Depressive Disorders

Depression is known as the common cold of mental health. It is very common. People are affected in different ways by depression. Some people have trouble sleeping, they lose weight, and they generally feel agitated and irritable. Others may sleep and eat too much and continuously feel worthless and guilty. Still others can function reasonably well at work and put a happy face on in front of others, while deep down they feel quite.

In addition they will have other physical and mental symptoms that may include fatigue, difficulty with concentration and memory, feelings of hopelessness and helplessness, headaches, body aches, and thoughts of suicide.

Symptoms of Depression
Symptoms that people have when they're depressed can include:

• depressed mood or sadness most of the time
  (for what may seem like no reason)
• lack of energy and feeling tired all the time
• inability to enjoy things that used to bring pleasure
• withdrawal from friends and family
• irritability, anger, or anxiety
• inability to concentrate
• significant weight loss or gain
• significant change in sleep patterns
  (inability to fall asleep, stay asleep, or get up
  in the morning)
• feelings of guilt or worthlessness
• aches and pains (with no known medical cause)
• pessimism and indifference
  (not caring about anything in the present or future)
• thoughts of death or suicide

When someone has five or more of these symptoms most of the time for 2 weeks or longer, that person is probably depressed.

At the Mood Disorders Clinic we take a practical approach with depression. We know that when a client is coming in for an initial assessment for depression that they are suffering. We work carefully to create an individualized treatment approach (plan) that will help you reduce symptoms of depression quickly. We may refer you to our in house Physician or to your primary care physician for a medication consult if we the think it is appropriate and if you are in agreement. We will get you started in The Mood Disorder Clinic as quickly as possible.

Call ext. 112 for more information or to schedule an appointment.

We will see you for an initial intake, make sure that your treatment plan is properly tailored to your needs, and refer you to the clinic.

Results are monitored every week. Most clients notice gradual improvement every week and in most cases anxiety is reduced or eliminated in 30-90 days.

Please get help immediately if you or your family members have any of the following symptoms:

• • Thoughts about suicide or dying
  • Attempts to commit suicide
  • New or worse depression
  • Trouble sleeping (insomnia)
  • New or worse irritability
  • Acting aggressive, being angry or
    violent New or worse anxiety
  • Feeling very agitated or restless
  • Panic attacks
  • Acting aggressive, being angry or violent
  • Acting on dangerous impulses
  • An extreme increase in activity and talking (mania)
  • Other unusual changes in behavior or mood

More Information about Depression

About two-thirds of those individuals who have a major depressive episode will recover completely. The other one-third may recover only partially or not at all. People who do not recover completely may have a higher chance of experiencing one or more additional episodes.

Those with a parent or sibling who has had major depression may be 1.5 to 3 times more likely to develop the condition than those who do not.

For those who have recurrent episodes of major depression, the course of the illness tends to vary. Some people experience bouts of depression separated by years between episodes in which there are no symptoms. Others may have periods of several episodes. Still others may have more and more occurrences as they age.

The development of major depressive disorder may be related to certain medical illnesses. As many as 20%-25% of those who have illnesses such as substance or behavioral dependence, cancer, stroke, diabetes, and myocardial infarction are likely to develop major depressive disorder sometime during the presence of their medical illness. Managing or treating a medical condition can be more difficult if a person is also clinically depressed. The prognosis for the medical problem may also be less positive.

Although there is no blood test to diagnose depression, there are well-developed clinical guidelines used by our clinicians to diagnose major depressive disorder.

Prescription Medications

There are several types of prescription antidepressant medications that are divided into different classes. Each antidepressant class affects the levels of chemicals in the brain called neurotransmitters, which are thought to be involved in regulating mood.

The most commonly prescribed prescription antidepressant classes are SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). SSRIs are believed to treat depression by affecting the levels of a neurotransmitter called serotonin. SNRIs are believed to treat depression by affecting the levels of two neurotransmitters called serotonin and norepinephrine.

It's important to know that it could take as many as 6 to 8 weeks for the full therapeutic effect to begin to occur. It is important to give the medication a chance to work and to take it exactly as directed by your health care professional.

How Others Act Around People Who Are Depressed

Not everyone recognizes depression when it happens to someone they know. Sometimes friends or family members recognize that someone is depressed. They may respond with kindness or support. They may offer to listen. Some people don't really understand about depression. They may react to a depressed person's low energy with judgment or criticism, yelling at the person for acting lazy or not trying harder. Some people mistakenly believe that depression is just an attitude or a mood that a person can shake off.

Sometimes people who are depressed don't take their condition seriously enough. Instead, they judge themselves for being weak in some way because they are depressed. This can be harmful if it causes people to hide their depression and avoid getting help.

Occasionally, when depression causes physical symptoms like apathy, tiredness, headaches or other stress-related problems, a person may see a doctor. Once in a while, even a well-meaning doctor may not realize a person is depressed, and just treat the physical symptoms.

