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Introduction to Depression: defining it, diagnosing it, & managing it

Introduction to Depression: defining it, diagnosing it, & managing it

Depression is a mental health condition that goes beyond mere feelings of sadness. It would be better described as a persistent and overwhelming sense of despair that can linger for weeks, months, and even years. Depression affects millions of people worldwide, oftentimes having a negative impact on personal well-being, relationships, work, school, and overall quality of life. 

Contrary to common misconceptions, depression isn’t a sign of weakness, nor is it a mere mood swing that one can easily snap out of. Rather, depression involves a combination of biological, psychological, and/or environmental factors. Physiologically, there can be multiple neurotransmitters involved, making it difficult to regulate mood. Genetic predispositions can also make certain individuals more susceptible to experiencing depressed mood. Additionally, life events such as trauma, loss, or chronic stress can act as triggers, exacerbating the condition.

Being able to recognize the symptoms of depression is essential, not only for those who experience it, but also for those close to them. Detecting depression at its earliest signs is optimal, as it allows for prompt initiation of treatment, which can prevent the condition from worsening. Common symptoms include persistent sadness, loss of interest in previously enjoyable activities, changes in sleep and appetite, fatigue, and difficulty concentrating. 

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) outlines the following criterion for depression (otherwise known as major depressive disorder or MDD). In order to meet diagnostic criteria, an individual must exhibit at least five of the following symptoms during the same 2-week period, representing a change from previous functioning. Additionally, at least one of the symptoms must be either (1) depressed mood, or (2) loss of interest or pleasure.

  1. Depressed mood most of the day
  2. Significantly decreased interest or pleasure in all (or almost all) activities
  3. Major change in weight or appetite (not due to dieting) 
  4. Insomnia or hypersomnia
  5. Excessive restlessness or observable reduction in activity levels
  6. Fatigue (exhaustion) or loss of energy
  7. Feelings of worthlessness or excessive/inappropriate guilt
  8. Diminished ability to think, concentrate, or make decisions
  9. Frequent thoughts of death or attempt to end one’s life

These symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. It’s important to note that the diagnosis also considers ruling out other medical conditions or substances that could contribute to the symptoms. Diagnosis and treatment should be conducted by qualified mental health professionals.

Seeking professional help, whether through therapy, medication, or a combination of both, is a crucial step for managing depression. It is certainly not a sign of weakness, but a courageous step towards healing. By fostering awareness, understanding, and compassion, we can collectively promote mental health treatment for those in need of support. The best thing we can do for those affected by depression is (1) listen without judgment, (2) validate their experiences and emotions, (3) connect them with a professional, and (4) continue to connect with them throughout their journey toward a brighter future.

A Young Woman’s Personal Experience with Anxiety

A Young Woman’s Personal Experience with Anxiety

Anxiety is something that everyone deals with, to some extent, during their life. For some people it’s a passing experience of feeling stressed and overwhelmed. For others, though, anxiety can be crippling. I mean truly, intolerably, despairingly crippling.

You can’t sleep, you can’t eat, you can’t focus. Your work suffers; your relationships suffer.  You question everything you do, and everything you say. Your mind never stops churning things over. You’re filled with feelings of self-doubt and never being good enough. It’s pure agony.

The term “anxiety” gets thrown around for everything, ranging from feeling nervous to experiencing unrelenting, incapacitating panic attacks. Because of this, there are people who equate “feeling stressed” to knowing what having an anxiety disorder feels like. Unfortunately, this attitude feels discrediting and invalidating to the person who truly experiences the wrath and magnitude of anxiety.

Anxiety can manifest itself as a condition, such as a phobia, social, or generalized anxiety; or on a greater level, it can present comorbidly with other conditions, such as Depression, ADHD, Schizophrenia, and so forth. Anxiety is not a character flaw. I repeat: ANXIETY IS NOT A CHARACTER FLAW. Anxiety is a neurological imbalance. It is the result of obtaining some unfortunate genetics and/or exposure to certain life experiences. None of those things are your fault in any way.

I am the youngest child of two girls. Some people believe that being the youngest child makes you “selfish.” I would say that I do, in fact, have a tendency towards selfishness. But my selfishness isn’t due to being the youngest child; rather, it’s a result of having to manage my anxiety.

For instance, I can’t be the person who goes and offers comfort to a friend in the middle of the night because of a break-up, or some other challenging situation. I have to be selfish; I need to sleep. Because altering my routine and extending myself could offset my own mental stability. I need to rest. I need to relax. I need time to myself.

I have to “be selfish” in order to operate in a fast-paced, high-producing, performance-based society. I’m at a disadvantage to others, who function at a higher level, and with more ease. Because of my anxiety, my mental and emotional reserves are easily and quickly depleted.

