Depression

Depression is a treatable illness involving an imbalance of brain chemicals called neurotransmitters. It is not a character flaw or a sign of personal weakness. You can’t make yourself well by trying to "snap out of it." Although it can run in families, you can’t catch it from someone else. The direct causes of the illness are unclear, however it is known that body chemistry can bring on a depressive disorder, due to experiencing a traumatic event, hormonal changes, altered health habits, the presence of another illness or substance abuse.

If you experience five or more of these symptoms for more than two weeks or if any of these symptoms interfere with work or family activities, consult with your doctor for a thorough evaluation. This should include a complete physical exam (some other illnesses can cause these symptoms) open and honest about how you are feeling and and a review of your family’s history.

You cannot diagnose yourself and you cannot be diagnosed by a friend or family member. Only a properly trained health professional can determine if you have depression. An online self-assessment can help you communicate your symptoms to your health care professional. (top)

If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or hospital emergency room or call 911 immediately.

Research has identified two major types of depression
People who have major depressive disorder have had at least one major depressive episode – five or more symptoms for at least a two-week period. For some people, this disorder is recurrent, which means they may experience episodes every so often – once a month, once a year, or several times throughout their lives.

Dysthymia is a chronic, moderate type of depression. People with dysthymia usually suffer from poor appetite or overeating, insomnia or oversleeping, and low energy or fatigue. People with dysthymia are often unaware that they have an illness because their functioning is usually not greatly impaired. They go to work and mange their lives, but are frequently irritable and often complaining about stress.

People of all ages, races, ethnic groups and social classes get depression. Although it can occur at any age, depression frequently develops between the ages of 25 and 44. If you have depression, you are not alone. Approximately 20 million adult Americans experience depression every day. (top)

Depression in Children
As many as one in 33 children and one in eight adolescents has depression. If your child has five or more symptoms for at least two weeks or if they interfere with his or her daily activities (e.g., going to school, playing with friends), then your child may be clinically depressed. Other warning signs of childhood depression include headaches, frequent absences from school, social isolation and reckless behavior.

Poor parenting does not cause childhood depression. It may have many origins – genetics, biochemistry and a variety of other factors. Fortunately, treatment for childhood depression is highly effective. If you think your child may suffer from depression, ask your pediatrician to do a screening or for a referral to a health professional experienced in dealing with depression in children. Research is now indicating that early diagnosis and treatment might lessen future depressive episodes.

The FDA has just released a public health advisory on the reports of suicidality in pediatric patients being treated with antidepressant medications for major depressive disorder. Click here to read the advisory, http://www.fda.gov/cder/drug/advisory/mdd.htm.

Depression in Late Life
Depression is not a normal part of aging. Of the 32 million Americans over the age of 65, nearly five million experience serious symptoms of depression and one million suffer from depression. Elderly people with untreated depression are more likely to have worse outcomes from treatment of co-existing medical illnesses (e.g., hypertension, diabetes, heart disease). Untreated depression is the most common psychiatric disorder and the leading cause of suicide in the elderly. (top)

Depression and Women
Women are almost twice as likely as men to experience depression. The lifetime prevalence of major depression is 24 percent for women; it’s 15 percent for men. One in four women will experience clinical depression in her lifetime. The hormonal and life changes associated with menstruation, pregnancy, miscarriage, the postpartum period and menopause may contribute to, or trigger, depression. (top)

During the postpartum period, many women feel especially guilty about having depressive feelings at a time when they should be or are expected to be happy. In fact, one in ten mothers meets the criteria for depression in the postpartum period. It’s extremely important to talk about postpartum feelings, as untreated postpartum depression can affect the mother-child relationship and, in severe cases may put the infant’s or mother’s life at risk. (top)

Depression and Men
Although men are less likely to suffer from depression than women, three to four million men in the United States are affected by the illness.

Men are less likely to admit to or seek help for depression, and doctors are less likely to suspect it. Depression in men is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged. Even if a man believes he may be depressed, he may be less willing than a woman to seek help. Support and encouragement from family and friends can make a difference. For more information, visit NIMH's Men and Depression Web site.
(top)

Depression and Other Illnesses
Depression often co-exists with other mental or physical illnesses. Substance abuse, anxiety disorders and eating disorders are particularly common conditions that may be worsened by depression. A great deal of research is currently underway into the relationship between depression and physical illnesses. Several recent studies have noted that when co-existing depression is treated, prognoses are substantially improved for conditions such as heart disease, AIDS, cancer, Parkinson’s disease and diabetew. It is important to tell your doctor about all of the symptoms you are experiencing and all other illnesses for which you are receiving treatment. For more information, click here. (top)

How does depression differ from bipolar disorder?
Bipolar disorder, also known as manic depression, is a treatable medical illness where a person’s mood alternates between the "poles" of depression and mania, a heightened energetic state. (top)

Treatments for Depression
Treatment of depression may include medication, talk therapy, or other strategies that you and your health care provider may want to try. The right treatment is the one that works best for you.

