General
Depression Information: Understanding Depression Symptoms
and Treatments
By
Craig Wilcox
The first thing to know about depression is
that it is not just in your head. Depression is, in
fact, a whole body disease that affects multiple systems.
In addition to feeling sad,
hopeless, or helpless, a person may suffer from extreme
fatigue, decreased motor (muscle) coordination, changes in
appetite and weight, and a loss of interest in activities
that are usually pleasurable--just to name a few of the more
common symptoms.
Anxiety, which is commonly
understood to consist of fear without any direct cause, is
highly correlated with depression. Anxiety is an imbalance
not just of brain chemicals, but of the entire nervous
system, which is over-responding throughout the body as if a
physical threat is impending. This can often cause the
depressed person to feel very jittery, and some people
experience extra clumsiness as they go about their day.
Only a doctor can diagnose
depression, and if you are suffering from what you believe
to be depression, you should make an appointment
immediately. (If you need help sooner, please dial 9-1-1.)
When you speak to a doctor during a formal assessment,
he/she will ask you questions like the following, which are
adapted from the Diagnostic and Statistical Manual of Mental
Disorders IV:
1. Are you experiencing a
depressed mood?
2. Have you lost interest in most or all of your normal
activities, including normally pleasurable ones?
3. Have you experienced a dramatic change in your appetite,
leading to noticeable weight gain or weight loss in the last
month?
4. Have your sleep habits changed? Do you sleep much more or
much less than normal, or do you have trouble getting to
sleep or waking up?
5. Do you feel agitated or jumpy, or have others noticed
that you are more irritable than normal?
6. Have you had trouble concentrating or thinking clearly?
7. Do you feel abnormally tired throughout the day?
8. Do you have overwhelming feelings of worthlessness,
guilt, or hopelessness that things won’t improve?
9. Have you been thinking about death or suicide more than
usual, or have you tried to commit suicide?
If you answered “yes” to
questions 1 and/or 2, plus any four of the other questions,
and these symptoms have persisted for at least two weeks
with little change, you may be suffering from clinical
depression.
Your doctor will also want to
make sure that these symptoms are not due to what would be
considered a normal reaction to a life situation, like a
death in the family. It is completely normal to feel those
things after a traumatic life event, unless those feelings
persist for longer than two months without seeming to become
easier to handle.
Additionally, the doctor will
want to know whether these symptoms are causing you great
difficulty in completing your normal daily activities.
Depression is serious enough that it can cause a person to
miss work and be unable to fulfill family obligations.
Risk Factors
People who suffer from
depression are much more likely to suffer from other life
threatening diseases, including diabetes, cancer, and heart
disease. Much focus has been put on discovering why
depressed patients are about four times as likely as their
peers to suffer a heart attack within 14 years of their
first depressive episode.
Underscoring the whole body
effect of depression is the research finding that depressed
patients have lower heart rate variability (HRV) than
normal. HRV is lowered when the parasympathetic branch of
the nervous system is not fully functioning, and people with
low HRH are at high risk for suffering heart attacks.
The malfunctioning of the
parasympathetic branch may be a key in understanding how
mental perception of events that lead to depression affect
the entire body.
Causes of Depression
Depression can be caused by
any number of circumstances. For some, genetics may play a
role (this is especially true for bipolar disorder, or manic
depression, which is not covered in this article). For
others, it could be the result of their life situation, such
as an overly stressful stretch of time or a disease.
Many times, depression can be
caused by “uncontrollable stress”. In this case, a person is
going through a negative event in which they perceive their
efforts will not affect the outcome. Caregivers are
especially prone to this. With the advent of disease such as
Alzheimer’s, a patient may need constant attention from a
family member for years, causing great disruption in the
caregiver’s life.
In cases of stress, it should
be repeated that the effects will be on the whole body, not
just the mind. Stress can cause the secretion of excess
cortisol, which in turn can damage tissues in the brain and
body. Stress hormones can also cause the nervous system to
become overworked in trying to maintain balance, eventually
causing it to shut down due to exhaustion.
