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The Many Faces of Depression

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Depression: What is It?

Depression is an illness that can affect a person's body as well as their mind & spirit. Most People feel down from time to time, that's normal. But when feelings are severe or prolonged, one may be experiencing depression.

Depression often goes ignored or untreated. People either don't understand or they don't recognize the symptoms, they may be afraid to appear "weak" or they may be too depressed to take action.

When someone is depressed, everyone close to them suffers. Untreated, depression can disrupt work, family relations, and social life. The good news is that depression can be treated. Most people begin to feel better within weeks after beginning treatment. Treatment might include antidepressant medications and/or psychotherapy. Some self-help remedies may also be helpful such as 20 minutes of exercise every day (i.e. walking), 20 minutes of sunshine per day, and reduction in caffeine intake.

Anyone can suffer from depression. The elderly, middle aged people, young adults, adolescents and even babies can suffer from depression. Many things can predispose someone to a bout of depression such as unbalanced brain chemistry, major life changes, alcohol and other drugs, a family history of depression, illness or medications.

 

Symptoms of Depression:

There are broad ranges of symptoms that can be related to depression. Symptoms in children can be markedly different than those of an adult. Women may have symptoms different than a man, and teenagers exhibit symptoms differently than adults. On the average, the Symptoms for an adult are:

  1. poor digestion.
  2. General slowing down
  3. neglect of responsibilities and appearance
  4. irritability (complaints about matters that used to be taken in stride)
  5. Persistent sad, anxious, or "empty" mood
  6. Feelings of hopelessness, pessimism
  7. Feelings of guilt, worthlessness, helplessness
  8. Insomnia, early-morning awakening, or oversleeping.
  9. Appetite and/or weight loss or overeating and weight gain
  10. Decreased energy. Fatigue, being "slowed down"
  11. Thoughts of death or suicide, suicide attempts
  12. Restlessness, irritability
  13. Difficulty remembering, making decisions
  14. Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.
  15. Emotional flatness or emptiness
  16. inability to find pleasure in anything
  17. haplessness
  18. loss of sexual desire
  19. loss of warm feelings for family or friends
  20. loss of self esteem

A depressive disorder is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is not a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help over 80% of those who suffer from depression.

Major Depression - A Case Study

Linda was in college when she first began to slip into depression. It seemed to hit her the worst when she felt she was being rejected. After she failed to get accepted into an elite sorority, her friends noticed changes in her otherwise perky demeanor. Her voice became lifeless, her face was pale and drawn, and her eyes seemed always on the verge of tears. Her energy level was lower than usual and she had difficulty getting out of bed or doing "normal" daily tasks like eating or shopping. She became reclusive and she had difficulty sleeping or concentrating on her studies. She admitted feeling like a fraud and felt as if her life was worthless.

Linda's case demonstrates how depression differs from despair or "the blues." Seriously depressed people experience feelings of helplessness, hopelessness or unrelenting sadness. They loose their ability to enjoy life's pleasures and often feel a strong sense of guilt.

Depression can also create physical changes. Sleep patterns are typically altered and the depressed individual often wakes in the early morning hours (around 2-3 a.m.) unable to get back to sleep. They may loose their appetite or experience stomach problems from poor digestion. The depressed individual may complain that they just want to hide somewhere or crawl into a cave and role a stone in front of the opening. The feeling of wanting to escape and find peace in nothingness, is one of the symptoms of the most serious cases of depression. It is difficult for the seriously depressed person to realize that their intense dark feelings will not last forever. The fact is that all feelings related to depression are transient. THEY WILL GO AWAY! When you begin to feel overwhelmed, force yourself to get up and do something physical. Do the dishes, pull weeds (very therapeutic), take a walk, and go to the mall. The point is to get up and move; stop dwelling on your sorrow.

