The Not so Wonderful World of Depression

From time to time, it is only human, for a person to experience some level of sadness, or frustration (Web-MD, 2009). Usually these emotions arise due to a particular life experience, such as loosing a loved one, separation or divorce, environmental changes, medical conditions, or as a side affects of medication (Web-MD, 2009), and since this is expected we tend to be less concerned so long as the symptoms fade and the individual returns to his or her natural state. But what happens when a person does not "bounce back? As quickly as we think he or she should?" What if his or her condition continues to deteriorate until they no longer eat, sleep, or function in a healthy manner? Well then, it is probably time for that individual to be evaluated by a mental health specialist; whether they want to be or not.

You see, according to the American Psychiatric Association, clinical depression is a psychological condition with symptoms that include prolonged periods of sadness, irritability, fatigue or restlessness, and/or decreased desire; that impairs one's ability to function normally or carry out his or her regular day-to-day activities (Web-MD, 2009). Individuals with this diagnosis may have difficulty thinking about one particular topic, concentrating on or completing a task, or making the simplest decisions. Of course, the longer the symptoms progress, the stronger the feelings of worthlessness, guilt, shame, or even suicide become (Web-MD, 2009).

Who Suffers From Depression?

It is important to understand that anyone can experience depression, and that 16% of all Americans will suffer from some form of depression during his or her life (GSK, 2009). But, there are certain people who are naturally more at risk than others. For instance, it is not uncommon for a woman to experience higher levels of depression than a man. This tends to be due to the biological/hormonal changes that happen within the woman's body as she reaches puberty, begins menstruation, endures a pregnancy, and/or enters menopause (GSK, 2009). Men, on the other hand, are capable of becoming depressed, but due to "social" expectations tend to hide their symptoms. Therefore, they go undiagnosed (GSK, 2009), which could cause any or all gender data to become flawed. Actually, it is probably safe to say that More people suffer from depression than anyone might think. This is not only due to the inconsistency associated with self reports and an individual's dedication to treatment. It is also due to the fact that a depressed individual's friend's and family may over look obvious symptoms and attribute the signs as a type of fad or normal aging process (GSK, 2009).

What Causes Depression?

There are many theories available that can explain the cause of depression, and it's not unusual for Neurobiologists and psychologists to debate the issue.

Some of these theories include biological and physical, as well as enviornmental issues. While others focus more on the individuals internal (psychological) self. For instance, on a biological level, studies that show that depression can be genetic, and that individuals with major depression in their immediate blood line are three times more likely to transfer the disorder through the geen pool for several generations (GSK, 2009 & Encyclopedia of Mental Disorders, 2009). But, this does not explain what actually happens within the body that causes the sympthoms to occure. Therefore, we must look deeper, and that is when we can find that there are certain neurotransmitters in an individual's brain that transfers messages between nerve cells (Encyclopedia of Mental Disorders, 2009). When there is an inbalance of these hormones, or they are not produced at all, it creates a situation within the bodily system that can cause a person to experience depression (Encyclopedia of Mental Disorders, 2009). But, these are not the only biological/physical condition that can bring on a depressive state, because there are many severe health conditions that cause an individual to experience physical weakness and stress, which can contribute to an individual's ability to become depressed (GSK, 2009). Some of these include heart disease, cancer, viral infections, low thyroid hormone levels, and biological rhythms, including women's menstrual cycles and HIV (GSK, 2009 & Encyclopedia, 2009). What's worse is that once depression sets in, the medical condition can worsen making it harder to control pain (GSK, 2009). Then again, there is always the chance that the medication used to control a medical condition can cause a person to slip into a depressive state (GSK, 2009).

. This is why it seems so improtant to evaluate both sides. After all, the circumstances surrounding depression can be so complex that it takes a combination of these theories to even begin to make comprehension possible.

This opens the door to other theories that claim that external or environmental factors such as abuse/neglect, financial problems, death of a loved one, divorce or seperation, miscarriage, or loss of a job, can cause the onset of depression (Encyclopedia of Mental Disorders, 2009 & GSK, 2009). This is because these experiences often create a lowered self-esteem and negative thinking that can intensify in nature, and/or reoccure throughout his or her lifetime (Encyclopedia of Mental Disorders, 2009). In other words, you can't always look at a person, or talk to him or her for five minuets and know for sure what has happen to cause his or her condition to progress.

How Is Depression Diagnosised?

The physical signs of depression are limited especially to those who have little to no knowledge about mentel health (Web-MD-3, 2009). But there are some behaviors that can become warning signs for those who understand their meaning. For instance, a depressed individual may quit showing concern for his or her personal appearance (Web-MD-3, 2009). They may be reluctant to hold eye contact, or exhibit memory loss, poor concentration, and poor abstract reasoning (Web-MD-3, 2009). It is also not abnormal for nervous twitches to appear, such as pacing, hand wringing, and/or twirling or pulling of ones hair (Web-MD-3, 2009). But the most obvious change that might be noticed is when someone all of a sudden becomes belligerant, and or difiant towards athority (Web-MD-3, 2009); especially when any of these sympthoms linger for longer than two weeks (Web-MD-3, 2009).

