can make the other worse and lead to bigger trouble, like addiction or flunking school. You need to be honest about both problems — first with yourself and then with someone who can help you get into treatment…it’s the only way to really get better and stay better.
Depression is a real medical illness and it’s treatable.
Be Able to Tell Fact From Fiction
Myths about depression often prevent people from doing the right thing. Some common myths are:
Myth: It’s normal for teenagers to be moody; teens dont suffer from real depression.
FACT: Depression is more than just being moody, and it can affect people at any age, including teenagers.
Myth: Telling an adult that a friend might be depressed is betraying a trust. If someone wants help, he or she will get it.
FACT: Depression, which saps energy and self-esteem, interferes with a person’s ability or wish to get help. It is an act of true friendship to share your concerns with an adult who can help.
Myth: Talking about depression only makes it worse.
FACT: Talking through feelings with a good friend is often a helpful first step. Friendship, concern, and support can provide the encouragement to talk to a parent or other trusted adult about getting evaluated for depression.
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Depression and Weight: An Undeniable Connection
There has been some recent press about the long speculated correlation between one’s weight and depression, or state of mind. Well, new studies are showing that overweight or obese people are significantly more prone to depression and mood disorders, which is contrary to the popular myth of the “fat and jolly” individual.
This newest study, which consisted of more than 9,000 adults of both male and female sex, found that obese individuals were approximately 25 percent more likely to suffer from depression than their slimmer counterparts.
Not only that, but contrary to earlier theories that obese women may have been more prone to depression than overweight men, the newest findings show that both men and women suffering weight problems are equally as likely to battle depression. But the question still remains, why is depression more common in the obese segment of the population, and what are some of the theories as to why this is the case?
While these new studies provide almost irrefutable evidence that obesity is strongly linked to depression and other mood disorders, there are unfortunately no definite answers as to why exactly this is true. There are theories of course, and there are also many documented cases of patients who are obese or simply over a healthy weight standard that are also suffering from depression and mood swings.
I’m sure if you think about it, you may be able to come up with someone in your life who you can make this correlation with. It may even be you. As I previously mentioned, there are a number of theories as to why depression occurs so much more often in people who are obese or overweight. One common sense theory is the simple fact that an individual may feel inferior or out of control if they have lost control over their weight.
They may emotionally beat themselves up over and over because they view themselves as “fat”, which has a direct impact on their every day interactions with people, their self esteem, and therefore leads to depression and feelings of sadness, lethargy and hopelessness. This may seem the most obvious of all theories, and it is, but it nonetheless is a very valid theory.
Another theory, which has been discussed in numerous diet and health books is the link between depression and weight through blood sugar and other key chemicals in the body and the brain which can be upset by the presence of obesity and a poor diet. The blood sugar link is the one I believe is most likely to be true, as I know from a personal perspective for me, when my blood sugar is bottoming out, I am the last person you’d want to be around.
Not only am I unpleasant, but I start to have feelings of despair, anxiety and anger for no apparent reason. Then, once my blood sugar is regulated again through means of “healthy” food, I’m back to my pleasant self, and those much-needed feelings of well being. This is not to discount other theories, as I think they all kind of work together. Weight and depression can become a vicious cycle for many of us.
When we’re thinner, we tend to feel better about ourselves, which produces more endorphins and feelings of happiness, which happens to also suppress our appetite, which in turn keeps us on the “thin track”, and vice versa. When we feel down or depressed, we may tend to overeat or binge on comfort foods as a temporary means of feeling good again, which in turn makes our weight balloon, which in turn makes us feel bad about our body image…. and so on and so forth.
You get the picture. Weight and depression in itself can become a vicious cycle, if we don’t learn to harness the power of our mind and take control of our bodies and our health. Not only will it lead to a more slender, heart healthy and longer-living you, but chances are, it will also lead to a much happier, mentally alert and content you. And that’s worth more than any size five jeans in my book.
