DEPRESSION
G'day folks,
Today I feature some facts about a scourge of the modern world - DEPRESSION. I do hope it helps someone.
WHAT IS IT?
While we all feel sad, moody or low from time to time,
some people experience these feelings intensely, for long periods of time
(weeks, months or even years) and sometimes without any apparent reason.
Depression is more than just a low mood – it's a serious illness that has an
impact on both physical and mental health.
WHAT CAUSES IT?
While the exact cause of depression
isn't known, a number of things can be associated with its development.
Generally, depression does not result from a single event, but from a
combination of recent events and other longer-term or personal factors.
Research suggests that continuing difficulties –
long-term unemployment, living in an abusive or uncaring relationship,
long-term isolation or loneliness, prolonged exposure to stress at work – are
more likely to cause depression than recent life stresses. However, recent
events (such as losing a job) or a combination of events can ‘trigger'
depression in people who are already at risk because of past bad experiences or
personal factors.
- Family history – Depression can run in families and some people will be at an increased genetic risk. However, this doesn't mean that a person will automatically experience depression if a parent or close relative has had the illness. Life circumstances and other personal factors are still likely to have an important influence.
- Personality – Some people may be more at risk of depression because of their personality, particularly if they have a tendency to worry a lot, have low self-esteem, are perfectionists, are sensitive to personal criticism, or are self-critical and negative.
- Serious medical illness – Having a medical illness can trigger depression in two ways. Serious illnesses can bring about depression directly, or can contribute to depression through associated stress and worry, especially if it involves long-term management of the illness and/or chronic pain.
- Drug and alcohol use – Drug and alcohol use can both lead to and result from depression. Many people with depression also have drug and alcohol problems. Over 500,000 Australians will experience depression and a substance use disorder at the same time, at some point in their lives.
CHANGES IN THE BRAIN
Changes in brain chemistry have been more commonly associated with severe depression rather than mild or moderate depression.
Everyone is different and it's often a combination of factors that can contribute to a person developing depression. It's important to note that you can't always identify the cause of depression or change difficult circumstances. The most important thing is to recognise the signs and symptoms and seek help.
TYPES OF DEPRESSION
There are different types of depressive disorders.
Symptoms can range from relatively minor (but still disabling) through to very
severe, so it is helpful to be aware of the range of disorders and their
specific symptoms.
Major depression
Major
depression is sometimes called major depressive disorder, clinical depression,
unipolar depression or simply depression. It involves low mood and/or loss of
interest and pleasure in usual activities, as well as other symptoms such as
those described here.
The symptoms are experienced most days and last for at least two weeks. The
symptoms interfere with all areas of a person's life, including work and social
relationships. Depression can be described as mild, moderate or severe;
melancholic or psychotic (see below).
Melancholia
This is
the term used to describe a severe form of depression where many of the
physical symptoms of depression are present. One of the major changes is that
the person can be observed to move more slowly. The person is also more likely
to have a depressed mood that is characterised by complete loss of pleasure in
everything, or almost everything.
Psychotic depression
Sometimes
people with a depressive disorder can lose touch with reality and experience
psychosis. This can involve hallucinations (seeing or hearing things that are
not there) or delusions (false beliefs that are not shared by others), such as
believing they are bad or evil, or that they are being watched or followed.
They can also be paranoid, feeling as though everyone is against them or that
they are the cause of illness or bad events occurring around them.
Antenatal and postnatal depression
Women are
at an increased risk of depression during pregnancy (known as the antenatal or
prenatal period) and in the year following childbirth (known as the postnatal
period). You may also come across the term 'perinatal', which describes the
period covered by pregnancy and the first year after the baby's birth.
The
causes of depression at this time can be complex and are often the result of a
combination of factors. In the days immediately following birth, many women
experience the 'baby blues' which is a common condition related to hormonal
changes, affecting up to 80 per cent of women. The 'baby blues', or general
stress adjusting to pregnancy and/or a new baby, are common experiences, but
are different from depression. Depression is longer lasting and can affect not
only the mother, but her relationship with her baby, the child's development,
the mother's relationship with her partner and with other members of the
family.
