We all feel a little blue from time to time. For most people, feeling down and sad is perfectly normal once in a while. Depression however can be very serious and limit everything we do in life. From eating to sleeping, going to work, and interacting with others, depression doesn’t go away.
Over 19 million people in the United States suffer from true clinical depression. This is around 9% of our total population. About 10 to 25% of all women suffer from a case of clinical depression during their lifetime and 5 to 12% of males. Depression is more common than you might think. This article explores all the facts about depression, the symptoms, and what to do about it.
Depression is a period of sadness, feeling blue, or withdrawal from usual activities that lasts more than a few days. The symptoms stop you from doing your usual routine, and affect eating and sleeping habits. Depression falls into a few different categories:
Major Depressive Disorder. This may happen one time only or reoccur several times over your lifetime. The symptoms of depression last from months up to a year and affect your ability to perform work, eat, sleep, and engage in social activities.
Persistent Depression. This is an episode of depression that can last for 2 years or longer. The episodes may range from severe to mild symptoms over the course of the 2 year period. Anything less than 2 years is considered a major depressive episode.
Seasonal Affective Disorder. This is commonly known as, SAD and affects people during the dark half of the year from October through February. It is attributed to less sunlight that affects the levels of serotonin in the body.
Bipolar Disorder. This condition is also called, “manic depression.” These are mood cycles that range from severe depression to extremely good moods and hyperactivity. The cycles may last from days to weeks to months long. Others can experience “rapid cycling” where moods swing quickly from one extreme to the other.
Psychotic Depressive Episodes. During severe depression, people may experience delusions or hallucinations. They may be out of touch with reality, hear things, or see things that are not really happening.
Postpartum Depression. Around 10 to 15% of new moms go through a period after the birth of a baby where they suffer severe depression. This is thought to be due to hormonal shifts in the body and the physical burden of healing and caring for a newborn. This can either be mild “baby blues” or severe depression that needs treatment.
True clinical depression symptoms will be present every day, for all or part of the day and last more than a few weeks. The symptoms of depression include:
Withdrawal from activities that make you happy
Trouble sleeping or excessive sleeping
No energy, feeling tired all the time
Lack of appetite
Weight loss or gain
Anxiety and worry
Slow thoughts and slowed speech
Inability to concentrate
Thoughts about dying, Suicidal thoughts
Physical pain that cannot be explained, migraines, joint pain
If you do have thoughts of suicide, it is important to tell someone you trust. This is highly treatable and people do very well with emergency intervention. Thoughts of suicide are usually only temporary and emergency help can teach coping skills to get through these episodes.
Depression can have many different causes. The factors that contribute to episodes of depression include:
Genetics. There is ongoing research into family history of depression. They are finding that there may be a genetic link and depression is common when there is a family history.
Brain Chemicals. Researchers have found that people with long lasting depression have biological and chemical differences in the brain. Symptoms of depression are often caused by a chemical imbalance of neurotransmitters. They have also found changes in brain matter.
Emotional Trauma. Depression can be triggered by emotional trauma including; divorce, stress, death, relationship break-up, or abuse.
Hormonal Changes. Hormonal changes can bring on symptoms of depression including; thyroid disease, pregnancy, birth, or menopause.
If you have the following factors in your life, your risk for depression can be higher. These don’t necessarily mean that you will become depressed, but the possibility is higher if you have:
Family History of Depression
Chronic Physical Illness (heart attack, cancer, stroke, thyroid disease)
Previous Major Depressive Episode
Traumatic Life Changes
Lack of Supportive Relationships
Age (Elderly, Young adults)
History of Sleep Disorder
Medication Use (Pain Medications, Tranquilizers, Steroid Use, Seizure Medications)
If you think you are depressed, first see your regular physician for a check-up. There are certain medical conditions that can cause symptoms of depression. The doctor will check the following:
History and Physical. The doctor will ask you about your symptoms, how long they have been going on, and medications you are taking.
Lab Testing The doctor will check for things like; thyroid disease, blood sugar problems (diabetes), hormone levels, pregnancy, and other conditions that may be causing the symptoms.
If no physical cause can be found, your doctor may perform psychological testing or send you to a psychologist for testing. In order to diagnose a depressive episode they will make a list of your symptoms. One of them needs to be loss of interest in usual activities or sad mood, plus five or more of the above symptoms that have lasted at least two weeks on a daily basis for most of each day.