I want to be there for my friends in the middle of the night, when they are hurting, but the fact of the matter is that I can’t. I have to take care of myself. This doesn’t mean that I don’t care. It doesn’t discredit me as a kind-hearted person. I absolutely want what is best for the people around me. I simply need my time, time when I am off limits, time to recuperate.

I’ve learned from past mistakes of over-extending myself. There have been times when I’ve tried to be everything to everyone. I went out of my way, above and beyond, to be there for people. Even when I did all that I could, I still felt this hankering guilt that it wasn’t enough; that I wasn’t enough.

I have since learned that the care and support I am able and willing to offer others is enough. I have since learned that I am enough. I realize that I owe it to myself (and others) to take care of me. I have to care for myself at least as well as I care for others. Self-care is a requirement for others-care. And when you think about it, there’s really nothing selfish about that.

 

* Special thanks to my considerate, generous, hard-working, and capable niece for sharing her story, in hopes of providing understanding and validation for those who face their own struggles, and in hopes of providing insight for others to develop empathy for such challenges. 

It’s All About Balance

It’s All About Balance

I am always preaching “balance” to my clients. 

Whether it’s in regards to having a good balance between your work and personal life
Balance in having structure, but with flexibility
Even in one’s personality having a balance between extroversion and introversion.

It’s important to have balance within character traits, as well.
Such as finding the right balance between confidence and humility.
Between passivity and assertiveness.
Between delicacy and strength.

Todd Stocker (writer, speaker, pastor) says, “To live a more balanced life, glance at the past, live in the present, and focus on the future.”

There is much wisdom in having this balanced perspective on life.  If you focus too much on the past, you might get stuck in it.  However, if you focus too much on the future, you risk feeling anxious about what’s coming.  The best approach is to live in the present.  Process and work through the past, and plan for the future, but LIVE in the present.

It’s all about balance.

When in doubt: SEEK BALANCE!

A Look at Test Anxiety

A Look at Test Anxiety

Interview with Kansas City Blogger Local

High school and college students are no strangers to the effects of anxiety and depression.  This segment of the population however, faces a unique type of anxiety and depression that the general population rarely comes in contact with.  Test anxiety is a major issue for students the Kansas City metro area.  We met up with one local counselor to discuss test anxiety and how to deal with it.

Ben: Hello there.  This is Ben Hartman from Blogger Local Kansas City.  We’re out in Leawood with Molly Pierce, a Kansas licensed professional counselor  and owner of True Self Counseling.  We’re meeting with her today to discuss some of the upcoming anxiety that is related to the school season being in full swing.  There are a lot of tests coming up.  We met with Linden at Get Smarter Prep the other day, and she was actually talking about the ACTs coming up on September 21st.  Molly, if you can just tell us a little bit about yourself and True Self Counseling, that would be awesome.

Molly: Aright.  I started True Self Counseling in 2010.  I really have a passion to help people deal with common everyday problems, such as anxiety, depression, and communication/relationship problems.

Ben: Okay, so you deal with individuals, and then you deal with people in relationships, and then some group counseling as well?

Molly: Yes, absolutely.

Ben: You have a test anxiety clinic going on over at Get Smarter Prep.  Tell us about it.

Molly: It’s a one hour clinic in the evening to help students prepare to manage their anxiety, to get the best score that they can on their ACT or SAT.  With the ACT test coming up, we actually just did a test anxiety clinic last week.

Ben: Is it open to only people that go to Get Smarter Prep already or is it open to the general public?

Molly: This was the first one we did, and it was just Get Smarter Prep students, but I’m sure that outside people would be welcome to come.  There’s just a $25 fee.

Ben: Okay, so this is something that you guys are developing and working on, and it seemed successful this time?  There was a good turnout?

Molly: It did seem successful.  It seemed like the students really benefited from it.

Ben: There’s kind of two sides to being anxious about tests, the side where it’s impending and you’re stressed and you’re trying to learn as much you can before it comes.  Then for some people, afterwards there’s the anxiety of not having gotten the goal they strived for and being let down by or disappointed by their performance.  Can you maybe talk a little bit about the difference in the problems face on either side of the test?

Molly: Sure.  A lot of the students are getting the help they need in learning how to solve the problems on the exams and they feel confident in that aspect, but they really get freaked out about being timed and running out of time, and then there’s just this train of negative thoughts of like, what if I run out of time?  What if I fail?  Then I’m not going to get into the school I want to get into, and into my preferred profession.

Ben: It’s a compounding cycle?

Molly: Yes, it can go down this compounding hole of anxiety.  Same thing for after the test if they don’t get the score they were hoping for.  It’s almost like this sense of impending doom that now they can’t pursue the career that they want.

Ben: Yes, that their life is over.

