Kevin Stevenson, LMHC, MCAP

Depression

Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness. Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, a combination of both, and other methods can effectively treat people with depression.

Depression is a treatable illness that affects the way a person thinks, feels, Behaves, and functions. At any point in time 3 to 5 percent of people suffer from depression.

Understanding the signs, symptoms, causes, and treatment of depression is the first step to overcoming the problem.

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted – the more likely it is that you’re dealing with depression. When these symptoms are overwhelming and disabling, that’s when it’s time to seek help.

Common signs and symptoms of depression

  • Feelings of helplessness and hopelessness: A bleak outlook, nothing will ever get better and there’s nothing you can do to improve your situation.
  • Loss of interest in daily activities: No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  • Appetite or weight changes: Significant weight loss or weight gain – a change of more than 5% of body weight in a month.
  • Sleep changes: Either insomnia, especially waking in the early hours of the morning, or oversleeping.
  • Anger or irritability: Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  • Loss of energy: Feeling fatigued, sluggish, and physically drained. You whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  • Self-Loathing: Strong feelings or worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  • Reckless behavior: You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • Concentration problems: Trouble focusing, making decisions, or remembering things.
  • Unexplained aches or pains: An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.
Depression and suicide
Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. Thoughts of death or suicide are a serious symptom of depression, so take any suicidal talk or behavior seriously. It’s not just a warning sign that the person is thinking about suicide: it’s a cry for help.
Warning signs of suicide include
  • Talking about killing or harming one’s self.
  • Expressing strong feelings of hopelessness or being trapped.
  • An unusual preoccupation with death or dying.
  • Acting recklessly, as if they have a death wish.
  • Calling or visiting people to say goodbye.
  • Getting affairs in order, giving away prized possessions, tying up loose ends.
  • Saying things like “everyone would be better off without me” or “I want out”.
  • A sudden switch from being extremely depressed to acting calm and happy.
If you think a friend or family member is considering suicide, express your concern and seek professional hep immediately. Talking openly about suicide thoughts and feelings can save a life!
When you’re feeling extremely depressed or suicidal, your problems don’t seem temporary – they seem overwhelming and permanent. But with time, you will feel better, especially if you reach out for help. If you are feeling suicidal, know that there are many people who want to support you during this difficult time, so please reach out for help by either calling 911 or 1-800-273-TALK (8255).
Types of depression
Depression comes in many shapes and forms. The different types of depression have unique symptoms, causes, and effects. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment.
  • Major depression
  • Dysthymia
  • Seasonal affective disorder (SAD)
  • Postpartum depression
  • Bipolar Disorder
Major depression
Major depression is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, eat, and enjoy once pleasurable activities. Major depression is disabling and prevents a person from functioning normally. The symptoms are constant, ranging from moderate to severe. Some people may experience only a single depressive episode within their lifetime, but more often a person may have multiple episodes. However, there are many things you can do to support your mood and reduce the risk of recurrence.
Dysthymia
Dysthmia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood. The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years). These chronic symptoms make it very difficult to live life to the fullest or to remember better times. Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.” If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.” However, dysthymia can be treated, even if your symptoms have gone unrecognized or untreated for years.
Seasonal affective disorder (SAD)
Seasonal affective disorder 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. Like depression, seasonal affective disorder is treatable. Light therapy, a treatment that involves exposure to bright artificial light or medication and psychotherapy in combination can reduce symptoms.
Postpartum depression
Many new mothers suffer from some fleeting form of the “baby blues.” Postpartum depression, in contrast, is a longer lasting and more serious depression triggered, in part, by hormonal and physical changes associated with having a baby along with the new responsibility of caring for a newborn. Postpartum depression usually develops soon after delivery, but any depression that occurs within six months of childbirth may be postpartum depression.
Bipolar depression
