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Depression: What you need to know – By Eyob B Kassa

What depression is NOT

Even though, depression is a common mental health problem, most people have wrong assumptions about what depression is. Depression is not just feeling down or sad. Because you have a bad mood or occasional melancholy, it doesn’t mean you have depression. We feel sad and our mood is fluctuated as we go through different life circumstances. However, feeling sad, like any other emotions, can also be a sign of accumulated problems or unresolved issues.

In addition, depression is not a sign of weak personality or something we should be ashamed of, because almost anyone can develop depression.

What depression IS

Depression is a mental health problem, which can cause significant physical, social, emotional and relational damage when it is untreated or addressed on time. It affects not only just our mind but also entire body. In other words, it affects our thoughts, feelings, behavior, decisions, choices, etc.

What causes depression?

There are number of factors that may enhance the chances of depression. But common causes of depression are:

1. Genetics: Some researches indicate that depression can runs in families. When we have parents with some major depression the chance of having depression is higher. Genes are like blueprints. These are very small biochemical structures inside each cells in our body which are made of a chemical called DNA (deoxyribonucleic acid) that determine our gender, hair and skin color, nose shape, height, and other traits. Our genes also determine which illnesses we may be vulnerable to at some point in our lives.

2. Biology: Some mental illnesses have been linked to an abnormal balance of special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or are not working properly, messages may not make it through the brain correctly, leading to symptoms of mental illness. In addition, defects in or injury to certain areas of the brain also have been linked to some mental conditions.

3. Psychological trauma: Some mental illnesses may be triggered by psychological trauma suffered as a child, such as severe emotional, physical or sexual abuse; a significant early loss, such as the loss of a parent; and neglect.

4. Environmental stressors: Certain stressors—such as a death or divorce, a dysfunctional family life, changing jobs or schools and substance abuse—can trigger a disorder in a person who may be at risk for developing a mental illness.

What are the warning signs and symptoms of depression?

Depression usually diagnosed by a mental health professionals and the diagnosis is based on the signs and symptoms listed in the Diagnostic and Statistical Manual (DSM-IV). According to DSM-IV, depression occurs when a person have at least five of the following nine symptoms at the same time:

1. A depressed mood during most of the day, particularly in the morning
2. Fatigue or loss of energy almost every day
3. Feelings of worthlessness or guilt almost every day
4. Impaired concentration, indecisiveness
5. Insomnia or hypersomnia (excessive sleeping) almost every day
6. Markedly diminished interest or pleasure in almost all activities nearly every day
7. Recurring thoughts of death or sucide (not just fearing death)
8. A sense of restlessness — known as psychomotor agitation — or being slowed down — retardation
9. Significant wieght lossor gain (a change of more than 5% of body weight in a month)

For a dignosis of depression, these signs should be present daily or often times for atleast two weeks. The symptoms should also cause “clinically significant distress or impairment.”

Types of Depression:

1. Major Depression: This is a severe category of depression. In this case, more of the symptoms of depression are present, and it affects the way you feel, think and behave. At this stage, because it is a clinical depression, you may have a problem doing your normal day-to-day activities.
2. Dysthymic Disorder: Dysthymia is a milder yet more enduring type of depression that affects women two to three times more often than men. While the symptoms are not as severe as a major depression, they are more enduring and resistant to treatment.
3. Unspecified Depression: Unspecified depressive disorder is a mental illness that does not fit any of the other classifications of depressive disorders. A person with unspecified depressive disorder may exhibit symptoms from some or all of the other types of depression.
4. Adjustment Disorder with Depression Mood: This is a mild and reactive depression which last only a few months or so. The symptoms are the same as the above depression types, for example, sadness, emptiness, loss of interest and pleasure, irritability and so on but the difference is that the adjustment disorder symptoms begin following a specific stressor. In other words, the disorder occurs due to or in response to some specific stressful situations or circumstances.
5. Bipolar: This type of depression includes both high and low mood swing, and varity of other significant symptoms. The changes in mood are spontaneous. With Bipolar Disorder, symptoms can include both a lowering of mood (depression) and an exaggerated elevation of mood (mania) which also known as “episodes.” People with Bipolar Disorder experience extreme mood swings that can take three different forms: manic, depressive, and mixed episodes.

Treatment options for Depression

Depending of each case, depression is treatable. There is hope and there are solutions. Of course, the kind of depression treatment that is suitable for you depends on the type of depression you have and there is no “one size fits all” kind of treatment.

1. Counseling/therapy: Counseling is a lot like learning. Through counseling, you learn about yourself, discover ways to over come difficulties, and develop skills that helps you to see even your problem in a different perspective. However, counselors are not miracle workers, we have to know how to work with them willingly and consistently.
2. Support groups: A support group address specific situation that helps you a lot in providing information and emotional support. Joining a support group is not a sign of weakness but it is a smart decision to help yourself and others. You can learn new coping skills, it open up doors for more knowledge on your own issues, and can motivate you to do major changes in your life.
3. Psychiatric medications: There are medications that can help you and you don’t have to afraid of them but don’t rely on medications alone. Medications work differently for different people. What you should know about psychiatric medications or Antidepressant medications (for example fluoxetine, citalopram, sertraline, etc) helps to correct the ‘low’ mood and other symptoms experienced during depression. They are not “silver bullet” for depression and they are not also ‘happy pills’. They do not change your personality but should always be taken under supervision. You need to consult your professional helper and educate yourself about the side effects and risk factors.
4. Life style changes: Life style change can be a simple idea but it is a very powerful tool. For example;
• Exercise: Doing exercise should not be an obligation. It is more about having fun and doing it regularly. Try to exercise as regularly as you can. It can be walking, running, biking, etc. but don’t over do it. Whatever you choose to do, start with something, build your level up gradually, and try to develop a habit of consistency.
• Develop positive social connections: Try to keep in regular contact with people. Although one of the most common symptoms of depression is social isolation, but it is important to establish or keep up with relationships that you have. You can develop social connection by volunteering, or joining a class or group. In any way, avoid isolation.
• Change your eating habit: A poor eating habit or diet has a significant contribution for depression. Our brain constantly needs supply of blood sugar and numerous studies shows nutrition can powerfully influence, emotion and behavior. Eating well is very important for both the physical and mental.
• Watch your sleep hours: Getting the right amount of sleep (7 to 9 hours each night) is very important. If you are having a hard time to get enough sleep, try to do some exercise before you go to bed, limit caffeine and alcohol, avoid watching TV or listening to radio late at night, adjust the room temperature, and avoid any distractions in your bedroom as possible as you can.

What to do when you are depressed or you know someone who is?

Well, remember you are responsible for your own health. Your health is your responsibility first. If you are feeling depressed and unable to function as possible as you can, don’t bottle things up. If you think your situation is getting worse and worse, contact the nearest counseling or psychiatric center. Call for help. Talk to your family doctor. But never be silent about what is going on in your life. The American Psychological Association and the American Psychiatric Association have online locators and you can call and get information from their website too.
Depression is not a sign of weakness or “punishment from God.” However, the sooner you start the treatment, the sooner you will be able to cope and manage your feelings.

Eyob B Kassa
Liberty University
February 9, 2012

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