Living with Clinical Depression

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The Problem of Depression

What Is Depression?

Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.

Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.

Depression is a common but serious illness. Most who experience depression need treatment to get better.

What are the different forms of depression?

There are several forms of depressive disorders.

Major depressive disorder, or major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major depression is disabling and prevents a person from functioning normally. Some people may experience only a single episode within their lifetime, but more often a person may have multiple episodes.

Dysthymic disorder, or dysthymia, is characterized by long-term (2 years or longer) symptoms that may not be severe enough to disable a person but can prevent normal functioning or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Minor depression is characterized by having symptoms for 2 weeks or longer that do not meet full criteria for major depression. Without treatment, people with minor depression are at high risk for developing major depressive disorder.

Some forms of depression are slightly different, or they may develop under unique circumstances. However, not everyone agrees on how to characterize and define these forms of depression. They include:

Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).

Postpartum depression, which is much more serious than the "baby blues" that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.1

Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.2

Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression). Check this link For more More information about bipolar disorder.

Source: National Institute of Mental Health.

Signs and Symptoms of Depression

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness. Signs and symptoms include:

1.Persistent sad, anxious, or "empty" feelings

2.Feelings of hopelessness or pessimism

3. Feelings of guilt, worthlessness, or helplessness

4. Irritability, restlessness

5. Loss of interest in activities or hobbies once pleasurable, including sex

6. Fatigue and decreased energy

7. Difficulty concentrating, remembering details, and making decisions

8. Insomnia, early-morning wakefulness, or excessive sleeping

9. Overeating, or appetite loss

10. Thoughts of suicide, suicide attempts

11. Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Source: National Institute of Mental Health.

Living With Clincal Depression

by Elizabeth Tull

Living with clinical depression and/or personality disorders within the family requires so much from loved ones. The challenges are no less complicated for the family than of the depressed. There is support and healing in creating an environment where there is only one patient and no hostages.

1. Remember that it is an illness.

Clinical depression often requires medical supervision as well as professional treatment. Clinical depression is treatable and requires commitment, understanding and patience from all those involved.

2. It is not your fault.

Clinical depression is usually a combination of chemical imbalance and learned behaviors. There may be times when the depressed individual is extremely sensitive, argumentative and/or blaming towards you, the children, the in-laws, the boss, and even the world. All the above mentioned are not the cause. What you are responsible for is how you choose to take on the outward symptoms and how they affect you, your home, and your relationships.

3. Be well informed.

Educate yourself on what type of depression is present and if there is a dual diagnosis (i.e., chemical dependency and depression or personality disorders and depression). Know what the symptoms, treatments, and follow-ups are. There are suggested guidelines for communication and setting boundaries. Though the illness is not your fault, it benefits you and your family to remain open-minded and willing to learn new ways of doing things.

4. Make sure to have a support network.

Depression and dual diagnosis affects the whole family. There are many ranges of emotions from anger and fear to hopefulness and hopelessness. Having others who have experienced it before can help eliminate unhealthy coping mechanisms such as isolation, shame, control, and low self-esteem. There are many national and local support groups available on-line. For more information, check with your favorite search engines or call a local and/or national mental health hotline.

5. Make time for yourself and your children.

Don’t fall into the trap of not taking care of yourselves. Misery and fear love company. Living with and loving someone who is clinically depressed can be incredibly draining. Do not become a hostage or enabler. Remember your flight instructions: For those traveling with small children; place the oxygen mask on yourself first and then assist the children.

6. Be a victor, not a victim.

Pain is inevitable; suffering is optional: We are all going to feel pain in life -- never mind a home with mental illness. Surround yourselves with knowledge, self-care, experienced support, and nurturing. There are no such things as victims, only volunteers.

7. Recognize that clinical depression is episodic.

Clinical depression comes in waves. People with clinical depression do get better!

8. Understand that medication takes time to work.

In most cases, improvement takes as long as 6-8 weeks. Even early responders require about 3-4 weeks before they notice mood improvement. Even after a person with clinical depression feels better, she or he needs to stay on medication at least 6 months. People should never stop taking medication on their own; medical supervision is a must. There can be serious physical and emotional complications from sudden withdrawal, such as increased depression and suicidal tendencies.

9. Medication alone is fairly ineffective.

Research shows that medication in combination with cognitive behavioral therapy is more effective than medication alone. Combined with therapy, the person who is clinically depressed may need to make lifestyle changes, including dietary and exercise changes. The family needs to find ways to reduce stressors by simplifying their lives.

10. Get a written relapse prevention plan.

Make a list of early symptoms such as sleep, appetite, and mood changes. Early intervention is the key to stopping a downward spiral. Determine what worked in the past to get the person with clinical depression back on track and do the things that worked before.