Bipolar disorder, once called manic-depression, is characterized by a mood cycle that shifts from severe highs (mania) or mild highs (hypomania) to severe lows (depression). During the manic phase, a person may experience abnormal or excessive elation, irritability, a decreased need for sleep, grandiose notions, increased talking, racing thoughts, increased sexual desire, markedly increased energy, poor judgment, and inappropriate social behavior. During the depressive phase, a person experiences the same symptoms as would a sufferer of major depression. Mood swings from manic to depressive are often gradual, although occasionally they can occur abruptly. When depressed, a person with bipolar disorder exhibits the usual symptoms of major depression, however, the treatments for bipolar depression are very different. In fact, antidepressants can make bipolar depression worse.
The faces of depression
Depression often looks different in men and women, and in young people and older adults. An awareness of these differences helps ensure the problem is recognized and treated.
Depression in men
Depression is a loaded word in our culture. Many associate it, however wrongly, with a sign of weakness and excessive emotion. This is especially true with men. Depressed men are less likely than women to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. Other signs and symptoms of depression in men include anger, aggression, violence, reckless behavior, and substance abuse. Even though depression rates for women are twice as high as those in men, men are a higher suicide risk, especially older men.
Depression in women
Rates of depression in women are twice as high as they are in men. This is due in part to hormonal factors, particularly when it comes to premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and perimenopausal depression. As for signs and symptoms, women are more likely than men to experience pronounced feelings of guilt, sleep excessively, overeat, and gain weight. Women are also more likely to suffer from seasonal affective disorder.
Depression in teens
While some depressed teens appear sad, others do not. In fact, irritability – rather than depression – is frequently the predominant symptom in depressed adolescents and teens. A depressed teenager may be hostile, grumpy, or easily lose his or her temper. Unexplained aches and pains are also common symptoms of depression in young people. Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing – even irreversible tragedy such as homicidal violence or suicide. But with help, teenage depression is highly treatable.
Depression in older adults
The difficult changes that many older adults face-such as bereavement, loss of independence, and health problems – can lead to depression, especially in those without a string support system. However, depression is not a normal part of aging. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression, and so the problem often goes unrecognized. Depression in older adults is associated with poor health, a high mortality rate, and an increased risk of suicide, so diagnosis and treatment are extremely important.
Depression causes and risk factors
Experts believe that depression is caused by a combination of biological, genetic, psychological, and environmental/social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much – if not more so – than genetics. However, risk factors make you more vulnerable to depression.
Causes and risk factors for depression
  • Recent stressful life experiences
  • Family history of depression
  • Loneliness
  • Lack of social support
  • Marital or relationship problems
  • Financial strain
  • Early childhood trauma or abuse
  • Alcohol or drug abuse
  • Unemployment or underemployment
  • Health problems or chronic pain
Treatment for depression
Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead end job, the best treatment might be finding a more satisfying career, not taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends at work or through a hobby will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.
Just as the symptoms and causes of depression are different in different people, so are the ways to feel better. What works for one person might not work for another, and no one treatment is appropriate in all cases. In most cases, the best approach involves a combination of therapy, medication, social support, lifestyle changes, and emotional skills building.
The key to depression recovery is to start small and ask for help. Having a strong support system in place will speed your recovery. Isolation fuels depression, so reach out to others, even when you feel like being alone. Let your family and friends know what you’re going through and how they can support you.
Lifestyle changes are not always easy to make, but they can have a big impact on depression. Lifestyle changes that can be very effective include:
  • Cultivating supportive relationships
  • Challenging negative thought patterns
  • Getting regular exercise and sleep
  • Managing stress
  • Practicing relaxation techniques
  • Challenging negative thought patterns
Many people lack the skills needed to manage stress and balance emotions. Building emotional skills can give you the ability to cope and bounce back from adversity, trauma, and loss. In other words, learning how to recognize and express your emotions can make you more resilient.
In addition to support from family and friends, positive lifestyle changes, and emotional skills building effective treatment for depression often involves therapy and medication.
Therapy gives you tools to treat depression from a variety of angles. Also, what you learn in therapy gives you skills and insight to prevent depression from coming back.
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.Research has shown that mild to moderate depression can often be treated successfully with either of these therapies use alone. However, severe depression appears more likely to respond to a combination of psychotherapy and medication.

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                    Kevin Stevenson, LMHC,CAP