Part Two - Way Down In The Dumps - Are You Depressed?

I guess most of us have felt down in the dumps or ‘blue’ from time to time. However, anxiety and depression are far more than just feeling down in the dumps.  They are serious diseases, which according to the www.mentalhealth.org.uk, present the following statistics:  

1 in 4 people will experience some kind of mental health problem in the course of a year

• Mixed anxiety and depression is the most common mental disorder in Britain

• Women are more likely to have been treated for a mental health problem than men

• About 10% of children have a mental health problem at any one time

• Depression affects 1 in 5 older people

• Suicide rates show that British men are three times as likely to die by suicide than British women

• Self-harm statistics for the UK show one of the highest rates in Europe: 400 per 100,000 population

• Only 1 in 10 prisoners has no mental disorder

Even in spite of these statistics, anxiety and depression are often underdiagnosed and undertreated.  How would you recognize serious depression in yourself or a loved one? There are signs to watch for, and the following are some of them.

A traumatic life event like a death in the family or divorce, even marriage, having a baby, or moving house, can trigger symptoms.  For some, these symptoms are immediate and drastic.  For others, depression shows slowly, in subtle ways that are harder for friends to notice, and which are sometimes even harder to diagnose. Doctors have a set list of specific symptoms.  Someone meets the clinical requirements of a major depressive episode if they experience five of those symptoms during a period of two weeks. 

If you read through the symptoms and know someone who has shown signs of depression,   the first move is to see a doctor or qualified therapist for an official diagnosis. Most importantly, if you're personally having thoughts about harming yourself or others, please seek immediate help from a medical professional.

Too many people casually use the word “depressed.” Whether used to describe yourself, or someone you know, it’s an easy way to explain someone’s mood, attitude or behavior. But depression is a serious condition with serious consequences, one with clinical standards for diagnosis and real treatment options. To understand depression and how it affects the mind and body, you need to know the warning signs.

• Appetite - a reduced appetite is a common symptom of depression, but so is an increased one. Wild swings in hunger, and being consistently hungrier or less hungry than normal can all be signals of major depression. A change in appetite may be difficult to notice; instead you may notice that you’ve gained or lost weight. If your weight has changed significantly, talk to your doctor.
  

• Lethargy.  This isn’t just a case of “I can’t be bothered”.  It is an overall feeling of low energy levels, including slowed thinking and even slowed down movement. Feeling sluggish is an early warning sign, and prolonged physical and mental slowness are both clues that the body gives when depression is setting in.
  

• When our body slows down, the effects of this show in the brain’s processes too.  Mental slowdown includes an inability to focus, especially on problems or topics that used to be easy. As depression sets in, people tend to become indecisive and have trouble concentrating on simple tasks. Tasks that were once quick and easy become difficult and frustrating

• Loss of interest in activities and topics that you used to enjoy is a classic symptom of depression. From time to time it is normal to wake up tired and without motivation. But dropping things you used to enjoy, skipping exercise, clubs, work or classes on a consistent, regular basis could indicate depression. Loss of interest can apply to people as well as activities. When facing depression, people withdraw and turn friends and family members away. Though it may be the most important time to draw on a support system, a bout with depression usually causes people to isolate themselves and try to deal with the condition alone. That usually makes things even worse.
  

• Change in sleeping patterns.  Most people aren’t getting enough sleep as a rule, so working out if you are getting too much or too little sleep may be difficult. True insomnia is more than just a night or two of tossing and turning:  those who are depressed spend weeks battling fatigue and low-quality sleep. A sudden increase in sleep or desire to sleep all the time or sleep instead of participating in fun activities is a major tip-off that depression is setting in, too.

• Irritability is another warning sign of depression. Especially in typically pleasant people, sudden mood swings aren’t just a result of hormones or “waking up on the wrong side of the bed” — they’re alerts. The tendencies to become agitated with little or minimal provocation, or to become irritable for no reason, are both tied closely to clinical depression.

