HEALTH: OVERCOME - DEPRESSION (BIPOLAR)

HEALTH: OVERCOME DEPRESSION (DEPRESSIVE) DEPRESSION SYMPTOMS (DEPRESSION)

What is Depression?

Depression is a medical health disorder characterized by feelings of sadness, hopelessness, pessimism, guilt, and a general loss of interest in life, combined with a sense of reduced emotional well-being and low energy. People with depression also tend to have disturbed sleep, reduced appetite and may even feel suicidal. Most of us feel this way at one time or another for short periods.

Depression is one of the most common health conditions in the world. Depression isn't a weakness, nor is it something that you can simply "snap out of." Depression, formally called major depression, major depressive disorder or clinical depression, is a medical illness that involves the mind and body. It affects how you think and behave and can cause a variety of emotional and physical problems. You may not be able to go about your usual daily activities, and depression may make you feel as if life just isn't worth living anymore.

True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time.

Most health professionals today consider depression a chronic illness that requires long-term treatment, much like diabetes or high blood pressure. Although some people experience only one episode of depression, most have repeated episodes of depression symptoms throughout their life.

Effective diagnosis and treatment can help reduce even severe depression symptoms. And with effective treatment, most people with depression feel better, often within weeks, and can return to the daily activities they previously enjoyed.

Symptoms of depression can occur as a result of a wide range of medical and psychiatric disorders. In a person who has not been found to be medically ill, there are three common psychiatric diagnoses in which depression is present:

Major depressive disorder, Dysthymic disorder, and Bipolar disorder:

Major depression

Major depression is characterized by a combination of symptoms that last for at least two weeks in a row, including sad and/or irritable mood (see symptom list), that interfere with the ability to work, sleep, eat, and enjoy once-pleasurable activities. Disabling episodes of depression can occur once, twice, or several times in a lifetime.

Dysthymia

Dysthymia is a less severe but usually more long-lasting type of depression compared to major depression. It involves long-term (chronic) symptoms that do not disable but yet prevent the affected person from functioning at "full steam" or from feeling good. Sometimes, people with dysthymia also experience episodes of major depression. This combination of the two types of depression is referred to as double-depression.

Bipolar disorder (manic depression)

Another type of depression is bipolar disorder, which encompasses a group of mood disorders that were formerly called manic-depressive illness or manic depression. These conditions show a particular pattern of inheritance. Not nearly as common as the other types of depressive disorders, bipolar disorders involve cycles of mood that include at least one episode of mania and may include episodes of depression as well. Bipolar disorders are often chronic and recurring. Sometimes, the mood switches are dramatic and rapid, but most often they are gradual.

When in the depressed cycle, the person can experience any or all of the symptoms of a depressive disorder. When in the manic cycle, any or all of the symptoms listed later in this article under mania may be experienced. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, indiscriminant or otherwise unsafe sexual practices or unwise business or financial decisions may be made when an individual is in a manic phase.

A significant variant of the bipolar disorders is designated as bipolar II disorder. (The usual form of bipolar disorder is referred to as bipolar I disorder.) Bipolar II disorder is a syndrome in which the affected person has repeated depressive episodes punctuated by what is called hypomania (mini-highs). These euphoric states in bipolar II do not fully meet the criteria for the complete manic episodes that occur in bipolar I.

For more information read the Bipolar Disorder Article

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Also see: Bipolar Disorder (Mania) Postpartum Depression (PPD) Children/Teen Depression Dysthymia
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In the 1950s and 60s, depression was divided into two types, endogenous and neurotic. Endogenous means that the depression comes from within the body, perhaps of genetic origin, or comes out of nowhere. Neurotic or reactive depression has a clear environmental precipitating factor, such as the death of a spouse, or other significant loss, such as the loss of a job. In the 1970s and 80s, the focus of attention shifted from the cause of depression to its effects on the afflicted people. That is to say, whatever the cause in a particular case, what are the symptoms and impaired functions that experts can agree make up a depressive disorder? Although there is some argument even today (as in all branches of medicines), most experts agree that:

A depressive disorder is a syndrome (group of symptoms) that reflects a sad and/or irritable mood exceeding normal sadness or grief. More specifically, the sadness of depression is characterized by a greater intensity and duration and by more severe symptoms and functional disabilities than is normal.

