|December 10, 2010||Posted by paul under Depression|
Topics on this page about depression are as follows:
* Depression; an Introduction.
* What Causes Depression?
* Depression; What can We do?
What is Depression?
Depression; an Introduction:
Depression is like the ‘common cold’ of mental illnesses/disorders. It is not uncommon by any stretch of our imagination, and it certainly can penetrate the lives of sufferers to varying degrees. The reasons for this can be varied and complex, but speaking from a clinical perspective there are distinct differences between ‘having the blues’ and feeling sad, and actually that of experiencing moderate to clinically severe depression. Having experienced a Major Depressive Disorder myself which included ECT treatment, depression of this form could be described as an utter complete sensation of nothingness, often beyond feeling sad where there seems NOTHING left. Sadness (from my own experience) was still relevant, but most of the time there was a feeling of nothingness. It was complete emptiness. Most people with depression experience a loss of hope and/or feel helpless often completely. From my battle with depression it seemed that there was nothing left, just nothing. But, whether one believes it or not, YES, something CAN actually be done. There IS hope! Words can be shallow and this should be acknowledged, but walking down the path of suicidal ideation, depression, denial and so much more from my own experience, a loss of hope and so-forth CAN actually be overcome, bit by bit in time. There is no simple solution of course and it can be very difficult not only for those actually experiencing depression and related problems, but also for others in their lives too.
What can we do? One thing that springs to my mind for others who may be trying to help are things that would be better off NOT said such as “just snap out of it”. It does not happen like this. It would be wonderful, but it is actually unrealistic to a large degree. However, through my experience, will-power and a willingness to get better is absolutely paramount as part of the ‘ingredients in the recipe’ to progress from total complete and utter nothingness, to stages of improvement and ideally to a stage of sub-clinical depression (which is more-or-less not having depression any more), but there are still also other very important factors that are crucial in recovery. Some other things (verbal comments) that are NOT particularly helpful to a person suffering depression (some things that are better off NOT said) are:
* “Oh, it’s all in your mind”.
* “Stop feeling sorry for yourself”.
* “There are plenty of people worse off than you”.
* ” You have so many things to be thankful for”.
* ” You think YOU’VE got problems”.
* “You should stop taking all those pills”.
* “Pull yourself together”.
* “You need to get out more”.
* ” Oh look, everybody gets depressed sometimes”.
* “Just don’t think about it”.
* “You’re making me depressed as well”.
* “I thought you were stronger than this”.
* “Have you tried some herbal tea?”
* “We all have problems, we have to get ourselves together sometime”.
For a person suffering depression hearing these things are not helpful at all. A depressed person will more likely even be even harder on themselves. It is difficult to know how to help. However, some ‘simple’ things can be useful-
* “I love you”.
* ” I care”.
* ” I won’t leave you, you are not alone”.
* ” You are important to me”.
* “We will get through this together”.
* “I will be with you in better times AND in worse times”.
* “I can see how hard this is for you”.
There is no quick fix (such as snapping out of it). There is much wonderful help though. There are some very good treatments for depression including the value that doctors can have in part of our recovery of depressive disorders. There are many many things we can do and arguably many things not to do, although most therapists would accept many ‘not to do things’ as a widespread guide of recognised ‘advice’, and many ‘to do’ things as recommended, helpful strategies that have a solid foundation of theory when put into practice, can reveal marvelous healing results one small attainable step at a time.
Is there really hope? YES, most certainly. It should be acknowledged that it is generally hard work and it may take a long long time to get back to what one once was or perhaps living a more sustained life than previously. How many of us in our lives have had falls? Surely, all of us. Admittedly, depression can be a major pit, something that seems too hard to conquer or even others can put us in ‘the too hard basket’. Perhaps we can see ourselves as this too, and without for a moment dismissing these thoughts, feelings and beliefs, it is quite arguable that the consequences of such beliefs, thoughts and general interpretation of life in a depressive state can be altered through our own disputing of such destructive patterns in our minds.
