Depression

WHAT IS DEPRESSION?

Most people experience depression from time to time. This is normal. However, major depression involves greater emotional distress and for longer periods of time. Major depression is a disorder characterized by persistent depressed mood which may last for months and possibly years and can interfere significantly with an individual’s ability to function. It is the most common psychological disorder and can happen at any age and at any point in time. A combination of genetic, environmental, and personality characteristics increases the chance a person will become depressed (Women’s Center, Counseling & Career Center, National Institute of Mental Health).


HOW IS DEPRESSION MANIFESTED?

Normal depression is not considered a mood disorder, and almost always results from current stress. There are two common reasons for normal depression:

• Grief/Loss Process. There are four phases of normal response:

        1. Numbing and disbelief. May last from a few hours to a week and may be broken up by the sudden occurrence of intense             anger, distress, or panic.

        2. Yearning and searching for the dead person. May last for several weeks and includes such reactions as restlessness,                      insomnia, and preoccupation with the deceased.

        3. Disorganization and despair. Person finally accepts the loss as permanent and tries to begin a new identity (widow or             widower). Criteria for major depression may be present at this stage.

        4. Some level of reorganization. Person starts to rebuild their life. Sadness decreases and the individual begins to find joy in             life once more (Butcher, Mineka, & Hooley, 2007).

• Situational Depression. Temporary depressed mood everyone experiences from time to time. Does not last long and doesn’t impair functioning


SIGNS AND SYMPTOMS OF DEPRESSION

• Noticeable change of appetite with either significant weight loss or gain. Similarly, changes in sleeping patterns, such as restless sleep, inability to sleep, or sleeping too much.

• Loss of interest in activities or hobbies previously enjoyed. Similarly, there is a loss of energy, feeling fatigue.

• Feelings of worthlessness or inappropriate guilt. People who are depressed are often very guilty that they are depressed. They feel guilty for dragging others down, for not being their best self, and a myriad of other things.

• Recurring thoughts of death or suicide. Persistent sad, anxious or “empty” feelings often leave people feeling like there is no hope and the only way out is by death.

• Persistent physical symptoms of pains that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

When several of these symptoms of depressive illness occur at the same time, last longer than two weeks, and interfere with ordinary functioning, professional treatment is needed (Women’s Center, Counseling & Career Center, National Institute of Mental Health). A few risk factors associated with higher depression include: being female, genetic disposition, environmental factors, stressful events, economic dependency, rigid patterns of thinking (Counseling & Career Center).


TYPES OF DEPRESSION INCLUDE THE FOLLOWING:

• Major Depressive Disorder (also known as Clinical Depression). A serious medical illness affecting 15 million American adults each year. Among the medical illnesses, it is the leading cause of disability in the U.S. Major depression is persistent, disabling and can drastically interfere with an individual’s thoughts, mood, behavior, and health.

• Often begins between ages 15–30 but can also appear in children. An episode of major depression may occur only once in a person’s lifetime, but more often it occurs throughout a person’s life. This diagnosis is made if several of the symptoms of depression (see list of symptoms) occur at the same time, last longer than two weeks, and interferes with ordinary functioning.

• Dysthymic Disorder. A less severe type of depression that involves long-term, chronic symptoms that do not disable the individual, but keep them from functioning or feeling well. This type of depression is diagnosed when the depressed mood persists for at least two years (one year in children), and is accompanied by at least two other symptoms of depression (see list of symptoms) (Women’s Center, National Institute of Mental Health).

• Postpartum Depression (or Postpartum “Blues”). Occurs in about 50 to 70 percent of women within ten days after giving birth. Hormonal readjustments may play a part in the depression. The symptoms include a mixture of mood changes: irritability, crying easily, or expressing happy feelings. Often these moods are expressed at the same time. The symptoms usually subside on their own, but withdraw more rapidly if the individual has social support and/or is able to adjust to the new demands. Women with a personal or family history of depression are more sensitive to postpartum depression (Butcher, Mineka, & Hooley, 2007; Women’s Center).


TREATMENT FOR DEPRESSION

Most depressive episodes eventually clear up with or without treatment interventions; however, several interventions can be useful in helping a person recover from depression sooner and with less impairment in functioning. Depression, including the most severe cases, is a highly treatable disorder.

The first step in treatment is to see a medical doctor in order to rule out any medical conditions that may be producing similar depressive symptoms. If the medical examination rules out any possibility of a medical condition, the doctor should conduct a psychological evaluation or refer the patient to a mental health clinic. Once diagnosed, the person with depression can be treated with a number of methods including psychotherapy (individual and/or group) and/or medications. Medications can be especially helpful for those with moderate to severe depression (Women’s Center, Counseling & Career Center, National Institute of Mental Health).