Depressive signs and symptoms are characterized not only by negative thoughts, moods, and behaviors but also by specific changes in bodily functions (for example, crying spells, body aches, low energy or libido, as well as problems with eating, weight, or sleeping). The functional changes of clinical depression are often called neurovegetative signs. This means that the nervous system changes in the brain cause many physical symptoms that result in diminished activity and participation.

Certain people with depressive disorder, especially bipolar depression (manic depression), seem to have an inherited vulnerability to this condition.

Depressive disorder is a huge public-health problem, due to its affecting millions of people.

The statistics on the costs due to depression in the United States include huge amounts of direct costs, which are for treatment, and indirect costs, such as lost productivity and absenteeism.
In a major medical study, depression caused significant problems in the functioning of those affected more often than did arthritis, hypertension, chronic lung disease, and diabetes, and in two categories of problems, as often as coronary artery disease.
Depression can increase the risks for developing coronary artery disease, HIV, asthma, and some other health disorders. Furthermore, it can increase the morbidity (illness/negative health effects) and mortality (death) from these conditions.

Depression is usually first identified in a primary-care setting, not in a mental health practitioner's office. Moreover, it often assumes various disguises, which causes depression to be frequently under diagnosed.

In spite of clear research evidence and clinical guidelines regarding therapy, depression is often under treated. Hopefully, this situation can change for the better.

For full recovery from a mood disorder, regardless of whether there is a precipitating factor or it seems to come out of the blue, treatment with medication and/or electroconvulsive therapy (ECT) and psychotherapy are necessary.

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OVERCOME YOUR DEPRESSION
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Health: Symptoms of Depression (Depressive Disorder)

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms and some many symptoms, also called warning signs. The severity of symptoms also varies with individuals.

Persistently sad, anxious, angry, irritable, or "empty" mood

Feelings of hopelessness, pessimism

Feelings of guilt, worthlessness, helplessness

Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

Insomnia, early-morning awakening, or oversleeping

Decreased appetite and/or weight loss, or overeating and/or weight gain

Fatigue, decreased energy, being "slowed down"

Crying spells for no apparent reason

Thoughts of death or suicide, suicide attempts

Restlessness, irritability

Difficulty concentrating, remembering, making decisions

Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and/or chronic pain

Depression symptoms can vary greatly because different people experience depression in different ways. A 25-year-old man with depression may not have the same symptoms as a 70-year-old man, for instance. For some people, depression symptoms are so severe that it's obvious something isn't right. Others may feel generally miserable or unhappy without really knowing why.

Children and adolescents with depression may also experience the classic symptoms described above but may exhibit other symptoms instead of or in addition to those symptoms, including the following:

Poor school performance

Persistent boredom

Frequent complaints of physical problems such as headaches and stomachaches

Some of the classic "adult" symptoms of depression may also be more obvious in children, such as a change in eating or sleeping patterns. (Has the child or teen lost or gained weight in recent weeks or months? Does he or she seem more tired than usual?)

Teen depression may be characterized by the adolescent taking more risks, showing less concern for their own safety.

Health: Mania Symptoms of Manic Depression

Inappropriate elation

Inappropriate irritability or anger

Severe insomnia or decreased need to sleep

Grandiose notions, like having special powers or importance

Increased talking speed and/or volume

Disconnected or racing thoughts

Severely increased sexual desire and/or activity

Markedly increased energy

Poor judgment

Inappropriate social behavior

Health: Causes of Depression (Depressive Disorder)

Some types of depression run in families, indicating that a biological vulnerability to depression can be inherited. This seems to be the case especially with bipolar disorder. Studies have been done of families in which members of each generation develop bipolar disorder. The investigators found that those with the illness have a somewhat different genetic makeup than those who do not become ill. However, the reverse is not true. That is, not everybody with the genetic makeup that causes vulnerability to bipolar disorder will develop the illness. Apparently, additional factors, possibly a stressful environment, are involved in its onset and protective factors are involved in its prevention.

