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1. DEPRESSION <br />Wondering how to tell the difference between depression and the blues? Worried that drugs taken to treat the condition will turn you into another person entirely?<br />There are many myths about depression, which will affect an estimated 32 to 35 million Americans at some point in their lives, according to a 2003 study in the Journal of the American Medical Association. Read on for eight common misconceptions and what's really true about this disabling condition.<br />Myth: Depression affects only women.Fact: Depression can affect anyone.Depression is nearly twice as common in women as in men, but men still get depressed -- especially as they get older -- and may feel a loss from career changes or the death of a spouse, says Dr. David Sommers, a scientific review officer at the National Institute of Mental Health.<br />quot;
It is true that depression is more common in women than in men and that women are more likely to seek help than men, but men have trouble with their vulnerability and are more likely to use counterproductive coping strategies,quot;
such as alcohol, than to ask for help, Duckworth says.Depression in guys can also look different than it does in women: Men are more likely to feel tired and irritable and lose interest in work or hobbies, while women tend to feel guilty, sad or worthless, according to the NIMH.Myth: Depression is an adult problem.Fact: Children can get depressed, too.quot;
Depression can happen across the lifespan,quot;
Duckworth says.Some 8 percent of kids ages 12 to 17 suffer a depressive episode, according to the Federal Interagency Forum on Child and Family Statistics. But depression can look different in children and teens than it does in adults.quot;
Teens and children are more likely to show people rather than tell them they're depressed,quot;
Duckworth says. quot;
Most adults can identify that they feel down, sad, and not every kid is able to articulate that.quot;
A depressed kid may frequent the school nurse, complaining of bellyaches and headaches, he says, while depressed teens may be irritable and angry. Myth: Depression isn't a medical problem; you could get over it if you wanted to. Fact: Depression is a medical problem that can require help to overcome.quot;
This is a treatable condition and not a right-wrong fault issue. But that is a common misconception,quot;
Duckworth says. quot;
Being sad, grieving a loss -- these are not clinical syndromes, but when you have a collection of symptoms that continue for weeks and are associated with sleep problems, negative thoughts, thoughts of suicide -- that's different from being down in the dumps.quot;
The key distinction is how long and how severly you feel this way and whether your ability to function at home and work are affected. Myth: Depression is a normal part of being a teenager.Fact: Adolescent moodiness is not the same thing as teen depression.quot;
I don't consider depression a natural outcome of being a teenager,quot;
Duckworth says. quot;
However, being a teenager can be a risky business.quot;
Be on the lookout for how long a teen's symptoms last and how severe they are. Irritability, anger, falling grades, trouble at school, time alone and drug and alcohol use can be signs of more than just the blues.quot;
Many teens have conflict with their parents and struggle with their identity, but normal adolescents don't talk about killing themselves or losing interest in their friends,quot;
Duckworth says. Myth: Depression is all in your genes.Fact: Depression runs in families, but genes are not determining factors.Family history does influence the likelihood of developing depression. Children whose parents experienced depression are three times as likely to suffer depression, anxiety and addiction as those whose parents have never been depressed, according to a 2006 study in the American Journal of Psychiatry. And research on identical twins (who share the same DNA) raised in separate families has shown that if one develops depression, the other is likely to, which points to a significant hereditary role, Sommers says.quot;
I wouldn't be fatalistic, but if you have an increased risk, be mindful of that,quot;
Duckworth says.If depression runs in your family, find out what treatment benefited your loved ones. It may help you, too, he says. Myth: Antidepressants will change my personality.Fact: Antidepressants won't change one's personality.Modern antidepressants are used to increase the circulation of serotonin and norephinephrine in the brain. The drugs can make you feel better, but they don't alter the traits that make you you, Sommers says. quot;
There's some concern about emotional numbing -- that by diminishing the bad feelings, [the drugs will] diminish the good ones; there's no real good evidence of it,quot;
he says.Adds Duckworth: quot;
