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Questions and Answers About Depression
Many people
who suffer from depression do not even know that they have
the disorder. They sense that something is wrong, but cannot
put their finger on exactly what it is. The following questions
and answers will help you to better understand the nature
of the illness so that you can determine if you or a loved
one may need to seek treatment.
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What is clinical depression? |
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A
depressive illness is a "whole body" disorder, involving one's
physiology, biochemistry, mood, thoughts and behavior. It affects
the way you eat and sleep, the way you think and feel about
yourself, others and the world.
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What
is the difference between clinical
depression and a passing blue mood? |
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Clinical
depression is not a passing blue mood or a sign of personal
weakness. Subtle changes in the brain's chemistry can create
a terrible malaise in the body-mind-spirit that can affect every
dimension of your being.
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How
common is depression? |
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Depression
is called the "common cold" of mental illness, not because its
symptoms are mild but because the disease is so widespread across
cultures. It is the most diagnosed mental health disorder in
the United States, among the most debilitating, and the most
lethal (15 percent of all untreated clinical depressions result
in suicide). At any given moment, somewhere between 15 and 20
million Americans are suffering from depressive disorders, and
about one in five will develop the illness at some point during
their lifetimes.
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Who
gets depressed? |
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Depression
does not discriminate among its victims-it affects all age groups,
all economic groups, and all gender and ethnic categories. While
the average age of onset was once a person's mid-thirties, it
is now moving towards adolescence and even early childhood.
Although depression has become the malaise of our times, it
has plagued humankind since antiquity.
King Saul of the Bible (who needed David's music to soothe his
despondency) was a classic depressive. The Greeks were the first
to understand the biological nature of depression and gave it
the name "melancholia" (from the roots "melaina chole", meaning
"black bile").
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What
causes depression? |
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Depression
is a complex, multi-faceted, multi-dimensional disorder. Just
as there is no single cause of cancer, neither is there a single
cause of depression. Depression, like the trunk of a tree, has
many roots. Some of these include:
* Genetics and biology.
Depression, like heart disease and cancer, tends to run
in families. People can be born with a certain brain chemistry or
temperament that predisposes them to being melancholic.
* Childhood trauma and other
psychological factors. Changes in our psychology
(reactions to trauma, personal loss, rejection) can also alter the
biochemistry of the brain and nervous system - sometimes permanently. Hence,
the greatest predictor of depression in adulthood is a person's
loss of a parent at an early age.
* Environmental factors.
Poor nutrition, hormonal imbalances, toxins in the environment,
brain injuries, stress, substance abuse, and can lead to
depressive states. People become depressed when losing a job,
a partner, or after contracting a serious illness.
* Adverse reactions to medication.
Many people do not realize that a number of common prescription
drugs have side effects that can induce depression. These
include cardiac drugs and hypertensives, sedatives, steroids,
stimulants, antibiotics, antifungal drugs and analgesics.
* Sociological factors.
Many changes in modern society, such as the breakdown
of traditional communities, the dissolution of extended families, the
widening gap between rich and poor, and our disconnection from
the natural world, may play a part in the rising rates
of depression worldwide.
* Spiritual crises.
People can suffer from an existential depression when
life loses its meaning and purpose. Any significant transition,
especially a change of roles in family or work, can trigger this
crisis in meaning.
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What
are the symptoms of depression? |
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Depression
is a complex disorder and its symptoms express themselves on
many levels. Depression creates physical problems, behavioral
problems, distorted thinking, changes in emotional well being,
troubled relationships and spiritual emptiness. The symptoms
of major depression can be divided into three categories:
- Disturbances
of emotion and mood.
- Changes in the
"housekeeping" functions of the brain - those that regulate
sleep, appetite, energy and sexual function.
- Disturbances
of thinking and concentration.
The
most common symptoms of clinical depression include:
* chronically sad or empty mood.
* loss of interest or pleasure in ordinary pleasurable activities, including
sex.
* decreased energy, fatigue, feeling slowed down, slowed movement,
slurred speech.
* sleep disturbances (insomnia, early morning waking, or oversleeping).
* eating disturbances (loss of appetite, significant weight
loss or weight gain).
* difficulty concentrating, impaired memory, difficulty in
making decisions.
* agitated actions (pacing, hand-wringing, etc.)
* feelings of guilt, worthlessness or helplessness.
* feelings of hopelessness and despair.
* thoughts and/or talk of death and suicide.
* irritability or excessive crying.
* social withdrawal or isolation.
* chronic aches and pains that don't respond to treatment.
* suicide attempts.
* increase in addictive behavior.
In
order to best apply this cluster of symptoms to your own situation,
think of your symptoms in terms of three words - number, duration
and intensity.
1) Number. The
symptoms of depression are "additive" - that is, the greater
the number of symptoms you have, the more likely you are to
be clinically depressed. According to the Diagnostic and Statistical
Manual of Mental Disorders (DSM IV), five or more of these
symptoms should be present for a person or someone close to
that person to consider him or herself "clinically depressed."
2) Duration.
The longer you have been down in the dumps, the more likely
it is that you are clinically depressed. According to the
DSM IV, the five or more symptoms must exist for at least
two weeks for a diagnosis of major depression to be made.
(In the case of dysthymia or chronic low-grade depression,
symptoms must be present for two years or more.)
3) Intensity. Many
of us can feel emotional pain and still cope with our daily
existence. Some experiences of depression are within the normal
course of living. The pain of major depression can be so great,
however, that its intensity (along with the number and duration
of symptoms) can significantly impair one's ability to cope.
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Can one
heal from depression? |
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Though depression is a serious illness, it
is highly treatable, as it normally responds to a combination
of antidepressants, psychotherapy, and a variety of holistic
treatments. Unfortunately, the majority of people with depression
do not seek treatment because the symptoms are unrecognized,
misdiagnosed, or so disabling that the person cannot reach out
for help. In many instances, the individual is deterred from
seeking help by the stigma surrounding mental illness. The promise
of highly effective treatment for sufferers makes it essential
for family members or friends to strongly encourage the depressed
individual to seek appropriate treatment. |
