Depression – One Size Does Not Fit All

This is the first in a series of Mental Health topics that will be presented by guest editor Jane Smith-Decker, our mental health navigator.

We’ve all seen the endless television commercials in which sad and dejected people suddenly start looking happy after taking the particular pill being advertised.  However, it’s just not that simple.  Depression or clinical depression is a mood disorder that comes in different forms.  Depression affects 1 out of 5 women and 1 out of 10 men.   It is more than just feeling sad or getting the “blues.” Depression lasts for two weeks or more with many symptoms.

Major Depression Disorder has a variety of symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy activities they previously enjoyed.  An episode of this depression can occur only once in a lifetime, but often usually recurs throughout life.

Dysthymia is a long term but less severe type of depression. The symptoms may not disable a person but can prevent them from functioning normally or feeling well.

Psychotic Depression occurs when a severe depressive illness also has some kind of psychosis. This psychosis can include a break with reality, hallucinations, or delusions.

Postpartum Depression is common in new mothers when they develop a major depressive episode within one month after giving birth.  It is estimated that 10 to 15% of women experience postpartum depression, as do some new fathers.  It is a serious illness that needs fast and effective treatment.

Seasonal Affective Disorder is the onset of a depressive episode during the winter months caused by lack of natural sunshine. Spring and summer usually alleviate the symptoms as well as light therapy.

Symptoms of depression disorder include persistent sad, anxious, or empty mood, sleeping too much or too little, and changes in appetite and weight.  In addition, there is loss of pleasure and interest in once enjoyable activities, including sex, persistent physical symptoms, restlessness, and irritability.  Difficulty concentrating, remembering, or making decisions, fatigue, loss of energy, feelings of guilt, hopelessness, or worthlessness and thoughts of suicide or death may also be present.

Many things contribute to depression.  Biological reasons seem to be one of the major causes. Depression can be caused by too little or too much of certain brain chemicals called neurotransmitters, such as Serotonin and Norepinephrine. Changes in these chemicals may cause or contribute to a major depressive episode.

Cognitive functioning may also contribute to depression.  Negative thinking patterns and low self-esteem more than likely lead to depression. Gender may play a role as well, with women experiencing a rate of depression nearly twice as that of men.  Though reasons are unclear, depression may be caused by hormonal changes and stress in women.

Depression may also be caused by side effects from medication or conditions of other illnesses such as heart disease or cancer.  Genetics may also play a part in depression with a family history of mental illness as well as situational causes such as divorce, financial problems, and death of a loved one.  Drugs and alcohol can also cause depression.

Depression, even the most severe cases, is highly treatable. First, medications or medical conditions should be ruled out.  Once that is done, a psychological evaluation can pinpoint the disorder.

Medication is often used in the treatment of depression. SSRIs (selective serotonin reuptake inhibitors) such as Celexa, Lexapro, and Zoloft are very effective in treating depression.  SNRIs (serotonin and norepinephrine reuptake inhibitors) such as Effexor or Cymbalta are similar to SSRIs and very helpful in treatment.  These medications often take three to four weeks to begin working and are to be used regularly for the therapeutic effects to occur.  For continued control of depression, medication must be used even if one is feeling better.  There may be side effects with some medications that can be managed with other medication or by trying a concurrent, antidepressant.

Therapy can also be a good treatment, along with medication, for depression. Talk therapy with a psychiatrist, psychologist, or therapist can help with understanding depression and its effects. It can work toward positive changes in outlook and practical changes to reduce stress. In, addition, group therapy may also work well. Others with depression can share their experiences, challenges, and ways of coping. It can be a strong base of support for one suffering with depression, with encouraging and positive experiences.

Depression is a serious mental illness that can be controlled with a doctor’s care and medication. Depression does not have to rule your life. With information and care, depression can be alleviated enough to help one function well.    If you think you may be depressed, please see a medicalprofessional.

For more information, please visit the National Institute of Mental Health athttp://www.nimh.nih.gov/index.shtml