Depression: what it is and how it affects family members

Depression

Currently, depression is a major health problem across the world. Largely, this is because many who suffer from it fail to recognize the severity of their problem, or they feel that they simply "have the blues" momentarily. However, many people who perceive their emotional state in such a way actually have a more permanent form of depression, which could be significantly improved through medical treatment. Fundamentally, depression needs to be recognized as a serious disorder if it is to be treated properly, and those living in close contact with individuals who they suspect may suffer from depression are most commonly the ones to ultimately address the problem. In this respect, depression influences the lives of family members significantly: they are usually the ones who suggest their loved ones seek medical treatment. Nevertheless, there remain certain courses of action and behaviors that family members can employ to help lessen the load upon themselves and their afflicted loved ones. Overall, the significance of depression in the eyes of most of the public is greatly lessened by the word's common usage and broad application; medically, depression is usually typified by particular symptoms and can be inferred from a number of risk factors. It can and should be treated for the sake of every individual's right to general well-being.

Centrally, "Depression is a serious illness, affecting about 17 million Americans each year, causing great pain not only to those who have depression but to their family and friends as well." Additionally, it is estimated that some two thirds of people suffering from depression -- in the United States -- receive absolutely no medical treatment. Those who interpret their depression as merely general feelings of sadness need to recognize two general concepts: first, the medical aspects of the disorder need to be recognized as such; and second, the value of available treatments should be impressed upon them. This makes depression somewhat unlike mast other illnesses in that it is not utterly apparent to most people that it is a medical condition, nor is it clear that there is anything the medical community can do to actually improve one's emotional state. Still, depression's importance is immense: "Approximately one in five adults in the United States will suffer from depression at some time."

Fundamentally, depression is merely a form of mental disorder that disturbs an individual's "mood." Naturally, people tend to experience moods as positions on a spectrum of particular underlying emotions. Human moods "range from severe depression through mild depression, normal sadness, everyday moods, mild mania, and euphoria." Sadness, of course, is extremely common and relatively healthy as a part of ordinary human life; depression however -- sometimes called major depression, or clinical depression -- is deep, debilitating, despondency, which typically lasts for long periods of time. This type of mood, also, tends to significantly interfere with the individual's social, familial, or work-related life. In this way, clinical depression is distinct from the common meaning associated with the word "depression": people who are medically depressed cannot climb out of the pits of sadness quickly, and have difficulty functioning in their day-to-day lives.

It is reasonable to wonder, however, whether depression is truly as serious as the medical community suggests it to be. After all, if so many people suffer from it but fail to treat it, then the incentive for those who suspect they may be clinically depressed to seek help is relatively small. Yet, depression is more than just an inconvenience to many people: "Untreated depression is the most common cause of suicide in the U.S." Accordingly, the battle against depression is a battle not only to improve the quality of lives, but to save lives as well.

The medical community recognizes two main types of mood disorders: depressive disorders, and bipolar disorders. The former is characterized simply by one or more prolonged periods of serious depression; the latter is characterized by at least one period of extreme euphoria, and one or more periods of severe depression -- this is often called manic depression. Many medical professionals define clinical depression as the expression of five of the following nine symptoms:

Depressed mood most of the day, nearly every day.

Diminished interest or pleasure in almost all activities of the day, nearly every day.

Significant weight gain or loss when not dieting, and decreased appetite nearly every day.

Insomnia or hypersomnia (sleeping too much) nearly every day.

Abnormal restlessness or a drop in physical activity nearly every day.

Fatigue or loss of energy nearly every day.

Feelings of worthlessness or excessive inappropriate guilt nearly every day.

Diminished ability to think, concentrate, or make decisions nearly every day.

Recurrent thoughts of death, or recurrent suicidal thoughts with a specific plan; or a suicide attempt; or a specific plan for committing suicide.

By no means is this list exhaustive, however. Considering the fact that human moods are experienced on a continuous spectrum, it should be anticipated that there are varying forms and degrees of depression. "Depression doesn't always look the same; it can manifest itself as a range of emotions.... Each person is unique." Physicians have recognized a number of illnesses related to clinical depression that are worthy of note. Aside from manic depression, there is also a more mild disorder known as cyclothymia. "People with cyclothymia have moods that swing between hypomania (a mild form of mania) and mild depression." The more mild form of depression is known called dysthymic disorder. This is more minor than clinical depression because although the bouts with depressive moods are quite severe and are recurring, they generally last for only brief amounts of time -- typically only a few days. Other, relatively common forms of depression include:

Postpartum depression disorder is a depressive illness that develops in new mothers about 1 week to six months after the birth of their babies. Premenstrual dysphoric disorder is a cyclic illness that affects 3% to 5% of menstruating women.... Seasonal affective disorder is a type of depression that occurs only at certain times of year.

There are also a number of depressive disorders that fail to fit nicely into these broad categories; these depressive disorders are simply termed "atypical mood disorders." One of the most common of these atypical disorders is characterized by episodic changes in emotional state based upon seasonal changes in the environment. "In another atypical and complex mood disorder called double depression, sufferers experience a chronic low-grade depression (dysthymia) periodically intensified by episodes of major depression."

