An Overview of Depression

“I am feeling down”, is feeling sad different from depression? We all have hard days, we all feel down sometimes, but individuals that have experienced depression understand that it’s very different than feeling a little down.

A brief description of depression:
It is estimated that on average 14-16 million Americans are affected by depression each year, making it one of the most commonly experienced mental health disorders in America. Depression can impact the way an individual feels, thinks and behaviors, causing difficulty in their ability to manage daily tasks, impairing sleep patterns, and impacting relational dynamics. Depression can impact individuals differently and present in many forms and differing circumstances.

Some forms of depression include:

• Major Depression – Individuals will experience a multitude of symptoms including experience of depressed mood more often than not last longer than 2 weeks.
• Persistent Depressive Disorder – Depressive symptoms are present for more than 2 years. Individuals may experience major depressive episodes during this time.
• Seasonal Affective Disorder (SAD) – Depression symptoms that present typically during winter months when less sunlight is available and physical activity is decreased. Individuals typically experience relief from symptoms during spring and summer months.
• Psychotic Depression – Individuals experience a psychotic disorder as well as symptoms of depression.
• Peripartum (Postpartum) Depression – Can occur in women during pregnancy or following delivery. Symptoms are more intense than ‘baby blues’ which are experience by most women during and post pregnancy. Peripartum depression can present with intense sadness, anxiety which causes difficulty caring for and feeling connected to the baby.
• Premenstrual Dysphoric Disorder (PMDD) – Individuals may experience extreme mood swings, irritability, hopelessness, among other symptoms. Symptoms onset 1 week prior to menstruation and typically subside a few days following the end of the menstrual cycle.
• Disruptive Mood Dysregulation Disorder – Is a form of depression that presents in young children. Typically diagnosed by the age of 10, however, can be present from the age of 6-17.  Children with Disruptive Mood Dysregulation Disorder commonly experience intense irritability, anger, and frequent temper tantrums which are out of proportion to triggers or not considered appropriate for the child’s age.

What is Depression?

According to the Diagnostic and Statistical Manual 5 (DSM 5) Depression is described as five (or more) symptoms experienced during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Symptoms that may be present include:

• Depressed mood most of the day, nearly every day. This may be described as irritability (in teens and children), sadness, emptiness, hopelessness, or emptiness.
• Loss of interest or pleasure in most activities
• Significant weight gain or loss; significant change in appetite
• Impaired sleeping (frequently waking up, difficulty falling asleep) or oversleeping
• Fatigue, loss of energy
• Feeling worthless, or excessive (inappropriate) guilt
• Difficulty thinking or concentrating; impaired memory
• Re-occurring thoughts of death or dying, suicidal thoughts, plan, and/or suicide attempts
• Feelings of restlessness or notably slow physical movement or speech patterns
• Loss of energy, frequent fatigue

The symptoms must cause significant distress or impairment in individuals ability to function in the home, school, work or relational settings.

When considering if you have a form a depression it is also important to rule out other possible causes of symptoms including underlying medical conditions, substance use, or other mental health disorders.

Do I have Depression?

Depression impacts individuals differently, everyone may not experience all the symptoms listed above or may experience different symptoms at different times. If you are worried that you may have depression talking to your doctor or a mental health professional may be a helpful resource to assess symptoms and if further support or treatment is needed.

Overcoming Depression

Even when experienced severely, counseling for depression is available and treatment can help greatly. The purpose of treatment is to reduce the intensity and frequency of symptoms. There are many different types of treatment approaches to consider.

Some of the most commonly used treatment approaches are:

Psychotherapy – Also known as ‘talk therapy’ or counseling is a common and helpful approach to treating depression. Counseling has come a long way since Freud analyzed peoples relationships with their mothers on his couch. While many therapy office may still have a comfy couch or oversized chair present they are also equipped with evidence-based treatment models like Cognitive Behavioral Therapy (CBT), and interpersonal therapy, two models with research supporting their effectiveness in alleviating symptoms of depression. Counseling approaches may include helping individuals change internal negative thinking patterns, develop a structure to their day, and help individuals develop skills to communicate and engage in healthy relationships in order to better manage symptoms of depression.

Medications  – Both pharmaceutical medications and natural supplements have been used to treat symptoms of depression. The most commonly used medications for treating depression are Antidepressants (typically SSRI, SNRI) designed to impact brain chemicals that impact mood. It is important to work closely with your doctor to find out if medication is the right approach for you. Depending on the medication used effects can be noticed quickly or up to 2-4 weeks following start of medications. Medications are typically not an isolated ‘fix’ or silver bullet to treating depression. It is strongly recommended that individuals seek counseling services in conjunction with medication in order to further treat underlying causes and triggers to depression.

Brain Stimulation Therapies –: If counseling and medication approaches have not been effective in reducing or eliminating depressive symptoms another option to consider is Brain Stimulation Therapies. These include electric convulsive therapy, transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). These approaches pose greater risks and side effects than most counseling and medication approaches and should be considered with the consultation of your doctor and individual research to make sure it is the right treatment for you.

Everyday approaches to support decreasing symptoms of depression – In additional or combination of the above-listed treatment models there are many things that individuals can do to increase their chances of relieving or decreasing symptoms of depression, including:

• Increasing physical activity and exercise
• Spending time with supportive friends and family
• Create small obtainable goals
• Educate yourself on depression and ways to manage symptoms safely and effectively
• Give yourself grace, you did not get to this point overnight and you will not feel relief overnight either. Change takes time and comes in small doses. Sometimes it’s hard for us to notice change and it may be helpful to ask those around you for feedback on the improvements or changes they observe.
• Eat healthy and stay hydrated (with water!). Trying to decrease intake of processed food, foods high in sugar and fillers, and making sure that you create a balanced diet to fuel you body on a daily basis.

The Take-Away

Depression can come in many forms and impact anyone at anytime in life. It’s important to remember that it’s not your fault if you are experiencing depression and there is help and support available! Reaching out and getting information is the first step toward feeling relief from symptoms.