Medicines don't help with persistent negative thoughts, but they may help with sleep, appetite, energy -- the biological pieces to the puzzle.quot;
Myth: Antidepressants help everyone. Fact: At best, 60 percent of people get better with antidepressants.Psychiatric meds might improve certain symptoms of depression, but they're not going to affect life circumstances or counterproductive thinking. The STAR*D trial, a large federally funded study, found that just 40 percent of people improve with the first antidepressant they try, a number that goes up to 60 percent once you count the people who try more than one. More recently, a January report in JAMA found that people with mild depression weren't helped any more with an antidepressant than they were with a placebo, so if your depression isn't severe, you may want to consider exercise and psychotherapy first.quot;
There's some evidence that the combination of medication and psychotherapy is better than either one alone,quot;
Sommers says. And, he adds, the effects of psychotherapy seem to be more durable than drugs. Myth: Women with postpartum depression are bad mothers who kill their children.Fact: Postpartum depression isn't a character flaw, and psychosis is rare.An estimated 9 to 16 percent of American women suffer from postpartum depression, or depression following childbirth, according to NAMI. Signs include feelings of guilt, anxiety and fear that make it difficult to function. It's rare -- between one to four in every 1,000 births -- that a mom suffers postpartum psychosis, the condition Andrea Yates' lawyers argued caused her to drown her five children. In those cases, women may have delusions, confusion, rapid mood swings and thoughts of hurting themselves or their child, according to NAMI.quot;
It's a reversible condition,quot;
Duckworth says.But how quickly a woman is treated and the effects on her baby depend on her support net. Babies of postpartum moms can be at extra risk of language and behavior problems, as well as experience difficulty bonding with their mothers, the association says.<br />By Judi Ketteler<br />Posted: 2008-09-12 12:57:59<br />There is no one single cause of depression -- and no one magic remedy, says Rob Udewitz, Ph.D., director of Behavior Therapy of New York. There are two major categories of depression: reactive depression (depression caused by a major life change, a crisis or a loss) and chronic depression (depression that returns again and again and may or may not be tied to specific life events). quot;
The treatments for both types of depression are similar,quot;
Udewitz says. Medication is always an option, but many of Udewitz's clients have luck trying one or more of the following natural remedies: <br />Cognitive Behavioral Therapy <br />A registered therapist can use this type of quot;
talk therapyquot;
to help you understand your own patterns of thought, Udewitz says. quot;
We pay attention to the language going on in your mind to see how your judge yourself and your perceived lack of ability to change anything in your life,quot;
he says. The goal is to become empowered to stop the negative thoughts and make the appropriate changes. <br />Group Therapy <br />It's true that there is strength in numbers -- especially when you're trying to work through difficult issues. quot;
Many people feel alone in their experiences and a group gives a sense of belonging,quot;
Udewitz says. Group therapy is especially helpful for things like social anxiety (which often goes along with depression) because it gives you practice talking in a group setting. <br />Exercise <br />quot;
I definitely recommend exercise and probably talk about it in every session,quot;
Udewitz says. Not only does exercise release endorphins -- natural quot;
feel goodquot;
chemicals -- it also gets you focused on goal setting. Udewitz is a big fan of running, but counsels that people should do whatever form of exercise feels good to them -- and one they'll stick with. <br />Rework Your Diet <br />When you eat a healthy diet, you feel better physically and mentally. quot;
Balance is really key,quot;
Udewitz says, especially since it's easy to use food as an emotional crutch, or on the other end of the spectrum, to restrict yourself too much. The recipe is relatively simple: keep processed, fried, and high-sugar foods and drinks to a minimum while focusing on whole grains, lean proteins and vegetables. It's also a good idea to avoid stimulants (like caffeine) if you're prone to anxiety. <br />Engage in a Hobby <br />quot;
It's really important to do something you enjoy every day,quot;