Depression Fast Facts:

  1. The younger a person is when they first experience an episode of major depression, the more likely they will suffer recurrent episodes.
  2. Those who have close relatives who are prone to depression are more likely to become affected.
  3. People with major depression are more likely to have physical illness and have more pain than other individuals.
  4. People who have been victims of physical and/or sexual, or emotional abuse are highly likely to experience recurring episodes of major depression.

    Take the Depression Quiz to see how you fair.

Bipolar Disorder (formerly known as Manic Depression)

Mania is feeling very high, full of energy and nearly immortal. Bipolar disorder is when a person experiences episodes of serious depression and mania alternately. The lows may last a few days or several weeks. Likewise the highs might be accompanied by inability to sleep or to relax. The person may go on shopping or gambling sprees for days or weeks at a time. They tend to be talkative, restless, aggressive, grandiose, extreme or destructive. They may boast or appear intimidating or powerful as if they had the power of the earth in their command. They may feel a sense of intense well being and they may have an increased desire for sexual gratification.

One man in a manic episode purchased seven red Camaros - one for each day of the week. A woman with the disorder became obsessed with a rock star and followed him, like a groupie, whenever she was in a manic phase. It is not uncommon for someone in a manic episode to give away all of their possessions and embark on a wild adventure. They may swing back and forth from depression to mania on a regular basis or they may experience a "calm" or "normal" period between episodes.

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some have many. Also, the severity of symptoms varies with individuals.

Symptoms of Mania:

  1. Inappropriate elation
  2. Inappropriate irritability
  3. Severe insomnia
  4. Grandiose notions
  5. Increased talking
  6. Disconnected and racing thoughts
  7. Increased sexual desire
  8. Markedly increased energy
  9. Poor judgment
  10. Inappropriate social behavior

Children and Depression

Children can experience depression as well as adults. Like adults the depression can be either a result of a chemical imbalance or a side effect of a traumatic experience. Children however, experience depression differently than adults. Unless we know what to look for, the illness can go unnoticed or be explained as a discipline problem. If a child is exhibiting any of the following problems, it may be a cover for a serious depression:

  1. Hyperactivity, delinquency, irritability aggressiveness.
  2. Physical complaints such as, headaches, stomach aches, fingernail biting or bedwetting.
  3. Or an intense desire not to go to school.

It is all too common for parents, teachers or physicians to overlook these symptoms and label the child inaccurately without realizing the undercurrent of depression. Because children don't understand the idea of depression, and have a limited vocabulary to describe how they feel, they are not likely to complain of feeling poorly. Children are also more likely to be energetic and show interest in activities than are adults experiencing depression. They may be moody, cry easily, have difficulty sleeping or have a decreased appetite. Like adults, children who are severely depressed may turn to self-destructive alternatives to emotional pain.

Suicidal children have many things in common with one another. Low self-esteem is one of them. If your child is exhibiting symptoms of severe depression, or despair, seek help immediately. Beware of falling into a trap of believing that it is not as bad as you think, or that "it will pass." The Fact is that each year hundreds of children between the ages of 5-21 kill themselves.

Look for changes in sleep patterns, eating habits, grades, peer relationships, degree of reclusivness, giving personal items away. If your child says ANYTHING insinuating that they don't want to live, or they "just can't go on," take it seriously and talk with the child, express your love for him/her and let them know that you would feel terrible if they weren't around. If your child has a long period of depression that is suddenly lifted and followed by a euphoria or an overall "relaxed" feeling, get help immediately. Children often become relaxed and even euphoric once they have made the decision to take their life. The euphoria comes from the relief of believing they won't have to suffer much longer.

Dealing With Suicidal Thoughts or Feelings

Suicide is a very serious and frightening subject. But it is a subject that needs to be understood and dealt with openly. Suicide is a significant cause of death in many western countries, in some cases exceeding deaths by motor vehicle accidents.