Molly: Their life is over, even though they can really just go retake the test and go on with life.

Ben: Yes.  For some people, they feel like it speaks about them and tells people outwardly something they don’t want to convey.

Molly: That is absolutely true.  A lot of people equate their self-worth with how well they perform whether it’s on the test, or in sports, or relationships, or jobs, or whatever, so not getting a good score can actually make people feel pretty bad about themselves.

Ben: Yes.  There’s that misconception that the test score you get is a reflection of your worth, and those things are really completely exclusive.

Molly: Exactly, and that type of thinking really leads into depression and just feeling bad about yourself.

Ben: For some people that didn’t come to the clinic what could you recommend?  What are some tips that people can follow to get in their habitual nature that will help them avoid getting test anxiety or help them in reducing test anxiety?

Molly:  Anxiety is really a twofold issue.  There are the physical symptoms of anxiety, so when you feel like your breathing is getting short and shallow, and you might feel tingly.  You might feel butterflies in your stomach.  One thing you can do is deep abdominal breathing, which really calms your body and soothes the physical symptoms of anxiety. 

The other aspect of anxiety is the mental part of it.  It’s the thoughts, so if you’re thinking, oh my gosh, I’m so nervous.  I’m going to do horrible. I’m going to fail. That thinking is not going to be helpful, so you need to identify that negative thinking and change it into more positive and accurate thinking, such as I’ve prepared for this test.  I know what I’m doing.  It’s going to work out, and so forth.

Ben: Okay.  Do you have any recommended reading for people that need some encouragement, that need to help to and reinforce a better positive mental frame of mind before a test?  

Molly: Sure.  There’s lots of good reading out there on anxiety and changing negative thinking.  One book is the Anxiety and Phobia Workbook  by Edmund J. Bourne. Another good one is When Panic Attacks, which is written by David Burns, and he really does a lot in the treatment of anxiety and depression.  He’s pretty big in that world.

Ben: Okay, so that would be some good recommended reading?

Molly: Absolutely.

Ben: We will check back in with you soon so we can learn about some of the group work you’ve been doing over at the  Leawood Church of The Resurrection on the topics of depression and anxiety.  Thanks for your time, and we encourage our readers to check out your test anxiety clinic over at Get Smarter Prep as well as many of the services you offer.

Molly: Absolutely, and really, anyone struggling with anxiety, depression, marital issues can feel free to check out True Self Counseling to see if we might have services that are helpful for them.

Ben: Definitely. Thanks for your time, Molly.

Molly: Thank you.

The Overlooked Epidemic of Depressed Teenage Girls

The Overlooked Epidemic of Depressed Teenage Girls

Many people are unaware of the fact that once an adolescent girl hits puberty, her risk of depression is double that of her male classmates (Gary Ginter).  This is important information to know, so parents, teachers, school counselors and youth leaders can be on the lookout for some of the tell-tale signs of depression.  These symptoms include frequent sadness or crying, feelings of worthlessness & hopelessness, low self-esteem, fatigue, apathy, changes in appetite, loss of pleasure in life, and difficulty concentrating.  For adolescents in particular, some additional signs to look out for include: a sudden drop in grades, uncharacteristic irritability, and moodiness.  Depressed teenage girls commonly act out with self-harm, including cutting or burning their skin.  Additionally, depressed young people are twice as likely to have a substance abuse problem than other adolescents (James Matta).  Therefore, if a problem abusing substances exists, it is imperative to also check for signs of depression.

The unfortunate truth is that only about 40 percent of adolescents needing treatment get adequate care, often because the problem is not spotted (Dr. Graham Emslie).  Perhaps this is because we assume, as a society, that it’s normal for a teenage girl to become moody and display frequent sadness once they go through the hormonal changes associated with puberty.  However, it is crucial to identify the severity of these behaviors, and to assess for the other symptoms of depression as well.  Interpersonal problems, such as difficulties or changes in peer relationships – – and how these changes are handled – – can become a trigger for depression among teenage girls.

Early identification of these problems is critical; the earlier these symptoms are identified, the greater chance of successful treatment and quick improvement.  For adolescents with mild to moderate levels of depression, psychotherapy or talk therapy is most useful (Matta).  If identified early, teens are likely to show improvement within four to six weeks of consistent counseling treatment.  Research supports the recommendation that psychotherapy intervention should be considered the first-line treatment.  (For more severe cases, the addition of an anti-depressant may be a consideration after several weeks of therapy without any improvement).

The good news is that with early identification and proper treatment, the recovery rate of adolescent depression is over 90 percent over one to two years from the onset of the depressive disorder (Matta).  There simply needs to be an awareness of the additional risk of depression among teenage girls in order to watch for the symptoms in ensure they receive timely and appropriate treatment.