• Being sad may sound like an obvious sign of depression, but this level of sadness goes beyond the passing feelings that may come throughout the day. In major depression, sadness is a pervasive feeling. It’s extreme, almost inescapable and comes with little explanation. Unprompted crying spells are a key warning of major depression.
  

• Along with extreme sadness can come feelings of worthlessness and helplessness. Depression can cause people to lose hope and even feel that the value of their own life has diminished or disappeared. Things seem unimportant. Those who are depressed sometimes feel as if the whole world has lost meaning and find it impossible to control all of the negativity surrounding them, feeling unjustified guilt over uncontrollable issues, from global issues like war and poverty to personal troubles like family issues or being sick.
  

The feeling that life isn’t worth living is just a step away from suicidal tendencies, a warning sign that requires immediate action. Even the closest friends or siblings may not notice that someone is having frequent thoughts of suicide. If you’re experiencing these feelings, immediately contact someone you trust, like a friend, relative, doctor, therapist or other mental healthcare clinician, adviser, or a religious or spiritual leader. If you don’t feel comfortable with those resources, or they aren’t responding to your needs, reach out for the help of a hotline, for example Lifeline.  There are many online resources for help with these feelings.  Where someone with depression reaches the point of suicidal tendencies, there are other signs to look for. Those with depression will often turn to risky behavior. Though it may not be a pursuit of death, turning to reckless activities, from dangerous stunts to drunk or impaired driving, recklessness is an important sign to look out for.

• Substance abuse. When you’re feeling down, do you find yourself reaching for a glass of wine, a bottle of beer or even a shot of vodka for a “pick-me-up?”  A study made by the Christchurch School of Medicine and Health Sciences, New Zealand, in 2009, suggests that problems with alcohol abuse lead to increased major depression - as opposed to major depression leading to alcohol abuse. However, it is common behavior for those who are battling depression to turn to alcohol as a form of self-medication to numb their pain. Because of its association with depression, alcohol abuse is a definite warning sign that depression might not be far behind.
  

• Loss of libido is usually associated with some physical or mental change. It goes along with a loss of interest in general social contact as a very common sign of depression. Clinical depression is so extreme as to virtually eliminate an individual’s pursuit of any kind of joy or pleasure, including physical contact and sex.

Though depression may seem like it all takes place in the head, it can be a full-body condition. Partly because people with depression aren’t getting the right amount of sleep or a balanced, nutritious diet, physical pain can set in. Headaches are the most common pain depression symptom, though back pain and aching joints and muscles are also possible. Even stomach and digestive problems can arise and be related to depression.  Conversely, chronic pain leads to major depression more often than not.

From pain to sleep disorders, people with depression have plenty of justifiable reasons to take strong prescription drugs. Unfortunately, they also have a tendency to abuse these drugs. Combine the inclination toward reckless behavior, physical pain and the need to escape, and the temptation to abuse prescription drugs is often just too great. Prescription drug abuse is even more frightening because of the potential risk for increasing the tendency towards suicide. Also, some prescription drugs have a risk of depression as a side effect, even when taken in the proper dose. If you think someone may be abusing prescription drugs or if you think your medication may be affecting your mood, call a doctor.

Not everyone knows that depression is a clinical condition with guidelines for diagnosis, so if you recognize these warning signs in yourself or someone you know, address the issues and seek medical help. Very often the biggest challenge is accepting the problem. In talking with a doctor, you’ll learn the various treatment methods, ranging from prescription pills to counselling, and figure out which treatment, or combination of treatments, works best for you.

While there is no sure way to prevent depression, there are things you can do to help you through tough days and keep your depression from worsening. Working to control your stress and anxiety levels, maintaining strong relationships with supportive friends and family and treatment at the earliest sign of problem can help. Also, maintaining treatment long-term and routine therapy may help in preventing a relapse.