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Depression – Still A Lot To Learn
What about depression? The word itself, particularly when used with regard to an illness, sends a shudder down the spines of most folk. Some would say that it is a disease of the 90s, something that television and the like, too much this, not enough of that and perhaps only confined to those in our community who have – what shall we say – some mental problem. It is so easy to dismiss this illness. We can then forget it and think of things a little more pleasant. What we don’t understand can certainly make us feel that way.
It’s all very easy to dismiss this very harrowing and distressing illness, for it is an illness, not a condition. Some of our community, although seeming physically fit, appear to be carrying the worries of the world on their shoulders. They find it impossible to cope with the normal pressures that the rest of us comfortably deal with in the course of our daily lives.
It is not meant to be patronising to call them poor people. It is merely gratitude for one not having the illness and pity, yes pity, that fellow human beings have to suffer such torment. Luckily nowadays there is some relief with medication that is available. It is however small compensation for the anguish that must be caused by this awful malady.
It is quite easy to remember the days when someone had an “off day” – due to what we now know as depression – to hear their close ones say “Buck yourself up – you’ll be OK tomorrow”. That was the diagnosis and cure for depression principally because not enough was known about the reason why it happens. We read of a blackness and inner torment that travels with it, unfortunately encouraging self harm in some cases.
Society now appears to be much more tolerant. It seems that a little knowledge does go a long way. People, who before seemed aloof and rude at times, with medical help and the correct medication, can now live a content and peaceful life, free from the demons that depression inevitably brings.
Depression hasn’t just happened in the last 15 years though. It surely must have been around for an incredible number of years. Does that mean that it has increased in intensity because of the type of lifestyle we lead, or does it mean that we simply shunned our lesser fortunate acquaintances because we felt there was something “odd” about them?
It is more likely to be the latter. It was far easier to think of someone as not quite the same as everyone else and reject them accordingly, which is what we normally do with things or people we don’t understand, than approach them and try to help them conquer their personal battles.
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The Invisible Disease: Depression
Symptoms and Types of Depression
Symptoms of depression include sad mood, loss of interest or pleasure in activities that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping, physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt, difficulty thinking or concentrating, and recurrent thoughts of death or suicide. A diagnosis of major depressive disorder is made if a person has 5 or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15 to 30 but also can appear in children. 1 Episodes typically recur.
Some people have a chronic but less severe form of depression, called dysthymic disorder, which is diagnosed when depressed mood persists for at least 2 years (1 year in children) and is accompanied by at least 2 other symptoms of depression. Many people with dysthymia develop major depressive episodes.
Episodes of depression also occur in people with bipolar disorder. In this disorder, depression alternates with mania, which is characterized by abnormally and persistently elevated mood or irritability and symptoms including overly-inflated self-esteem, decreased need for sleep, increased talkativeness, racing thoughts, distractibility, physical agitation, and excessive risk taking. Because bipolar disorder requires different treatment than major depressive disorder or dysthymia, obtaining an accurate diagnosis is extremely important.
Facts About Depression
Major depression is the leading cause of disability in the U.S. and worldwide. 2 Depressive disorders affect an estimated 9.5 percent of adult Americans ages 18 and over in a given year, 3 or about 18.8 million people in 1998. Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive disorder each year.
Depression can be devastating to family relationships, friendships, and the ability to work or go to school. Many people still believe that the emotional symptoms caused by depression are “not real,” and that a person should be able to shake off the symptoms. Because of these inaccurate beliefs, people with depression either may not recognize that they have a treatable disorder or may be discouraged from seeking or staying on treatment due to feelings of shame and stigma. Too often, untreated or inadequately treated depression is associated with suicide.
Treatments
Antidepressant medications are widely used, effective treatments for depression. Existing antidepressants influence the functioning of certain chemicals in the brain called neurotransmitters. The newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), tend to have fewer side effects than the older drugs, which include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). Although both generations of medications are effective in relieving depression, some people will respond to one type of drug, but not another. Other types of antidepressants are now in development.
