Depression

Everyone suffers from symptoms of depression from time to time. It's a natural defense mechanism that allows the mind to take a rest by causing an individual to withdraw from reality for a day or two. But for some people, the withdrawal is deeper and lasts longer. It interferes with their lives and can lead them to substance abuse or suicide as a means of escape. When this happens, a person is said to have a mental illness called depression.

Types of depression.

There are three types of depression:

• Mild depression is the most common and can be brought on by both happy and sad events. A wedding is certainly happy, but also very stressful, and the stress can be depressing. Another common cause is childbirth, which may lead to post-partum blues. While usually mild, it can become severe. 
• Moderate depression, or a feeling of hopelessness, lasts longer and is more intense. Moderate depression is often brought on by a sad event, such as a death of a loved one or loss of a job. It usually does not interfere with daily living, but can become severe. If it persists, professional help may be warranted. 
• Severe depression can cause a person to lose interest in the outside world, can cause physical changes, and can lead to suicide. A person with severe depression requires professional treatment. 

Note: Bipolar disorder is a mental illness characterized by extreme mood swings from mania (excessive excitement or joy) to deep depression with many of the same symptoms and causes as depression, but requiring a different course of treatment. 

Who is affected 
One in five people suffers from depression at some point in their life. Depression can strike anyone, even children and babies who have been abused or neglected. Middle-aged adults, however, are more likely to become depressed than any other age group. While depression is often associated with loneliness, married people are more likely to become depressed than single people. Women are twice as likely as men to become depressed.

Symptoms
The symptoms of depression range from:

• Feeling "down" to feeling suicidal
• A slowing down or neglect in performing daily tasks, irritability, poor memory, or changes in behavior 
• A loss of sexual desire or loss of warm feelings toward family members, a lack of pleasure in anything, or a loss of self-esteem 
• Physical changes can include sleep disturbances, fatigue, unexplained headaches or backaches, digestive problems, and nausea.

All of us at some time experience one or more of these symptoms. But when they become persistent (lasting longer than two weeks) and/or so severe that pain and other problems outweigh pleasure much of the time, then it is time to seek professional help. 

Concerned you might be suffering from depression? Take a fast, free screening.

Causes
There is no one cause for depression. Personality, personal relationships, physical health, and genetics are all factors. People who are highly self-critical, very demanding, or unusually passive may be prone to depression. Problems with a romantic partner, a child, or an employer can cause depression. Imbalances in the chemicals in the brain due to illness, infection, or medications can be a cause. Substance abuse can be a symptom of depression, but also a cause. And while depression cannot be inherited, it does seem to be more prevalent in some families.

Treatment
As with most illnesses, treatment is easiest and most effective when begun early. A combination of the following is often used:

• Psychotherapy in the forms of counseling, group sessions, and therapy are valuable tools in treating depression. Call (314) 516-5711 to schedule an appointment with UMSL Counseling Services.
• Medication is often used in cases of severe depression and can bring relief in three to four weeks. 
• Electroconvulsive therapy, or "shock therapy," involves administering mild electrical shocks to the brain while a patient is under anesthesia.

Prevention
Depression cannot always be avoided, but because it is often related to stress and physical problems, it is possible to lessen the chances of becoming severely depressed. Here are some tips: 

• Take time for a favorite activity as a way to relax and relieve stress. 
• Get plenty of exercise to maintain a healthy body, to relieve tension, and to help get a good night’s sleep. 
• Don’t try to be superhero. Know your limitations and avoid stressful situations. 
• Cultivate friendships to have someone to talk to who can provide support. 
• Don’t be afraid of feelings. There’s nothing wrong with being mildly depressed. But if you feel it is more than mild depression, don’t hesitate to see a counselor.

Stigma
People with depression or any mental illness also face the stigma attached by society to these illnesses. This stigma causes discrimination against people with a mental illness in employment, housing, and health care. By learning more about mental illness and the effectiveness of treatment, this discrimination can end, removing the stigma that acts as a barrier to successful treatment.

Suicide
Severe depression sometimes leads to a suicide attempt. Suicide threats or attempts must be taken seriously even if there is no intent to actually die. Warning signs include making out a will, giving away personal possessions, saying goodbye or suicide preparations, such as buying a gun or stockpiling pills. If you become concerned that a depressed person may be thinking of suicide, ASK THEM IMMEDIATELY. Here are ways to help: 

• Give emotional support — Don’t challenge the person, but take him or her seriously and offer to help. Listen to what the person has to say. Try to explain that, with help, the problem can be overcome and that things can get better. Stay with the person until help is available or until the crisis passes. 
• Encourage positive action — Suggest steps the person can take to improve the situation. Help the person to stay busy, balancing both work and recreation. The recreation should include physical exercise that will help the person relax and sleep better. Suggest a change or pace or scenery to gain a new perspective.  Remember to be patient with the person; depression saps energy so much the person may struggle to feel like doing anything.  If the person does not feel up to taking you up on your suggestions, ask if they would like you to just sit with them.
• Seek professional help — Don’t feel like you have to help a suicidal friend alone. Call UMSL Counseling Services at (314) 516-5711 or better yet, ask your friend if they would like you to walk over to our office at MSC 131 with them.  If someone you care about is talking about hurting themselves, it’s better to ask for help and risk them being upset with you than to keep quiet and wish you hadn’t.

Adapted from information from the Missouri Advisory Council for Comprehensive Psychiatric Services.