Depression; Signs, Warning, Management

The normal ups and downs of life mean that everyone feels sad or has "the blues" from time to time. But if emptiness and despair have taken hold of your life and won't go away, you may have depression. Depression makes it tough to function and enjoy life like you once did. Just getting through the day can be overwhelming. But no matter how hopeless you feel, you can get better. Understanding the signs, symptoms, causes, and treatment of depression is the first step to overcoming the problem.


What is depression?
Sadness or downswings in mood are normal

reactions to life’s struggles, setbacks, and disappointments. Many people use the word “depression” to explain these kinds of feelings, but depression is much more than just sadness.

Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don't feel sad at all - they may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless.

Whatever the symptoms, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.

Are you depressed?

If you identify with several of the following signs and symptoms, and they just won’t go away, you may be suffering from clinical depression.

• You can’t sleep or you sleep too much.
• You can’t concentrate or find that previously easy tasks are now difficult.
• You feel hopeless and helpless.
• You can’t control negative thoughts, no matter how much you try.
• You have lost your appetite, or you can’t stop eating.
• You are much more irritable, short-tempered, or aggressive than usual.
• You’re consuming more alcohol than normal or engaging in other reckless behavior.
• You have thoughts that life is not worth living (seek help immediately if this is the case)

Signs and symptoms of depression
Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted — the more likely it is that you’re dealing with depression. When these symptoms are overwhelming and disabling, that's when it's time to seek help.

Signs and symptoms include:

• Feelings of helplessness and hopelessness. A bleak outlook — thoughts or feelings of nothing will ever get better and there’s nothing you can do to improve your situation.
• Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
• Appetite or weight changes. Significant weight loss or weight gain — a change of more than 5% of body weight in a month.
• Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
• Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
• Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
• Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
• Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
• Concentration problems. Trouble focusing, making decisions, or remembering things.
• Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Depression and suicide risk

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and learn to recognize the warning signs.

Warning signs of suicide include:

• Talking about killing or harming one’s self
• Expressing strong feelings of hopelessness or being trapped
• An unusual preoccupation with death or dying
• Acting recklessly, as if they have a death wish (e.g. speeding through red lights)

• Calling or visiting people to say goodbye
• Getting affairs in order (giving away prized possessions, tying up loose ends)
• Saying things like “Everyone would be better off without me” or “I want out”
• A sudden switch from being extremely depressed to acting calm and happy

The different faces of depression
Depression often looks different in men and women, and in young people and older adults. An awareness of these differences helps ensure that the problem is recognized and treated.

If You Are Feeling Suicidal...

When you’re feeling extremely depressed or suicidal, your problems don’t seem temporary—they seem overwhelming and permanent. But with time, you will feel better, especially if you reach out for help. If you are feeling suicidal, know that there are many people who want to support you during this difficult time, please reach out for help!

If Someone You Love is Suicidal...

If you think a friend or family member is considering suicide, express your concern and seek professional help immediately. Talking openly about suicidal thoughts and feelings can save a life!

Depression in men
Depression is a loaded word in our culture. Many associate it, however wrongly, with a sign of weakness and excessive emotion. This is especially true with men. Depressed men are less likely than women to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. Other signs and symptoms of depression in men include anger, aggression, violence, reckless behavior, and substance abuse. Even though depression rates for women are twice as high as those in men, men are at a higher suicide risk, especially older men. 

Depression in women
Rates of depression in women are twice as high, than in men. This is due in part to hormonal factors, particularly when it comes to premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and perimenopausal depression. As for signs and symptoms, women are more likely than men to experience pronounced feelings of guilt, sleep excessively, overeat, and gain weight. Women are also more likely to suffer from seasonal affective disorder.

Depression in teens
While some depressed teens appear sad, others do not. In fact, irritability, rather than depression, is frequently the predominant symptom in depressed adolescents and teens. A depressed teenager may be hostile, grumpy, or easily lose his or her temper. Unexplained aches and pains are also common symptoms of depression in young people.

Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing, even irreversible tragedy such as homicidal violence or suicide. But with help, teenage depression is highly treatable. 

Depression in older adults
The difficult changes that many older adults face - such as bereavement, loss of independence, and health problems - can lead to depression, especially in those without a strong support system. However, depression is not a normal part of aging. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression, and so the problem often goes unrecognized. Depression in older adults is associated with poor health, a high mortality rate, and an increased risk of suicide, so diagnosis and treatment are extremely important.

Postpartum depression
Many new mothers suffer from some fleeting form of the “baby blues.” Postpartum depression, in contrast, is a longer lasting and more serious depression triggered, in part, by hormonal changes associated with having a baby. Postpartum depression usually develops soon after delivery, but any depression that occurs within six months of childbirth may be postpartum depression.

What are the types of depression?
Depression comes in many shapes and forms. The different types of depression have unique symptoms, causes, and effects. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment.

Major depression
Major depression is characterized by the inability to enjoy life and experience pleasure. The symptoms are constant, ranging from moderate to severe. Left untreated, major depression typically lasts for about six months. Some people experience just a single depressive episode in their lifetime, but more commonly, major depression is a recurring disorder. However, there are many things you can do to support your mood and reduce the risk of recurrence.

Dysthymia (recurrent, mild depression)
Dysthmia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood. The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years). These chronic symptoms make it very difficult to live life to the fullest or to remember better times. Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.” If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.” However, dysthymia can be treated, even if your symptoms have gone unrecognized or untreated for years.

