Depression is a condition that affects a very large number of people with some estimates suggesting as many as 18-20 million American adults every year. It also tends to be among the least reported with likely millions who suffer in silence and don’t seek professional help. In recent years the stigma associated with admitting we may be depressed has reduced somewhat and more people seek help. This help often from their primary care providers (doctor, nurse practitioner, physician assistants etc) and not a trained mental health professional. Most frequently in these settings they are prescribed antidepressant medication and under the best circumstances they are referred to a psychologist for additional assistance. Studies show that psychotherapy combined with antidepressant medication is more effective than either alone.
The reasons why medications alone don’t always solve the problem can be many. It could be that there are underlying causes of your symptoms that while they do have depressed mood as part of the picture, may need more specific treatment (for example past trauma, grief, high stress). It could be that your symptoms are so longstanding that they have changed the way you live your life, the types of relationships you have, the support you seek in ways that actually cause the depressed mood to be very hard to change and new coping skills are needed. So the bottom line is that in some cases a brief trial with medication can help you get past some difficult times. In other cases there is a need for medication with additional psychotherapy particularly if you are struggling to participate in ‘normal’ everyday activities. In the most severe cases medications are needed to lift your mood enough to get you functioning again and allow you to tackle some of the life-issues and other causes that keep the depression going. There is one more situation where medicine may be prescribed yet it may not be the best answer. It relates to the fact that we seem to not want to feel badly, and our doctors really want us to not feel badly either – that’s natural. Unfortunately we sometimes run to the quick fix like finding a pill instead of accepting our negative emotional experiences as ‘part of life’ and learning positive coping strategies for dealing with life’s ups and downs and also life’s major transitions like death of a loved one, loss of a job, retirement and so forth. To really understand whether one should or should not be taking a medication sometimes we need professional help beyond the primary care practitioner from a specialist in mental health in order to fully understand which course of treatment best fits our circumstances. With treatment, 80 percent of people recover from an episode of depression within 6–12 months. Psychotherapy, medications, and exercise can all be beneficial. The majority of studies show that while therapy and medications are each effective on their own, the outcomes are even better when they\'re used together. Exercise can also help to treat certain types of depression (and it has a host of other benefits as well).
With all that being said, it is important for each of us to become educated about depression so we can better understand which route is best for us. So here are some brief outlines of depression in its various forms to get you started.
Depression is an illness involving the body, mood, and thoughts. It can affect many areas of our lives including how well people eat and sleep and how interested they are in participating in their own lives, attention and concentration ability, and even memory. Depression is not the same as feeling bad after a hard day or a difficult life event like being sad after a falling out with a friend. Its more than just a low or \"down mood.\" It is a medical and psychological condition and certainly is not a flaw in character or personality. Feeling depressed or better yet admitting you are depressed is not a sign of weakness. Given what we have just said, it’s clear that depression is also not a matter of will — you can\'t will yourself out of depression or simply resolve to not be depressed. Although the most effective treatment for depression; Cognitive Behavioral Therapy does actually teach you to use the power of your thoughts and actions to help you to take control of the depression and initiate your recovery.
There are several different types of depression that are summarized below to to help you get a general idea of the symptoms that are involved. If any of these symptoms seem very familiar to you or a loved one please feel free to reach out to us to set up an appointment info@DrBinks.com or consult your doctor or another mental-health professional for appropriate guidance.
Includes depressed or saddened mood and/or loss of interest in daily activities; interference with ability to participate fully in and/or enjoy your usual activities. At least five classic symptoms of major depression (see \"How Is It Diagnosed\") must be present fairly consistently for at least two weeks. These \"Major Depressive Episodes\" can last a couple weeks to much longer, can completely resolve then reappear at another time or partially resolve and vary in intensity over time.
This is best described as chronic low mood that really never reaches the severity (or has enough of the symptoms all at once) of a major depressive episode but persists for most of the day, more days than not for at least two years. Mood is often described as \"sad\" or \"down in the dumps.\" It is not any less troubling or less important than major depression and is equally painful and damaging to well-being – it’s just different both in terms of the focus of treatment and in how people react to it.
Bipolar disorder is a frequently misunderstood and complex diagnostic picture that shares some characteristics with other disorders. We can’t stress enough the importance of seeing a qualified mental health provider (psychologist or psychiatrist) if you suspect you may have bipolar disorder. This will ensure you are getting a comprehensive evaluation that can rule out other possible reasons for the difficulty you are experiencing. This is particularly important since the medications used to treat this issue (mood stabilizers) are very specific to bipolar disorder (and anti-depressants run the risk of making things worse).
A person with bipolar disorder typically has experienced at least one manic episode (unusually and substantially elevated mood) and may or may not have experienced one period or more of low mood (depression). During depressive phases, people have the symptoms of depression; during manic phases they have a very noticeably ‘elevated or expansive mood’ which is well beyond feeling good or being “hyper.”A person experiencing mania may often have extremely high energy and a lack of need or desire to rest or sleep. They may be quite noticeably overactive or overly talkative. Judgment and impulse control may be impaired during the manic phase and people may engage in reckless behavior, excess spending, risky or excessive sexual activity, or make unwise business decisions. Irritability and lack of concern for personal boundaries or social norms is sometimes present too during a manic episode. There are several different types of bipolar illness based largely on the frequency and extent of the manic episodes.
This is a specific subtype of depression (or depressive episodes in bipolar disorder). It is identified based on the onset and remission of a depressive episode being associated exclusively with seasonal changes (typically during the periods characterized by shorter daylight hours). If a person has any depressive episodes not related to seasonal changes, seasonal affective disorder is not diagnosed. Seasonal affective disorder may be related to the amount of daylight a person is exposed to, but research is not yet conclusive as there are often so many other factors in people’s lives that change in relation to seasons. However some preliminary research does suggest that at least a subset of people with the disorder will benefit from reputable medical devices that produce full-spectrum light therapy. Unfortunately there are a lot of unscrupulous vendors selling ineffective light machines.
It is important for both those afflicted and loved ones to remember that Depression is not a problem with attitude and it is not imagined. It is a serious and sometimes deadly medical condition. Many symptoms can in fact be linked to very real biochemical changes. It can exist all by itself or can be secondary to other medical conditions, hormone fluctuations (male and female), stress, traumatic events or changes in life circumstances.
If you recognize any of these symptoms be sure to seek professional advice. For additional information on how to start improving your mood even if you really aren’t “depressed” check out our article on Cognitive Behavioral Therapy Basics: Improving My Mood.