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Depression: What You Should Know
Understanding depression, treating depression, living with depression day by day
#1. John looks out across the family farm and wonders how long it will be before he has to sell off land in order to pay the bills that keep piling up. As the drought persists, fuel prices increase and commodity prices fluctuate, John finds himself sinking deeper and deeper into debt and despair. At first he thinks he is simply tired from working long hours. Then he tells himself heís coming down with the flu. When the feelings of hopelessness, sadness and lack of energy go on for five weeks, John realizes he is depressed but does not want to admit it to anyone else. After all, he tells himself, itís probably all just in his head. He feels he should be able to snap out of it.
#2. Julie attends high school and feels the pressure mounting to please her parents, be popular with the cliques in school, be perfect at sports and achieve high grades. She feels her whole world is crashing in on her. Her head feels cloudy. All she wants to do is sleep so she doesnít have to deal with anything.
#3. Mary recently had a baby. She and her husband were excited for the birth of their first child but now Mary feels resentment, jealousy, anger and sadness. She doesnít know why. She feels she should be overjoyed with her new baby, but canít seem to shake her crying spells and mood swings.
According to the National Institute of Mental Health of America, in any given one-year period, approximately 9.5 percent of the population (21 million American adults) suffers from a depressive illness. At any one time in the United Kingdom, around 3.5 million Britons are also affected. Depressive illness can interfere with the normal functioning of the affected people as well as those around them. Depression can become a serious illness for individuals and their families, sometimes destroying family life as well as the life of the ill person. Unfortunately, most people with depressive illness do not seek treatment, even though there are a variety of treatment options available. The information provided in this guide will help you identify depression and the symptoms, recognize the causes of depression and understand available treatment.
What is Depression?
Depression is a serious medical illness that affects your body, mood and thoughts. It can have a negative impact on your eating habits, sleeping patterns, self-esteem and physical well-being. Depression doesnít just go away and should not be confused with having the blues. People with a depressive illness cannot simply "pull themselves together" and get over it. If left untreated, depression can last for weeks, months or years. Appropriate treatments will help most people who have depression.
Severe depression is one of the most common forms of mental illness.
Types of Depression
Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. The three most common depressive disorders are: Major Depressive Disorder, Dysthymic Disorder, and Bipolar Disorder. However, within these types there are variations in the number of symptoms, their severity, and persistence.
Major Depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
A less severe type of depression, Dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
Another type of depression is Bipolar Disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression), often with varying periods of normal mood in between. Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania shouldn't be left untreated, or at the very least, monitored for any deterioration.
Symptoms of Depression and Mania
It is important to understand that not everyone who has a depressive illness will exhibit all of the following symptoms. The number and severity of these symptoms vary with each individual and also varies over time:
Even though some depressive illness runs in some families, suggesting that a biological vulnerability can be inherited, not everyone who has a predisposition for depression will experience it. Typically, people who have lower self-esteem, who tend to be pessimistic or who can be easily overwhelmed by stress will be more prone to depression. Stresses at home, work, or school, are often involved in the onset of depression. Also, in recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Other significant events such as the loss of a loved one, loss of a job, relationship changes, difficult relationships, financial problems or any stressful change in daily life can trigger a depressive episode, according to the National Institute of Mental Health. Often, it is not one single factor that leads to depressive illness, but rather a complex combination of genetic, psychological, and environmental factors. Later episodes of illness typically are precipitated by only mild stresses, non-specific triggers or even no triggers at all.
Depression in Women
Depression is twice as likely to occur in females as in males. Hormonal changes throughout life including menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause and menopause are likely to contribute to the increase in occurrence. Some women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents. Many women seem particularly vulnerable after giving birth. This may be due to physical changes, added responsibility and hormonal fluctuations. While many women who experience the 'blues' after giving birth bounce back, a full-blown depressive episode is cause for concern and signals the need for extra help. Treatment by a sympathetic physician and the family's emotional support for the new mother are prime considerations in aiding her to recover her physical and mental well-being and her ability to care for and enjoy the infant.
Depression in Men
Although men experience depression less often than women, around 6 million (USA) and 1.5 million (UK) men are affected by the illness. Doctors are less likely to suspect depression in men, and men are less likely to admit experiencing depressive symptoms than their female counterparts. Men often hide their depressive illness through the use of alcohol, drugs or working longer hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men.