The Depression and Bipolar Support Alliance does not endorse or recommend the use of any specific treatment or medication for mood disorders. For advise about specific treatments or medications, individuals should consult their physicians and/or mental health professionals.

The good news is that of all psychiatric illnesses, depression is one of the most responsive to treatment. With proper care, approximately 80 percent of people with major depression experience significant improvement and lead productive lives – even those with severe depression can be helped. Be patient and persistent. Do not give up hope and remember you are not alone. At DBSA, we’ve been there and we can help.

Medication
The Food and Drug Administration (FDA) has approved dozens of medications to treat depression. These medications are divided into various classes; each one having a distinct chemical structure that acts on different chemicals in the brain. It is important to remember that all FDA-approved medications for depression are effective – they just don’t work the same for everyone. You should work closely with your doctor to determine which medication might be best for you. Sometimes this may involve trying more than one medication or a combination of medications. Never change your dosage or discontinue your medication without talking to your doctor.

Talk therapy
Psychotherapy, or "talk therapy" is an important part of treatment of depression for many people. It can sometimes work alone in cases of mild to moderate depression or it can be used in conjunction with other treatments. People who are severely depressed may not be able to benefit from psychotherapy until their symptoms have been lifted through another means of treatment.

A good therapist can help you modify behavioral or emotional patterns that contribute to your depression. There are several types of psychotherapy: interpersonal, cognitive-behavioral, group, marriage and family, to name a few. Research the different types and find one that is right for you. Psychotherapists, while highly-educated professionals, are not medical doctors and therefore cannot prescribe medication. If you or your therapist think you could benefit from medication, you need to see a general practitioner or a psychiatrist.

Herbal or Natural Treatments
Dietary supplements and other alternative treatments that are advertised to have a positive effect on depression regularly enter the marketplace. These alternative treatments include Omega-3, St. John’s wort, SAM-e and others. DBSA does not endorse or discourage the use of these treatments. However, remember that natural is not always synonymous with safe. Different brands of supplements may contain different concentrations of the active substance when processed in different ways and these alternative treatments may have side effects, so read labels carefully and discuss them with your doctor or pharmacist.

Recent studies have suggested that herbal treatments, such as St. John’s wort, may interfere with the beneficial effects of some medications. Be sure you tell your doctor about all of the medications or herbal remedies you are taking.

Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (also known as shock therapy) is intended for people with severe symptoms of depression or sometimes mania. When medications and psychotherapy fail to adequately lessen symptoms, ECT can be a safe and effective alternative treatment. ECT is never forced upon people or used as a means of submission.

Mild electrical stimulation to the brain causes brief seizures which, in turn, relieve the depression. ECT is painless; muscle relaxants are administered to the anesthetized person to eliminate shaking. An average of six to 12 treatments over a three-to four-week period is usually required. After successful treatment subsequent depressive episodes may be managed by antidepressants or less frequent maintenance does of ECT. Like all treatments, ECT has potential side effects. Although there have been reports of memory disturbances, most ECT patients feel that the benefits far outweigh the prospect of suffering from long-term, severe depression. This is especially true for suicidal patients who may otherwise have carried out there impulses if they had waited for medication therapy to take effect. (top)

DBSA support groups provide a caring environment for people to come together to discuss their challenges and successes in living with the illness. They are not group therapy, though each group has a professional advisor and appointed facilitators. DBSA groups provide a forum for mutual understanding and self-discovery, help people stay compliant with their treatment plans and gain support from others who have been there.

How do I help my friend or family member who is depressed?
Often people who are depressed do not recognize the symptoms in themselves. The most important thing anyone can do for some who is depressed is to help him or her get an appropriate diagnosis and effective treatment. This may involve helping the person to find a doctor or therapist and make their first appointment. You may also want to offer go with the person to their first appointment for support. Encourage the individual to stay with treatment. Keep reassuring the person that, with time and help, he or she will feel better.

The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the person in conversation and listen carefully. Resist the urge to function as a therapist or try to come up with answers to the person’s concerns. Often times we just want someone to listen. Do not put down feelings expressed, but point out realities and offer hope. Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your first invitation is refused.

Do not ignore remarks about suicide. Report them to the person's therapist. Never promise confidentiality if you believe someone is close to suicide. If you think immediate self-harm is possible, contact their doctor or dial 911 immediately. Make sure the person discusses these feelings with his or her doctor. (top)

Copyright © 2008 Depression and Bipolar Support Alliance New Jersey