Bipolar Disorder: When Depression is Just One Side of the Coin
Bipolar disorder, also known as manic depression, is characterized by cycling mood changes. Episodes of depression alternate with manic episodes, which can include impulsive behavior, hyperactivity, rapid speech, and little to no sleep. Typically, the switch from one mood extreme to the other is gradual, with each manic or depressive episode lasting for at least several weeks. When depressed, a person with bipolar disorder exhibits the usual symptoms of major depression. However, the treatments for bipolar depression are very different. In fact, antidepressants can make bipolar depression worse.

Depression causes and risk factors
Some illnesses have a specific medical cause, making treatment straightforward. If you have Type-1 diabetes, you take insulin. If you have appendicitis, you have surgery. Depression, however, is more complicated. Depression is not just the result of a chemical imbalance in the brain, and it’s not simply cured with medication. Experts believe that depression is caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much — if not more so — than genetics. However, certain risk factors make you more vulnerable to depression.

Seasonal affective disorder: When winter brings the blues

Many people feel sad when summer wanes, but some actually develop depression with the season’s change. Known as seasonal affective disorder (SAD), this form of depression affects about 1% to 2% of the population, particularly women and young people. SAD seems to be triggered by more limited exposure to daylight; typically it comes on during the fall or winter months and subsides in the spring.

To combat SAD, doctors suggest exercise, particularly outdoor activities during daylight hours. Exposing yourself to bright artificial light may also help. Light therapy, also called phototherapy, usually involves sitting close to a special light source that is far more intense than normal indoor light for 30 minutes every morning. The light must enter through your eyes to be effective; skin exposure has not been proven to work.

Some people feel better after only one light treatment, but most people require at least a few days of treatment, and some need several weeks. You can buy boxes that emit the proper light intensity (10,000 lux) with a minimal amount of ultraviolet light without a prescription, but it is best to work with a professional who can monitor your response.

There are few side effects to light therapy, but you should be aware of the following potential problems:

• Mild anxiety, jitteriness, headaches, early awakening, or eyestrain can occur.

• There is evidence that light therapy can trigger a manic episode in people who are vulnerable.

• While there is no proof that light therapy can aggravate an eye problem, you should still discuss any eye disease with your doctor before starting light therapy. Likewise, since rashes can result, let your doctor know about any skin conditions.

• Some drugs or herbs (for example, St. John’s wort) can make you sensitive to light.

Causes and risk factors for depression
- Loneliness
- Lack of social support
- Recent stressful life experiences
- Family history of depression
- Marital or relationship problems
- Financial strain
- Early childhood trauma or abuse
- Alcohol or drug abuse
- Unemployment or underemployment
- Health problems or chronic pain

The cause of depression helps determine the treatment. Understanding the underlying cause of depression may help overcome the problem. For example, if you are depressed because of a dead end job, the best treatment might be finding a more satisfying career, not taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends at work or through a hobby will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.

The road to depression recovery
Just as the symptoms and causes of depression are different in different people, so are the ways to feel better. What works for one person might not work for another, and no one treatment is appropriate in all cases. If you recognize the signs of depression in yourself or a loved one, take some time to explore the many treatment options. In most cases, the best approach involves a combination of social support, lifestyle changes, emotional skills building, and professional help.

Ask for help and support
If even the thought of tackling depression seems overwhelming, don’t panic. Feeling helpless and hopeless is a symptom of depression — not the reality of your situation. It does not mean that you’re weak or you can’t change! The key to depression recovery is to start small and ask for help. The simple act of talking to someone face to face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you; he or she just needs to be a good listener.

Having a strong support system will speed your recovery. Isolation fuels depression, so reach out to others, even if you feel like being alone or don’t want to feel like a burden to others. The truth is that most people will be happy that you chose to confide in them; they’ll be flattered that you trust them enough to open up. So, let your family and friends know what you’re going through and how they can support you. 

Make healthy lifestyle changes
Lifestyle changes are not always easy to make, but they can have a big impact on depression. Lifestyle changes that can be very effective include:

• Cultivating supportive relationships.
• Getting regular exercise and sleep.
• Eating healthfully to naturally boost mood.
• Managing stress.
• Practicing relaxation techniques.
• Challenging negative thought patterns.
• Build emotional skills.

Many people lack the skills needed to manage stress and balance emotions. Building emotional skills can give you the ability to cope and bounce back from adversity, trauma, and loss. In other words, learning how to recognize and express your emotions can make you more resilient.

Seek professional help
If support from family and friends, positive lifestyle changes, and emotional skills building aren’t enough, seek help from a mental health professional - a psychiatrist or a psychologist - they are there to help you beat this. There are many effective treatments for depression, including therapy, medication, and alternative treatments. Learning about your options will help you decide what measures are most likely to work best for your particular situation and needs.

Are antidepressants right for you?
Medication can help relieve the symptoms of depression in some people, but they aren’t a cure and they come with drawbacks of their own. Learning the facts about antidepressants and weighing the benefits against the risks can help you make an informed and personal decision about whether medication is right for you.

Effective treatment for depression often includes some form of therapy. Therapy gives you tools to treat depression from a variety of angles. Also, what you learn in therapy gives you skills and insight to prevent depression from coming back.

Some types of therapy teach you practical techniques on how to reframe negative thinking and employ behavioral skills in combating depression. Therapy can also help you work through the root of depression, helping you understand why you feel a certain way, what your triggers are for depression, and what you can do to stay healthy.

Culled from HealthGuide, edited. Images: Google