Udewitz says. We already know that hobbies like knitting can help reduce the stress response; other hobbies -- especially ones that involve working with your hands, like sewing, cooking, woodworking or gardening -- can have similar calming responses. Leisure activities can help pull you out of your funk because you're forced to focus on something outside yourself. <br />Meditation <br />Udewitz often recommends meditation to his clients, so that they learn to develop the ability to just be with themselves and their thoughts. Everyone meditates differently. Some people chant a mantra and try to focus; others just let their mind go blank and let thoughts wander in and out of their brain. A good way to get started: Focus on tracing the path of your breath. <br />Biofeedback <br />Biofeedback machines measure physiological functions (like temperature and heart rate). It gives you information about your body (sometimes while introducing stressors) so that you can see how you are responding physically to a stress. quot;
You can learn to regulate your physiology through breathing and quieting the mind,quot;
Udewitz says. Many psychologists (including Udewitz) use biofeedback as part of therapy. <br />St. John's Wort <br />St. John's Wort is a yellow flowering plant that many people take to aid their depression. According to National Center for Complementary and Alternative Medicine (run by the National Institutes of Health), there is conflicting evidence on whether or not <St. John's Wort can relieve symptoms of depression. However, keep in mind that even traditional prescription anti-depressants don't work all the time either. If you're interested in trying St. John's Wort (or any herbal supplement), always consult your doctor first, because it can interfere with other medications (including birth control pills and blood thinners). <br />Sam-E <br />S-adenosyl-L-methionine (SAMe, usually pronounced quot;
sammyquot;
) is another supplement many believe helps alleviate depression. The U.S. Department of Health and Human Services examined 47 studies on SAMe and depression and found that 28 of them suggested that taking SAMe decreased the symptoms of depression. <br />Valerian Root <br />Valerian root is most commonly used as a sleep aid, but some people have found it helps with anxiety and mood as well. Udewitz hasn't seen solid scientific evidence that it helps, but does have patients who have tried it and seemed to have benefited from it. A review article in American Family Physician (published by the American Academy of Family Physicians) reached a similar conclusion.<br />This topic covers depression in children and teens. For information about depression in adults, see the topic Depression. For information about depression with episodes of high energy (mania), see the topic Bipolar Disorder in Children and Teens.<br />What is depression in children and teens?<br />Depression is a serious mood disorder that can take the joy from a child’s life. It is normal for a child to be moody or sad from time to time. You can expect these feelings after the death of a pet or a move to a new city. But if these feelings last for weeks or months, they may be a sign of depression. <br />Experts used to think that only adults could get depression. Now we know that even a young child can have depression that needs treatment to improve. As many as 3 in 100 young children and 9 in 100 teens have serious depression.1<br />Still, many children don't get the treatment they need. This is partly because it can be hard to tell the difference between depression and normal moodiness. Also, depression may not look the same in a child as in an adult. <br />If you are worried about your child, learn more about the symptoms in children. Talk to your child to see how he or she is feeling. If you think your child is depressed, talk to your doctor or a counselor. The sooner a child gets treatment, the sooner he or she will start to feel better.<br />What are the symptoms?<br />A child may be depressed if he or she:<br />Is grumpy, sad, or bored most of the time. <br />Does not take pleasure in things he or she used to enjoy. <br />A child who is depressed may also:<br />Lose or gain weight. <br />Sleep too much or too little. <br />Feel hopeless, worthless, or guilty. <br />Have trouble concentrating, thinking, or making decisions. <br />Think about death or suicide a lot. <br />The symptoms of depression are often overlooked at first. It can be hard to see that symptoms are all part of the same problem. <br />Also, the symptoms may be different depending on how old the child is. <br />Very young children may lack energy and become withdrawn. They may show little emotion, seem to feel hopeless, and have trouble sleeping. <br />Grade-school children may have a lot of headaches or stomachaches. They may lose interest in friends and activities that they once liked. Some children with severe depression may see or hear things that aren't there (hallucinate) or have false beliefs (delusions). <br />Teens may sleep a lot or move or speak more slowly than usual. Teens with severe depression may hallucinate or have delusions.