Understanding Depression

Depression has been called having “the blues”, “feeling down”, “sad” or “in the dumps” but that doesn’t begin to cover what depression is and does. Depression affects the body, mind and spirit.  It can be devastating and life changing. It affects not only the person’s life, but can impact significant others, family members, employment and even the community as well.  It can last for weeks, months or years without treatment and it can end in death by suicide.

Depression is a serious illness.

What causes depression?

Depression has its roots in chemical changes in the brain. There are many factors that can combine to cause depression.  The person’s temperament and personality, early grief and losses, trauma, stressful life events, the change in seasons or any time the body’s internal clock is out-of-sync. Medical problems such as a thyroid imbalance heart attack survivors, immune diseases, cancer, and nutritional deficiencies can also play a part. The presence of persistent pain, women associated with having their premenstrual cycles and some medications and their side effects are all contributing factors. Substance abuse issues and associated withdrawal symptoms can also result in depression.

Genetics plays a part. If someone on either side of the family was depressed there is a better chance that this would be passed on to the next generation.  Depression also affects the brain and is negatively affected by stress.  The more stress and longer the stress occurs, the more the brain and the body is affected.

Are there different types of depression? If so, what are they? 

There are a number of different types of depression. The most common is Major Depressive Disorder which can be mild, moderate, or severe, in partial or full remission.  Other types can include 

  • Persistent Depressive Disorder, known as Dsythymia which occurs for at least two years.
  • Disruptive Mood Dsyregulation Disorder includes temper outbursts with irritability or anger that occur daily and is seen in children between 6-18 years old.
  • Premenstrual Dsyphoric Disorder is associated with the menstrual cycle, starting a week before and ending in the week afterwards. This brings mood swings, crying, irritability and anger, depressive symptoms, tension and anxiety.
  • Substance or Medication Induced Depression associated with taking a substance or medication.
  • Depressive Disorder due to another medical condition. 
  • Specified Depressive Disorder, which is when full criteria cannot be met but most symptoms are present.
  • Unspecified Depressive Disorder. This diagnosis may be made when there is not sufficient information or time to make a specific diagnosis.

In addition, depression can be a symptom of other diagnoses such as Bipolar Disorder, anxiety disorders with depression, Attention Deficit Hyperactivity Disorder and sadness, which is not a diagnosis, but a natural part of our existence.

Can depression be prevented? 

Depression is complex. It can’t be prevented for everyone yet, but it can be treated. That is why one pill won’t work the same way for everyone, and why medication usually takes weeks before a change in symptoms is noticed.  For some people taking their medication as prescribed, being proactive when participating in therapy and actively making changes in their lifestyles can greatly reduce symptoms over long periods of time. Cognitive Behavioral Therapy has proven to be effective in changing thoughts and feelings that are associated with depression and in helping to identify, and make lifestyle changes that reduce depressive symptoms.

How can we help someone who may be struggling?

The first part is to become aware that there has been a change.  The change includes having a depressed mood, a loss of interest or pleasure and feelings of hopelessness or despair.  Remember, depression can be sneaky.  It can start by a person feeling “off”, more sad than usual, or having low energy, and may be perceived as the onset of a flu or cold when no other flu or cold symptoms appear.

Be aware of changes in routine, difficulty with starting tasks, staying in bed longer, or increased feelings of not caring about anyone or anything.  Family members or friends who notice these symptoms should talk to the person about it and suggest that they get help. 

Above all, don’t ignore the symptoms.  Be patient, encouraging, understanding and support the person who is depressed. Talk to them and, more importantly, listen to them. Encourage them to be more active, don’t push too hard, but continue trying.

Are there resources to seek help?

If there are ever any suicidal thoughts or feelings, the person should immediately call their therapist, doctor, or the crisis hotline 1-888-568-1112.  Above all, if the person is a danger to themselves or others, hospitalization may be necessary.

If the person is not suicidal, a doctor’s appointment can help to determine if there is any physical cause for the depression. Depending on the severity, a psychiatrist or doctor may prescribe antidepressants. This can help reduce depressive symptoms and may be given in combination or alone. If there are any side effects noted, encourage the person to call their doctor and go to their appointments. 

Seeing a therapist or clinician, whether on medications or not, has been proven to be effective in helping reduce symptoms of depression. There are a number of psychotherapies treatments that can help.

Research has shown that getting treatment sooner can relieve symptoms quicker and reduce the length of time of treatment. In other words, try to encourage the person to seek therapy.  For the person that cannot get out of the home there are also telehealth services, so getting therapy is easier than ever. The best thing to do to treat symptoms of depression is to get help as soon as possible.

 

Author: Cynthia Booker-Bingler, LCSW, Health Affiliates Maine

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