Major depression also seems to occur in generation after generation in some families, although not as strongly as in bipolar I or II. Indeed, major depression can also occur in people who have no family history of depression.

An external event often seems to initiate an episode of depression. Thus, a serious loss, chronic illness, difficult relationship, financial problem, or any unwelcome change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder.

Women are twice as likely to become depressed as men. However, scientists do not know the reason for this difference. Psychological factors also contribute to a person's vulnerability to depression. Thus, persistent deprivation in infancy, physical or sexual abuse, clusters of certain personality traits, and inadequate ways of coping (maladaptive coping mechanisms) all can increase the frequency and severity of depressive disorder, with or without inherited vulnerability.

The effect of maternal-fetal stress on depression is currently an exciting area of research. It seems that maternal stress during pregnancy can increase the chance that the child will be prone to depression as an adult, particularly if there is a genetic vulnerability. It is thought that the mother's circulating stress hormones can influence the development of the fetus' brain during pregnancy. This altered fetal brain development occurs in ways that predispose the child to the risk of depression as an adult. Further research is still necessary to clarify how this happens. Again, this situation shows the complex interaction between genetic vulnerability and environmental stress, in this case, the stress of the mother on the fetus.

Depression may be brought on by:

Alcohol or drug abuse
Childhood events like abuse or neglect
Chronic stress
Death of a friend or relative
Disappointment at home, work, or school (in teens, this may be breaking up with a boyfriend or girlfriend, failing a class, or parents divorcing)
Drugs such as sedatives and high blood pressure medications
Medical conditions such as hypothyroidism (underactive thyroid), cancer, or hepatitis
Nutritional deficiencies (such as a lack of folate and omega-3 fatty acids)
Overly negative thoughts about one's self and life, self blame, and ineffective social problem solving skills
Prolonged pain or having a major illness
Sleeping problems
Social isolation (common in the elderly)

Health: Risk Factors of Depression (Depressive Disorder)

Depression cuts across all racial, ethnic and economic divides — no one is immune from the risk of getting depression.

Depression typically begins in the late 20s, but it can arise at any age, affecting everyone from young children to older adults. Twice as many women are diagnosed with depression as men, but this may be due in part because women are more likely to seek treatment for depression.

Although the precise cause of depression isn't known, researchers have identified certain factors that seem to increase the risk of developing or triggering depression, including:

Having other biological relatives with depression

Having family members who have taken their own life

Stressful life events, such as the death of a loved one

Having a depressed mood as a youngster

Illness, such as cancer, heart disease, Alzheimer's or HIV/AIDS

Long-term use of certain medications, such as some drugs used to control high blood pressure, sleeping pills or, occasionally, birth control pills
Certain personality traits, such as having low self-esteem and being overly dependent, self-critical or pessimistic

Alcohol, nicotine and drug abuse

Having recently given birth

Being in a lower socioeconomic group

Health: Diagnosis of Depression (Depressive Disorder)

People who wonder if they should talk to their health professional about whether or not they have depression may consider taking a depression self-test, which asks questions about depressive symptoms. The first step to obtaining appropriate treatment is accurate diagnosis, which requires a complete physical and psychological evaluation to determine whether the person may have a depressive illness, and if so, what type. Certain medications, as well as some health conditions, can cause symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through an interview, physical examination, and laboratory tests. Many primary-care doctors use screening tools for depression, which are usually questionnaires that help identify people who have symptoms of depression and may need to receive a full mental-health evaluation.

