D E P R E S S I O N
"MORE THAN THE BLUES"
"Life is full of emotional ups and downs and everyone experiences the 'blues' from time to time. But when the 'down' times are long lasting or interfere with an individual's ability to function at home and at work, that person may be suffering from a common, serious illness--- depression.
Clinical depression affects mood, mind, body and behavior. Research has shown that in the United States more than 17 million people-one in ten adults- experience depression each year, and nearly two thirds do not get the help they need. Treatment can alleviate the symptoms in over 80% of cases. Yet, because it often goes unrecognized, depression continues to cause unnecessary suffering.
Women are disproportionately affected by depression, experiencing it at roughly twice the rate of men. Research continues to explore how the illness affects women and to identify new areas that hold promise of deepening our understanding. At the same time it is important to increase women's awareness of what is already known about depression, so that they seek early and appropriate treatment.
WHAT IS DEPRESSION?
No two people become depressed in exactly the same way. Many have only some of the symptoms, varying in severity and duration. For some, symptoms occur in time-limited episodes; for others, symptoms can be present for long periods if no treatment is sought. The age at which depression first appears also varies. There is evidence that in individuals born after 1945, it occurs at a younger age than in previous generations. Common to all age groups, affecting rich and poor alike, depressive illness occurs most frequently in adults between the ages of 25-44.
THE SYMPTOMS OF DEPRESSION AND MANIA
DEPRESSION
MANIA
A thorough diagnostic evaluation is needed if five or more of these symptoms persist for more than two weeks, or if they interfere with work or family life. An evaluation involves a complete physical checkup and information-gathering on family health history.
Having some depressive symptoms does not mean a person is clinically depressed...Up to a point, such feelings are simply a part of the human experience. But when the symptoms increase in number, duration and intensity, so that an individual is unable to function as usual, a temporary mood has very likely become a clinical illness.
TYPES OF DEPRESSIVE ILLNESS
MAJOR DEPRESSION
Emerges in episodes. Some people have one episode in a lifetime; others have recurrent episodes. While initial symptoms may not always seem significant, eventually the individual will experience emotional pain and misery, and impairment in productivity at work and home and in relationships with family and friends.
Sometimes the episodes appear seasonally--typically with depression occurring in fall and winter and diminishing in the spring. Women seem to be especially prone to this kind of depression, known as Seasonal Affective Disorder (SAD)
MANIC-DEPRESSIVE ILLNESS
Manic-Depressive Illness is also called bipolar disorder, it involves cycles similar to major depression alternating with inappropriate 'highs'. Unlike other depressions, women and men are equally vulnerable. During manic episodes, people become overly active, euphoric, irritable, talkative and may spend money irresponsibly and get involved in sexual misadventures.
DYSTHYMIA
Dysthymia involves symptoms similar to those of major depression. They are milder but longer lasting, with a minimum duration of two years. People with dysthymia are frequently lacking in zest and enthusiasm for life, living joyless and fatigued existences that seem almost natural outgrowths of their personalities. If, in addition, they have a major depressive episode, as often happens, they are sometimes referred to as having 'double depression'.
CAUSES OF DEPRESSION
GENETIC FACTORS
There is a risk for developing depression when there is a family history of the illness, indicating that a biological vulnerability may be inherited. The risk is somewhat higher for those with bipolar disorder. However, not everybody with a family history develops the illness. In addition, major depression can occur in people who have had no family members with the illness. This suggests that additional factors, possibly biochemistry, environmental stressors, and other psychosocial factors, are involved in the onset of depression.
BIOCHEMICAL FACTORS
Evidence indicates that brain biochemistry is a significant factor in depressive disorders. It is known, for example, that individuals with major depressive illness typically have too little or too much of certain brain chemicals, called neurotransmitters. Additionally, sleep patterns, which are biochemically influenced, are typically different in people with mood disorders. Depression can be induced or alleviated with certain medications, and some hormones have mood-altering properties. What is not yet known is whether the 'biochemical disturbances' of depression are of genetic origin, or are secondary to stress, trauma, physical illness, or some other environmental condition.
ENVIRONMENTAL AND OTHER STRESSORS
Significant loss, a difficult relationship, financial problems, or a major change in life pattern have all been cited as contributors to depressive illness. Sometimes the onset of depression is associated with acute or chronic physical illness. In addition, some form of substance abuse disorder occurs in about one third of people with any type of depressive disorder.
OTHER PSYCHOSOCIAL FACTORS
Persons with certain characteristics--pessimistic thinking, low self-esteem, a sense of having little or no control over life events, and proneness to excessive worrying--are more likely to develop depression. These attributes may heighten the effect of stressful events or interfere with taking action to cope with them or with getting well. Upbringing or sex role expectations may contribute to the development of these traits. It appears that negative thinking patterns typically develop in childhood or adolescence.
VICTIMIZATION
It is known that far more women than men are sexually abused as children. Studies show that women molested as children are more likely to have clinical depression at some time in their lives than those with no such history. In addition, there appears to be a higher incidence of depression among women who were raped as adults. Women who experience other, commonly occurring forms of abuse, such as physical abuse and sexual harassment on the job, also may experience higher rates of depression. It has been suggested that abuse may lead to depression by fostering low self- esteem, a sense of helplessness, self-blame, and social isolation.
THE PATH TO HEALING
Reaping the benefits of treatment begins by recognizing the signs of depression. The list of symptoms can be useful for this purpose.
The next step is to be evaluated by a qualified professional. Depression can be diagnosed and treated by psychiatrists, psychologists, clinical social workers, and other mental health professionals, as well as by primary care physicians.
Treatment is a partnership between the patient and the health care provider. An informed consumer knows her treatment options and discusses concerns with her provider as they arise.
If you don't feel some improvement after several weeks of treatment, or if symptoms worsen, discuss this with your treatment provider. Trying another treatment approach, or getting a second opinion from another health or mental health professional, may be in order.
HELPING YOURSELF
Depressive illnesses make you feel exhausted, worthless, helpless and hopeless. Such feelings make some people want to give up. It is important to realize that these negative views are part of the depression and will fade as treatment begins to take effect.
Along with professional treatment, there are other things you can do to help yourself get better. Some people find participating in support groups very helpful. It may also help to spend some time with other people and to participate in activities that make you feel better, such as mild exercise. Just don't overdo it or expect too much from yourself right away. Feeling better takes time. Your treating professional can also suggest other self-help strategies.
HELPING THE DEPRESSED PERSON
The most important thing anyone can do for the depressed person is to help him or here get appropriate diagnosis and treatment. This may involve encouraging the person to seek professional help or to stay in treatment once it is instituted.
The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation or activities and be gently insistent if you meet with resistance. Remind that person that with time and help, he or she will feel better.
From: "Depression: What Every Woman Should Know" National Institutes of Mental Health