DEPRESSION & RELATED DEPRESSIVE ILLNESSES FACTS YOU SHOULD KNOW WHAT ARE DEPRESSIVE ILLNESSES? They are total-body illnesses that affect a person's thoughts, feelings, behavior, and physical health and appearance. They affect all areas of a person's life - home, work, school, and social life. These illnesses are different from ordinary blues - which are normal feelings that eventually pass. Depressive illnesses last for months or years with varying patterns. A person with a depressive illness cannot talk themselves into feeling good. They cannot snap themselves out of it. Suffering or not suffering from these illnesses does not have anything to do with a person's willpower. Many times, society assumes a person suffering from depression is just lazy, or lacks motivation to get his or her life together. One might be labeled as simply having a behavior problem. This simply is not true. To determine whether a depressive illness is present or not, a thorough medical examination is essential; Many drugs used in the treatment of other illnesses, such as cancer, heart disease, high blood pressure or arthritis, as well as oral contraceptives and some antibiotics, can trigger depressive illnesses. Long-term or sudden illnesses can also bring on or exacerbate a depressive illness. And neurological disorders, hormonal disorders, infections, and tumors can mimic the symptoms of depressive illnesses or anxiety. If all medical tests come out negative, or if chronic physical pain does not respond to treatment, there is a strong possibility a depressive illness exists. Depression is the most common, most misdiagnosed illness in America. Over 17 million Americans suffer from depressive illnesses in any given year. WHAT CAUSES A DEPRESSIVE ILLNESS? Depressive illnesses are not due to personal weakness or a character flaw, but are biological illnesses related to imbalance or disrupted brain chemistry. The brain is an organ of the body and can get sick just like the heart, liver, or kidneys. A combination of genetic, psychological, and environmental factors all play a role in how and when a depressive illness may manifest itself. And because these are illnesses, stress doesn't necessarily have to be present, but can trigger or exacerbate a depression. Depression can appear out of nowhere, when everything is going fine, at a time when there would be no reason for a person to feel depressed. People of all ages, including infants and children (who may be born with a chemical imbalance), can suffer from depressive illnesses. Since they may be genetic, a person who is predisposed may be at a higher risk for developing these illnesses than someone who does not have these illnesses in their family (as in cancer, heart disease, etc.). We needn't let the fear of inheritability frighten us. This does not mean everyone will inherit a depressive illness. Instead, this is good news. By recognizing the signs of depressive illnesses early on, people can get the help they need, avoiding needless suffering for months or even years. Depressive illnesses are nothing to be ashamed of. We aren't ashamed of having other biological illnesses like heart disease or diabetes. And we aren't ashamed of going to the doctor for treatment of these illnesses. Depression and other depressive illnesses are no different. We would never expect a loved one to treat their high blood pressure on their own. We shouldn't expect them to treat their depression on their own either. ARE THERE DIFFERENT TYPES OF DEPRESSIVE ILLNESSES? Yes, all with various symptoms, degrees of severity, and duration. SAD (Seasonal Affective Disorder) - this illness has to do with a person's reaction to the amount of light a person receives. Symptoms of depression - low energy, fatigue, overeating may appear when the days begin to get shorter and there is less sunlight. People who have Seasonal Affective Disorder may produce an excess of the hormone melatonin, which is related to the body's sleep cycle and biological clock. Unipolar Depression - person has times when he/she feels normal, and other times when he/she feels depressed, slowed-down, or in a fog. Their ability to function normally may be significantly impaired. A person may have only one or two episodes, or may continue to have episodes throughout his or her lifetime. Bipolar Illness or Manic Depression - there are two forms of this disease. With the first type, Bipolar I, a person may have dramatic mood swings, from severe lows to extreme highs (mania). A person who is experiencing mania may have excessive energy, he or she may feel restless and unable slow down, appearing hyper. This state causes grandiose thinking, impaired judgment, and often times embarrassing social behavior. With the second type, Bipolar II, the manias are milder (hypomania) and the lows may be of any severity. A person experiencing hypomania may be very talkative and social, their thinking may be extraordinarily clear and sharp, with heightened creativity. They feel in a wonderfully good mood, but eventually sink into a low period. Dysthymia - this is chronic mild to moderate depression. A person usually continues to function, but just doesn't experience the pleasure out of life like a healthy person does. Cyclothymia - a form of bipolar illness, this is a mood rollercoaster. A person may feel up one day and down the next, or up one week and down the next. Seemingly unpredictable. Periods of normal mood may be few and far between. Hypomanias occur, along with