You’ve got that feeling again…something’s not quite right. Maybe you know why those feelings are taking over. Maybe you’re not sure at all what’s making you feel so bad. But could it be more than just a case of the blues? I asked Dr. Deborah Serani, a psychologist specializing in trauma and depression, to shed some light on the darkness of this illness.
Q: What are the typical signs of depression?
A: Depression is more than just feeling of sad or having occasional blues. The symptoms of depression can be very subtle at first. It is important to learn the symptoms of depression so early identification can lead to treatment. Common symptoms include:
- Depressed or flat mood.
- Inability to enjoy activities or feel pleasure.
- Problems concentrating or sustaining attention.
- Difficulties decision making.
- Changes in eating habits or appetite, sometimes eating more or eating less.
- Weight gain or weight loss.
- Changes in sleeping habits. Sleeping too much or sleeping too little.
- Difficulty meeting responsibilities in the home, work or school because of a lack of energy.
- Feelings of guilt and hopelessness.
- Feeling despair, wondering if life is worth living.
- Slowed thoughts and speech.
- Many physical complaints, like headaches, stomach aches, backaches.
- Thoughts of death or even suicide
A person struggling with depression may not experience all of these symptoms listed. But if an individual has experienced a few of these symptoms for at least 2 weeks in duration, it is important to be evaluated for a depressive disorder. It is also important for readers to know that there are actually many kinds of depression. The two that get the most exposure are Major Depression and Bipolar Disorder. But there are other depressions.
*Dysthymic Disorder is a less severe form of Major Depression, but it can be disrupting nonetheless. Dysthymic disorder is characterized by a chronic melancholy and social withdrawal for a period of at least 2 years in adults or 1 year in children and adolescents.
* Seasonal Affective Disorder, where depressive symptoms encroach within a person when the fall and winter months roll in.
*Cyclothymic Disorder, where a mild depressed mood cycles with a hypomania component.
And then there is also the depressive disorders of Post Partum Depression which can appear anytime within the first year after childbirth. and Premenstrual Dysphoric Disorder, where depressed mood, anxiety, irritability, anger, and other symptoms occur before a woman’s period to consider as possible diagnoses. SO, when getting diagnosed, it would be imperative to work with a professional who knows about the subtleties of depression.
Q: How common is it?
A: According to the World Health Organization, depression occurs in persons of all genders, ages, and backgrounds. At present, depression affects over 120 million people worldwide. It is also the leading cause of disability worldwide. In the United States, one in five Americans will experience a depressive disorder. Of these, women experience depression more than men. The reason for this higher incidence rate is that women are more apt to go to the doctor and seek intervention than men.
Q: When should you seek help?
A: I always recommend that whenever a person feels “out of sorts”, it’s time to get a check up. Anything that feels more or not-the-usual is suspect of something. Some people are very good at knowing when their own sense of well-being is compromised. At other times, a person cannot see the depression wave washing over them. In those circumstances, it would be important to seek help if a loved family member or friend conveys concern that you seem depressed or sad.
Depression has neurobiological origins, so the first step once you decide to seek help is to go for a thorough physical examination. Certain medical conditions, like diabetes, thyroidism or a viral infection can cause the same symptoms a depression. Once the medical findings rules out a medical reason for the symptoms, a psychological evaluation should be done by a psychologist, social worker or psychiatrist.
Q: Why do you think many people suffer in silence, and are too scared or embarrassed to talk to their doctor?
A: In a word, Stigma! Though technology and research have shown that depression is a true medical condition, there are many who feel it is a weakness. Society in general often views people who are depressed as lazy or of a flawed character. These ill-formed views keep many suffering in silence from getting help that can cure the disorder. I blog about aspects of stigma often, and I have seen personally and professionally the rigid clutch stigma holds in our culture.
Q: What’s one of the biggest myth about depression?
A: That depression is not a REAL illness. That it is the result of a weak character or laziness in a person.
Q: What’s the truth about that myth?
A: It IS a real disorder. Depression research has shown us that genetics plays a large role as do hormones, neurochemistry and neurobiology. I love all the technological advances in medical imaging because now people can SEE how depression operates. http://www.musc.edu/fnrd/petdep.htm
Q: Any tips to offer on how to deal with depression?
A: Research tells us that using psychotherapy and medication together offers the best results for curing depression. Holistic approaches can be helpful as well, and I am a big believer in people finding what works uniquely for them. The triad of eating, sleeping and exercising can do great things to help overcome depression. Other natural remedies I often suggest are making sure you get in the sun as much as possible. There are studies that have shown us that depression can improve with exposure to the sun.
If sun is not available, for climate or seasonal reasons, light therapy can also be helpful. Light boxes can be purchased online helpful http://www.sunbox.com or at Costco. Color therapy is helpful as well – filling one’s home or room with vibrant and warm colors has shown to decrease sadness and stress. Meditation, yoga and massage have benefits as do the taking of omega-3 fatty acids. There have been recent studies that focused on Vagus Nerve Stimulation Treatment http://www.cyberonics.com and Transcranial Magnetic Stimulation. I think the bottom line for me as a clinician is to recommend solid clinical interventions of talk therapy and medication, and to open the door to these other alternatives as an accompaniment.
Here are some links and resource websites:
- American Psychiatric Association: http://www.psych.org
- Breaking News Blog on Depression http://www.breakingnewsblog.com/depression/
- Depression and Bipolar Support Alliance http://www.dbsalliance.org
- GlaxoSmithKline’s Depression.com http://www.depression.com
- The International Foundation for Research and Education on Depression (IFRED) http://www.ifred.org
- National Alliance of Mental Illness http://www.nami.org
- National Association of Social Workers http://www.naswdc.org/pubs/news/2005/02/bailey.asp
- National Institute of Mental Health on Depression http://www.nimh.nih.gov/health/topics/depression/index.shtml