|
 Everyone feels sad from time to time. It's only natural. Most
people go through blue days or normal periods of feeling
down, especially after they experience a loss. But what specialists call clinical depression is different from just being "down
in the dumps." The main difference is that the sad or empty
mood does not go away after a couple of weeks - and everyday
activities like eating, sleeping, socializing, or working can be
affected.
Estimates indicate that perhaps one in five adults in the general population experiences a depressive disorder (e.g., major depression, bipolar disorder, dysthymia, post-partum
depression, or seasonal affective disorder) at some point in
their lives. In any given year, over one in 20 people will have a
depressive episode. For each person suffering directly from
depression, three or four times that number (relatives, friends,
associates) will also be affected to some degree. It is impossible to obtain exact figures because so many people try to live
with this condition without looking for help. Recent studies
strongly suggest that this condition is on the rise, especially
among single women, women in poverty, single men, and adolescents. National tragedies or natural disasters can also generate depressive symptoms for large parts of a population.
A depressive disorder can change a person's moods,
thoughts, and feelings. Without appropriate treatment, this
condition can go on for a very long time—weeks, months, or
years. Even among those suffering from depression, most do
not know they have a treatable condition. Most blame themselves or may be blamed by others. This leads to the alienation
of family and friends who, if they knew of the illness, would
likely offer support and help find effective treatment. Although
this is one of our most devastating emotional disorders, treatment can bring relief to over eighty percent of those who experience depression.
Several causes of depression have been identified. For
example, the illness has been seen to run in families, suggesting that some people may have a genetic predisposition to
depression, which may show itself particularly during times
of stress. However, it is important to note that just because
you have a family member with depression, you are not necessarily going to suffer from this condition yourself.
Sometimes a major change in a person's life patterns can
trigger a depressive episode. These changes may be due to
serious illness, a period of financial difficulties, stressful relationships, or a severe loss (such as the death of a loved one,
divorce, or the loss of a job). Researchers find that people
who are easily overwhelmed by stressful events, tend to
worry, have low self-esteem, and see the
world in a pessimistic way
are more prone to
depression than
other people.
TYPES OF DEPRESSIVE DISORDER
Major Depression
A major depression is different from a state of normal sadness.
People who experience depression describe it as
agonizing pain that cannot be shaken and seems to have no
end in sight. They feel trapped and often talk about having a
dark empty pit in their chest or stomach that cannot be filled.
Some depressed people contemplate suicide. Virtually all people with depression complain about reduced energy, reduced
concentration, and the inability to complete projects. About
eighty percent of depressed people say they have trouble
sleeping, with frequent nighttime awakening during which
they worry about their problems. Many people with depression oversleep during the daytime. Many people with this disorder report that they have had either an increase or a
decrease in their appetite, sometimes accompanied by weight
gain or loss. About fifty percent of people with depression say
that their symptoms are worse in the morning and that they
feel a bit better by evening. Half of all people with depression
report only one severe episode within their lifetimes, but the
remainder may have this happen twice, or repeatedly, during
their lives.
Here are some symptoms of major depression --
- Diminished ability to enjoy oneself
- Loss of energy and interest
- Difficulty concentrating; slowed or fuzzy thinking; indecision
- Magnified feelings of hopelessness, sadness, or anxiety
- Decreased or increased sleep and/or appetite
- Feelings of worthlessness or inappropriate guilt
- Recurring thoughts of death
Dysthymia
A nother common form of depressive disorder is called dysthymia. This involves having chronic, long-lasting symptoms of depression, which are not disabling, but prevent a person from functioning at top capacity or from feeling good.
Women experience dysthymia about twice as often as men,
and it is also found in those who lack a relationship and in
those who are young or with few resources (such as a low
income or few social contacts). The primary symptoms of dysthymia (which means "bad humored") include a depressed
mood, a feeling of being down in the dumps, and a lack of
interest in usual activities for at least two years. People with
dysthymia can experience any of the symptoms of major
depression, but usually not to the severe degree that may be
found in a full-blown depression. Dysthymic people, though,
are vulnerable to moving into a major depression during times
of stress or crisis. Dysthymia often leads to a life without
much pleasure, and many people with this condition feel that
it is simply a part of their personality so that they never seek
treatment.
Symptoms of dysthymia include --
- Poor appetite or overeating
- Insomnia (lack of sleep) or hypersomnia (oversleeping)
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
- Fatigue or low energy
Bipolar Disorder
A third type of depressive disorder is bipolar disorder or
manic-depressive illness. This disorder, which is much
less common than major depression, is characterized by a pattern of cycling between periods of depression and elation.