In saying this though, from my own experience of overcoming intensive depression, other ‘treatments’ for depression are also critical. Many doctors will prescribe anti-depressants but also simply say or acknowledge that the answer is not in any bottle.
There are other very important factors, and talking to a therapist, a counsellor, a friend, Pastor, colleague or anyone can have its benefits. Generally, most people agree that the medical field has its place and is important, but we must put the effort in ourselves. Nobody can help us much if we don’t even want to try to help ourselves. It is to be acknowledged that if people are so depressed, there may seem no hope at all and that we can literally give up on life. We can certainly get to a point going beyond even trying to help ourselves. Well, there still IS hope and medical professionals can literally save the life of a person who is struggling with depression. People can help us, and we can help ourselves too.
Overcoming depression can be a daunting task and it may take considerable time to feel back to one’s old self. However, the prognosis of recovery for depression is quite good and there are many effective and proven methods to treat depression. Personally as I have experienced a lengthy period of Major Depressive Disorder (clinical diagnosis) , I understand the depths of despair and so-forth that so commonly accompanies many feelings of people who are experiencing depression, however we all experience things differently, and we need to be careful in not minimising or not validating others’ unique and individual experience in any mental health problem including depression.
Depression goes far beyond, and is far more intense than ‘having the blues’. It is more than just feeling sad. Everybody will experience sadness and have ‘down’ days/periods or ‘the blues’. Endless reasons can contribute to this and generally a person without depression has a probability of ‘bouncing back’ and resuming normal activities and be more able to handle life’s adversaries. A person experiencing depression has in a way, lost belief and hope that life can actually get better including a reduced ability to cope in general. Anxiety can commonly accompany depression or depressive symptoms (Ref…………………………….). A person can also feel very tense or edgy and many symptoms may fluctuate in a course of depression.
Many other thoughts and feelings are common with depression including hopelessness, helplessness, worthlessness, guilt or shame, irritability/agitation, slowed thinking and/or difficulties in concentrating and a general loss of self-esteem however none of these symptoms alone may constitute depression and we need to be very careful about self-diagnosis and referring to depression loosely(Ref……………………………). Depression could be seen or experienced as a sense of unhappiness which could be described as feelings of mild anhedonia ( which is a lowered or decreased ability to have a sense of enjoyment from activities that were once pleasurable), or feelings of apathy or fatigue through to a profound or intense sense of complete worthlessness. Generally speaking, there is particular clinical criteria (pertaining to symptoms) which is recognised by a treating physician, that last or present itself every day for at least 2 weeks. Other symptoms can include: * Social withdrawal. * Decreased physical activity. * Sleep or appetite disturbances. * Loss of sexual drive/interest. * Loss of interest in work, hobbies, activities. * Serious considerations of death and suicide. * Sleeping problems such as insomnia or hypersomnia (excessive sleeping). * Changes in eating patterns or weight changes. * Dysphoria (depressed mood). * Difficulties in performing simple tasks (can be as ‘simple’ as making a coffee). * Difficulties in decision-making. * Conversational problems. * Memory problems. (Ref…………………………….). If you can identify with some of these symptoms or are worried about somebody you know or care for/love who may be experiencing some of these characteristics, it may be very worthwhile seeking help from a doctor. S/he will be able to use his/her knowledge and experience in assessment in areas such as a mental state examination. This can include doctors taking note (of the patient) of : 1. Lack of attention to personal grooming and hygiene. 2. Affect of the person (mood). The person may be irritable or anxious, may be easily moved to tears or appear ‘beyond tears’ and have a blunted affect. 3. Feelings of hopelessness/helplessness. 4. Negative views of themselves, the world and future. 