Depression: Coping with the Unexpected

Dahlia was recognized for her upbeat personality, witty charm, and contagious humor. At the office, she was known to carry her load. On the home front, she made sure dinner was on the table by 6 p.m., the laundry was folded and neatly tucked away, while still finding time to select the perfect birthday gifts for those listed on her calendar. Dahlia's zest for life was awe inspiring to onlookers who desired to have just a fraction of her pace.

Over the past year, she has experienced several significant life changes that have affected her perception of life and interaction with others. Her husband received a "dream" job offer in another state, which came immediately following the miscarriage of their first child. He felt a new environment would help them to grow as a couple and heal. She thought she had coped well with the miscarriage by closely identifying with the fact that it was not her fault. Due to the relocation, she landed in an area of unfamiliarity with people, places, and things. She longed for her previous work environment, church home, and neighborhood grocery store. Therefore, starting from scratch to develop a new social network was turning into a daunting task. As her husband went to work each day, Dahlia was left in the home to dwell on her thoughts. At this time, self-blame about the miscarriage returned in addition to grief about abandoning her home, peers, and comfort zone. This daily routine of isolation, guilt, and grief plummeted Dahlia into a depressed mood.

Depression can be expressed in differing ways according to the individual. For example, in children and adolescents, it may show as angry episodes or rebellion to authority figures (i.e. parents and teachers). In addition, in adults, it may present as angry episodes, withdrawal, or deep sadness. Although the presentation of symptoms may vary according to the individual, there are several key features of major depressive disorder. Those characteristics include, but are not limited to: (1) a depressed or irritable mood most of the day, (2) repeated thoughts of death/suicide or an actual suicide attempt, (3) difficulty concentrating, (4) feelings of hopelessness and guilt, (5) withdrawal, and (6) negative changes in sleeping and eating patterns (Durand & Barlow, 2006). When experiencing such symptoms, the following steps may be beneficial.

1. Contact a Mental Health Professional

There are several types of mental health professionals who can provide an initial assessment to determine if major depressive disorder is present and provide individual therapy. Such persons include licensed clinical social workers, licensed professional counselors, psychologists, and psychiatrists. In addition to contacting a mental health professional, be sure to make contact with your primary care physician to explore any biological factors that may be causing symptoms that can "look" like depression (i.e. abnormal thyroid) or allergies that may contribute to irritability and discomfort (i.e. wheat, dairy, and peanuts). It is important to explore all factors that may contribute to a change in mood.

2. Support Group

If a significant life experience has occurred, such as the loss of a loved one, divorce, or unexpected illness (i.e. cancer), then the support from a group of people experiencing similar circumstances may aide with the expression of feelings and provide needed assistance.

3. Psychopharmacology

At times, a primary care physician or psychiatrist may recommend the use of medication to alleviate symptoms. The use of medications is the choice of the patient/client, therefore it is important to learn the purpose and side effects of the prescribed medicine. In addition, it is necessary for patients to take into consideration that the psychotropic medications are not a cure but helps to decrease the impact of symptoms to a certain extent. Therefore, it is recommended that psychotropic medications be used in conjunction with mental health therapy so the person can learn daily coping skills for major depressive disorder.

Overall, it is important to be aware of yourself and any changes that may seem significantly out of character regarding your mood. If you have concerns, take steps to gather information, which includes contacting your primary care physician or a mental health professional.

Durand, V. M. & Barlow, D. H. (2006). Essentials for abnormal psychology (4^th ed.). Belmont, CA: Thomson Wadsworth.