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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.

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.

Physical Risks of Depression

Physical Risks of Depression

Most people realize all of the emotional, mental and social tolls that Depression takes on a person and his or her loved ones.  I.e. Extreme feelings of sadness, excessive guilt, isolation, changes in eating patterns, changes in sleeping patterns, and so forth.  However, most people fail to realize the physical risks that Depression has on a person’s physical health. The article below does a great job of pointing out the physical risks of Depression in addition to the emotional, mental and social risks.  – Molly Pierce, MA, LPC, NCC

Depression Treatment: Your Heart and Mind Depend on It
Author: Dr. Kira Stein, MD and Erin Yates, Bsc
(kirastein.com; westcoasttmsinstitute.com)

You likely know the impact that depression can have on a person mentally. However, it’s important to note that depression takes a physical toll as well, and it’s important for a person suffering from emotional difficulties to realize that seeking treatment is essential for his or her overall health and well-being.

It’s common knowledge that living with major depression has its mental health risks, including suicide, anxiety, fibromyalgia, and difficulties with attention; but these are not the only implications associated with depression. In fact, recent research has shown that depression can be linked with a number of physical conditions, including heart disease, stroke and decreased cognitive functions. And, the more severe the depression symptoms, the higher the risk for these illnesses.

Physical depression risks

When inadequately managed or untreated, the physical toll depression takes can be significant for sufferers. In fact, these individuals can find themselves at a much higher risk of cardiovascular disease or even death, and studies have proven that even people who did not previously have any type of coronary artery disease before suffering from depression had an increased risk of developing the condition after the onset of depressive episodes.

One study looked at patients aged 60 and older diagnosed with high blood pressure, and found that these people had 2-3 times the occurrence of heart failure when they were depressed. In addition, those who had been hospitalized before for heart failure and also suffered from depression had a higher mortality rate three months (7.9 percent) and a year (16.2 percent) after being hospitalized.

There are also alarming numbers when it comes to depression and the risk of stroke. Studies indicate that untreated clinical depression also increases the risk of having an ischemic stroke and of dying from a stroke. Plus, individuals who suffer from chronic depressive symptoms for several years often experience a decline in cognition, even if the individual’s depression is in remission.

Seek Treatment for Depression

Considering these studies, it’s important for individuals suffering from clinical depression to also look at the physical ramifications of leaving their conditions untreated. After all, people commonly take supplements, engage in exercise and start healthy diets to improve their physical health, but don’t realize that they need to take into account their mental health, as well. Thus, if you or a loved one feel that depression has become a problem, you should have that person seek treatment in order to prevent further health problems in the future.

If you feel that you may need treatment for depression risks, help is available to you. Contact us if you feel you would like to look into your depression risks, set up a consultation and explore your options further.

References:
Abramson, J., et al. Depression and risk of heart failure among older persons with isolated systolic hypertension. Arch Intern Med. 2001 Jul 23;161(14):1725-30.
Empana, JP., et al. Clinical depression and risk of out-of-hospital cardiac arrest. Arch Intern Med. 2006 Jan 23;166(2):195-200.
Jiang, W., et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med. 2001 Aug 13-27;161(15):1849-56.
Mojtabai, R. & Olfson, M. Cognitive deficits and the course of major depression in a cohort of middle-aged and older community-dwelling adults. J Am Geriatr Soc. 2004 Jul;52(7):1060-9.
Pan, A., et al. Depression and risk of stroke morbidity: a meta-analysis and systematic review. JAMA. 2011 Sep 21;306(11):1241-9. Review. Erratum in: JAMA. Dec 21;306(23):2565.