Tuesday, August 19, 2008

Health Care and Depression

Millions of Americans suffer from depression. According to a recent report by CBSNews.com, more than one in 20 Americans aged 12 and older are depressed, according to the latest statistics from the CDC. Of them, 80% report some level of functional impairment because of their illness, with 27% reporting that it is extremely difficult to work, get things done at home, or get along with others because of the symptoms of their depression. Rates of depression were higher in women and baby boomers aged 40-59 and non-Hispanic black people than other demographic groups, the study shows. And rates of depression were higher among poor people when compared to people with higher incomes. A treatment gap also exists. Only 29% of depressed individuals said that they contacted a mental health professional in the past year, and just 39% of people with severe depression contacted a mental health professional in the past year. The stigma that is still attached to depression may be partially to blame.

Depression.com has plenty to say about this disease. Some people say that depression feels like a black curtain of despair coming down over their lives. Many people feel like they have no energy and can't concentrate. Others feel irritable all the time for no apparent reason. The symptoms vary from person to person, but if you feel "down" for more than two weeks, and these feelings are interfering with your daily life, you may be clinically depressed. Most people who have gone through one episode of depression will, sooner or later, have another one. You may begin to feel some of the symptoms of depression several weeks before you develop a full-blown episode of depression. Learning to recognize these early triggers or symptoms and working with your doctor will help to keep the depression from worsening. Most people with depression never seek help, even though the majority will respond to treatment. Treating depression is especially important because it affects you, your family, and your work. Some people with depression try to harm themselves in the mistaken belief that how they are feeling will never change. The consensus is that Depression is a treatable illness.

Major depressive disorder, commonly referred to as "depression," can severely disrupt your life, affecting your appetite, sleep, work, and relationships according to Depression.com. The symptoms that help a doctor identify depression include:
--constant feelings of sadness, irritability, or tension.
--decreased interest or pleasure in usual activities or hobbies.
--loss of energy, feeling tired despite lack of activity.
--a change in appetite, with significant weight loss or weight gain.
--a change in sleeping patterns, such as difficulty sleeping, early morning awakening, or sleeping too much.
--restlessness or feeling slowed down.
--decreased ability to make decisions or concentrate.
--feelings of worthlessness, hopelessness, or guilt.
--thoughts of suicide or death.

If you are experiencing any or several of these symptoms, you should talk to your doctor about whether you are suffering from depression. Additionally, there are other types of depression that require specific treatment for the disorder:
1.) Dysthymia is another mood disorder. People who have it may feel mildly depressed on most days over a period of at least two years. They have many symptoms resembling major depression, but with less severity.

Information also provided by Depression.com indicates that symptoms of depression may surface with other mood disorders. They include seasonal major depression (also known as seasonal affective disorder), postpartum depression, and bipolar disorder:
2.) Seasonal Affective Disorder has symptoms that are seen with any major depressive episode. It is the recurrence of the symptoms during certain seasons that is the hallmark of this type of depression.
3.) Postpartum Depression is a type of depression that can occur in women who have recently given birth. It typically occurs in the first few months after delivery, but can happen within the first year after giving birth. The symptoms are those seen with any major depressive episode. Often, postpartum depression interferes with the mother's ability to bond with her newborn. It is very important to seek help if you are experiencing postpartum depression. Postpartum depression is different from the "Baby Blues", which tend to occur the first few days after delivery and resolve spontaneously.
4.) Bipolar disorder, another mood disorder, is different than major depressive disorder and has different treatments.

There are many causes for depression. Depression has no single cause; often, it results from a combination of things as reported by Depression.com, and you may have no idea why depression has struck you. Whatever its cause, depression is not just a state of mind. It is related to physical changes in the brain, and connected to an imbalance of a type of chemical that carries signals in your brain and nerves. These chemicals are called neurotransmitters. Some of the more common factors involved in depression are:
--Family history. Genetics play an important part in depression. It can run in families for generations.
--Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.
--Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).
--Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.

The National Institute for Mental Health (NIMH) reports that Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented. The first step to getting appropriate treatment is to visit a doctor. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by conducting a physical examination, interview and lab tests. If the doctor can eliminate a medical condition as a cause, he or she should conduct a psychological evaluation or refer the patient to a mental health professional. The doctor or mental health professional will conduct a complete diagnostic evaluation. He or she should discuss any family history of depression, and get a complete history of symptoms, e.g., when they started, how long they have lasted, their severity, and whether they have occurred before and if so, how they were treated. He or she should also ask if the patient is using alcohol or drugs, and whether the patient is thinking about death or suicide. Once diagnosed, a person with depression can be treated with a number of methods. The most common treatments are medication and psychotherapy.

The NIMH offers suggestions to help a friend or relative:
--Offer emotional support, understanding, patience and encouragement.
--Engage your friend or relative in conversation, and listen carefully.
--Never disparage feelings your friend or relative expresses, but point out realities and offer hope.
--Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor.
--Invite your friend or relative out for walks, outings and other activities. Keep trying if he or she declines, but don't push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.
--Remind your friend or relative that with time and treatment, the depression will lift.

There are many resources to help with depression. Consult your doctor about how to get treatment. Also, there are many sources including both public and private where you can get assistance or refer someone who is suffering from depression. Remember, the sooner treatment is available, the more readily you or a loved one can begin to recover.

Until next time. Let me know what you think.

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