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Depression What is Depression? Depression is more than a day of feeling low. It is a long-lasting, often recurring illness as real and disabling as heart disease or arthritis. Adults who experience clinical depression may feel an oppressive sense of sadness, fatigue and guilt. Performing on the job may be difficult. Going out with friends may be unthinkable. Merely getting out of bed may be impossible. The person who has depression feels increasingly isolated from family and colleagues -- helpless, worthless and lost. Depression is a very common emotional illness. In varying degrees of severity, it affects about 6 percent of all U.S. adults, more than nine million people in any given six month period, according to the American Psychiatric Association. At least one in five Americans will experience a major depressive episode during their lifetime, with women twice as likely to develop depression as men. Modern research has led to significant advances. Today, there are extremely effective treatments for depression. Between 80 to 90 percent of those with depression can be successfully treated. Many experience relief from symptoms within three to six weeks. Treatment is generally necessary -- people with depression cannot snap out of it on their own, nor will it go away. How Do You Know If A Person Has Depression? If you or a person you know has exhibited four or more of the following symptoms for more than two weeks, professional help should be considered: Sleeping to much or too little Frequent wakening in the middle of the night Eating too much or too little Inability to function at work or school Headaches, digestive disorders, nausea, pain with no medical basis Excessive crying Thoughts of death or suicide Lack of energy, constant fatigue Slowed thinking Difficulty in concentrating, remembering, making decisions Loss of interest in daily activities Loss of sex drive Persistent feelings of sadness, anxiety, hopelessness Restlessness, agitation, irritability Feelings of inappropriate guilt or worthlessness What Causes Depression? We now know that depression results from an interaction of several factors -- environemental, biological and genetic.     Environmental Factors. Stress resulting from the loss of a job, death of a family member, divorce, or ongoing health or family problems can trigger depression.     Biological Facors. Depression may also be tied to disturbances in the biochemicals that regulate mood and activity. These biochemicals, called neurotransmitters, are substances that carry impulses or messages between nerve cells in the brain. An imbalance in the amount or activity or neurotransmitters can cause major disruptions in thought, emotion and behavior. Some people develope depression as a reaction to other biological facors such as chronic pain, medications, hypothyroidism or other medical illnesses.     Genetic Factors. Because depression appears to be linked to certain biological factors, people can inherit a predisposition to develop depression. In fact, 25 percent of those people with depression have a relative with some form of this illness.     Alcohol and Other Drugs. Excessive use of alcohol or other drugs can lead to -- or worsen -- depression in some people.     Medications. Certain drugs used alone or in combination can have side effects much like the symptoms of depression. Depression can also occur for no apparent reason at all! Learn More... The Common Types of Depressive Disorders Major Depression. This type is characterized by symptoms that: begin suddenly, possibly triggered by a loss, crisis or change. are so severe that they interfere with normal functioning. continue for months or years if not treated. It's possible for a person to have only one episode of major depression. However, it's more common for the episode to repeat several times during the person's life or to be long-lasting. Seasonal Affective Disorder (SAD). This is depression that may result from changes in the season. Most cases begin in the fall and winter. Dysthymia. People with this illness experience a chronic state of mild depression -- they feel "down" much of the time. They may function fairly well on a daily basis, but over time their work and relationships suffer. Fortunately, dysthymia can be successfully treated. Bipolar Disorder. (This was previously known as Manic Depressive Illness) The person shifts between periods of depression and periods of mania (a frantic 'high"). The mood changes can be sudden, but are usually gradual. Symptoms of mania include: insomnia overconfidence racing thoughts 'wild' behavior greatly increased energy All types of Depression require professional treatment. There is Help ... Therapists know more about depression than perhaps any other emotional illness. Because of research and medical advancements 80 to 90 percent of those with depressive disorder can be treated successfully. Evaluation. A complete evaluation with a qualified professional is the first step in seeking treatment. Only a licensed physician or psychologist can diagnose a person with a psychiatric disorder. During the diagnostic evaluation, the physician or psychologist will determine if any other factors are contributing to or even causing the depressive symptoms. Professional Counseling. Various psychotherapies or 'talk therapies' commonly used in the treatment of depression focus on the causes and effects of the illness. Interpersonal therapy helps people deal with problems in personal relationships. Cognitive therapy helps patients change negative thoughts or perceptions, such as high achievers who are convinced they are failures. Medication. Sometimes used in combination with psychotherapy, medication can correct the biochemical imbalances that may cause depressive episodes. When carefully prescribed and monitored by a physician, medications can relieve symptoms in three to six weeks. Over the pasty 20 years, the most