Certain types of psychotherapy, specifically cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been found helpful for depression. Research indicates that mild to moderate depression often can be treated successfully with either therapy alone; however, severe depression appears more likely to respond to a combination of psychotherapy and medication. 7 More than 80 percent of people with depressive disorders improve when they receive appropriate treatment.
In situations where medication, psychotherapy, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms such as psychosis (e.g., hallucinations, delusional thinking) or suicidality, electroconvulsive therapy (ECT) may be considered. ECT is a highly effective treatment for severe depressive episodes.
The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.
One herbal supplement, hypericum or St. John’s wort, has been promoted as having antidepressant properties. Results from the first large-scale, controlled study of St. John’s wort for major depression, which was funded in part by NIMH, are expected in 2001. Note: There is evidence that St. John’s wort can reduce the effectiveness of certain medications. Use of any herbal or natural supplements should always be discussed with your doctor before they are tried.
Research Findings
Brain imaging research is revealing that in depression, neural circuits responsible for moods, thinking, sleep, appetite, and behavior fail to function properly, and that the regulation of critical neurotransmitters is impaired. Genetics research, including studies of twins, indicates that genes play a role in depression. Vulnerability to depression appears to result from the influence of multiple genes acting together with environmental factors.
Other research has shown that stressful life events, particularly in the form of loss such as the death of a close family member, may trigger major depression in susceptible individuals. The hypothalamic-pituitary-adrenal (HPA) axis, the hormonal system that regulates the body’s response to stress, is overactive in many people with depression. Research findings suggest that persistent overactivation of this system may lay the groundwork for depression.
Studies of brain chemistry, mechanisms of action of antidepressant medications, and the cognitive distortions and disturbed interpersonal relationships commonly associated with depression, continue to inform the development of new and better treatments.
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Depression Is An Equal Opportunity Condition
Symptoms of depression can interfere with a person’s ability to work, sleep, study and enjoy life in a fruitful way. If you find that these symptoms persist for more than a few weeks you should discuss it with your doctor. The symptoms to look for include: sadness, irritability, no interest in hobbies and activities which once were loved, hopelessness, problems sleeping, fatigue, thoughts of suicide or death, feelings of guilt and significant weight change.
Once these symptoms start affecting the way you live your life, it’s time to seek help. M.I., who has had depression on and off for many years says, “I never really knew what was wrong with me. I would have these bouts with trying to cope with life, but all I would end up doing is staying sad and crying all the time. I couldn’t see any way out of what I was dealing with in my life, but I’m glad I hung in there. Being able to find out what was wrong with me and knowing that I could get treatment for it changed my life.”
Depression an also affect the physical health of a person, which is a symptom that is often overlooked. I. A., a depression sufferer shares, “I would get these pains in my arms, shoulder and hands. My doctor told me that he couldn’t find anything wrong. Nothing wrong with my bones or my joints, but the pains never seemed to go away. Now I know it was related to the depression.”
No one knows what exactly causes depression, but some believe it might be caused by an imbalance of certain chemicals in the brain, and in that instance you and your doctor might decide that you need to take antidepressants. One form of depression called “Seasonal Affective Disorder” (SAD) uses light therapy as treatment since it’s thought that a lack of sunlight during certain times of the year could be a cause.
If you think depression might be entering your life, don’t wait to get help. There is nothing wrong with asking questions and trying to get help. Many people are too afraid or feel guilty about asking for help for depression. A lot of the world still thinks that depression is “just the blues” or just a person feeling down. Depression is a very real medical condition that is just as valid as having a broken bone that would need to be treated.
“A reluctance to get help can lead to years of disability and not having a good and happy life,” says B.D., “I could have gotten help a long time ago, but I waited for about ten years before taking action. I thought I should have been a person strong enough to beat depression on my own. I sure wish I had made the move toward help instead of waiting.”
Remember, depression is a treatable condition that can get better. You need to take the steps to get the help you need.