Why Do People Get Depressed?

There is no single cause for depression. Many factors play a role including perceptual habits, medical conditions, genetic history, environment, life events.

Genetics

Research shows that depression runs in families and that some people inherit genes that make it more likely for them to get depressed. Not everyone who has the genetic makeup for depression gets depressed, though. And many people who have no family history of depression have the condition. So although genes are one factor, they aren't the single cause of depression.

Life Happenings

The death of a family member, friend, or pet can go beyond normal grief and sometimes lead to depression. Other difficult life happenings, such as divorce, separation, job loss, and retirement, can trigger depression. Even happenings like moving to a new neighborhood or changing schools can lead to a person becoming depressed.

Family and Social Environment

For some a stressful or unhappy family atmosphere can lead to depression. This can also include high-stress living situations such as poverty; homelessness; and violence in the family, relationships, or community.

Substance use and abuse also can cause chemical changes in the brain that affect mood - alcohol and some drugs are known to have depressant effects. The negative social and personal consequences of substance abuse also can lead to severe unhappiness and depression.

At the same time there are many people who live in these social conditions that do not develop depression.

Medical Conditions

Certain medical conditions can affect hormone balance and therefore have an effect on mood. Some conditions, such as hypothyroidism, are known to cause a depressed mood in some people. When these medical conditions are diagnosed and treated by a doctor, the depression usually disappears.

For some teens, undiagnosed learning disabilities might block school success, hormonal changes might affect mood, or physical illness might present challenges or setbacks.

What Happens in the Brain When Someone Is Depressed?

Depression involves our brain chemistry.

These chemicals help send messages between nerve cells in the brain. Certain neurotransmitters regulate mood, and if they run low, people can become depressed, anxious, and stressed. Stress also can affect the balance of neurotransmitters and lead to depression.

Sometimes, a person may experience depression without being able to point to any particular cause. People who have a genetic predisposition to depression may be more prone to the imbalance of neurotransmitter activity that is part of depression. Medications that doctors use to treat depression work by helping to restore the proper balance of neurotransmitters.

Depression versus Sadness?

Sadness is a natural emotion. The normal ups and downs of life can lead anyone to feel sad every once in a while. A relationship breakup, criticism from others, not getting a job, or a best friend moving out of town can lead to feelings of sadness, hurt, disappointment, or grief. These reactions are natural and dissipate with time.

Depression is a mood disorder. It is an illness. Depression is a stronger than a mood involving sadness or discouragement. It is more like despair, or hopelessness that lasts for weeks, months, or even longer. It interferes with a person's ability to function and participate in normal activities.

Depression affects a person's thoughts, outlook, and behavior as well as mood. A person with depression can also feel tired, irritable, and notice changes in appetite.

When someone has depression, it can cloud everything. The world looks bleak and the person's thoughts reflect that hopelessness and helplessness. People with depression tend to have negative and self-critical thoughts. Because of feelings of sadness and low energy, people with depression may pull away from those around them or from activities they once enjoyed. This usually makes them feel lonelier and isolated, making the depression and negative thinking worse.

Depression can be mild or severe. At its worst, depression can create such feelings of despair that a person thinks about suicide.
Depression can cause physical symptoms, too. Some people have an upset stomach, loss of appetite, weight gain or loss, headaches, and sleeping problems when they're depressed.

Everyone can benefit from mood-boosting activities like exercise, yoga, dance, journaling, or art. It can also help to keep busy no matter how tired you feel.

People who are depressed shouldn't wait and hope it will go away on its own because depression can be effectively treated. Friends or others need to step in if someone seems severely depressed and isn't getting help.

Many people find that it helps to open up to parents or other adults they trust. Simply saying, "I've been feeling really down lately and I think I'm depressed," can be a good way to begin the discussion. Ask your parent to arrange an appointment with a therapist. If a parent or family member can't help, turn to your school counselor, best friend, or a helpline to get help.

When Depression Is Severe

People who are extremely depressed and who may be thinking about hurting themselves or about suicide need help as soon as possible. When depression is this severe, it is a very real medical emergency, and an adult must be notified. Most communities have suicide hotlines where people can get guidance and support in an emergency.

Although it's important to be supportive, trying to cheer up a friend or reasoning with him or her probably won't work to help depression or suicidal feelings go away. Depression can be so strong that it outweighs a person's ability to respond to reason. Even if your friend has asked you to promise not to tell, severe depression is a situation where telling can save a life. The most important thing a depressed person can do is to get help. If you or a friend feels unsafe or out of control, get help now. Tell a trusted adult, call 911, or go to the emergency room.

Depression doesn't mean a person is "crazy." Depression (and the suffering that goes with it) is a real and recognized medical problem. Just as things can go wrong in all other organs of the body things can go wrong in the brain.