A thorough diagnostic evaluation includes a complete history of the patient's symptoms:

The doctor should ask about alcohol and drug use and whether the patient has had thoughts about death or suicide. Further, the history should include questions about whether other family members have had a depressive illness, and if treated, what treatments they received and which were effective.

A diagnostic evaluation also includes a mental-status examination to determine if the patient's speech, thought pattern, or memory has been affected, as often happens in the case of a depressive or manic-depressive illness.

When doctors suspect someone has depression, they typically run a battery of medical and psychological tests and exams. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:

Physical exam. This may include measuring height and weight; checking vital signs, such as heart rate, blood pressure and temperature; listening to the heart and lungs; and examining the abdomen.

Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.

Psychological evaluation. A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You'll also discuss any thoughts you may have of suicide or self-harm.

Diagnostic criteria for depression
There are several other conditions whose symptoms may include depression. It's important to get an accurate diagnosis so you can get the appropriate treatment. Your doctor or mental health provider's evaluation will help determine if you have major depression or one of these other conditions that can sometimes resemble major depression:

Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect your feelings, thoughts and behavior.

Bipolar disorder. This type of depression is characterized by mood swings that range from highs to lows. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's very important to get the right diagnosis so that you can get the proper treatment and medications.

Cyclothymia. Cyclothymia, or cyclothymic disorder, is a milder form of bipolar disorder.

Dysthymia. Dysthymia (dis-THI-me-uh) is a less severe but more chronic form of depression. While it's usually not disabling, dysthymia can prevent you from functioning normally in your daily routine and from living life to its fullest.

Postpartum depression. This is depression that occurs in a new mother usually within a month of having a baby.

Psychotic depression. This is severe depression accompanied by psychosis, such as delusions or hallucinations.

Schizoaffective disorder. Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder.
Seasonal affective disorder. This type of depression is related to changes in seasons and a lack of exposure to sunlight.

Major depression is distinguished from these other conditions by its symptoms and their severity. To be diagnosed with major depression, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Diagnostic criteria for depression include:

Symptoms that occur nearly every day for two or more weeks
A depressed mood
Loss of interest or pleasure in most activities
Significant unintentional weight loss or weight gain
Sleeping difficulties, whether sleeping too much, too little or frequent waking episodes while trying to sleep
Feelings of restlessness and agitation
Feelings of sluggishness
Fatigue or lack of energy
Feelings of worthlessness or guilt
Problems thinking, concentrating or making decisions
Thoughts of death or suicide
Your symptoms cause you distress or impair your ability to function in your daily life

Make sure you understand what type of depression you have so that you can learn more about your specific situation and its treatments.

Health: Complications of Depression (Depressive Disorder)

Depression is a serious illness that can take a terrible toll on individuals and families. Untreated, depression can lead to a downward spiral of disability, dependency and suicide. Depression can result in severe emotional, behavioral, health and even legal and financial problems that affect every area of your life. Complications that depression may cause or be associated with include:

Suicide
Alcohol abuse
Substance abuse
Anxiety
Heart disease and other medical conditions
Work or school problems
Family conflicts
Relationship difficulties
Social isolation

Health: Conventional Treatment of Depression (Depressive Disorder)

Numerous treatments for depression are available. Conventional depression treatment options include:

Medications
Psychotherapy
Electroconvulsive therapy (ECT)

Emerging and less-studied treatments for depression include:

Brain stimulation
Complementary and alternative treatments

In some cases, your primary care doctor can treat your depression. In other cases, you may benefit from treatment with a qualified mental health provider, such as a psychiatrist, psychologist or social worker.

Try to be an active participant in your depression treatment. Working together, you and your doctor or therapist can decide which treatment options may be best for your situation, depending on your symptoms and their severity, your personal preferences, insurance coverage, affordability, treatment side effects and other factors. In some cases, though, depression is so severe that a doctor, loved one or guardian may need to guide your care until you're well enough to participate in decision making.

Health: Alternative Treatment for Depression (Depressive Disorder)

You may be interested in trying to relieve depression symptoms with complementary or alternative medicine strategies. These include nutritional and dietary supplements and mind-body techniques.