mild depressions. Atypical Depression - person can still have fun and experience pleasure if an opportunity presents itself, such as a party or good news, but the feeling is short-lived. Heaviness, fatigue, and lack of motivation then recurs until the next pleasurable occasion comes up. There may be moodiness, plus at least 2 of these 4 symptoms; oversleeping, overeating, extreme fatigue and rejection sensitivity. Premenstrual Syndrome - seems to be related to depression in some people, with symptoms of irritability, nervousness, sadness, low energy, and physical symptoms of body aches and bloating presenting themselves prior to a woman's menstrual period. WHAT IS ANXIETY? Anxiety is feeling excessive fear, nervousness or worrying that something bad might happen, even though there is no logical or specific reason to be afraid. Many times depressive illnesses and anxiety go hand in hand. Various types of anxiety disorders include: Panic Disorder - panic attacks occur with symptoms of dizziness, rapid heart beat, feelings of faintness or detachment from body, shortness of breath, nausea, diarrhea, numbness or tingling in arms/legs, trembling, flushes or chills, fear of dying, the immediate need to flee the situation which has triggered the attack. Phobias - intense fear of an object (animal, insects), activity (flying, heights, driving), or situation (public speaking, eating or writing in public) that causes an individual to avoid these things at all costs. Phobias may result in agoraphobia causing a person to never leave the security of their home. Obsessive-Compulsive Disorder - characterized by having continuous thoughts or doubts (obsessions) that keep playing over and over again in a person's mind, in an annoying and bothersome way, interfering with everyday functioning. Obsessions are repetitive, irrational thoughts such as excessive fears of germs. Also may have a need to do something over and over again (compulsion), such as checking appliances, cleaning, washing hands, counting, repeating tasks or performing rituals in order to ease anxiety. Post-Traumatic Stress Disorder - this disorder can occur as a result of an emotional or physical trauma such as a car or plane crash, physical/sexual assault, war, or natural disaster. Symptoms such as flashbacks or nightmares may suddenly begin happening years after the event took place, resulting in social isolation, panic attacks, angry outbursts or substance abuse, which may be an attempt to forget. Generalized Anxiety Disorder - people who worry constantly about anything and everything (money, health, safety of their children taken to extremes) may have GAD. Possible symptoms include trembling, pain in arms & legs from muscle tension, chronic fatigue, stomach problems, dizziness, inability to concentrate, irritability, jittery and nervous appearance. May have problems with eating and sleeping. Social Phobia - anxiety about appearing foolish or acting in such a way as to embarrass oneself. Examples may be speaking in a group of people or to someone with authority, anxiety in social situations, writing in public, or eating in public. THE FOLLOWING SIGNS AND/OR SYMPTOMS MAY BE A RESULT OF POSSIBLE UNIPOLAR DEPRESSION, BIPOLAR ILLNESS, ANXIETY DISORDERS, OR ATTENTION DEFICIT DISORDER WITH OR WITHOUT HYPERACTIVITY. A person may have as few as 2 or 3 symptoms or many of the symptoms. * * * IT IS NOT UNCOMMON TO HAVE A COMBINATION OF ILLNESSES WITH OVERLAPPING SYMPTOMS * * * * Note: It is important to understand what constitutes normal development in infants, children and adolescents vs. what may be signs of a depressive illness. You may not see a drastic change in a child/adolescent's behavior or mood if they were born with a depressive illness. It may be part of their make-up having been present from day one. Infants Unresponsive when talked to or touched, never smile or cry, or may cry often being difficult to soothe. Failure to gain weight (not due to other medical illness). Unmotivated in play. Restless, oversensitive to noise or touch. Problems with eating or sleeping. Digestive disorders (constipation/diarrhea). Children Persistent unhappiness, negativity, complaining, chronic boredom, no initiative. Uncontrollable anger with aggressive or destructive behavior, possibly hitting themselves or others, kicking, or self-biting, head banging. Harming animals. Continual disobedience. Easily frustrated, frequent crying, low self-esteem, overly sensitive. Inability to pay attention, remember, or make decisions, easily distracted, mind goes blank. Energy fluctuations from lethargic to frenzied activity, with periods of normalcy. Eating or sleeping problems. Bedwetting, constipation, diarrhea. Impulsiveness, accident-prone. Chronic worry & fear, clingy, panic attacks. Extreme self-consciousness. Slowed speech & body movements. Disorganized speech - hard to follow when telling you a story, etc. Physical symptoms such as dizziness, headaches, stomachaches, arms or legs ache, nail-biting, pulling out hair or eyelashes. (ruling out other medical causes) Suicidal talk or attempts. In children, depressive illnesses/anxiety may be disguised as, or presented as school phobia or school avoidance, social phobia or social avoidance, excessive separation anxiety, running away, obsessions, compulsions, or everyday rituals, such as having to go to bed at the exact time each night for fear something bad might happen. Chronic illnesses may be present also since depression weakens the immune