5. General psycho-motor retardation. (Ref……………………………). Also, the doctor will take note if there are concerns of delusional thinking (and this does not necessarily mean something like schizophrenia). Even if these symptoms are present, you or another person (any patient) is in good hands with a doctor as an anchor point in the handling or management of cases such as various forms of depression. Hallucinations are less common, but can certainly occur in severe depression (Ref………………). With severe depression it can be very difficult to even talk much. This is difficult in itself because professional people do want to help us yet it is literally so draining and exhausting to talk sometimes. Just the thought of talking can be so daunting, but also sometimes once we start to do something like talking to someone, we may surprise ourselves of our reservior of inner-strength or ‘appliances’ that we mat actually posses even in such awfully draining and literally horrid times. There are indeed many different types of depression including severe forms which can be more readily recognised, through to milder forms which may be often difficult to distinguish from other issues such as grief and loss. For example, bereavement, divorce, loss of a job and/or income and so on can manifest itself in more of a “depressive reaction” that only lasts short-term, compared to a clinical diagnosis of say Mild Depressive Disorder (Ref…………………….). For those experiencing Major Depressive Disorder (and indeed other types of depression) life in general can seem hopeless. Experiencing major depression myself, I felt completely and utterly empty and had a deep sense of emptiness far beyond sadness and I very much questioned the value of my life. Nevertheless, there IS an enormous array of methods of help available to those suffering depression. Depression manifests itself in many ways, as indeed there are many different types of depression. Apathy can be a constant feeling that may endure for quite some time and for the sufferer it can be an enormous task just to read information about depression let alone actively seeking help by themselves. Yet, by firstly recognising your depression and NOT denying it, talking to a doctor or other professional such as a counsellor can be one of many opportunities to become more pro-active in your recovery. It IS very difficult, yet there also is so much help for depression. Depressed=failure. No! Failure is not falling down, it is staying down. Everybody has falls, everybody has downs. For some, the periods are longer. There are endless reasons why this might be and many can be related to depression. Why is it so hard to pick ourselves up if we are depressed? It could be likened to the nature/nurture debate. People experiencing clinical depression can certainly endure biochemical disturbances in the brain, but also be affected by environmental influences (Ref………………). Whether it be genetic, inherited, environmental or situational (in general mental health) many of us face the enormous task of picking ourselves up off the floor. Being down and/or feeling like a failure is something we probably all (at least most of us) experience at some time. Whether this turns into depression is another matter. But, how do we pick ourselves up? There are so many ‘tools/utilities/weapons’; things we CAN do.
In acknowledgement of people experiencing depression especially ongoing and/or major depression, this seems more than a battle, it seems like an ongoing war (or however each of us interpret our own unique experiences). Yet, in time, each battle, each hurdle, each challenge can be overcome, bit by bit. Remember that generally speaking the best goals to set and achieve are generally those that are attainable or realistic and that can be achieved in a realistic time frame. People experiencing or dealing with depression will not get better overnight. Personally, I found that being hard on myself only reinforced depressive symptoms and keeps us on the canvas; staying down. We need to acknowledge our problems, our faults, our weaknesses, our vulnerabilities but also things that we might be able to do to get back on our feet. It can be so difficult to fight many of life’s issues by ourselves, and in recognition of our particular problems, we can start to reach out to others for help such as doctors (including psychiatrists) who have expertise and ways of helping us. A doctor can genuinely help us initially in the sense that s/he can get the ball rolling. They can help not just by listening or prescribing tablets, but they can certainly help us to find specialty professionals including counsellors who can help us fight the battle with joint efforts. We need to do our part, yet we often need help. Tablets are not the only answer. They can be a vital ingredient in our ‘map’ to healing, but also with other important ingredients in conjunction with tablets such as visiting a counsellor or therapist for a while. Life is full of mountains and valleys, and often when we are in a valley, it may be then that we may discover the opportunities to grow and start to ascend up the mountain again. Pick up the phone, do something. Reach out for help! Coping with Bipolar, anxiety and Depression. Click Here! Depression Free Method. Understand and free yourself from Depression. Click Here! What Causes Depression?: Perhaps for some people, they may ask questions such as “What causes depression? I didn’t think I would end up like this”. There are several factors that can cause or contribute to the cause of depression such as biological factors, cognition, gender, co-occurrence with other medical conditions, medications, genetic and situational elements (Ref………………….). So, is there a