Regardless of its particular forms, depression simply skews the way an individual perceives the world and themselves into something that is not altogether in touch with reality. Furthermore, people suffering from all forms of depression commonly find that it influences nearly every aspect of their lives, and make it difficult for people to live the type of lives they strive for. Considering all its debilitating characteristics, the fact that it is often called the "common cold of mood disorders," and the fact that it is treatable, it is amazing that depression goes untreated in most individuals who suffer from it.

Still, recognizing the symptoms and the varying forms of depression may not be enough for most people to be able to distinguish it from more healthy forms of sadness or grief. Depressed mood, though not typically clinical depression, is a common secondary effect of other illnesses. "Indeed, depressed mood is commonly associated with illness, and though it rarely approaches the intensity of major depression, it can be quite serious." Also, depressed moods can be caused by, and amplified by anxiety disorders, and other utterly unrelated conditions -- such as cancer, or chest pains.

Depression can also be a side effect of many drugs. Some of the most common drugs to cause depression are those used to treat hypertension. Additionally, "The hormones cortisone, estrogen, and progesterone often produce changes in mental state, including depression." Depression can also be the result of recreational drug or alcohol abuse. This should not be surprising since many drugs directly alter the brain chemistry responsible for differing forms of mood.

The difference between depression and typical grief can be seen both from the symptoms of depression and the typical characteristics of grief. "Normal grief tends to go through stages, during which you react to your loss by first denying it, then coming to terms with it, and eventually accepting it." But during this process, some of the symptoms of clinical depression may rear themselves. These symptoms can commonly be difficulty sleeping, loss of appetite, or difficulty concentrating. Over time, individuals experiencing grief will begin to reenter the world of other people and attempt to make social connections. Also, the person emerging from grief may make significant alterations to their lives as a result of their loss. "If your loved one was murdered, for example, you might become active in a group that lobbies for changes in the sentencing of convicted murderers." However, this is not re requisite of someone who is grief-stricken but not depressed. Broadly, if someone is exceedingly sad but not depressed, they will continue to work and focus upon their own lives, and they will continue their relationships with friends and family. So, although the reverse of these characteristic is not indicative of depression, their expression within the context of grief suggests the lack of clinical depression.

With the fundamentals of depression outlined, it is reasonable to wonder why such symptoms and behaviors manifest themselves in certain people and why they do not in others. Many different researchers coming from many different scientific backgrounds -- from psychology to biochemistry -- have investigated the fundamentals of depression, and each have constructed models as to what its underlying causes are. Each of these investigations has attempted to explain the causes and symptoms of depression and has offered treatment possibilities.

The psychological models of depression have focused their attention on failed early attachment, inability to obtain desired rewards, impaired social relations, and distorted thinking." This approach to depression has yielded some valuable information regarding the disorder; yet, much of the results make it unclear as to whether these aspects of depression are actually the causes or outward expressions of depression. Researchers and practitioners who adhere to this credo believe, "Depression is not a genetic fault of a mysterious illness which descends on us. It is something which we create for ourselves, and just as we create it, so we can dismantle it." However, people who understand depression in this way have difficulty explaining how certain groups of people experience higher rates of depression than others -- this implies some sort of predisposition towards clinical depression in certain people. Studies have also shown that genetic causes of depression are quite plausible: "It has been found that when one identical twin becomes depressed the other will also develop clinical depression approximately 76% of the time. When identical twins are raised apart from each other, they will both become depressed about 67% of the time."

Recognizing the possible shortcomings of purely psychoanalytical methodologies pertaining to depression has caused individuals in the fields of biology and biochemistry to investigate the illness. As a result "considerable gains have been made in viewing depression within the context of a biological framework. From this perspective, diagnostic tests and medications have emerged to counter the negative consequences of depression." These sorts of advancements have come from an evaluation of depression that focuses upon genetic vulnerabilities as well as the observable chemical changes that occur in the brain and can be associated with different moods. Generally, depression should be attacked from all directions; as is the case with most genetic disorders, the actual manifestation of clinical depression is most likely interplay between genetic predisposition and environmental factors. Consequently, both evaluations of the illness retain much of their validity, but taken together, they merge to produce the most accurate policy for approaching depression that can reasonably be hoped for.

From the biological point-of-view, we all are at some risk for depression. However, "Women are diagnosed and treated for major depression more often than men. In the U.S., a woman is about twice as likely as a man to be diagnosed with depression." Prior to adolescence, both genders tend to experience symptoms of depression equally, but in adulthood women have about a 25% chance of experiencing bouts of depression, whereas men have about a 12% chance. From the psychological point-of-view, this may be because women simply have more stressful lives in our society, and as a result, react more adversely to the environment. Statistically, this may simply be because more women seek help regarding their depression than do men. However, the difference may also come from men's greater usage of alcohol or drugs to stifle the effects of depression. Or biologically, women may simply be more prone to depression because of their particular hormonal makeup.