system. Adolescents Physical symptoms such as dizziness, headaches, stomachaches, neckaches, arms or legs hurt due to muscle tension, digestive disorders. (ruling out other medical causes) Persistent unhappiness, negativity, irritability. Uncontrollable anger or outbursts of rage. Overly self-critical, unwarranted guilt, low self-esteem. Inability to concentrate, think straight, remember, or make decisions, possibly resulting in refusal to study in school or an inability (due to depression or attention deficit disorder) to do schoolwork. Slowed or hesitant speech or body movements, or restlessness (anxiety). Loss of interest in once pleasurable activities. Low energy, chronic fatigue, sluggishness. Change in appetite, noticeable weight loss or weight gain, abnormal eating patterns. Chronic worry, excessive fear. Preoccupation with death themes in literature, music, drawings, speaking of death repeatedly, fascination with guns/knives. Suicidal thoughts, plans, or attempts. Depressive illnesses/anxiety may be disguised as, or presented as eating disorders such as anorexia or bulimia, drug/alcohol abuse, sexual promiscuity, risk-taking behavior such as reckless driving, unprotected sex, carelessness when walking across busy streets, or on bridges or cliffs. There may be social isolation, running away, constant disobedience, getting into trouble with the law, physical or sexual assaults against others, obnoxious behavior, failure to care about appearance/hygiene, no sense of self or of values/morals, difficulty cultivating relationships, inability to establish/stick with occupational/educational goals. Adults Persistent sad or empty mood. Feelings of hopelessness, helplessness, guilt, pessimism, or worthlessness. Drug/alcohol abuse. (Often masks depression/anxiety.) Chronic fatigue, or loss of interest in ordinary activities, including sex. Disturbances in eating or sleeping patterns. Irritability, increased crying; generalized anxiety (may include chronic fear of dying/convinced dying of incurable disease), panic attacks. Hypochondria - sufferer actually feels symptoms, they are real and not imagined. Difficulty concentrating, remembering, or making decisions. Thoughts of suicide; suicide plans or attempts. Persistent physical symptoms or pains that do not respond to treatment - headaches, stomach problems, neck/back pain, joint pain, mouth pain. Note: Many people feel that it is normal for elderly persons to be depressed. This is simply not true and is a very dangerous misconception. If you suspect a older adult is suffering from a depressive illness, he/she should have a thorough medical examination as soon as possible. Symptoms of Mania: Decreased need for sleep. Restless, agiated, can't sit still. Increased energy, or an inablilty to slow down. Racing, disorganized thoughts, easily distracted. Rapid, increased talking or laughing Grandiose ideas, increased creativity. Overly excited, euphoric, giddy, exhilarated. Excessive irritability, on edge. Increased sex drive, possibly resulting in affairs, inappropiate sexual behaviors. Poor judgment, impulsiveness, spending sprees Embarrassing social behavior Paranoia, delusions, hallucinations. CAN DEPRESSIVE ILLNESSES BE TREATED? Yes. There are various ways of treating depressive illnesses depending on the type of illness, the severity, and the age of the person being treated. Much of the research has shown that a combination of antidepressant medication along with psychotherapy is the quickest, most effective treatment. Many times, antidepressant medication is first needed to clear the foggy head, thereby allowing a person to concentrate better and think more clearly in their therapy sessions. The brain has to be in good working order before problem-solving can begin. Antidepressant medications correct the chemical imbalance or the chemical disruption in a person's brain. They are not addictive like common street drugs, because they aren't pep pills or uppers. If a person took antidepressant medication who didn't have depression, the medication wouldn't have any effect on them. It wouldn't make them happier or give them any more energy. That's why they've never been bought or sold on the street, because they aren't mood-altering in the sense that street drugs are. If a person took an aspirin, but didn't have a fever, the aspirin wouldn't do anything to his/her normal body temperature. Antidepressant medication can't treat something that doesn't exist in the first place. Some people take antidepressant medication for a year or so, others may take it for the rest of their life. Diabetes is treated with insulin, heart disease is treated with heart medication, and depressive illnesses are treated, many times, but not always, with antidepressant medication. Psychotherapy is talking therapy. There are several types of psychotherapy, but two have been proven to be very beneficial in the treatment of depressive illnesses. Cognitive therapy focuses on trying to change a person's negative thinking and the inaccurate perceptions they have of themselves and their environment. People are taught to think logically. Example: "If I can't do this project perfectly, I can't do it at all." (illogical) Interpersonal therapy teaches a person how to successfully interact with others. Depressive illnesses interfere with how a person treats his or her family, friends, and co-workers, which consequently affects how he or she is treated in return. Interpersonal therapy focuses on social skills.