solitary cause of depression? No. No-one really knows for certain what the causes of depression are. It is such a complex condition and every-body’s experience of depression is different. There are certainly various theories of causes of depression and factors that are considered are: * Biological factors – A cause or contribution to clinical depression can be too much or too little of certain brain chemicals called neurotransmitters. * Cognitive – People who have negative thinking patterns and low self-esteem are more vulnerable or likely to develop clinical depression. * Gender – Females are more prone (although there may be other factors as to why females are more often diagnosed than males) to developing depression. An example of such contributing factors is that women have multiple responsibilities (and men can of course too) which may manifest itself in depression or depressive symptoms. * Co-occurrence/ overlap with other medical conditions – Statistics will show that depression is more likely to occur along with certain other illnesses such as Alzheimer’s disease, Parkinson’s disease, diabetes, heart disease, cancer, hormonal disorders and can also be highly significant with other issues such as anxiety disorders and other mental health disorders. * Medications – Some medications have side-effects which can bring about depression. * Genetics – A family history of clinical depression may increase the risk. * Situational – This can include difficult life events such as divorce, death of a loved one, financial struggles and more. (Ref…………………….). Depression is very convoluted or intricate in terms of what actually causes it. Each person’s experience of depression is different, and it can be quite complicated for others to accurately comprehend each person’s individual experience. There is no exact known cause, although theories have emerged such as situational and biochemical probabilities of contributing factors. There is evidence that parts of the brain can literally shrink in a person suffering depression (Ref………………). But, what causes it? There seems to be varying theories and/or debates. From my own diagnosis in 2004, psychiatrists told me that the cause of my depression was partly biological and partly situational. To me this made sense and from my own experience I have found people to be welcoming of such theories that there is biological element (those diagnosed, that is). For many people it seems to make sense that biological aspects could well be a part of the cause(s) of depression. However, others may think that situational elements are a leading cause and perhaps it may be the case. Nevertheless, some people say it’s biological or that it’s situational (perhaps psychological or psychiatric), or perhaps a mixture if the different elements. This site is not intended though to get bound up in causes or reasons of disorders such as depression, but to offer insights in the hope that some people may find something useful from reading about somebody who has experienced mental health problems to severe degrees and to discuss ways and insights into overcoming a life plagued with psychiatric problems even if it is just improving parts of our lives. Depression: Depression Basic Introduction to Depression Different Types of Depression What can Cause Depression? Problems Which are Commonly Related to Depression You can Overcome Depression What can Others do to Help? A Word for You; for Carers and Others Personal Message for those who may be struggling with Depression. Depression and ECT Videos About Depression. Is Depression a ‘Thought Disorder’ or a ‘Brain Disorder’? Help for Depression. Managing Depression with Another Disorder Such as OCD. Clinical Depression. Some common barriers to recognising depression. Thank you for visiting this site, and please write to [email protected] if you would like to contribute to this site in any way such as by sharing some of your knowledge and insights. Best regards, Paul. Different Types of Depression: What different types of depression are there? Depressive disorders come in an array of different types. They are listed in the DSM4 (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and other diagnostic materials and different types of depression all have specific names as all types have various signs and symptoms. Depression is recognised as a mood or affective disorder as it is concerned with alterations of mood. Some main types can include Adjustment Disorder with depressed mood, Post-natal Depression, Bipolar Mood ( Affective ) Disorder and General Depressive Episode with more emphasis put on the more severe forms. Depression can also be categorised into depression that originates from a bad (or perceived bad) or disturbing event in one’s life or depression that seems to develop with no known or apparent cause or reasoning. The second type here (‘with no known cause’) can be more difficult to overcome as a large part could be that the source of the depression is not known. It may be arguably advantageous to know a little about what we are facing (specifically here, knowing a bit about depression) in order to be better equipped