MOOD MANAGEMENT STRATEGIES

There are many events in life that are not in our control. There are steps one can take in order to be more resistant to depression when negative events come our way. These include:

• Live a balanced lifestyle by exercising, eating a healthy balanced diet, and getting adequate sleep. These actions are critical to our emotional health. They will do more for an individual than anything else they could do.

• Include time for relaxation and pleasure (e.g., movies, ballgames, walks, reading, and conversations with family and friends).

• Socialize. Studies have shown that people who socialize and have good social support systems are less vulnerable to stress and depression.

• Find appropriate ways to express intense emotions such as sadness and anger. Examples include: Identifying persons in your life with whom you can talk about your feelings. Learning how to assert yourself appropriately when you are angry. This involves respecting both your rights and the rights of others. Learning how to be honest without being hostile. Writing feelings down in a journal. Write letters to people whom you have angry or sad feelings over. Once you have written the letters thoughtfully decide whether or not to send them. Last, Serve others and pray (Counseling & Career Center, Women’s Center).


WHAT CAN CLERGY DO?

The first and most important step is to recognize the symptoms of depression, and help the person get an appropriate diagnosis and treatment. Other suggestions include offering emotional support, understanding, patience and encouragement. While being supportive and understanding, be careful not to do things that fulfill any unreasonable or unrealistic needs of the
depressed person. There is a very thin line between being supportive and being overly concerned. Too much concern can feed an unrealistic demand for attention. It can also cause dependency and sooner or later feelings of guilt over being indebted to someone else.

Second, engage the individual in conversation, and listen carefully. It is frequently difficult for a depressed person to carry on a conversation. Attempts to help may be met with defensiveness and verbal attacks. Constant reassurance that they are really cared about is important.

Last, Never belittle their feelings, rather point out realities and offer hope. Encourage the individual to engage in social activities. Be careful not to push them, too many demands can frustrate them and cause feelings of failure. Remind them that with time and treatment, the depression will go away (Counseling & Career Center, National Institute of Mental Health).


MYTHS AND REALITIES OF DEPRESSION

• Depression is hurtful but not a major medical condition. This is a myth. Depression is a serious, common medical condition that can significantly disrupt a person’s ability to function with daily tasks and routines. If depression becomes extreme, the individual may become a threat to themselves and/or others. Areas in the brain that regulate mood, behavior, thinking, sleep and appetite function abnormally when a person is depressed. Chemicals in the brain called neurotransmitters become unbalanced.

• Children do not get depressed. This is a myth. About 2.5% of children in the U.S. suffer from depression. Depression is significantly more common in boys under the age of 10. But by age 16, girls have a greater incidence of depression. As in adults, depression in children can be caused by any combination of factors that relate to physical health, life events, family history, environment, genetic vulnerability and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment.

• If your parent or grandparent had depression, you’re sure to get it eventually. This is a myth. Depression does run in families, and one is three times more likely to become depressed if their parent suffered from depression. Genes do play a role. But it is not inevitable that a child or grandchild will end up with depression.

• Only emotionally troubled people become depressed. This is a myth. Depression can affect any individual suffering from stressful or traumatic events.

• Talking about depression only makes it worse. This is a myth. Different types of talk therapy and psychotherapy have proven to be very effective in treating depression.

• Depression is most common in elderly people. This is a myth. Many people believe that the elderly experience the greatest depression when in reality depression is highest in middle-aged people between 40–59. However, the elderly do suffer from depression as a result of ill health, medication side effects, social isolation, and financial concerns. It is important that the elderly receive help for their depression, especially since white men 85 and older have the highest suicide rate.

• Depression does not cause physical pain. This is a myth. Depression can cause chest pain, queasy or nauseated sensations, dizziness or light-headedness, sleep problems, exhaustion, and changes in weight and appetite. It can also intensify joint and back pain (webmd.com).


COMMUNITY RESOURCES

Wasatch Mental Health
801-373-4766
750 N 200 W
Provo, UT 84601

Family Support and Treatment Center
801-229-1181
1255 N 1200 W
Orem, UT

National Alliance for Mental Illness (NAMI)
801-255-3855
Utah County
http://www.nami.org

BYU Comprehensive Clinic
801-422-7759
John Taylor Building (TLRB)
1190 N 900 E
Provo, UT 84602
http://cc.byu.edu