Depression Treatment
Options
Anti-Depressants
One of the great advances in
pharmaceutical medicine was the advent of the SSRI class of
anti-depressants. Depression can cause an imbalance in the
brain chemical called serotonin. Serotonin is a
neurotransmitter that helps us feel calm and relaxed with a
sense of wellbeing.
In people who are depressed,
serotonin production may be lowered, or it may not be
utilized most effectively in the brain.
Neurotransmitters are
secreted into the spaces between the brain cells. SSRIs, or
Selective Serotonin Reuptake Inhibitors, prevent the
serotonin from being absorbed back into brain cells as
quickly, and brain researchers believe that leaving more of
the serotonin in between the cells has a mood-enhancing
effect.
Examples of SSRI class
anti-depressant drugs include Prozac, Zoloft, and Paxil.
They have been shown to be highly effective for alleviating
depression and anxiety in a wide range of people, though
their safety in children has recently been questioned.
Counseling
In addition to medication,
patients are usually also referred to a counselor for what
is often referred to as “talk therapy”, or more formally as
cognitive behavior therapy. With this type of counseling,
the depressed person learns to notice their negative
thinking patterns and challenge them. Over time, patients
are able to prevent negative moods by intervening in their
own to reflect a more positive outlook.
Exercise
Research has shown that
consistent aerobic exercise in a specific heart rate zone
has very beneficial effects in fighting depression in both
the short- and long-term.
While it may be difficult for
someone experiencing a major depressive episode to rally the
energy necessary to exercise, most people who do experience
at least some relief from depression within just 10 minutes
of starting.
Though not widely publicized,
the effects of exercise have been repeatedly shown to result
in decreases in depression that are on par with both drug
and counseling therapies. For more information on an
exercise program that may help alleviate depression
symptoms, please go to www.hrh-for-depression.com.
Herbal Therapies
Interest in herbal therapies
for depression has always been high, and in some countries,
such as Germany, herbal therapies are preferred over
medicinal therapies, according to the National Institute of
Mental Health. Many people prefer herbal therapies in
general, because they believe the side effects of
anti-depressants may affect them negatively.
Herbs such as ginseng and
gingko biloba have been used to treat depression, but the
only herb to be tested in a large scale study is St. John’s
wort. Patients who were followed for 26 weeks of St. John’s
Wort use did experience a reduction in depression that was
nearly comparable to sertraline, an SSRI.
Researchers warned, however,
that St. John’s wort may utilize the same metabolic pathways
as other drugs for depression, heart disease, seizures, and
some cancers. As a result, patients need to be certain to
consult their doctors on the use of St. John’s wort with
other medications.
Getting Help
Nearly 10% of Americans will
experience a depressive illness in any given year. If you
feel you are in the throes of depression, please understand
that there are very effective treatments available to you.
Modern SSRI medications, which are the most commonly
prescribed anti-depressants, can start working within 2
weeks of taking the first dose. By engaging in some moderate
exercise, you might even feel somewhat better by the end of
today.
Though doing anything while
suffering from depression is difficult, please do make it a
priority to seek some sort of help. If you need others to
intervene on your behalf, please communicate that to them.
If you are feeling depressed,
chances are that people around you have noticed, but they
may not want to say anything about it to you. With a small
overture on your part, they will likely jump at the
opportunity to help you seek treatment.
If you would like more
information on depression, you can go to the National
Institute of Mental Health web site at http://www.nimh.nih.gov/publicat/depression.cfm.
There you can download information about depression and
search for topics related to depression and depression
treatment.
Craig D. Wilcox is the author
of The Heart Rate Health Program, which could help people
suffering from depression ease their symptoms. Information
about the Heart Rate Health Program for depression can be
found at
http://www.hrh-for-depression.com He also maintains the
sites
http://www.heartratehealth.com and
http://www.hrhprogram.com.
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