Depression, Depressive Illness - Symptoms, Treatment

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What is Depression?

Everyone experiences variations in mood -- transitory blues, disappointments, the normal grief that accompanies the loss of someone you love. But a severe or prolonged depression that interferes with the ability to function, feel pleasure, or maintain interest is not a mere case of the blues. It is an illness. Researchers have demonstrated that it results from biochemical imbalances in the brain.

Depressive Illness, also referred to as Affective or Mood Disorder, attacks millions of Americans and is often fatal; yet few people are being properly treated or even diagnosed. The costs of this neglect, both in terms of human suffering and economic loss, are staggering.

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Overcoming Depression: An Overview of Treatment Strategies

Depressive Illness is among the most common and destructive of illnesses prevalent in the United States today. In addition to major depression, many people suffer from manic depressive illness (bipolar disorder) which is characterized by radical mood swings from severe depression to exaggerated, inappropriate elation.

An estimated 35-40 million Americans living today will suffer from major Depressive Illness during their lives. For each person directly suffering, three or four times that number of their relatives, employees, associates, and friends will also be adversely affected.

Of those 35-40 million afflicted, a substantial percentage will commit suicide if not treated with appropriate medication.

In terms of human suffering, the consequences of untreated depression are beyond measure. They include loss of self-esteem, "self-medication" with alcohol and drugs, family and career disruption, chronic disability and, in many cases, death. Suicide is now the second leading cause of death among children and adolescents.

Those Who Suffer Blame Themselves

Even among those suffering from Depressive Illness, most do not know they have a treatable illness. Most blame themselves and are blamed by others. This leads to the alienation of family and friends who, if they knew of the illness, would be likely to offer support and help find effective treatment.

There Are Several Causes of Depressive Illness

There are probably several causes of Depressive Illness and several different types of depression. Recent research shows that depression runs in families. The most severe form, bipolar disorder, is most likely inherited.

Certain environmental situations, such as stress or breakup of important attachments, may precipitate depression, especially in vulnerable persons.

Research is underway to understand the interaction of genes and environment, and precisely what is inherited.

Symptoms of Depression and Manic Depression

The symptoms of Depressive Illness are highly recognizable, both to those affected and to those closest to them, once they are told what to look for.

Here is a checklist of symptoms of Depressive illness:

Loss of energy and interest.
Diminished ability to enjoy oneself.
Decreased -- or increased -- sleeping or appetite.
Difficulty in concentrating; indecisiveness; slowed or fuzzy thinking.
Exaggerated feelings of sadness, hopelessness, or anxiety.
Feelings of worthlessness.
Recurring thoughts about death and suicide.

If most of these symptoms last for two weeks or more, you probably have Depressive Illness. Sometimes depression alternates with "mania" and is called Manic-Depressive Illness.

Manic Depression causes mood swings creating periods with the following symptoms:

A high energy level with decreased need for sleep.
Unwarranted or exaggerated belief in one's own ability.
Extreme irritability.
Rapid, unpredictable emotional change.
Impulsive, thoughtless activity, with a high risk of damaging consequences (i.e., stock speculations, sudden love affairs, etc.).

Failure To Diagnose

Studies have revealed that of those individuals who do eventually seek help, only a fraction seek out a specialist in the diagnosis and treatment of Depressive Illness.

More and more nonspecialists are learning to diagnose and treat depression, but too often, when medication is needed, it is not prescribed or is prescribed ineffectively. We are doing our best to educate professionals in depression's proper diagnosis and medical treatment. (For diagnosis and treatment of depression, see a psychiatrist vs. your family doctor.)

Correct Diagnosis, Wrong Treatment

When Depressive Illness is diagnosed, minor tranquilizers and sleeping pills are prescribed twice as often as the right medication; and even when the right medication is prescribed, dosages are frequently lower than those needed to achieve an adequate level of therapeutic benefit.

Correct Diagnosis and Correct Treatment Are Available

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The principal medications used in treating Depressive Illness are SSRIs, tricyclic antidepressants, and MAO inhibitors. Only patients with a Depressive Illness will experience a positive response, which may take up to six weeks. Lithium, a natural salt, is effective in the treatment of mania and, sometimes, of depression. On occasion, electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is incapacitating, severe, life-threatening, or for those who cannot take or do not respond to antidepressant medications.

For proper diagnosis of Depressive Illness and administration of antidepressant medication, physicians expert in diagnosis and biochemical therapy (preferably a psychiatrist) must be consulted. All physical treatments incur the risks of side effects and make informed medical monitoring a mandatory part of all treatment.

Over 80 percent of those treated with these medications respond favorably, and most are able to resume normal activity. Many find psychotherapy or counseling useful as well.

How To Get Help

Call the National Foundation for Depressive Illness, Inc., 1-800-248-4344, for up-to-date information on Depression and Manic Depression, for nationwide referral lists of university medical centers and physicians who specialize in the treatment of Depressive Illness, and for patient support groups.
Discuss this information and your symptoms with your physician.
Contact the Department of Psychiatry at your nearest university medical school to determine if they have or can recommend a mood/affective disorder clinic. If not, ask for their referrals to physicians in the community who specialize in the treatment of Depressive Illness.
If you, or someone you know, has been diagnosed with Depressive Illness and treatment has not been effective within three months, get a second consultation, preferably from a physician who specializes in the treatment of this illness.

How To Make Life Easier

Recognize that there may be certain times of the day when you feel better and use that to your advantage.
Break large tasks into smaller ones; set priorities and take things one at a time; avoid taking on too much responsibility and setting overly difficult goals.
Try not to expect too much from yourself so as to lessen any feeling of failure you may have.
Activities such as exercise, attending sports or cultural events or participating in a religious or social event can help you feel better. It is important not to overdo it; feeling better takes time.
Avoid alcohol and non-prescribed drugs. This kind of self-medication may provide a temporary "high", but in the end will intensify depression.
If affected with Depressive disorders, you may feel exhausted, worthless, helpless and hopeless. You may feel like giving up. It is important to realize that these symptoms and negative thinking are part of depression. When treatment begins to take effect, the negative thinking fades.

Source: National Foundation For Depressive Illness