to overcome it. From my experience, it certainly helped me to know a bit about what I was facing. Depression can be so very difficult even just getting by day-by-day, and it may be an asset or ‘a string to our bow’ that we can use to fight, stand up against or repel depression if we know a little bit about what we are dealing with. We can use a repertoire of ‘weapons’ to fight depression and this topic is addressed later in these writings. While I was battling severe depression (author’s insights/ experience) I felt quite alone and in a lot of despair, so much so that I continually questioned the value of my life (it certainly appeared to have very little meaning). Many people have experienced such thoughts and more than likely, very similar feelings to this, and there are also so many people who vouch that while looking back, they are so relieved that they are here today. It is easy to say things like “don’t despair”, but when you’re in depression these sorts of words seem very irrelevant, useless or any other interpretation that the sufferer may have. It can be a long path to recovery, but ultimately, there really is hope for a much better, more functional and sustained life. A person with depression may be suffering from any of many different types of depression for example, one person may have Recurrent depressive disorder (current episode severe without psychotic symptoms) and another may have Recurrent depressive disorder (current episode severe with psychotic symptoms) (Ref. Keks). There are many more types of depression other than these and they may involve similar symptoms, yet there are major differences, and that is why types appropriately have a place and name of their own in medical books such as the DSM4. Briefly, some different types of depression are : * Manic episode - This bracket of depression includes different types such as mania with or without psychotic symptoms. * Bipolar affective disorder - There are different severity’s, with or without psychotic symptoms. In general, (also know as Manic depression), Bipolar affective disorder is a disorder of mood which is characterised by changing mood swings or shifts which can vary from a depressive state through to mania and this can occur quite rapidly. * Depressive episode - There are several types of depressive episodes which also will vary in intensity and may or may not include psychotic symptoms. * Recurrent depressive episode - Again here, there are varying degrees of intensity, with or without psychotic symptoms. Variations include Recurrent depressive disorder currently in remission, through to currently severe types and unspecified types. * Persistent mood (affective) disorders - This includes cyclothymia, dysthmia and others. Cyclothymia is basically a milder form of manic depression more along the lines of hypomania (which is a milder form of mania), but alternating with mild bouts of depression. Dysthymia is more of a long-term type of depression that is generally not as severe as Major depressive disorder. Dysthymic depression is still a chronic condition but it does not really disable the sufferer, but yet it does certainly tend to hinder a person from functioning well and/ or feeling good day by day (Ref. Keks). We should consider also that many disorders will have similarities in signs and symptoms, and also coincide with behaviours that can be seen as similar too. Basically, many disorders may appear similar and they will overlap with symptoms, and only a qualified professional should attempt to make a diagnosis. Dangers or risks may stand in the way of self-diagnosis. So, many disorders can be confused and generally ‘mixed-up’ with others, but a suitable doctor will know the subtle and major differences. To sum up, depression can vary from extreme apathy through to mania, may or may not include psychotic symptoms and generally vary in intensity and/or duration. Symptoms may vary from person to person and specific symptoms in each individual may vary or alter through our own unique experience and fight against depression. Coping with Bipolar, anxiety and Depression. Click Here! Depression Free Method. Understand and free yourself from Depression. Click Here! Depression; What can We do? What about treatments ? It is generally considered that treatment is very affective. A good start on the road to recovery could be visiting your family doctor or some type of community centre who deals in health issues. Treatments of today can certainly help people suffering depression to rediscover themselves or return to more normal feelings to cope with and enjoy life again. Because we are all so different and have different symptoms including feelings about ourselves and our world (including subjective points of view), treatment can involve one or more of the following : * Psychological interventions: endeavouring to help individuals understand their thoughts and their behaviours can be part of therapeutic intervention although specific techniques can be implemented from from specific therapeutic interventions such as Cognitive Behavioural Therapy and/or Rational Emotive Behaviour Therapy. There are