These cycles, or "mood swings," can be rapid, but most often
occur gradually over time. When in the depressed part of the
cycle, the person can experience any of the symptoms of
depression. When the person moves into the manic or elated
phase, however, he or she can experience irritability, severe
insomnia, inappropriate social behavior (like going on spending sprees), talking rapidly with disconnected thoughts, increased energy, poor judgement, and increased sexual desire.
There is strong evidence that bipolar disorder is largely an
inherited condition, and many people with this disorder
respond well to medication.
Symptoms of bipolar disorder are --
- High energy with a decreased need for sleep
- Extreme irritability
- Rapid and unpredictable mood changes
- An exaggerated belief in one's abilities
- Impulsive actions with damaging consequences (e.g.,
charging up credit cards, sudden love affairs, etc.).
Two other forms of depression --
Post-Partum Depression
is linked to hormonal changes
following the birth of a child. This can be a serious
form of depression, sometimes with psychotic features, but most sufferers respond well to treatment.
Seasonal Affective Disorder or SAD
is found among those who are sensitive to the shorter days of winter, especially those who live at northern latitudes. Many people with SAD respond to daily exposure to full-spectrum lighting.
A depressive disorder is a serious condition which affects
virtually every aspect of a person's everyday life experiences. It is not a sign of personal weakness, although many
depressed people feel guilty about not being stronger and tend
to blame themselves. It is not possible just to "pull yourself
up by the bootstraps" in order to get better. The sufferer
should find the help of a trained professional. A depression is
a time for introspection and reflection, a time to discover
what has gone wrong and what can be made better. A trained
professional can help the person with depression begin to see
things in a more positive light.
Many people respond to psychotherapy alone in their
treatment for depression. Others are helped by a combination of therapy and an antidepressant medication. Medications can facilitate the healing process. People also benefit by
acquiring the life tools that are learned in psychotherapy.
Recent studies have indicated that medication alone without
psychotherapy doesn't work in the long run as well as psychotherapy alone or psychotherapy used in conjunction with
medication.
What is most encouraging about this
devastating condition is that
so many people do get better
when they find the
appropriate treatment!
THINGS YOU CAN DO TO DEAL WITH DEPRESSION
1. Give yourself permission to feel depressed. Don't expect
too much from yourself, since this will only lead to feelings of failure - and this in turn perpetuates the depressive pattern. Don't fight the depression so hard. Giving
in to it may alleviate the depressed feelings. (However, if
you have suicidal thoughts, you are advised never to give
in to these - and to consult a professional immediately.)
2. Try not to set difficult goals for yourself or to take on
more responsibilities than you can realistically handle.
Break large tasks into smaller ones. Set priorities and
take things one at a time. Learn to comfort yourself when
you feel depressed.
3. Realize that you may have negative thoughts - and that
they are a symptom of the depression. One thing you
may focus on in therapy is turning negative thoughts into
positive ones.
4. Postpone important life decisions until your depression is
brought under control. If you must make major decisions, consult others who can be trusted and can take an
objective view of the situation.
5. It is important during a depression to avoid the use of
alcohol or drugs. While you may feel a temporary
"high," this can lead to a dangerous pattern of highs and
lows which can ultimately create a negative spiral that is
very difficult to get out of.
6. Try to spend as much time as you can around other people. While this may seem impossible, it is better than
being alone. It is important not to overdo it, however.
Feeling better takes time.
7. Recognize that there are certain times of the day when
you feel better. Use these times to your advantage.
8. While it may seem impossible, try to get some exercise.
Pumping up your heart for even half an hour every other
day does wonders for your mood, and you can do this by
taking a walk. Don't blame yourself, though, if you cannot accomplish as much as you think you should.
9. Treat yourself, everyday if possible, to some activity that
makes you feel better. Take a walk in a park or enjoy a
bubble bath. Read an interesting article, listen to some
music you like, or attend a social or religious function.
A DEPRESSION CHECKLIST
If you experiencing at least half of the following
items, you may benefit from a consultation with a trained professional who can
help you in working through a depression.
- It is hard for me to concentrate
on reading or watching TV.
- My future seems hopeless.
- I do things slowly.
- Pleasure and joy have gone out
of my life.
- I feel sad, blue and unhappy.
- I have lost interest in things that
used to be important to me.
- I have difficulty making decisions.
- I feel that I am guilty and
deserve to be punished.
- It takes a great effort to do even
simple things.
- I feel fatigued.
- I have had thoughts about hurting myself.
- My sleep is disturbed - too little,
too much, or broken sleep.
- Without trying to diet, I have
lost (or gained) weight.
- I feel depressed even when good
things happen.
- I have negative thoughts much
of the time.
|
