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Understanding Depression from the Inside Out — What You Wish Your Friends and Family Knew

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“Snap out of it!” “Get it together.” ”Are you gonna feel this way forever?” If you’ve ever experienced a major depressive episode, you may have heard these types of comments from well meaning friends and family. Depression, while treatable is a mental illness that affects millions of men, women, adolescents, and seniors every day. In fact, in the U.S. alone, over 16 million people suffer from depression.[1] And contrary to what many believe, depression is not just a period of sadness.

Depression also differs from feelings of grief over the loss of a friend or loved one. You cannot wish depression away or will it away.[3]

Depression Hurts

What depression feels like mentally:

  • Confusion
  • Fear
  • Low Self Confidence
  • Sadness
  • Difficulty concentrating
  • Self-blaming
  • Ruminating
  • Guilty feelings
  • Irritability

What depression feels like physically:

Behavioral effects of depression:

  • Low motivation
  • Crying
  • Difficulty enjoying things you once did
  • Short-tempered
  • Less tolerant
  • Angry outbursts
  • Feelings of depersonalization/dissociation
  • Difficulty getting out of bed[3]

What I wish people knew about depression.

Depression is not a sign of weakness or a character flaw. I don’t want to be depressed, and I’m doing what I can to feel better. Be patient with me and try to accept that I am not quite myself right now.

What others can’t see about the way I feel.

I would do anything to just “get over it” if I could. I can’t “think” my way out of it. By blaming me, I just feel worse. Even if I look the same on the outside, I’m fighting a difficult battle inside.

Why me? I feel like I’m the only one.

You’re not alone. Millions of people just like you are suffering from depression today. In fact, roughly 7% of all adults have experienced depression at one time or another in their lives.

According to recent studies, 1 out of every 20 people over age 12 currently suffers from depression.[2]

Depression usually begins between the ages of 15 and 30.

Will my depression ever end?

Yes, even severe depression responds well to treatment once properly diagnosed. A major depressive episode can last 6-8 months, if untreated.

Will I feel like this forever?

No, there is help. Many treatment options, including medical, alternative and complementary therapies are available. In fact, depression is one of the mental health conditions most understood by physicians, and mental health professionals.

Am I weak because I’m depressed?

No, depression is not a sign of weakness. It is not a statement about who you are as a person. It is a mental health condition, just like any other condition.[5]

Is there more than one type of depression?

Yes, many types of depression exist.

These include:

Major depression—This involves symptoms of depression for a period of at least two weeks that interfere with work, school, home life, eating, sleeping or the ability to enjoy life. It is possible to experience just one episode of major depression in a lifetime, but some individuals experience more.

Persistent depressive disorder (dysthymia)—This type of depression lasts for at least two years, though there may be periods of more or less severity.

Some forms of depression may only be situational and develop under certain circumstances.

These include:

Perinatal Depression—Women suffer depression only during pregnancy or directly thereafter, as in the case of postpartum depression.

Seasonal Affective Disorder (SAD)—This type of depression is tied directly to the seasons. In fall and winter, when there is less sunlight, people suffer depression. Symptoms disappear during spring and summer months.

Psychotic Depression—This type of depression is accompanied by psychosis such as delusions, or auditory or visual hallucinations.[4]

How to help when a loved one is depressed.

Dos and Don’ts

  • Do not blame a person with depression
  • Do not discount his or her feelings
  • Do not urge the person to just “snap out of it”
  • Do support individual feelings without encouraging rumination

Health Effects of Depression

Individuals who suffer with mental illnesses may actually live shorter lives than those without depression. Statistically, they are more likely to develop serious illnesses such as cancer, heart disease, stroke, and diabetes. In this sense, depression can kill you.[8]

How do I know if I have depression?

How is depression diagnosed?

According to the Diagnostic and Statistical Manuel of Mental Disorders (DSM-IV) depression is diagnosed as having a depressed mood or loss of pleasure along with four other symptoms that affect normal function such as sleep issues, appetite disturbances, loss of energy or concentration, difficulty with self image, or recurring thoughts of suicide.[7]

What causes depression?

While there may be no one specific cause of depression, one or more of the following factors affect depressive mood and irregular neurotransmitter activity in the brain.

Family history—Individuals with a family history of depression are much more likely to suffer depressive symptoms or a major depressive episode at some point in their lifetime.

Brain changes—Certain brain abnormalities may be responsible for depression.

Chemistry—A difference in chemistry in the areas of the brain that manage mood, sleep, appetite, and behavior may indicate a chemical imbalance.

Hormone levels—Changes in hormone levels during specific periods in life (menopause/andropause) can increase the risk of depression for both men and women.

Stress—Traumatic events, difficult relationships, overwhelming work pressures can all cause stress, which can lead to major depression.

Medical problems—Serious health issues such as a heart attack, stroke, cancer, or the health of loved one can lead to depression.

Pain—Physical or emotional pain, whether chronic or acute can cause depression in some individuals.[3]

What treatment can I get for depression?

A number of treatments, both pharmaceutical and complementary are effective for fighting depression.

These include:

Medications—A number of antidepressants may be prescribed to help treat depression including “cleaner” SSRI’s (Selective Serotonin Reuptake Inhibitors) that cause fewer side effects than older tricyclic antidepressants. These may take several weeks to reach complete efficacy and must be carefully monitored by a physician.

Psychotherapy—Therapy may be useful in the treatment of depression by helping individuals understand the thinking, perception, behavior and habits that negatively impact their life.

Brain Stimulation Therapies—Electroconvulsive therapy (ECT) is a brain stimulation therapy that can be used for severe depression if the body does not respond to medication.[5]

What can I do on my own to heal from depression?

There is actually a lot an individual can do to lessen symptoms of depression and hasten healing.

It may help to:

  • Exercise[6]
  • Refrain from smoking or alcohol
  • Eat nutritious food
  • Supplement the diet with natural mood or energy support
  • Stay away from sugar and caffeine
  • Write your feelings down
  • Remain connected to loved ones
  • Be productive
  • Pamper yourself (just don’t overspend)

While only an experienced medical or mental health professional can accurately diagnose and treat depressive disorders, it’s important to educate yourself and those around you about the facts of depression. While finding the right course of therapy, or combined therapies may take some time, it is critical to the overall healing process and emotional well being.


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