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Depression – What is it?

IS FEELING “DOWN” DEPRESSION?

The word “depression” has many meanings in our society that don’t equal clinical depression.
There are several types of depression, each with unique features and symptoms.
There are many causes of depression, most often resulting from a combination of factors.

WHO GETS DEPRESSED, AND HOW COMMON IS IT?

Depression is seen in children, adolescents, adults and seniors.
Women become depressed nearly two times more often than men.
Having one episode of depression increases the likelihood of having another episode.

POSSIBLE CAUSES OF DEPRESSION (not an exhaustive list)

Prolonged stress and major life changes
Physical illness (thyroid problems, cancer, etc.)
Side effects of some medications
Harboring sin and/or reckless living
Built up anger, bitterness and unforgiveness
Perfectionism, unrealistic expectations and negative thinking
Sleep disorders (sleep apnea, etc.)
Changes in the seasons (wintertime blues)
Unresolved grief and loss
Family history of depression
Interpersonal and/or marital problems
Emotional, sexual or physical abuse
Recent childbirth (i.e. Postpartum)
Alcohol and/or drug use
Irregular hormones and menopause

TYPES OF DEPRESSION

Major Depression (Unipolar Depression)

Major Depression is diagnosed when a person has several of the following symptoms for more than two weeks:

Depressed or sad mood
Diminished desire for usual activities
Significant weight loss OR weight gain
Oversleeping OR insomnia
Agitation OR feeling slowed down
Fatigue or loss of energy
Feelings of worthlessness; excessive or inappropriate guilt
Difficulty concentrating or making decisions
Recurrent thoughts of death or suicide

Bipolar I Disorder (Manic-Depression)

Bipolar depression includes both periods of Major Depression (see box at left) along with periods of intense “highs” called Mania. The symptoms of mania are:

Inflated self-esteem or grandiosity
Decreased need for sleep (may not sleep for several days or may sleep very little)
Feeling pressured to keep talking
Racing thoughts
Highly distractible
Engaging in high-risk behavior; poor decision making (buying sprees, etc.)

Bipolar II Disorder is a disorder in which the person has episodes of depression alternating with milder mania.

Dysthymia (long term depression)

Depressed mood for at least 2 years
Poor appetite OR overeating
Insomnia OR oversleeping
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness

Postpartum Depression

Some facts about Postpartum Depression: 50-80% of mothers experience the “postpartum blues” (baby blues) after childbirth. Symptoms include mood swings, feeling anxious, tearful or irritable. These symptoms are passing and usually stop within 1-2 weeks. If symptoms last longer than 2 weeks, it is important to seek medical attention. 20% of women with postpartum blues develop postpartum depression. Women who have previously been depressed (either unipolar or bipolar) have a higher rate of postpartum depression. 10-15% of women develop postpartum depression.

Symptoms include depressed mood, fatigue, thoughts of death or suicide, feelings of worthlessness, difficulty concentrating, incessant worrying about the baby OR an indifferent attitude toward the baby. Seek medical attention especially if you are having suicidal thoughts and/or the depression interferes with your ability to care for the new baby. Many women put off seeking help because they are embarrassed or because others minimize their symptoms.

Seasonal Affective Disorder (S.A.D. – also known as Wintertime Depression)

Almost half of the US population reports that their mood is lower during the winter months. A smaller percentage of these people will develop S.A.D. This mood change occurs during months from fall to spring and is caused by changes in the amount of sunlight. Symptoms of S.A.D. may include:

Depressed mood
Oversleeping, low energy, general fatigue
Overeating and weight gain
Irritability and interpersonal difficulties
Aches and pains, lowered immune system

Premenstrual Dysphoric Disorder (PMDD)

There is an absence of anxiety or depressive symptoms during the first ½ of the cycle (follicular phase). Symptoms appear during the second half of the cycle (luteal phase). Symptoms disappear when menses begins. Symptoms of PMDD may include:

Depressed mood and feelings of hopelessness
Feeling overwhelmed or out of control
Anxiety, tension, feeling “on edge”
Mood swings
Irritability or interpersonal conflicts
Decreased interest in usual activities
Difficulty concentrating
Lack of energy
Overeating and food cravings
Oversleeping or insomnia

Symptoms are more severe than is seen in PMS.

Some Important Notes

Depression often occurs in combination with other disorders. A recent study found 72% of patients with Major Depression also met criteria for at least one other disorder. When seeking treatment, it is important that a thorough assessment be completed so that important issues are not overlooked. Not getting an accurate diagnosis can lead to longer and less effective treatment, increased expense and prolonged suffering. Depression can manifest itself in a variety of ways. It is important to realize that depressive symptoms in one person may look entirely different in another person. Seek help early and proactively for depressive symptoms. Denying and/or minimizing symptoms is not helpful or wise.

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For Further Information:

Helping a Depressed Person This site discusses how to reach out and help a family member or friend who is depressed. [Helpguide.org]