various psychological interventions and different therapists may use various or a combined type of approach to what their expertise is and also moulded around each individuals response to certain types of therapy. This can include utilising one or more theoretical approaches such as C.B.T. (Cognitive Behavioural Therapy), Interpersonal Therapy and more. Regardless of which type or approach is applied in psychological intervention, generally this type of intervention has a good success rate (Ref. Keks). * General counselling: counselling can support people and assist them to sort out or improve practical problems and conflicts, and help them also to understand the reasons for their particular depression (although some types of psychological intervention are not based on understanding the reasons about things). * Anti-depressant medications :This can help relieve depressed feelings, can help in restoring normal sleep patterns and appetite, and also help reduce anxiety. What they do is generally help the brain restore a balance of neurotransmitters in the brain itself. It is very understandable from a patient’s point of view why one may be concerned or reluctant to use anti-depressants. There is no doubt they DO have side-effects however several of these side-effects are not long-term. Like any drug, our bodies “get used to it”, and will tolerate it much better after a period of time. Doctors will ask specific questions in relation to prescribing an anti-depressant that may suit the person best. There is a fair chance that a different anti-depressant could be tried if there are any concerning longer-term side-effects. Most General Practitioners are very understanding and will usually listen very closely to their patients in relation to concerns with any anti-depressants, so it is important to keep in touch with your doctor. S/he will give you good sound advice and generally offer ongoing support. Nobody generally wants to have to take anti-depressants. I will never forget when I started them myself. The emotional and other issues were other factors that were to be overcome let alone concerns about side-effects. I had to change medication quite a bit until I got the right one for me. Hang in there as hard as it might be and some anti-depressant will most likely work for you. Personally, I need to take anti-depressants as long as I live, but hardy experience any side-effects at all (and this is taking 4 of them every day). Your body will manage and as far as any psychological/ emotional struggles you may have, there are always counsellors and other people who can help you to put strategies into place to deal with these other things. * Also other specific medications can be prescribed by your doctor to help with particular problems such as mood swings. * Electro-convulsive therapy (ECT): ECT is a highly effective treatment (Ref. Keks). There is NO NEED to be frightened about this. I have personally had this treatment myself and have known others who have had no major problems at all with it. It IS quite safe! Physicians (who perform this type of treatment) take thorough precautions such as performing scans and x-rays to ensure maximum safety for the patient. They will not administer this treatment if they think or feel there are risks or dangers to the patient. Generally though, ECT is only administered for some severe forms of depression (specifically talking about depression here) and not used as an early treatment in phases of depression. ECT is sometimes used in other illnesses which are not mentioned here. ECT can literally be life-saving for people at high risk of suicide, including those who have stopped eating and drinking and at high risk of death. Personally, my experience of ECT was NOT horrific at all, not one bit. We have good, thorough and professional doctors and helpers who know what they are doing, and they will not advise this as a treatment if there are any significant risks what-so-ever. Having ECT myself, I can somewhat relate to others’ concerns or reluctance to accept various forms of treatment for depression such as ECT. Fears and so-forth of procedures like this are likely to be closely related to a general lack of awareness of some facts and general information about such treatments that leads people to feel unnecessarily frightened, concerned or confused. * Physical exercise: exercise and other lifestyle changes can certainly help. From my own experience however, just the thought of exercise seemed way beyond my capacity. This is a hard goal to achieve if one is significantly depressed, but do try it, the benefits are rewarding. For more about what we can do about depression, please refer to the sub-page ‘Overcoming Depression’. Bibliography : Keks, N.A & Burrows, G.D. 1998, Practice Essentials Mental Health, Australasian Medical Publishing Company Limited, North Sydney. Thank you for visiting www.depressionmentalhealth.com Coping with Bipolar, anxiety and Depression. Click Here! Depression Free Method. Understand and free yourself from Depression. Click Here! Emotional S.O.S. E-book; highly recommended (even by doctors). Price: $27.00 Click Here!