Depression, things you may not knowRodney WilliamsStudent of Psychology
What is Depression?• A mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), withdrawal from social contact, and vegetative states such as loss of appetite and insomnia.
Symptoms of Depression Feelings of sadness or unhappiness•• Irritability or frustration, even over small matters•• Loss of interest or pleasure in normal activities•• Reduced sex drive•• Insomnia or excessive sleeping•• Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain•• Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still•• Slowed thinking, speaking or body movements•• Indecisiveness, distractibility and decreased concentration•• Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort•• Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things arent going right•• Trouble thinking, concentrating, making decisions and remembering things•• Frequent thoughts of death, dying or suicide•• Crying spells for no apparent reason•• Unexplained physical problems, such as back pain or headaches
What are the different forms of depression?• Major depressive disorder, or major depression, is characterized by a combination of symptoms that interfere with a persons ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major depression is disabling and prevents a person from functioning normally. Some people may experience only a single episode within their lifetime, but more often a person may have multiple episodes.• Dysthymic disorder, or dysthymia, is characterized by long-term (2 years or longer) symptoms that may not be severe enough to disable a person but can prevent normal functioning or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.• Minor depression is characterized by having symptoms for 2 weeks or longer that do not meet full criteria for major depression. Without treatment, people with minor depression are at high risk for developing major depressive disorder.• Some forms of depression are slightly different, or they may develop under unique circumstances. However, not everyone agrees on how to characterize and define these forms of depression. They include:• Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).• Postpartum depression, which is much more serious than the "baby blues" that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.1• Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.2• Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression).
How can I help myself if I am depressed?• Do not wait too long to get evaluated or treated. There is research showing the longer one waits, the greater the impairment can be down the road. Try to see a professional as soon as possible.•• Try to be active and exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed.•• Set realistic goals for yourself.• Break up large tasks into small ones, set some priorities and do what you can as you can.•• Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.•• Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.•• Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.•• Remember that positive thinking will replace negative thoughts as your depression responds to treatment.•• Continue to educate yourself about depression.
Treatment Options• Medication• Antidepressants primarily work on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways that they work. The latest information on medications for treating depression is available on the U.S. Food and Drug Administration (FDA) website.• Psychotherapy• Two main types of psychotherapies—cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT)—are effective in treating depression. CBT helps people with depression restructure negative thought patterns. Doing so helps people interpret their environment and interactions with others in a positive and realistic way. It may also help you recognize things that may be contributing to the depression and help you change behaviors that may be making the depression worse. IPT helps people understand and work through troubled relationships that may cause their depression or make it worse.• Electroconvulsive therapy and other brain stimulation therapies• For cases in which medication and/or psychotherapy does not help relieve a persons treatment- resistant depression, electroconvulsive therapy (ECT) may be useful. ECT, formerly known as "shock therapy," once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to feel better with other treatments.
Tips for living with depression• Take medication as described• Join a Support Group• Having a caring group of people who can be there to listen to you and support you is perhaps the most important thing you can do outside of medical treatment to help you with your depression. There are numerous groups, both online and in your community, dedicated to supporting those with depression and other mental illnesses.• Reduce Your Stress• When the body is under stress, the adrenal gland increases secretion of cortisol. Short-term, this hormone can help aid in survival. Long- term elevation of cortisol, however, can have detrimental effects. Although the exact mechanism that causes depression is uncertain, clinical studies suggest that chronically elevated cortisol may induce clinical depression by somehow affecting the neurotransmitter serotonin. Learning stress reduction techniques may be helpful in reducing depression.• Improve Your Sleep Hygiene• Sleep and mood are intimately related. In fact, some studies seem to show that rather than being only a symptom of depression, insomnia may in fact be a cause of depression. Learning how to get a good nights sleep could improve your mood.• Improve Your Eating Habits• A poor diet can affect both your physical and mental well-being. Eat better to feel better.• Learn How to Stop Negative Thoughts• Did you know that habitual negative thinking can lead to depression? Cognitive Behavioral Therapy (CBT) is a type of therapy which works to alter common patterns of negative thinking called cognitive distortions in order to eliminate depression. Numerous studies have shown that CBT is an effective treatment for both depression and anxiety. The best results are obtained by using CBT in conjunction with medication.• Beat Procrastination• The symptoms that we experience when depressed, such as fatigue and hopelessness, make it easy to fall into a habit of putting things off until we feel better. When important deadlines draw near, however, procrastination creates anxiety and guilt that further feeds our depression. Its a vicious cycle, but it can be stopped by learning how to break through the habit of procrastination.• Get a Handle on Your Household Chores• Depression destroys so much of our motivation and energy that if can become difficult to keep up with day-to-day chores, yet a dirty living environment only serves to make us feel more worthless and discouraged.• Learn How to Forgive• Holding on to anger about past events can contribute to depression. Forgiving these wrongs can help you heal and move forward with your life, but the Biblical definition of forgiveness is very hard for most of us to swallow. How can you forget the unforgettable? How can you forgive the unforgivable? To enjoy the benefits of forgiveness, however, we dont need to go that far.
A True Story• January 2009 as I was about to put the last of the seasons decorations in the hall closet I suddenly felt drained and very sad. I made it upstairs to the bedroom and crawled into bed and there I stayed for almost two weeks, only leaving to use the bathroom or nibble on something to eat. I was asleep most of the time so I had no idea how much time was passing. When I was finally feeling well enough to get out of bed and participate in life I noticed that everything annoyed me. I wanted to fly into a rage over the smallest things. I became so sensitive to the world around me and the people in it I was afraid that I might do damage to something or someone so I voluntarily signed myself into an inpatient facility for evaluation. I was diagnosed with major depression and the first a many medication regiments was implemented.• Taking the medications as prescribed and seeing my doctor on a regular basis helped some but I still had sadness, low energy, lack of enthusiasm and began to isolate myself at home with little or no contact with the outside world. Desperate to get some relief I took the suggestion of getting involved with group therapy.• The decision to get involved with group therapy was one of the best ones I have ever made. At first it was difficult to get up and be somewhere at a specific time with complete strangers. It did however get me out of the house and present the opportunity for social interaction. As time passed I began to feel more alive. Having a place to talk about the way I was feeling and hearing how others were feeling cleared my thoughts and allowed new ones to flow through that were not all about me. The tools that were introduced by the therapist for coping with feelings, thought stopping, affirmations and others are as important as the medications I take to effectively manage my symptoms. I have learned so many valuable techniques over the past three years, all of which are directly responsible for my success with mental health, daily living and now seeing a future that looks bright.• I have recently started college and rarely have any symptoms of depression, but when I do have low days I use all of the tips mentioned in the ,”living with depression”, section of this presentation. It’s not easy but with determination, discipline and the tools I have to help me cope I dare say I am happy most of the time now.
Resources• Medilexicon Medical Dictionary• www.medilexicon.com• Mayo Clinic• www.mayoclinic.com• Depression Outreach Study• www.depressionoutreachstudy.com• National Institute of Mental Health• www.nimh.nih.gov• U.S. Food and Drug• www.fda.gov• Nancy Schimelpfening• http://.depression.about.com