DEPRESSION

Depression is one of the most common psychological problems, affecting nearly everyone at some time through either personal experience or through depression in a family member or friend. Each year over 17 million American adults (7%) experience a period of clinical depression. Depression can interfere with normal functioning, and frequently causes problems at work, socially and with the family. Depression causes pain and suffering not only to those who have a disorder, but also to those who care about them. Serious depression can destroy family life as well as the life of the depressed person.  Depression has been estimated to cost the USA $44billion each year.

Bipolar disorder was formerly called manic-depressive disorder. It is a type of depression, and it characterized by the presence of mood swings, especially “manic highs” that often result in high risk, self-damaging behaviour.  Most individuals with bipolar disorder have both depressive episodes and hypomanic episodes.

Depression is a psychological condition that changes how you think and feel, and also affects your social behaviour and sense of physical well-being. We have all felt sad at one time or another, but that is not depression. Sometimes we feel tired from working hard, or discouraged when faced with serious problems. This too, is not depression. These feelings usually pass within a few days or weeks, once we adjust to the stress. But, if these feelings linger, intensify, and begin to interfere with work, school or family responsibilities, it may be depression.

Once identified, most people with depression can be successfully treated. Unfortunately, depression is not always diagnosed, because many of the symptoms mimic physical illness, such as sleep and appetite disturbances. Recognizing depression is the first step in treating it.

Nearly two-thirds of depressed people do not get proper treatment because:

  • the symptoms are not recognized as depression.
  • depressed people are seen as weak or lazy.
  • social stigma causes people to avoid needed treatment.
  • the symptoms are so disabling that the people affected cannot reach out for help.
  • many symptoms are misdiagnosed as physical problems
  • individual symptoms are treated, rather than the underlying cause.

With proper treatment, nearly 80% of those with depression can make significant improvement in their mood and life adjustment.

You may have heard people talk about chemical imbalances in the brain that occur in depression, suggesting that depression is a medical illness, without psychological causes. However, all psychological problems have some physical manifestations, and all physical illnesses have psychological components as well. In fact, the chemical imbalances that occur during depression usually disappear when you complete psychotherapy for depression, without taking any medications to correct the imbalance. This suggests that the imbalance is the body’s physical response to psychological depression, rather than the other way around.

Some types of depression do seem to run in families, suggesting a biological vulnerability. This seems to be the case with bipolar depression and, to a lesser degree, severe major depression. Studies of families, in which members of each generation develop bipolar disorder, found that those with bipolar disorder have a somewhat different genetic makeup than those who are not diagnosed.

Not everybody with the genetic makeup that causes this vulnerability to bipolar disorder develop the disorder. Additional factors, such as stress and other psychological factors, are involved in its onset as well. Likewise, major depression also seems to occur, generation after generation, in some families, but not with a frequency that suggests clear biological causes. It also occurs in people who have no family history of depression. So, while there may be some biological factors that contribute to depression, it is clearly a psychological disorder.

A variety of psychological factors appear to play a role in vulnerability to these severe forms of depression. It seems likely that psychological factors are completely responsible for other forms of mild and moderate depression, especially reactive depression. Reactive depression is usually diagnosed as an adjustment disorder during treatment.

People who have low self-esteem, who consistently view themselves and the world with pessimism, or who are readily overwhelmed by stress are more prone to depression. Psychologists often describe social learning factors as being significant in the development of depression, as well as other psychological problems.  People learn both adaptive and maladaptive ways of managing stress and responding to life problems within their family, educational, social and work environments. These environmental factors influence psychological development, and the way people try to resolve problems when they occur. Social learning factors also explain why psychological problems appear to occur more often in family members, from generation to generation.  If a child grows up in a pessimistic environment, in which discouragement is common and encouragement is rare, that child is at risk of developing a vulnerability to depression.

A serious loss, chronic illness, relationship problems, work stress, family crisis, financial setback, or any unwelcome life change can trigger a depressive episode. Very often, a combination of biological, psychological, and environmental factors are involved in the development of depressive disorders, as well as other psychological problems. When you feel depressed, and don’t know where to turn, talk to someone who can help…. a psychologist

Depressive disorders come in different forms. There are several different diagnoses for depression, mostly determined by the intensity of the symptoms, the duration of the symptoms, and the specific cause of the symptoms, if that is known.

Psychology Information Online provides information on the following depressive disorders. Follow the title link for more information about each type of depression:

Major Depression is the most serious type of depression, in terms of number of symptoms and severity of symptoms, but there are significant individual differences in the symptoms and severity. You do not need to feel suicidal to have a major depression, and you do not need to have a history of hospitalizations either, although both of these factors are present in some people with major depression. There is no official diagnosis of “moderate depression.”

Dysthymic Disorder refers to a low to moderate level of depression that persists for at least two years, and often longer. While the symptoms are not as severe as a major depression, they are more enduring and resistant to treatment. Some people with dysthymia develop a major depression at some time during the course of their depression.

Unspecified Depression is used to help researchers who are studying other specific types of depression, and do not want their data confounded with marginal diagnoses. It includes people with a serious depression, but not quite severe enough to have a diagnosis of a major depression. It also includes people with chronic, moderate depression, which has not been present long enough for a diagnosis of a Dysthymic disorder. (You get the idea!)

Adjustment Disorder, with Depression describes depression that occurs in response to a major life stressor or crisis.

Bipolar Depression includes both high and low mood swings, as well as a variety of other significant symptoms not present in other depressions.

Following the diagnostic explanations for different types of depression as a way to self-diagnose is not recommended. There are many factors that go into identification and treatment of depression and other psychological problems, and only a qualified mental health professional, such as a psychologist, should diagnose psychological problems. The information provided on this web site is intended to help you determine whether you, or a friend or family member, should consult a psychologist for an evaluation and treatment.  Psychologists complete a four year college degree, and then complete an average of five to seven years of graduate professional training, resulting in either a Ph.D., Psy.D. or Ed.D. degree in psychology, plus additional experiential training, prior to becoming licensed to practice. The information presented here is general, and simplified. When you need to talk to someone who can help with depression, consult a psychologist.

Clinical depression commonly accompanies general medical illnesses, although it is often undetected and untreated. In fact, while the rate of major depression among persons in the community is estimated to be between two to four percent, among primary care patients it is between five and ten percent, and among medical inpatients it is between ten and fourteen percent. An additional two to three times as many persons in these groups experience depressive symptoms.

Some studies have suggested that nearly 65% of all visits to primary care physicians involve emotional symptoms associated with psychological problems, with depression being the most common problem. Research suggests that recognition and treatment of co-occurring depression may improve the outcome of medical conditions, enhance your quality of life, and reduce the degree of pain and disability experienced by the medical patient.

Recent research suggests a better recovery rate from many serious illnesses, when psychological treatment is offered as well as medical treatment. This makes a lot of sense, since a serious medical condition can easily result in a reactive depression.  There has also been some research that suggests that psychological distress can reduce the effectiveness of your natural immune system, making it more difficult for your body to fight disease.  While conclusive evidence of all of these factors is not yet available, there is enough evidence to suggest that psychological treatment may be a benefit to your health, in addition to any medical treatment.

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