Middle-aged men are among the highest risk groups for completion of suicide and the rate of suicide in men is four times that of women, though more women attempt it. Men display their depression in different ways than females and it can also affect the physical health in men differently from women. A new study (National Health and Nutrition Examination Survey) shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a huge difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand the need for help and accept depression as a real illness that needs treatment.
Depression in Older Adults
15% of people over 65 have depression. Depression in older adults living in the US and UK is often overlooked and left untreated. One reason for this is the incorrect belief that depression is a normal part of the aging process, whereas, in actual fact, most older people feel very satisfied with their lives and achievements. Another reason is that depression in elders is often considered a symptom of other illnesses. Depression is not a normal part of aging for anyone. Depression in the elderly, undiagnosed and untreated, causes needless suffering for the family and for the individual who could otherwise live a fruitful life. When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss. Some older adults fail to seek treatment because of the mistaken belief that they must stay strong and tough it out, or they may be afraid of becoming a burden to their children.
Recognizing how depressive symptoms in older people are often missed, many health care professionals are learning to identify and treat the underlying depression. They recognize that some symptoms may be side effects of medication the older person is taking for a physical problem, or they may be caused by a co-occurring illness. If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Recent research suggests that talk therapy counselling is effective in reducing symptoms in short-term depression in older persons who are medically ill. Psychotherapy (including counselling or talk therapy) is also useful in older patients who cannot or will not take medication. Efficacy studies show that late-life depression can be treated with any of these modalities.
Improved recognition and treatment of depression in late life will make those years more enjoyable and fulfilling for the depressed elderly person, the family, and caretakers.
Depression in Children and Teens
Depressive disorders often begin between ages 15 and 30 but can also appear in quite young children. Only in the past two decades has depression in children been taken very seriously. The depressed child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood. Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child is just going through a temporary "phase" or is suffering from depression. Sometimes the parents become worried about how the child's behavior has changed, or a teacher mentions that "your child doesn't seem to be himself." If you suspect that a child is exhibiting symptoms of depression, it is important to get help from a doctor or a mental health professional.
Depression will not just go away, but there are many different, effective options for treatment. These include counseling, diet improvement, exercise and in some cases medication. Other successful treatment options include getting training in social skills, and assertiveness and relaxation techniques. It is important that individuals work with their doctor and/or mental health provider to find the right combination of treatment options. More than 80% of people with depressive disorders improve when they receive appropriate treatment.
Here are some other ways you can help yourself if youíre suffering from depression:
If you are given medication to help control your condition, it should be noted that tablets are chemical based and may come with Side Effects. Typically these are annoying, but not normally serious. However, any unusual reactions or side effects or those that interfere with functioning should be reported to the doctor immediately. The most common side effects of tricyclic antidepressants, and ways to deal with them, are:
If you suspect that someone you know is depressed, the most important thing you can do is to be supportive and help that person get the right treatment. Helping someone with depression may be as simple as listening to them, or going with them to see a doctor or mental health professional.
Where to get Help
Check your local phone book for services including mental health, health care, suicide prevention, crisis intervention, counselors, psychologists, hospitals or physicians. In case of an emergency, emergency room doctors can provide temporary help and should be able to provide you with resources for ongoing care. If you do not have personal insurance or a relationship with a mental health professional, contact the Mental Health Center nearest you. Information on local Mental Health Centers can be found in the phone services pages of your local telephone book. Here are two national resources that may also be helpful:
National Institute of Mental Health
Office of Information and Communications
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 (local)
Toll Free: 1-866-615-NIMH (6464)
TTY toll-free: 1-866-415-8051
E-mail address: firstname.lastname@example.org
American Psychiatric Association (APA)
1000 Wilson Boulevard, Suite 1825
Arlington, VA 22209-3901
In the UK dial 08457 90 90 90. In the Republic of Ireland dial 1850 60 90 90.
Textphones (for the deaf and hard of hearing): in the UK dial 08457 90 91 92
You can write to Samaritans at:
Chris. P.O. Box 90 90
Stirling FK8 2SA
My sincere thanks to the National Institute of Mental Health, Montana State University Extension Service and various other sources, for allowing me to recreate and modify their articles. Their copyright is acknowledged and retained. Phil
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DISCLAIMER: This information is not presented by a medical practitioner and is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read.|
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