Understanding Depression

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7 Revealing Depression Questions Answered

By Richard OConnor, Ph.D., Special to Lifescript Published September 03, 2009 Bookstores hold volumes on coping with depression. But you won't find much out there about prevention. As a psychotherapist with depression, I'll answer 7 questions that shed new light on this disease. Plus, are you depressed? Take the quiz When it comes to depression, the emphasis is too often on treatment after someone has hit rock bottom. There's a sense that the illness happens to you without warning. But I think there is a sign: People lead depressed lifestyles before they feel blue. If they believed they could avoid hitting bottom, their recovery could be much faster. I wrote Undoing Depression (Berkely Trade) because I wanted to help prevent people from suffering what my family and I have gone through when I was depressed. Above all, I wanted to give people hope, something that those with the disease lack. There's good reason to be hopeful: 80%-90% of people recover if they get proper treatment. Here are answers to 7 common questions about depression: 1. Is the incidence of depression increasing? Yes, it's no exaggeration to call it an epidemic. At any given time, 20% of the population one in five Americans suffers from some form of depression. Take the phone book and start with the letter A. Go on through to the end of the Es. That's how many people from your community are clinically depressed. Research suggests that more people are depressed, more of the time, more severely, and starting earlier in their lives than ever before. People born after World War II are more likely to develop depression and develop it at a younger age, than the previous generation. Baby boomers seem to be at higher risk. This isn't because of a growing awareness of the disease. Nor is it only a phenomenon of American or Western culture. It's true growth. One study comparing the global incidence of depression found that in each successive generation, the ailment was likely to begin at an earlier age. Over a lifetime, the risk increases. 2. Are a lot of depressed people and don't even know it? Absolutely. Something that touched me deeply at our clinic was the large number of people who don't know they're depressed. People call for help, not because of depressed feelings, but because something is wrong in their lives: Their children won't listen; there's a marital problem; they're having trouble at work.

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Understanding Depression

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It doesn't take much digging to learn that the person has been depressed for some time. The family or job issue is a manifestation, not a cause, of the depression. There are millions of people like this. They may go to their doctor for aches and pains, sleeplessness or lack of energy, and they get a useless prescription, medical procedure - or worse, they're dismissed as hypochondriacs. Depression is a disease, but the word disease makes us think about infectious illnesses. Both are caused by a complex set of factors, but depression is more like heart disease it develops gradually over time. Genetic and biochemical factors may determine a different stress level for each that, once reached, puts her over the edge into depression. Childhood trauma, stress and loss may bring us closer to that edge. 3. How has media attention affected the public's awareness of depression? Depression doesn't receive nearly the media attention it deserves. It's the second-most costly disease to American society, just behind cancer. More brave individuals Mike Wallace, Joan Rivers, Larry King, Brooke Shields to name a few are coming forward to talk about their depression, which is helping to reduce the stigma. 4. Why are more children being diagnosed with depression? Because of better observation, not necessarily a real increase. Until 1980, most mental health professionals were guided by a theory that said, in essence, depression is caused by a punitive superego. The thinking was that people don't develop a superego until adolescence; therefore, pre-adolescents can't suffer depression. It sounds silly today, but that's the way the mental health community thought. About 10% of children will suffer a depressive episode before age 12, but the disease is difficult to recognize. They usually don't know that the way they're feeling isn't normal. Depression in children and adolescents is also confusing because they can't express their feelings as directly as adults can. Irritability is a key indicator. Children may seem easily frustrated, cranky or moody. Boys may simply appear unusually angry or sullen. Other signs: Change in appetite or energy level Sleeping a great deal more or less than usual A drop in school performance Excessive worrying Loss of interest in things or activities that used to give pleasure

If untreated, depression can be permanently devastating to children. 5. How can you help a depressed person? What does a depressed person need most? Understanding, patience and acceptance from those close to him or her. Here are some ways you can help:

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Understanding Depression

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Try to be considerate, thoughtful and empathetic. If your spouse had a broken leg, you'd expect that his abilities would be restricted, that he'd be in pain and that he couldn't heal himself quickly just because you want him to. Think about depression the same way. Don't be provocative. Every relationship has hot buttons that can trigger a fight at any time: dirty socks on the floor, a misplaced remote control, an empty gas tank in the car. You know what your partner's buttons are. Don't push them while he or she is depressed. Be nice. Small acts of kindness are appreciated and do help, even if the person doesn't reciprocate. When I go to bed, my wife makes a point of kissing me goodnight. Even though I sometimes don't act very glad to see her, I'd feel worse, lonely and unloved without her attention. Remember that actions speak louder than words. Easing your partner's burden in small ways can significantly help. Offer to do the shopping, empty the garbage, do the laundry, or take the kids out for pizza. More than words, these actions communicate that you understand how difficult these mundane chores can seem at times. Educate yourself on depression. Be willing to talk to the therapist treating your friend or family member. It's amazing how seeing information in print or hearing from an authority can change your perspective. It also shows the sufferer that you care enough to take the time to learn about the disease. Create "advance directives," a contract loved ones arrange while the sufferer is not depressed, describing what to do when depression sets in. It can be detailed in stages: Stage 1: Leave me alone. Stage 2: Be kind, patient, and attentive. Stage 3: Insist I call my therapist. Stage 4: Take me to the hospital. One patient Ive worked with loses her ability to see color when depression sets in. From experience, she has learned to tell her husband when this happens because otherwise, she won't let him know when it gets worse. 6. Will therapy or medication help? Therapy and medication are the solution, and anyone seeking treatment should be open to both. Medication can help faster than therapy alone but can counteract the out-of-control mood swings that will come during recovery. Therapy can help us resolve the problems that led to the depression and teach us how to prevent future episodes. Research shows that medication and therapy together are more effective than either alone. Some people recover with one or the other, but I strongly recommend both. After recovery, sometimes a maintenance dose of medication or a periodic check-in with a therapist is helpful. 7. How does depression differ from manic depression? Manic depression, or bipolar disorder, is a different animal. Striking 1% of the population, it's more genetically linked than other forms of depression and responds uniquely to a single medication: lithium. People with other forms of depression don't respond to lithium and don't experience the manic highs that are characteristic of the disease. Sometimes it's difficult to differentiate between depression and manic depression. For a definitive diagnosis, talk to your doctor.

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Understanding Depression

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Want more? Get your own copy of Undoing Depression and Happy at Last, or visit UndoingDepression.com. Have a question for Dr. O'Connor? Email him here. Please be sure to include your first name and last initial. Plus, meet Dr. Richard OConnor. Could You be Depressed? Depression affects 20 million people in any given year and is a serious enough disorder to compromise one's ability to function normally day to day. Find out if you're just blue or if you might be clinically depressed. Check out Health Bistro for more healthy food for thought. See what Lifescript editors are talking about and get the skinny on latest news. Share it with your friends (its free to sign up!), and bookmark it so you dont miss a single juicy post! Copyright 1998 2009 www.LifeScript.com All rights reserved.

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9/3/2009