<br />Depression can range from mild to severe. A child who feels a little “down” most of the time for a year or more may have a mild, ongoing form of depression called dysthymia (say “dis-THY-mee-uh”). In its most severe form, depression can cause a child to lose hope and want to die. <br />Whether depression is mild or severe, there are treatments that can help. <br />What causes depression?<br />Just what causes depression is not well understood. But it is linked to an imbalance of brain chemicals that affect mood. Things that may cause these chemicals to get out of balance include:<br />Stressful events, such as changing schools, going through a divorce, or having a death in the family. <br />Some medicines, such as steroids or narcotics for pain relief. <br />Family history. In some children, depression seems to be inherited.<br />How is depression diagnosed?<br />To diagnose depression, a doctor may do a physical exam and ask questions about the child's past health. You may be asked to fill out a form about your child’s symptoms. The doctor may ask your child questions to learn more about how the child thinks, acts, and feels. <br />Some diseases can cause symptoms that look like depression. So the child may have tests to help rule out physical problems, such as a low thyroid level or anemia.<br />It is common for children with depression to have other problems too, such as anxiety, attention deficit hyperactivity disorder (ADHD), or an eating disorder. The doctor may ask questions about these problems to help your child get the right diagnosis and treatment.<br />How is it treated?<br />Usually one of the first steps in treating depression is education for the child and his or her family. Teaching both the child and the family about depression can be a big help. It makes them less likely to blame themselves for the problem. Sometimes it can help other family members see that they are also depressed. <br />Counseling may help the child feel better. The type of counseling will depend on the age of the child. For young children, play therapy may be best. Older children and teens may benefit from cognitive-behavioral therapy. This type of counseling can help them change negative thoughts that make them feel bad.<br />Medicine may be an option if the child is very depressed. Combining antidepressant medicine with counseling often works best. A child with severe depression may need to be treated in the hospital.<br />There are some things you can do at home to help your child start to feel better. <br />Urge your child to get regular exercise, eat a healthy diet, and get enough sleep. <br />See that your child takes any medicine as prescribed and goes to all follow-up appointments. <br />Make time to talk and listen to your child. Ask how he or she is feeling. Express your love and support. <br />Remind your child that things will get better in time.<br />What should you know about antidepressant medicines?<br />Antidepressant medicines often work well for children who are depressed, but there are some important things you should know about them.<br />Children who take antidepressants should be watched closely. These medicines may increase the risk that a child will think about or try suicide, especially in the first few weeks of use. If your child takes an antidepressant, learn the warning signs of suicide, and get help right away if you see any of them. Common warning signs include: <br />Talking, drawing, or writing about death. <br />Giving away belongings. <br />Withdrawing from family and friends. <br />Having a way to do it, such as a gun or pills. <br />Your child may start to feel better after 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. Make sure your child takes antidepressants as prescribed and keeps taking them so they have time to work. <br />A child may need to try several different antidepressants to find one that works. If you notice any questions or have concerns about the medicine, or if you do not notice any improvement by 3 weeks, talk to your child's doctor. <br />Do not let a child suddenly stop taking antidepressants. This could be dangerous. Your doctor can help you taper off the dose slowly to prevent problems.<br />Frequently Asked Questions<br />Learning about depression in children and teens:What is depression in children and teens? What causes depression in children and teens? What are the symptoms? How can I tell the difference between normal moodiness and depression? What happens when my child or teen is depressed? Who is affected by childhood and teen depression?Being diagnosed:How is depression in children and teens diagnosed? What is a mental health assessment? Who can diagnose and treat depression in my child or teen? What increases my child's risk of depression?Getting treatment:How is depression in children and teens treated? What medicines are used to treat depression in children <br />