Almost 10
per cent of women will experience depression during pregnancy. This increases
to 16 per cent in the first three months after having a baby.
Bipolar disorder
Bipolar
disorder used to be known as 'manic depression' because the person experiences
periods of depression and periods of mania, with periods of normal mood in between.
Mania is
like the opposite of depression and can vary in intensity – symptoms include
feeling great, having lots of energy, having racing thoughts and little need
for sleep, talking fast, having difficulty focusing on tasks, and feeling
frustrated and irritable. This is not just a fleeting experience. Sometimes the
person loses touch with reality and has episodes of psychosis. Experiencing
psychosis involves hallucinations (seeing or hearing something that is not
there) or having delusions (e.g. the person believing he or she has
superpowers).
Bipolar
disorder seems to be most closely linked to family history. Stress and conflict
can trigger episodes for people with this condition and it's not uncommon for
bipolar disorder to be misdiagnosed as depression, alcohol or drug abuse,
Attention Deficit Hyperactivity Disorder (ADHD) or schizophrenia.
Diagnosis
depends on the person having had an episode of mania and, unless observed, this
can be hard to pick. It is not uncommon for people to go for years before
receiving an accurate diagnosis of bipolar disorder. It can be helpful for the
person to make it clear to the doctor or treating health professional that he
or she is experiencing highs and lows. Bipolar disorder affects approximately 2
per cent of the population.
Cyclothymic disorder
Cyclothymic
disorder is often described as a milder form of bipolar disorder. The person
experiences chronic fluctuating moods over at least two years, involving
periods of hypomania (a mild to moderate level of mania) and periods of
depressive symptoms, with very short periods (no more than two months) of
normality between. The duration of the symptoms are shorter, less severe and
not as regular, and therefore don't fit the criteria of bipolar disorder or
major depression.
Dysthymic disorder
The
symptoms of dysthymia are similar to those of major depression but are less
severe. However, in the case of dysthymia, symptoms last longer. A person has
to have this milder depression for more than two years to be diagnosed with
dysthymia.
Seasonal Affective Disorder (SAD)
SAD is a
mood disorder that has a seasonal pattern. The cause of the disorder is
unclear; however it is thought to be related to the variation in light exposure
in different seasons. It's characterised by mood disturbances (either periods
of depression or mania) that begin and end in a particular season. Depression
which starts in winter and subsides when the season ends is the most common.
It's usually diagnosed after the person has had the same symptoms during winter
for a couple of years. People with Seasonal Affective Disorder depression are
more likely to experience lack of energy, sleep too much, overeat, gain weight
and crave for carbohydrates. SAD is very rare in Australia and more likely to
be found in countries with shorter days and longer periods of darkness, such as
in the cold climate areas of the Northern Hemisphere.
Remember,
depression is treatable and effective treatments are available. The earlier you
seek
help, the better.
SIGNS AND SYMPTOMS
Depression affects how people feel about themselves. They
may lose interest in work, hobbies and doing things they normally enjoy. They
may lack energy, have difficulty sleeping or sleep more than usual. Some people
feel irritable and some find it hard to concentrate. Depression makes life more
difficult to manage from day to day.
A person
may be depressed if, for more than two weeks, he or she has felt sad, down or
miserable most of the time or has lost interest or pleasure in usual
activities, and has also experienced several of the signs and symptoms across
at least three of the categories below.
It’s
important to note that everyone experiences some of these symptoms from time to
time and it may not necessarily mean a person is depressed. Equally, not every
person who is experiencing depression will have all of these symptoms.
Behaviour
- not going out anymore
- not getting things done at work/school
- withdrawing from close family and friends
- relying on alcohol and sedatives
- not doing usual enjoyable activities
- unable to concentrate
Feelings
- overwhelmed
- guilty
- irritable
- frustrated
- lacking in confidence
- unhappy
- indecisive
- disappointed
- miserable
- sad
Thoughts
- 'I’m a failure.'