Therefor when a professional is expected to diagnose and treat depression, he or she must first take the time to gather as much data as is available (Web-MD-3, 2009). He or she may utilize specialized blood tests, or other expensive laboratory tests, but this is generally to examine the client's over all health, and/or rule out alcohol/drug abuse, or other biological inconsistancies (Web-MD-3, 2009). In other words, these tests usually fail to actually diagnose depression. This is why open communication becomes the best diagnostic tool the examiner has to rely on (Web-MD-3, 2009).

You see, when the professional speaks to the client on a one-on-one basis, he or she can gain a better understanding about the individual's family history, daily moods, his or her normal behaviors, and/or lifestyle habits that might be contributing to his or her current condition (Web-MD-3, 2009). For instance, one depressed individual may withdraw into a state of apathy. Another might find him or herself becoming extreamly irritable. Then there are the differences in sleep or appitite patterns that cause some clients to become overly reliant on these behaviors or even decrease them to a point that they rarely exsist at all. Of course there is always an exception to any rule, so some individuals Can be expected to show none of these observable sympthoms at all; even if their lives are in complete turmoil.

For those clients, it becomes very important to ask the right questions. Therefore, the professional might ask if he or she experience days weeks or months of persistent sadness, anxiety, feelings of helplessness, guilt, worthlessness, hopelessness, or persistent pessimism (Web-MD-3, 2009)? He or she may ask the client if he or she suffered from frequent or repetitive fatigue, restlessness, irritability, mood swings, headaches or gastrointestinal problems (Web-MD-3, 2009)? He or she may ask the client if he or she found that they have lost pleasure in his or her normal activities (anhedonia), endured unexplained crying spells, memory loss, or had difficulty concentrating, or making simple decissions (Web-MD-3, 2009)? Last but not least, one of the most important questions that should be asked is whether or not the individual has ever thought about or attempted to end his or her life (Web-MD-3, 2009). If at least five of these sympthoms pretain to the client, and cause the client to be unable to function then he or she is probably suffering from depression (Web-MD-3, 2009).

How is Depression Treated?

Often medications such as Zoloft, or Paxil are used to treat individuals with depression. These medications assist the neurotransmitters in the brain, and allow them to fire properly, which in return will allow the messages being sent to reach their destination. When this result is achieved, the hormonal levels (serotonin, norepinephrine, and dopamine) equal out, and the individual is more apt to be able to reach a normal or near normal state (Web-MD-2, 2009). This seems like a simple fix. But, it is not that easy, because first you have to find the right medicine or combination of medicines, which can take several tries to achieve. Then you have to give those medicines time to work, which usually takes weeks to occur (GSK, 2009). During this process, the client may experience a variety of different side effects (dizziness or nausea, diarrhea, vomiting, changes in sexual appetite or abilities, and weight loss or gain) that may be less than comfortable (GSK, 2009). This is not abnormal, and if they occur, they usually stop when the client's body gets use to the chemical (GSK, 2009).

Another treatment for depression is called Psychotherapy, or "talk therapy". This treatment consists of two (or more) people (usually a client and a mental health agent such as a social worker, psychologist, psychiatrist, or counselor) discussing what the individual has been thinking, feeling, and experiencing (GSK, 2009). Of course each therapist may have his or her own method or theory that he or she follows. For instance, some clients and therapists prefer a cognitive-behavioral approach. Some therapists prefer an interpersonal approach. Some prefer a more psychodynamic approach. Still others prefer to operate in a less structured environment such as that used for group therapy (GSK, 2009).

Each type of therapeutic approach works in a different manner. For instance, cognitive behavioral therapy (CBT), a short-term treatment, is meant to assist a client in identifying and then altering the problem actions and/or thought processes that contribute to his or her depression. This is because depressed individuals often get stuck in his or her own negative thoughts, and once those problems are handled the individual will be more capable of dealing with his or her day-to-day pressures (GSK, 2009). Interpersonal therapy, another short-term therapy, examines the client's relationships, and attempts to connect the thoughts, feelings, and actions to these relationships (GSK, 2009). Psychodynamic therapy tends to be a much longer process, focuses on past events, such as childhood trauma, and conflicts and how those events have contributed to the client's current state (GSK, 2009). Lastly, Group therapy, which can be short or long-termed, allows a group of clients who all suffer from similar problems to meet together, with a therapist, and share each other's experiences, strengths, and hopes. It may incorporate any of the above approaches, but the over all idea is to create a support system that not only provides a variety of opinions, but also does so in the least restrictive manner (GSK, 2009).

