Depression

What is depression? Life is full of ups and downs. But when the down times last for weeks or months at a time or keep you from your regular activities, you may be suffering from depression. Depression is a medical illness that involves the body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things.

It is different from feeling “blue” or down for a few hours or a couple of days. It is not a condition that can be willed or wished away.

What are the different types of depression? 

Different kinds of depression include:

  • Major depressive disorder. Also called major depression, this is a combination of symptoms that hurt a person’s ability to work, sleep, study, eat, and enjoy hobbies.
  • Dysthymic (diss-TIME-ic) disorder. Also called dysthymia, this kind of depression lasts for a long time (two years or longer). The symptoms are less severe than major depression but can prevent you from living normally or feeling well.

Some kinds of depression show slightly different symptoms than those described above. Some may start after a particular event. However, not all scientists agree on how to label and define these forms of depression. They include:

  • Psychotic depression, which occurs when a severe depressive illness happens with some form of psychosis, such as a break with reality, hallucinations, and delusions.
  • Postpartum depression, which is diagnosed if a new mother has a major depressive episode within one month after delivery.
  • Seasonal affective disorder (SAD), which is a depression during the winter months, when there is less natural sunlight.
  • What causes depression?

There is no single cause of depression. There are many reasons why a woman may become depressed:

  • Genetics (family history) – If a woman has a family history of depression, she may be more at risk of developing it herself. However, depression may also occur in women who don’t have a family history of depression.
  • Chemical imbalance – The brains of people with depression look different than those who don’t have depression. Also, the parts of the brain that manage your mood, thoughts, sleep, appetite, and behavior don’t have the right balance of chemicals.
  • Hormonal factors – Menstrual cycle changes, pregnancy, miscarriage, postpartum period, perimenopause, and menopause may all cause a woman to develop depression.
  • Stress – Stressful life events such as trauma, loss of a loved one, a bad relationship, work responsibilities, caring for children and aging parents, abuse, and poverty may trigger depression in some people.
  • Medical illness – Dealing with serious medical illnesses like stroke, heart attack, or cancer can lead to depression.

What are the signs of depression?

Not all people with depression have the same symptoms. Some people might only have a few, and others a lot. How often symptoms occur, and how long they last, is different for each person. Symptoms of depression include:

  • Feeling sad, anxious, or “empty”
  • Feeling hopeless
  • Loss of interest in hobbies and activities that you once enjoyed
  • Decreased energy
  • Difficulty staying focused, remembering, making decisions
  • Sleeplessness, early morning awakening, or oversleeping and not wanting to get up
  • No desire to eat and weight loss or eating to “feel better” and weight gain
  • Thoughts of hurting yourself
  • Thoughts of death or suicide
  • Easily annoyed, bothered, or angered
  • Constant physical symptoms that do not get better with treatment, such as headaches, upset stomach, and pain that doesn’t go away

I think I may have depression. How can I get help?

  • Family doctor
  • Counselors or social workers
  • Family service, social service agencies, or clergy person
  • Employee assistance programs (EAP)
  • Psychologists and psychiatrists

If you are unsure where to go for help, check the Yellow Pages under mental health, health, social services, suicide prevention, crisis intervention services, hotlines, hospitals, or physicians for phone numbers and addresses.

What if I have thoughts of hurting myself?

Depression can make you think about hurting yourself or suicide. You may hurt yourself to:

  • Take away emotional pain and distress
  • Avoid, distract from, or hold back strong feelings
  • Try to feel better
  • Stop a painful memory or thought
  • Punish yourself
  • Release or express anger that you’re afraid to express to others

How is depression found and treated?

Most people with depression get better when they get treatment.

The first step to getting the right treatment is to see a doctor. Certain medicines, and some medical conditions (such as viruses or a thyroid disorder), can cause the same symptoms as depression. Also, it is important to rule out depression that is associated with another mental illness called bipolar disorder. A doctor can rule out these possibilities with a physical exam, asking questions, and/or lab tests, depending on the medical condition. If a medical condition and bipolar disorder can be ruled out, the doctor should conduct a psychological exam or send the person to a mental health professional.

Once identified, depression almost always can be treated with:

Some people with milder forms of depression do well with therapy alone. Others with moderate to severe depression might benefit from antidepressants. It may take a few weeks or months before you begin to feel a change in your mood. Some people do best with both treatments — therapy and antidepressants.

How can I help myself if I am depressed?

You may feel exhausted, helpless, and hopeless. It may be very hard to do anything to help yourself. But it is important to realize that these feelings are part of the depression and do not reflect real life. As you understand your depression and begin treatment, negative thinking will fade. In the meantime:

Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social, or other activities.

  • 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.
  • Be confident that positive thinking will replace negative thoughts as your depression responds to treatment.
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