- 'It’s my fault.'
- 'Nothing good ever happens to me.'
- 'I’m worthless.'
- 'Life’s not worth living.'
- 'People would be better off without me.'
Physical
- tired all the time
- sick and run down
- headaches and muscle pains
- churning gut
- sleep problems
- loss or change of appetite
- significant weight loss or gain
If you
think that you, or someone you know, may have depression, there is a quick,
easy and confidential checklist you can complete to give you more insight. The
checklist will not provide a diagnosis – for that you need to see a health
professional.
TREATMENTS
The encouraging news is that there is a range of treatments,
health professionals and services available to help with depression, and there
are many things that people with depression can do to help themselves.
There is no one proven way that
people recover from depression. However, there is a range of effective
treatments and health professionals who can help people on the road to
recovery.
There are
also many things that people with depression can do for themselves to help them
recover and stay well. The important thing is finding the right treatment and
the right health professional for the individual's needs.
Psychological
treatments (also known as talking therapies) help people with depression to
change negative patterns of thinking and improve their coping skills so they
are better equipped to deal with life's stresses and conflicts. Psychological
therapies may not only help a person to recover, but can also help to prevent
the depression from reoccurring.
There are
several types of psychological treatments shown to be effective in the
treatment of depression:
Cognitive behaviour therapy (CBT)
CBT is a
structured psychological treatment which recognises that a person's way of
thinking (cognition) and acting (behaviour) affects the way they feel. CBT is
one of the most effective treatments for depression, and has been found to be
useful for a wide range of people, including children, adolescents, adults and
older people.
In CBT, a
person works with a professional (therapist) to identify the patterns of
thought and behaviour that are either making them more likely to become
depressed, or stopping them from improving once they become depressed.
CBT has
an emphasis on changing thoughts and behaviour by teaching people to think
rationally about common difficulties, helping them to shift their negative or
unhelpful thought patterns and reactions to a more realistic, positive and
problem-solving approach.
CBT is
also well-suited to being delivered electronically (often called e-therapies).
Interpersonal therapy (IPT)
IPT is a
structured psychological therapy that focuses on problems in personal
relationships and the skills required to deal with these problems. IPT is based
on the idea that relationship problems can have a significant impact on a
person experiencing depression, and can even contribute to the cause.
IPT is
thought to work by helping people to recognise patterns in their relationships
that make them more vulnerable to depression. Identifying these patterns means
they can focus on improving relationships, coping with grief and finding new
ways to get along with others.
Behaviour therapy
Behaviour
therapy is a major component of cognitive behaviour therapy (CBT), but behaviour
therapy focuses exclusively on increasing a person's level of activity and
pleasure in their life. Unlike CBT, it does not focus on changing the person's
beliefs and attitudes. Instead it focuses on encouraging people to undertake
activities that are rewarding, pleasant or give a sense of satisfaction, in an
effort to reverse the patterns of avoidance, withdrawal and inactivity that
make depression worse.
Mindfulness based cognitive therapy (MBCT)
MBCT is
generally delivered in groups and involves learning a type of meditation called
'mindfulness meditation'. This meditation teaches people to focus on the very
present moment, just noticing whatever they are experiencing, be it pleasant or
unpleasant, without trying to change it. At first, this approach is used to
focus on physical sensations (like breathing), but later it is used to focus on
feelings and thoughts.
MBCT
helps people to stop their mind wandering off into thoughts about the future or
the past, or trying to avoid unpleasant thoughts and feelings. This is thought
to be helpful in preventing depression from returning because it allows people
to notice feelings of sadness and negative thinking patterns early on, before
they have become fixed. It therefore helps the person to deal with these early
warning signs better.
To find
out about other psychological treatment approaches and the level of evidence
behind them, download A guide to what works for depression.
Clancy's comment: I guess we all know someone who is suffering, or has suffered from, depression. Send this post onto them if you feel it might help. Better still, give them a call or drop around and see them.
I'm ...
Think about this!
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