Depression

Depression, the common cold of America.

The illness no one wants to talk T about. It permeates our society crossing boundaries of race, gender and socioeconomic class. We whisper well wishes and wonder (as if it were the plague) how this ever happened. The truth is, daily exposure to the stresses and strains of life, traumas, tragedies or genetic tendencies provides fertile ground for the seed of depression to grow. Depression is the most common adult psychiatric disorder and whether we like it or not we are all vulnerable to it. Ten to twenty-five percent of us will experience an episode of depression in our life time. Some professionals see the rise of depression becoming an epidemic with approximately 18 million Americans currently affected.

There is a common misconception that feeling blue or moody must be depression. Not true. Feeling blue, grieving over a loss, or being moody for a day or two does not mean that you are depressed. So. what does it mean to be depressed? If you look it up in the dictionary it is defined as “a mental condition of gloom or sadness; dejection.” Because it is a subjective personal experience that is accompanied by varying degrees of intensity and symptoms, when you ask a depressed person what it means to them, you will get a variety of responses. A common response is. “! feel miserable most of the time.” Professionals who work with depressive patients or who study depression aren’t eager to agree on any single definition either. What we do know to be true is that depression is a condition of the mind, as well as a physical affliction. It is a genetic tendency; a mood disorder caused or exacerbated by many separate bio chemical imbalances. According to C. Robert Cloninger, M.D., a professor of Psychiatry and Genetics at the Washington University School of Medicine in St. Louis, many factors such as life events, social support. personality, environment, and unspecified genetic factors can provoke depression. Everyone is in agreement that this state of mind overwhelms and distorts the senses it is all encompassing. Nearly every one suffering from depression has pervasive feelings of sadness. Many more also feel helpless, hopeless and irritable. As we can see, depression is a complex disease caused by an interplay of many factors which manifests itself in a myriad of ways.

The American Psychiatric Association has established diagnose the classification systems that allow consistent diagnoses of major depressive disorder, dysthymia disorder, bipolar disorder and seasonal affective disorder. These classification systems are contained in the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IVR). According to DSM-IVR, the check list below could help you decide if you are experiencing a temporary sadness or clinical depression. If you are suffering from clinical depression, you should seek professional help.

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Signs and symptoms of major depression are recognizable and treatable. The most common symptoms of major depression include:

• persistent “emptiness” of intense sadness,
• Pessimism,
• feelings of worthlessness or helplessness,
• loss of pleasure in ordinary activities,
• problems with sleep (insomnia. early morning waking, over sleeping),
• decreased energy or fatigue,
• loss of appetite or over eating,
• irritability and restlessness anger out of proportion to the situation,
• difficulty concentrating remembering, and making decisions,
• inappropriate guilt,
• social withdrawal,
• marked personality changes,
• headache or chronic pain that doesn’t respond to treatment,
• recurrent thoughts of death or suicide,

Depression may be a dreaded illness but there is hope because there are many effective treatments. In a recent Consumer Reports study which surveyed 4,000 respondents, who were treated by professionals for such problems as depression. stress and phobias, nine out of ten reported that their condition significantly improved after receiving some type of treatment. It is clear from all the research and surveys that treatment works. The practitioner and the method will vary according to the individual’s lifestyle, personality, attitude, diagnosis and therapeutic needs. The two forms of therapy that seem to be extremely effective for depression are cognitive behavior therapy and interpersonal psychotherapy. Cognitive therapy aims to reverse the person’s distorted thinking and his beliefs that insecurities and inadequacies will lead to inevitable failure in the future. Interpersonal therapy focuses on the person’s conflicts with others and environmental stressors, such as divorce or painful life transitions. The goal is to help the patient cope with their current problems. Support groups also contribute to the well ness of depressed people and their families. Besides someone to lean on they provide referrals, information and advocacy.

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Antidepressant drug therapy treats the symptoms of the existing depression by correcting biochemical imbalances. There are the tricyclics such as Tofranil, first used in the mid-1950’s, the selective serotonin reuptake inhibitors (S.S.R.1.s) of the late 1980’s (of which Prozac was the prototype) and the monoamine oxidase (MAO) inhibitors such as Nardil. Researchers know that these drugs work by affecting the levels of neurotransmitters in the brain. However, selecting the most effective medication for any particular individual is not an exact science. It remains. largely a process of educated guess es; often a person needs to try one or two separately, or a combination of two drugs, before the most effective one is selected. These drugs usually produce a significant improvement within six weeks. Studies have shown that the art of finding the right medication takes trial and error, but once found, it is a therapy with a significantly high success rate.

Aerobic exercise, such as brisk walking daily for thirty minutes, also helps alter neurochemicals in the brain and helps to elevate energy and mood. The key is to make your aerobic workout vigorous and often, enough to increase the production of endorphins. Exercise as therapy is an excellent complement to talk therapy. Some professionals combine the two and have found the combination to be most effective with mild or moderate depression. With the various treatment options available depression can be managed, and for many. relief can last forever.

The following resources can provide low-cost support, advocacy and education:

Depression and Related Affective Disorders Association

Depression Awareness Recognition & Treatment Program

Emotional Health Anonymous

National Depressive and Manic-Depressive Association

Anneliese London, M.A. is a Mental Health Rehabilitation Specialist, Assistant Professor and Writer specializing in health and wellness issues.