Help For Depression
- Are you feeling hopeless and stuck in life?
- Are you no longer able to be the person you used to be or who you want to be?
- Do you no longer experience joy or laughter in your life?
- Do you feel lost and confused about where you belong or what the purpose of your life is?
- Are you overcome by feelings of guilt, shame, or self-disgust? What about self-loathing?
- Are you finding it increasingly difficult to listen to people telling you that you have nothing to worry about so just “keep your chin up and be happy?”
- Has it gotten painful enough that you have even considered suicide or have been thinking that you would be better off dead?
If you have answered YES to one or more of the above questions, then you may be suffering from depression.
What Causes Depression?
Depression is a common mental illness that can significantly impact the lives of individuals and their loved ones. When people are depressed, they often find it difficult to meet obligations and responsibilities or to function at a level that they were once able to.
Depression is very different than the “blues” that all of us experience from time to time as the “blues” tend to pass within a few days. In order for depression to be diagnosed, however, symptoms must persist for at least two weeks. Although the severity of symptoms may fluctuate over time, for some people, the symptoms of depression can persist for much longer than two weeks, sometimes months or even years.
Depression often causes people to feel chronically tired, unmotivated, and disinterested in activities and past-times that they used to enjoy. Often, depression will make it difficult for people to make decisions, to be able to concentrate or focus on what they are doing, and to become forgetful and scattered. Many people complain about sleep disruptions, varying from too much sleep (and still not feeling rested or rejuvenated) or not nearly enough. Appetite is also usually impacted, sometimes leading to under-eating or over-eating and thus, many people with depression may have moderate or significant changes in their weight. As hopelessness, worthlessness, guilt, irritability, and disinterest set in, depression can cause people to withdraw from their friends and family and seek isolation.
In order to avoid their emotional pain or having to talk about it with others, some people may become “workaholics,” as being too busy with work can provide an easily acceptable excuse for missing social gatherings or get-togethers. It is also not uncommon for those with depression to also feel it physically in their bodies in the form of aches and pains, headaches, digestive problems, and more (even when there are no underlying physical reasons).
With a list like this, it is not surprising that when people are depressed, they often find that it significantly interferes with their daily family, social, and work lives and that it causes them significant levels of distress.
What Causes Depression?
Although there are many explanations for depression, it is most likely caused by a combination of biological, environmental, and psychological factors. It can arise from within a person, such as from hormonal imbalances, or from without, such as from adverse or stressful life experiences (job loss, loss of health, deaths, relocation, a new baby, lack of work-life balance, etc).
Types of Depression
Major Depressive Disorder or Major Depression (DSM-IV-TR and DSM-5)
Major Depression (MDD) Is the more severe outcome of chronic low mood, pessimism, lack of energy, and decreased interest in once-pleasurable activities. It significantly impacts a person’s ability to function like they used to, to meet responsibilities, and to perform at work, school, or to connect with loved ones. Often, people experiencing clinical depression also have significant difficulties with sleep, appetite, and poor concentration and decision-making. To meet the criteria for MDD, symptoms must exist for at least two weeks and separate episodes can occur (meaning a person may experience alternating time periods of when they are feeling okay and then clinically depressed).
Although dysthymia involves the same symptoms at major depression, these symptoms, which often last for two or more years, are of a lesser intensity or less severe. Many people with dysthymia may still feel hopeless and have a lack of energy or interest in things, but the severity of their symptoms does not significantly impact their ability to function in their personal lives, at work, or at school. It is possible, however, for someone to have dysthymia and also experience episodes of depression.
NEW * Persistent Depressive Disorder Diagnosis (DSM-5)
This diagnosis has been added with the release of the new DSM-5 (May, 2013). It was added with the intent to highlight how some forms of depression are much more chronic than others. As a result, both dysthymia and chronic major depressive disorder are included within this new diagnostic label.
Related Disorders or Difficulties?
Depression in Bipolar Disorder, also known as Manic-Depressive Illness, occurs when a person experiences depression and at least one manic or hypomanic episode. A manic or hypomanic episode is when the person feels extremely high, has lots of energy and ideas, and a reduced need for sleep. They will also tend to talk fast and non-stop (making it difficult for others to understand them and/or to interrupt) and feel quite restless and thus, find it hard to slow down or remain still. At times, a manic episode can become severe enough to include hallucinations, delusions, or require hospitalization. For more information on Bipolar Disorder, please click here.
Bereavement & Grief. Previously, before the DSM-IV-TR was recently updated to the DSM-5 (2014), if a person had experienced a recent death of a loved one (bereavement), they would not have been diagnosed with depression - unless they became psychotic, suicidal, or severely impaired. Now, with the DSM-5, even if you are in bereavement, if you meet the diagnostic criteria for depression, you can be diagnosed with depression.
This change in diagnostic criteria is more accurate because the fact remains that some people are clinically depressed whether or not they lost a loved one. More importantly, the death of their loved one may not be the reason for their depression. Although the death of a loved one can be a trigger for someone to develop depression, it should also be noted that most people do not develop clinical depression as a result of bereavement.
How are Depression and Grief Different? Some of the defining differences between grieving (one’s reaction to a loss) and depression is that when someone is grieving, they can experience moments of happiness, enjoyment, or hope that things will get easier and then moments of sadness or grief. They also don’t tend to suffer from feelings of worthlessness or self-shame. In depression, people tend to be chronically burdened by low moods and energy without any or very few moments of reprieve.
Bereavement and grieving are normal and do not usually require professional support. However, if your grief is becoming complicated or doesn’t seem to be easing after a long time, or you would like extra support while you are grieving, then obtaining professional help may be beneficial.
Can a person have another disorder in addition to depression?
Yes! Often people struggling with depression will find themselves also struggling with an anxiety disorder (i.e., obsessive-compulsive disorder, panic disorder, social phobia, generalized anxiety disorder, and post-traumatic stress disorder), alcohol or drug abuse or addictions. This is called co-morbidity.
How many adults does depression impact?
According to the most recent data (2008) collected by the Substance Abuse and Mental Health Services Administration (SAMHSA), depression is experienced by about 6.4%1 of the adult population (USA) each year and by about 16.5%2 of the adult population at some point in their lifetime. It also occurs more often for people between the ages of 18-49 years3 and tends to impact women almost twice as much than men3.
How Many Kids or Teens Does Depression Impact?
About 3.3% of 13 to 18 year olds (USA) have suffered from severe depression and about 11.2% of 13 to 18 year olds have experienced dysthymia or major depression at some point in their lives<sub>5</sub>. If left untreated, then childhood depression often continues or recurs in adulthood4.
Questions and Answers
- Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.
- Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.
- Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters, EE, Wang PS. The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association. 2003 Jun;289(23):3095-3105.
- National Institute of Mental Health. (n.d.). Transforming the understanding and treatment of mental illnesses. Health and Education, Mental Health Information, Depression. Retrieved April 1, 2014.
- Merkikangas, KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-989.