Depression:  Symptoms and Treatment

Depression is a surprisingly commonplace condition that can have very serious repercussions.  Many people don't know or understand what depression is, who it affects, or what to do if a friend or loved one experiences it.  It is important to know that depression comes in many different forms, is treated in multiple ways, has many symptoms, and can appear differently for people of varying ages, sexes, and overall health conditions.  Having basic knowledge of the condition will help you know what to do if it arises in you or someone you love.

Symptoms of depression:

These can be mild to severe and include any combinations of the following:

• Sadness that doesn’t go away
• Anxiety
• Feeling “numb” or “empty”
• Lacking optimism or feeling like everything is hopeless

• Changes in sleeping patterns such as lack of sleep or too much sleeping
• Lack of interest in formerly enjoyed activities 
• Lack of energy and extreme fatigue
• Being irritable, unable to concentrate, or memory issues
• Changes in eating habits such as eating too little or too much
• Soreness, headaches, cramps, digestive issues, or general pain
• Thoughts or attempts of suicide

According to the National Institute of Health there are six major types of depression.  Each type presents itself differently and affects people in different ways.  

Major Depression is diagnosable if the individual experiences symptoms affecting their ability to perform daily tasks such as work, recreational activities, sleeping, eating, or socializing.  In major depression symptoms only last for a short period, less than two years.  If symptoms occur for longer than two years, the condition is more likely Persistent Depressive Disorder.  Any time depression symptoms last longer than two years, the condition is labeled as persistent depressive disorder.  This version of depression does not have any additional symptoms, it is solely determined by the length of time an individual suffers from depressive symptoms.  In rare cases, Psychotic Depression may occur.  This occurs when an individual has general depressive symptoms with the addition of psychoses, such as delusions, a break from reality, or hallucinations.  Another type that affects mothers is Postpartum Depression.  This occurs after childbirth and is much more than feeling sad and overwhelmed with the new baby.  Symptoms are much more severe, and this occurs in about 10-15% of mothers post childbirth.  Some people only suffer from depression seasonally during the winter months.  This type of depression is known as Seasonal Affective Disorder or SAD.  Symptoms are similar to major depression except that the individual recovers during the summer months.  Lastly, there is depression due to bipolar disorder.  In this condition, the individual will experience severe depressive lows and elated highs known as mania.  With bipolar disorder, those highs and lows cycle from one to the other with little time spent in a more normal range of emotion. 

Treatment for depression is incredibly personal.  Individuals will react to various treatments in different ways.  Often a combination of treatments is required, and it may take some time to find the right combination.  The main ways all types of depression are treated is with prescription medication and counseling (psychotherapy).  Antidepressants are often prescribed after diagnosis, and there are several types of medication available.  Selective serotonin reuptake inhibitors (SSRIs), Selective norepinephrine reuptake inhibitors (SNRIs), Tricyclics, and Monoamine oxidase inhibitors (MAOIs) are the most common.  It is important that you work closely with your doctor to determine which type of medication you or your loved one needs.  Many of them interfere with other medications, have serious side effects, or can even worsen depression.  In rare cases, children and young adults have been at higher risk of suicide while taking antidepressants.  Close monitoring of the individual taking the medication as well as an open mind about changing the medication if it doesn’t work is required. 

The Two main types of counseling/psychotherapy:

Cognitive behavior therapy is used to help the individual reprogram negative thoughts into positive ones and over time can lift mood by the adoption of automatic positive thinking.  

Interpersonal therapy helps the individual understand relationship issues and assists them in finding ways to cope or work out things that may be worsening their depression.

In many cases, it is best if the individual seeks out both types of treatment.  Medication and counseling may not work by themselves, but in conjunction with one another they can be very effective.

Depression affects different people in different ways.  

Men:  In men, it depression more likely to present as frustration, irritability, fatigue, and loss of interest, and insomnia.  Men are more likely to abuse drugs and alcohol while depressed than women, and they are also more likely to become abusive and reckless.  

Women:  Depression occurs more frequently in woman than men - In women, it presents itself as overwhelming sadness, lack of self-worth, and extreme guilt.  Prevalence among women might be brought on by hormonal changes as they go through life and the added responsibility of work and raising a family.  
 
Children:  When children are depressed, they may not have obvious symptoms.  They are more likely to fake sickness, avoid going to school, be very dependent on parents, or have irrational fears that love ones may die.  They may also act out, be in trouble at school, have a negative attitude and express feelings that no one understands them or their life.  

Elderly:  It is especially difficult to diagnose the elderly with depression because the symptoms of depression are so similar to those of grief. Furthermore, there are also several medical conditions that mimic the symptoms of depression, so it is important to monitor elderly loved ones closely and discuss concerns with a medical professional to determine if they need to be treated for depression.  

What To Do:  

The best thing you can do for a friend or a loved one that has depression is to be supportive, listen to what they have to say, and try to understand what they are going through.  You should offer hope and give them a new perspective, but never tell them they shouldn't feel what they do.  Ask them to go out and do things with you but don’t be pushy and encourage them to talk to their doctor.  Help them get to appointments if necessary.  Above all, never ignore statements about suicide.  Those comments are very serious and should be reported to their doctor or counselor.

If you feel like you are depressed or may have depression, do not wait to seek out treatment.  Help is available, and there is hope that you can recover.  Try to exercise and participate in activities you usually enjoy even if you don’t feel like doing it, just engaging in the activity will help prevent symptoms from worsening.  Try to stay as positive as possible and be careful not to withdraw from your relationships.  Confide in someone you trust and be patient about recovery.  It will come, but it may take time to find the right combination of treatments best suited to you and your situation.

Depression is a serious condition that affects millions around the world.  It can occur in people regardless of age, sex, and overall health.  There are many ways to treat depression and often a combination of treatments is required.  Being armed with a basic understanding of this condition will help you better understand what a depressed person is going through and how to help them on their road to recovery.  Or if you find yourself in a depressed state, how best to help yourself.

- Tina Fuster

Insightful Comments:

I have counseled hundreds of patients.  My treatment methodologies involve the myriad treatments ranging from CBT to talking through problems, which have been highly successful. Now - I am in no way anti-medication treatment for depression, and in fact I have regularly instructed and encouraged my patients to seek the advice of their personal physician or psychiatrist.  However, I believe that the best treatment for depression, as with most maladies, is early detection and acknowledgement of emotions.

The focus upon detection of depression and acknowledgement of emotions today is far more effective when compared to the not so distant past, when depression was not clinically recognized much less frequently recognized and diagnosed. However, when that diagnosis began to emerge in the medical and psychological communities, it was still taboo and carried a a strong stigma.  Many people who were diagnosed with depression were ashamed of their diagnosis, and their communities often responded with "Just SNAP out of it!".  Depression was actually so stigmatized that it resembled another ‘D-word’ in mid century American society - Divorce. The early 20th century was practically fanatic about avoiding discussion on either topic.

Thankfully, with today’s advancements in medical and psychological science, diagnosis has become more commonplace and accepted. Acknowledgement may still be the biggest first step, but it can certainly be made.  You can tackle this with the help of your family, friends, and doctors. Don’t let depression beat you because of the stigma and a desire to appear invincible - Take action and change your state of mind.


- Bergen

Depression. (n.d.). Retrieved December 5, 2014, from http://www.nimh.nih.gov/health/topics/depression/index.shtml