Depression

Everyone feels "sad" or "blue" on occasion; however, if those feelings interfere with daily life activities, something more serious may be going on.  Depression is the most prevalent mental health disorder. According to the National Institute of Mental Health, approximately 17 million adults in America suffer from depression during any one-year period. Depression is a real illness and carries a high cost to those affected in terms of relationship problems, family suffering and lost work productivity.  It is critical for people who suspect that they or a family member may be suffering from depression seek care from a licensed mental health professional. Unexpressed feelings and concerns accompanied by a sense of isolation can worsen a depression. With that being said, it should be noted that depression is a highly treatable disease. 

Depression can be caused by several factors such as genetics, body chemistry and situational factors; most likely depression is caused by a combination of the above factors. While depression can run in families, it's important to realize that people with no family history also are diagnosed with depression every day. There also are different kinds of depression.

Major depression: Often characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat and enjoy once pleasurable activities.  Major depression is disabling and prevents a person from functioning normally. While some people may have one episode of major depression in their lifetime, it more often reoccurs throughout the life span.

Dysthymic disorder: Characterized by long term (2 or more years) of depressed mood for more days than not, accompanied by other depressive symptoms that do not meet diagnosis for major depression.

Adjustment disorder with depressed mood: psychological response to an identifiable stressor or stressors. Symptoms include depressed mood, tearfulness or feelings of hopelessness.

Psychotic depression: A severe depression plus some form of psychosis, such as false beliefs or breaks in reality (audio or visual).

Postpartum depression: A depression much greater than the "baby blues." Occurs after a birth, and includes hormonal and physical changes. 

Seasonal affective disorder (SAD): Characterized by the onset of depression during winter months, when there is a less natural sunlight.  

Mood disorder due to a general medical condition: Characterized by a prominent and persistent disturbance that is judged to be a direct physiological consequence of a general medical condition.

Substance-induced mood disorder: Characterized by a prominent disturbance in mood, judged to be a direct physiological consequence of a drug of abuse, medication, or toxin exposure.

Diagnosing depression

Depression is often difficult to diagnose, because it can be displayed differently in so many people. Some signs of depression can be: 

• Loss of interest or pleasure in activities.
• Restlessness, agitation and irritability.
• Sad, anxious or empty mood.
• Fatigue or loss of energy.
• Change in appetite or weight.
• Changes in sleep patterns.
• Poor self-esteem.
• Crying, a sense of hopelessness.
• Physical pains that do not seem to have a physical cause. Depression can often manifest in physical symptoms; this especially is true in the elderly population.
• Depression should be suspected when excessive drug or alcohol use is occurring.

Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that brains of people with depression look different than those brains of people without depression.  Like other illnesses, depression often occurs with other illnesses. Some of these illnesses may come on before the depression, others can cause the depression and still others are a consequence of depression. Illnesses associated with depression include:

• Anxiety disorders.
• Post traumatic stress disorder (PTSD).
• Obsessive-compulsive disorder (OCD).
• Panic disorder.
• Social phobia.
• Heart disease.
• Stroke.
• Cancer.
• HIV/AIDS.
• Parkinson's disease.

Depression and Suicide

Major depression is the psychiatric diagnosis most commonly associated with suicide. Statistics show that approximately 75 percent of people that complete suicide are depressed at the time of their deaths. The risk of suicide in people with major depression is about 20 times higher than the general population. As stated above, people with a diagnosis of major depression are likely to experience multiple periods of depression in their lives. These people are at a higher risk of suicide than those who have had only one episode of depression. People with depression will often use drugs or alcohol to "self-medicate" their feelings of depression rather than talk to a doctor or mental health provider. These people also are at a higher risk of suicide.

Treatment and depression

Depression is a highly treatable disease. Some sources will say that up to 80 percent of the time treatment for depression is effective. However, the World Health Organization states that less than 25 percent of people with depression receive adequate treatment. Medications can be very helpful in reducing the symptoms of depression in some people. Some people prefer psychotherapy instead of medications, especially if their depression is mild. The most often recommended as the best course of treatment is medication with psychotherapy.  It is important to talk to your doctor about all types of treatment.

Depression and gender

Depression is more common among women than in men. Researchers believe the higher rate in women is in part due to biological, life cycle, hormonal and psychosocial factors that women experience. Hormones directly affect the brain chemistry that controls emotions and mood. Another factor that plays into women being diagnosed more than men is women are more likely to seek help and see a professional to receive a diagnosis. Women often experience depression with feelings of sadness, worthlessness and excessive guilt. Men tend to experience depression by being very tired, losing interest in once pleasurable activities and having a difficulty sleeping. Men may also be more likely to turn to drugs or alcohol when depressed.

How to help yourself

Because of lack of energy and feelings of indifference and hopelessness, it may be hard to take action to help yourself. However, being aware of your emotions and feelings can assist you in doing this. Below are some other ideas to help:

• Do not wait too long to get evaluated and treated. Research has shown the longer a person waits to be treated, the greater the depression can be.
• Try to be active and exercise.
• Go to a movie, a ballgame or participate in other healthy activities you used to enjoy doing.
• Set realistic goals for yourself.
• Break up large tasks into small ones. Set priorities and do what you can do.
• Try to spend time with people you trust such as friends or relatives. While you may want to isolate yourself, it's important to spend time with positive people in your life.
• Expect your mood to improve gradually, not immediately. Often with depression, sleep and appetite will begin to improve before the depressed mood lifts.
• Postpone important decisions until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
• Positive thinking will replace negative thoughts as your depression responds to treatment.  Work on reframing negative thoughts and turning them into positive ones. This will become easier the more you practice.
• Continue to educate yourself about depression and its treatment.

Helping someone you care about

Support and involvement of family and friends can play a crucial role in helping someone who is depressed.  These people can be a great resource by encouraging the person with depression to stick with treatment and practice the coping skills he or she is learning.

Living with someone with depression can be difficult on family and friends. It is often hard to watch your loved one suffer from depression and can bring about feelings of helplessness and loss in the support system. It is important to realize your emotions as well and to take a break to do healthy activities you enjoy. You also may find psychotherapy helpful. Some families will participate in therapy together, while others prefer to have individual therapy with different therapists. There is not a wrong way to get therapy for yourself and family member; however, you need to decide what works with your family.

Information adapted from the National Institute of Mental Health, American Association of Suicidology and the American Psychological Association.