Depression: Darkness into Light
Randi Jones, Ph.D.
Depression.... a word that is so familiar to most of us. Whereas most of us have experienced brief periods of the "blues" lasting two-three days, clinical depression is a horse of another color. Major depressive illness, as it is known in the psychiatric lingo, is a disturbance of mood which lasts at least two weeks and may be characterized by the following warning signs described by the American Psychological Association:
- Depressive mood: feelings of helplessness and pessimism
- Sleep disturbance - inability to sleep, or sleeping too much: irregular sleep patterns
- Appetite disturbance, eating far less or far more than usual
- Social withdrawal: refusing to go out, to see friends
- Blaming yourself for your problems, or feeling that you are worthless
- Inability to concentrate, even on routine tasks
- Substance abuse - alcohol or drugs
Depression may be seen by itself or may alternate with periods of increased energy known as mania. If the depressive symptoms follow such a cyclical pattern, it is called Bipolar I or Bipolar II disorder. Other situations in which depression may be evident is when a person is suffering from a chronic illness such as heart disease or diabetes, from a neurological (brain or central nervous system) disorder such as multiple sclerosis or Huntington's disease, following childbirth (post partum depression) or as a result of substance abuse. Another situation which must be assessed for the presence of depression is that of grief after the death of a loved one. Usually, the most acute feelings occur during a three month period following the death. If the emotions of severe sadness, loss, or bitterness and the inability to resume one's former life continue past that point, then a more insidious depression may have resulted. In all major types of depression, the body's neurotransmitter levels are altered. This is probably what gives depression the feeling of a physical illness, which it is!
Ironically, depression can drain away your energy, cause you to avoid friends and family and stop doing the activities which are known to improve mood, such as exercise and social contact. It is at this very time when you must try to resume these activities or reach out to others who can help you. It may seem like climbing the highest mountain just to walk around the block and it may take weeks of walking around the block (along with other health-enhancing activities) before you begin to feel better, but it is crucial that you force yourself to engage in such activities. Research has demonstrated that if a person does some of these activities, despite not wanting to or not feeling like it, that after a period of time, your mood will gradually change and the activity will once again be enjoyable.
Similarly, it is very important to examine the types of thoughts you have. If they seem to all be in the direction of "nothing good ever happens" or "I can't possibly do this", it is time to get a different mental slant. Thinking negative, pessimistic thoughts is a learned behavior, a habit. This is very good news, because what was learned can be unlearned.
Psychotherapy for depression may be short term, to improve the most significant symptoms or may be more long term, to understand the sources of the problem and address unhealthy personality features. If you choose a psychotherapeutic avenue, be sure that the therapist you choose is licensed and has experience in the field. You may wish to visit several psychotherapists in order to satisfy yourself that you have found someone who is a "good fit". Referral services are available which can give further confidence to your choice. Examples are:
Medication for depression has greatly improved the treatment options for those who have disorders in the depressive continuum. The classes of antidepressants are: tricyclics, serotonin reuptake inhibitors and atypical. The newer medications tend to have fewer side effects and may be easier to take since several require only one pill per day. If your depression has gone on longer than you think is necessary, consider discussing these medications with your physician. One of the most serious aspects of depression is the increased risk for suicidal ideation and attempts. If you or your loved one has such thoughts, take them seriously and seek professional help as soon as possible.
Copyright © 1998 Randi Jones, Ph.D.