frequently used depression medications have been tricyclic antidepressants and monoamine oxidase (MAO) inhibitors and possibly lithium (often used in bipolar disorder, which was previously known as manic depressive illness). These medications are not habit-forming and are helpful in reducing the severity, frequency and duration of depressive episodes. However, side effects such as dry mouth, difficulty urinating, constipation and blurred vision have been associated with their use. Recently, researchers have introduced a new generation of antidepressants that include serotonin re-uptake inhibitors (SRI's), fluoxetine (Prozac), bupropion (Wellbutrin), and sertraline (Zoloft) -- usually these newer medications have few side effects than the older medications. (NOTE: Antidepressants are not habit forming, but their use needs to be monitored for maximum effectiveness. Always follow instructions carefully, inform your healthcare provider of all medications or drugs you take (including alcohol), and report any side effects.) Other Treatments. Some people with depression respond well to light therapy. In cases of severe depression where other treatments have not worked, ECT (electroconvulsive therapy) may be used. A measured dose of electric current is applied briefly to the brain under anesthetic. The shock is painless. (NOTE: ECT usually has temporary side effects such as memory loss and lethargy. In some patients, certain memory and/or intellectual functions may be permanently lost. Discuss all possible side effects with your healthcare provider before undergoing ECT). Who is At Risk for Depression? Depression can affect anyone at any time, including: people who have a family member with depression; people who have experienced a stressfull or traumatic life event; people who lack the social support of a spouse, friends and extended family; people who abuse drugs or alcohol; people who have chronic medical illnesses or persistent pain. Elderly People may get depressed over physical problems, retirement or the loss of loved ones. Middle-Aged Adults may become depressed when children leave home or goals begin to seem out of reach. Young Adults may become depressed as they struggle with new responsibilities and search for fulfillment. Married People may get depressed more often than singles, due to the interpersonal conflicts of married life. Adolescents experience social and physical changes that can lead to wide mood swings. Children, even babies, can suffer depression. It's often related to family conflicts, and symptoms usually pass quickly. However, never ignore symptoms. Women are twice as likely as men to be diagnosed with depression. This may be due to biological differences or a greater willingness to express feelings. If You Think You Have Depression... Remember, your depression is not your fault and it can be effectively treated. Seek treatment. Don't let misconceptions about emotional illness or the discouragement of your depression stop you. Either on your own, or by asking a friend or family member, contact your family doctor, community mental health center, or local medical or psychiatric hospital for help. In the weeks until treatment becomes effective, you can take some simple steps to help your deal with life on a day-to-day basis: break large tasks into small steps; set easily managed priorities; participate in light exercise and relatively undemanding social activities, such as attending a movie or visiting a friend. Simply being with others can be helpful. If Someone You Care About Has Depression... Encourage treatment. Remember that the symptoms of depression may prevent a person from trying to get help. Your personal physician, mental health center, or local psychiatric hospital will be able to help you find a treatment specialist. Adjust your expectations and offer support, understanding and encouragement. Demonstrate that you know the person is in pain. When the person says or does something upsetting because of the depression, try to put your reaction into calm, resonable words. This will help the person understand how his or her conduct affects others, and help you better cope with a trying situation. Depression and Suicide Thoughts of death and suicide are a typical symptom of depression. As estimated 15 percent of those with depression commit suicide, and depression is considered to be the underlying cause in half of all suicides. Because depression can have fatal consequences, treatment should not be delayed. Any mention of suicide -- such as "I wish I were dead," or "Everyone would be better off without me" -- should be taken seriously. Don't ignore symptoms of depression. Get Help! The cost of treatment is small compared to the suffering and problems that may result from prolonged depression! Help is Available Remember -- reaching out for support is a sign of strength, not weakness. If you need help, you can contact: Western Arkansas Counseling & Guidance Center 1-479-452-6650 or 1-800-542-1031 (toll-free in Arkansas) Your Family Health-Care Provider A Psychiatrist or other mental health professional The National Alliance for the Mentally Ill 200 North Glebe Road, Suite 105 Arlington, VA 22203-3754 1-800-950-NAMI (6264) National Depressive and Manic Depressive Association Suite 501, 730 North Franklin Chicago, IL 60610 (312) 642-0049 The National Mental Health Association Mental Health Information Center 1021 Prince Street Alexandria, VA 22314-2971 1-800-969-6642 Or check the phone book under 'Counseling,' 'Mental Health,' etc. This information is not a substitute for an informed discussion with a mental health professional or your health-care provider about the procedures, information, symptoms, medications or diagnoses described on this page.

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© 1998
Western Arkansas Counseling
and Guidance Center, Inc.
PO Box 11818
Fort Smith, Arkansas
Tel. 479/452-6650
TF.  800/542-1031
Fax. 479/452-5847
wacgc@wacgc.org