Keep in mind that nutritional and dietary products aren't regulated. The Food and Drug Administration doesn't test them for safety, purity or effectiveness. You can't always be sure of what you're getting and if it's safe.

Also, be aware that herbal and dietary supplements can interfere with the way certain prescription medications work or cause dangerous interactions that can harm your health. Talk to your doctors and other health care providers before taking any herbal or dietary supplements.

Nutritional and dietary supplements
Here's a look at some nutritional supplements commonly used for depression:

St. John's wort. Known scientifically as Hypericum perforatum, this is an herb that's been used for centuries to treat a variety of ills, including depression. It's not approved by the Food and Drug Administration to treat depression in the United States. Rather, it's classified as a dietary supplement. However, it's a popular depression treatment in Europe. Some studies show it may be helpful if you have mild or moderate depression.

SAM-e. Pronounced "sammy," this is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosyl-methionine. It's not approved by the FDA to treat depression in the United States. Rather, it's classified as a dietary supplement. However, it's used in Europe as a prescription drug to treat depression.

Omega-3 fatty acids. These are polyunsaturated fats found mostly in seafood. Good sources of omega-3s include fatty, cold-water fish, such as salmon, mackerel and herring. Flaxseed, flax oil and walnuts also contain omega-3 fatty acids, and small amounts are found in soybean and canola oils.

While some researchers are studying the effectiveness of complementary and alternative medicine, the jury's still out. Make certain you understand possible risks as well as benefits before pursuing them. Complementary and alternative treatments generally aren't a good substitute for traditional medical care.

Health: Self-help for Depression (Depressive Disorder)

Depression generally isn't an illness that you can treat on your own. But you can do some things for yourself that will build on your treatment plan.

Depressive disorder makes those afflicted feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up.

It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual situation. It should be remembered that negative thinking fades as treatment begins to take effect. In addition to professional treatment, follow these self-help steps for depression:

Eat healthy foods and make time to get enough rest to physically promote improvement in your mood.

Express your feelings, either to friends, in a journal, or using art to help release some negative feelings.

Do not set difficult goals for yourself or take on a great deal of responsibility.

Break large tasks into small ones, set some priorities, and do what you can when you can.

Do not expect too much from yourself too soon, as this will only increase feelings of failure.

Try to be with other people, which is usually better than being alone.

Participate in activities that may make you feel better.

You might try exercising mildly, going to a movie or a ball game, or participating in religious or social activities.

Don't rush or overdo it. Don't get upset if your mood is not greatly improved right away. Feeling better takes time.

Do not make major life decisions, such as changing jobs or getting married or divorced without consulting others who know you well. These people often can have a more objective view of your situation. In any case, it is advisable to postpone important decisions until your depression has lifted.

Do not expect to "snap out" of your depression. People rarely do. Help yourself as much as you can, and do not blame yourself for not being up to par.

Remember, do not accept your negative thinking. It is part of the depression and will disappear as your depression responds to treatment.

Plan how you would get help for yourself in an emergency, like calling friends, family, your physical or mental-health professional or a local emergency room if you were to develop thoughts of harming yourself or someone else.

Limit your access to things that could be used to hurt yourself or others (for example, do not keep excess medication of any kind, firearms or other weapons in the home).

Low self-esteem is common with depression. So are sudden bursts of anger and lack of pleasure from activities that normally make you happy, including sex.

Health: Prevention of Depression (Depressive Disorder)

There's no sure way to prevent depression. However, taking steps to control stress, to increase your resilience and to boost low self-esteem may help. Friendship and social support, especially in times of crisis, can help you weather rough spells.
In addition, treatment at the earliest sign of a problem can help prevent depression from worsening. Long-term maintenance treatment also may help prevent a relapse of depression symptoms.

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Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.

Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services

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HEALTH: OVERCOME DEPRESSION AND DEPRESSION SYMPTOMS