Attempts at suicide, and suicidal thoughts or feelings are usually a symptom indicating that a person isn't coping, often as a result of some event or series of events that they find overwhelmingly traumatic or distressing. In many cases, the events will pass, their impact can be mitigated, or their overwhelming nature will gradually fade. Since this can be extremely difficult, this article is an attempt to raise awareness about suicide, so that we may be better able to recognize and help other people in crisis, and also to find how to seek help or make better choices ourselves.

Facts about suicide:

  1. People who suffer from Major Depression, Bipolar Depression or a chemical imbalance are much more likely to attempt suicide than those in the general public.
  2. Women attempt suicide twice as often as men but men are twice as likely to die from their attempts.
  3. Men use more violent methods, which often result in permanent impairments to survivors.
  4. In a lifetime, 15% of patients with major depression will eventually die by suicide.
  5. Those who have a close relative or friend who has committed suicide are at greater risk of an attempt.
  6. Those who are abusing drugs or alcohol are at greater risk.
  7. Those who suffer from chronic illness or who have Obsessive-Compulsive tendencies or have perfectionist tendencies are at greater risk.
  8. 80% of those who kill themselves have seen their physicians in the previous six months often for symptoms of major depression (insomnia, decreased energy etc.)

People who contemplate suicide often talk about it beforehand to friends and/or family members. Because they are afraid of the thought of suicide, or because they are blind to the symptoms of depression. Many times these verbal cues go unnoticed or are rationalized as being "just talk." Whenever someone you know is jesting about dying, threatening suicide, or hinting that they wish they didn't have to live anymore, you need to ask them the following questions directly and compassionately:

  • Do you sometimes have a feeling that life isn't worth living, or do you think about death much?
  • Do you sometimes think that if you died tomorrow from an accident or illness, that it just wouldn't matter? (This is passive suicidal ideation.) >
  • Have you had thoughts of killing yourself? (This is active suicidal ideation.)

    If the person answers yes to passive but not to active suicidal ideation, for now they are probably at low risk, unless they are engaging in high risk behaviors (auto racing, doing drugs, etc.). If a person answers yes to the last question, further risk assessment is in order. Next you should ask:

  • What has kept you from acting on your suicidal ideal? If they respond that they are too afraid to try, or that their children need them too much (or something similar) then they are low risk.

    • Regardless of whether a person is low risk or high risk, they need to speak with a professional. If the underlying reason for their suicidal thoughts is not dealt with ASAP they could quickly fall into a high-risk category.

    Suicidal people are best managed on a day to day basis. That is instead of making them promise "never" to make an attempt on their life, you need to get them to commit not to make an attempt that day, for the next 24 hours or for the next week. This will help you buy time to get them help and it will provide opportunity to rethink their decision. More often than not, people who once thought they wanted to die, later state that they are EXTREMELY grateful that they did not.

    No matter how bad a person feels at the moment, the feeling will not last forever! All sad, depressed, and hopeless feelings eventually go away. Suicide is a permanent solution to a TEMPORARY problem. Depressed people, after being successfully treated, invariably stop feeling suicidal. Those who have attempted suicide but did not succeed, later express great relief that they did not die.

    The following are warning signs of someone contemplating suicide:

    1. They may feel and act very happy and/or relaxed after previously feeling depressed or lethargic.
    2. They may give away possessions.
    3. They may express feelings of worthlessness, hopelessness or helplessness.
    4. They may quit work or school or have poor performance at work or school.
    5. They may become irritable or excessively complacent.
    6. They may abuse drugs or alcohol.
    7. They may make attempt to speak with people close to them (grandparents, parents, siblings, etc.).
    8. They may be feeling better than they had been in the recent weeks.
    9. They may see a physical with complaints of pain, lethargy or sleeping problems.
    10. They may make statements that indicate their thoughts of death (i.e., "Death would feel so quiet." or "I just feel like dying." or "I think everybody would be better off without me.")

      For More on Suicide Click Here

    If you or anyone you know is exhibiting any of these signs, get help immediately. Suicide does not have to happen! See the "hotlines" listings at this site.
    Or call 1-800-999-9999 for help.

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