There are a number of treatments for depression depending on the severity and type you are suffering from. Many times, mild depression can easily be treated with counseling. More severe cases may need medications or a combination of counseling and medications together. Some cases need inpatient hospitalization to stabilize the episode. Here is an overview of the treatments:
Counseling/Therapy A counselor will have you talk about your symptoms and how you are feeling. They ask about life events that “trigger” episodes. After you learn about your “triggers” the therapist will teach you coping skills that consist of certain techniques including:
Cognitive Behavioral Therapy (CBT)
Dialectic Behavioral Therapy (DBT)
Acceptance and Commitment Therapy
Medication Therapy. Medications for depression consist of antidepressants, mood stabilizers, and possible antipsychotic medications. Antidepressants come in different types that include:
Selective Serotonin Reuptake Inhibitors (SSRI). These are the most commonly prescribed antidepressants and work by blocking the reabsorption of serotonin in the brain.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI). These medications block both the reabsorption of serotonin and norepinephrine in the brain.
Norepinephrine and Dopamine Reuptake Inhibitors (NDRI). These medications block the reabsorption of norepinephrine and dopamine and have less side-effects.
Atypical Antidepressants. Atypical antidepressants can help with insomnia and sleep problems because they cause sedation and are mainly taken at bedtime.
Tricyclic Antidepressants. These are older antidepressants with a high risk of side-effects and are not as commonly used at this time. Newer SSRI’s and SNRI’s tend to have fewer side-effects. These medications are not used unless SSRI’s do not work for you.
Monoamine Oxidase Inhibitors (MAOI). These are rarely used because of severe side-effects that can have serious complications. A special diet has to be followed and many medications interact with MAOI’s.
You may have to try several medications to find the right one. It also takes two to six weeks to adjust to a medication and feel the benefits.
Severe episodes may need inpatient hospitalization, therapy, and medications. If you have felt suicidal or are unable to take care of yourself you will need to be in a safe setting. They start trials of medication therapy inpatient to see what will work to stabilize you quickly. You will participate in group therapy, private therapy, and activities. When you are feeling stable, you will be discharged home and referred for outpatient therapy services.
Exercise. Exercise can help relieve anxiety and give you energy.
Diet. Eat plenty of fresh fruits and vegetables. Increase fish that contain high amounts of Omega-3 fatty acids, like Salmon.
Spend Time Outdoors. Spend time outside in nature to improve your sense of well-being.
Create a Support System. Surround yourself with supportive people.
Meditate. Meditation can help you connect with yourself and improve your emotional state. Studies show meditation improves brain function and thinking.
Take Time for Yourself. If you are overstressed, take time for yourself and break away from the things that are getting you down.
There are some alternative remedies for depression that may be helpful in mild cases. Remember to talk to your doctor if you are choosing to use alternative remedies. These include:
St. John’s Wort. This herbal remedy is an ancient treatment for depression. The Food and Drug Administration (FDA) has not approved it for depression, but some European countries use it as a medical treatment. Some research shows that it may help with mild depression, but it does have side-effects and drug interactions. It cannot be taken with other anti-depressants, immunosuppressant medications, blood-thinning drugs, aids drugs, chemotherapy, or contraceptive pills.
Omega-3 Fatty Acids. Omega-3 fatty acids may help people who have bipolar depression or other types of depression. This supplement is safe in small amounts, but can interact with blood thinning drugs. The best way to get Omega-3 fatty acids is to eat foods high in this fatty oil like; salmon, walnuts, and flax seeds.
SAMe. SAMe is a normally made by your own body, but there are synthetic form that some people use to treat depression. It is not approved by the Food and Drug Administration. This supplement is still under research for depression and it is not completely known if it is helpful.
Saffron. There may be some benefits with saffron for depression. It needs to be used in very small amounts because too much can cause major side-effects.
Vitamin C. Some studies show that if you have a low level of vitamin C in your body, taking extra vitamin C may help improve low mood symptoms.
Prevention of Depression
Talk to a Trusted Source. If you find yourself stressed, feeling down, or withdrawing from usual activities, talk to someone you trust. Sometimes just talking about your feelings to someone can help prevent the onset of depression.
Find ways to Relieve Stress. Take up activities that relieve stress and keep your mind busy.
Eat Healthy. Certain deficiencies in vitamins and nutrients lower how your body deals with stress. Make sure you eat plenty of foods that are high in B vitamins, vitamin C, and healthy fats.
Get Enough Sleep. Being sleep deprived can increase the chances of depression. Your body needs time to rest and recharge both physically and emotionally. Sleep deprivation in new moms is one of the factors for post-partum depression. Ask for help if you need it.
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