(Special Note: No matter which of the above therapies are chosen it is important that a client always inform his or her specialist if his or her symptoms worsen, or if he or she experiences thoughts of suicide (GSK, 2009).)

What is Prognosis of Untreated Depression?

Untreated depression can last weeks, months, or years. Without proper treatment, it is unlikely that the person who is suffering will ever be able to totally "pull themselves together" and be cured (Web-MD, 2009). Then there is the fact that prolonged depression can effect the individual's physical health. For instance, depression has been linked to individuals who have suffered strokes or coronary artery disease. It has also been proven that untreated depression causes many clients to ignore his or her doctor's instructions which can contribute the whether or not the illness presents (Web-MD, 2009). Then again, it is not uncommon for a depressed client to suffer from insomnia, and everyone knows that when you are ill you need rest (Web-MD, 2009). A person doesn't just need rest to get well, they need rest to function, and since depressed people often work, and lack of sleep increassed stress all contribute to irratibility, it is easy to see how difficult it could be for someone who is depressed to consentrate or work well with others; especially when he or she is irritable (Web-MD-2, 2009). This can cause co-workers and authority figures to become frustrated, and eventually decide enough is enough.

Prognosis When Treated

With early detection, intervention, treatment, and support, 80% of depressed individuals can lead successful lives. However, it is still possible for the sympthoms of this condition to last for months or years before they subside. Therefore, treatment should include teaching the individual certain activities that he or she can do that may ease the client's stress and discomfort (Web-MD-2, 2009). The first step would be to recognize what the individual's beginning stage of depression looks like. This way he or she can watch for and avoid those triggers and seek help when it gets to be too much (GSK, 2009). The second step would be to learn to be cautious of ones limitations while setting goals. It is better to set a bunch of smaller goals that are obtainable, then to be unrealistic and set one's self up for failure (GSK, 2009). The third step is to take the time for relaxing, enjoyable activities, such as talking to friends, going for walks, or any other hobby that appeals to them (GSK, 2009). The last step is a good practice for anyone who is experiencing any level of stress, and that is to avoid mind altering substances, exercise, and save those mind boggling decisions for a time when things are calmer (GSK, 2009).

(Special Note: Always seek medical advice before attempting a new activity level that you are not use to.)

Conclusion

Just because we have covered the definition, symptoms, causes, diagnosis, treatment, and prognosis of depression, does not mean that subject is complete. You see, we have yet to cover one very important area. Therefore, we will conclude with a section about how a loved one or friend can seek out the assistance he or she needs to help someone in his or her life who may be suffering from depression. After all, this diagnosis affects everyone who comes in contact with the individual who is suffering.

Anyone can learn about depression. By knowing the definition, causes, symptoms, and treatments. You place yourself in a better position to help someone in need (GSK, 2009). Second, anyone can encourage someone to seek medical/psychological advide. Sometimes a simple suggestion will place a set of events into process. Third, anyone can encourage a friend or loved one to stick with the therapy or medication that they are being given. Remember it is easy to walk away when things get hard or uncomfortable. It might even help to offer to sit in on appointments if for no other reason than moral support (GSK, 2009). Fourth, anyone can be supportive by listening when the person needs to talk, or spending time with the person just to get his or her mind off the situation at hand for a while. Either way, it is important to use caution, and not come across as being pushy for this might push the individual is a totally different direction than you intend to (GSK, 2009). Last but not least, the person needs to remember that feelings of fear or frustration are natural and justifiable. However, it is not natural or justifiable for them to place his or her own needs, whether it be physical, financial, or psychological on the shelf if that means causing one's self harm. After all, we cannot be the driving force for another if we aren't healthy ourselves.

References

Encyclopedia of Mental Disorders (2009) Depression and Depressive disorders. Retrieved September 20, 2009 from the Encyclopedia of Mental Disorders website:

http://www.minddisorders.com/Del-Fi/Depression-and-depressive-disorders.html

Glaxo Smith Kline (GSK) (2009) Depression.Com Retrieved on September 20, 2009 from the Depression.com website: http://www.depression.com/index.html

WEB-MD-1 (2009) Understanding Depression - Symptoms Retrieved on September 19, 2009 from the webmd website: http://www.webmd.com/depression/understanding-depression-symptoms?rdserver=depressionresources.webmd.com

WEB-MD-2 (2009) Untreated Depression. Retrieved on September 19, 2009 from the webmd website: http://www.webmd.com/depression/guide/untreated-depression-effects

Web-MD-3 (2009). Depression Diagnosis. Retrieved on September 19, 2009 from the webmd website: http://www.webmd.com/depression/guide/depression-diagnosis