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Health Tips
Depression Health Tips
Niki’s Experience
One year ago, I was admitted to the psychiatric ward of a local hospital. Technically, the admission was voluntary. Nonetheless, it took two hours of sympathetic coaxing from nurses and my husband to get me to sign the form that would begin my five-day stay.
Mental illness is no stranger to my family. Several members of my immediate family live with (largely untreated) depression. An uncle and a great-uncle suffer from schizophrenia. Another uncle died from liver failure related to alcoholism--the bottle was his way of self-medicating. I easily recognized mental illness in my own family members, and I had urged many of them to seek medical treatment.
The fact that I easily recognized depression in my immediate family didn’t mean I was able to identify it in myself, or even accept it when others identified it in me. Accepting mental illness is, I think, a bitter pill for anyone to swallow.
Besides, I didn’t feel depressed. My symptoms simply didn’t jive with what I thought depression was supposed to feel like. I didn’t feel overly sad or blue. I wasn’t crying at all. Rather, I felt empty. Nothing.
Of course, I knew something was drastically wrong. I wasn’t sleeping well and didn’t feel much like eating. My short-term memory was failing me. I couldn’t concentrate at work. Writing a simple e-mail, as well as other routine activities, had become impossibly difficult chores. I no longer wanted to read books or do any of the things I usually enjoyed doing—especially since I believed I wasn’t doing them well anyway. Surely that wasn’t depression. Besides, I had a steady job, a new house, a happy home life—I felt I really had no right to be depressed.
Being in the hospital stabilized me, but it was only a first step. Three months, four psychiatrists, seven medications, two therapists, and a bunch of tests after my hospitalization, I was correctly diagnosed with clinical depression. Still, I kept asking the question, "Why?"
I was lucky. I had an incredible network of family, friends, and mental health professionals to support me. I needed them all. My mother-in-law flew in from Denver to spend a week with me and my husband immediately after I was released from the hospital. Two weeks later, I spent a week with my parents and youngest sister in Shenandoah, where they were vacationing. For months afterward, one of my parents would call me every day or two, just to check in. Extended family members I hadn’t spoken to or seen in several years wrote or called--including the uncle with schizophrenia, who doesn’t have a phone.
Friends did the same, persisting in calling me even when I failed to respond. My employer urged me to take the time I needed, as a two-week leave of absence extended into two months, and then became a resignation. Support groups showed me that others were struggling too, and demonstrated that successful treatment for the same diagnosis varies drastically from person to person. My husband, who bore the brunt of my illness, never wavered in his patience, commitment to my recovery, or support of me as a person with a treatable, though intangible, illness.
Most people with mental illness are not as lucky. A large number do not receive appropriate medical care. Many suffer silently and, frequently, needlessly. When mental health consumers do speak up, well-intentioned friends and family members sometimes counsel, "Think happy thoughts," or "Just pull yourself out of it." I can tell you from personal experience that thinking happy thoughts alone would not have gotten me any closer to recovery.
I understand the awkward silence when the person at the other end of the phone line simply doesn’t know what to say, or when years of easygoing friendship are thrown out of kilter by a single, looming word: depression. I understand the family member who believes in prayer or attitude adjustment as a primary means of treatment. While prayer and positive thought undoubtedly played a role in my recovery, so too did medication, family and community support, and therapy. As with most people who learn to live with and understand their mental illness, my own recovery required a multi-faceted approach.
There are no definite answers to the how and why of mental illness. Treatment can be like throwing darts at a dartboard and hoping one will stick, since one medicine or therapy may work wonders in one consumer, but have no effect on another. The irony is that those who are least in a position to advocate for themselves must not only seek treatment, but also stay the course through medicinal and therapeutic trial and error.
Our attitudes toward mental illness are slowly changing. Yet mental illness remains a stigma, one that is not usually discussed openly or honestly. Mental illnesses don’t discriminate based on age, gender, ethnicity, or socioeconomic background. They can strike when you least expect them, and they are insidious in the way they manifest themselves. They are not tangible, but they’re real. And they are treatable.
I hope I never experience again what I did last year. But if I do, I will deal with it, and I know my family, my friends, other consumers, and mental health professionals will be there to support me. Believe me, it makes all the difference in the world.
-Nicole Wanner
Basic Facts About Clinical Depression
National Mental Health Association
- Clinical depression is one of the most common mental illnesses, affecting more than 19 million Americans each year. This includes major depressive disorder, manic depression and dysthymia, a milder, longer-lasting form of depression.
- Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can even be serious enough to lead to suicide.
- Depression can occur to anyone, at any age, and to people of any race or ethnic group. Depression is never a "normal" part of life, no matter what your age, gender or health situation.
- Unfortunately, though treatment for depression is almost always successful, fewer than half of those suffering from this illness seek treatment. Too many people resist treatment because they believe depression isn’t serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.
Causes of Clinical Depression
National Mental Health Association
Many things can contribute to clinical depression. For some people, a number of factors seem to be involved, while for others a single factor can cause the illness. Oftentimes, people become depressed for no apparent reason.
- Biological – People with depression typically have too little or too much of certain brain chemicals, called "neurotransmitters." Changes in these brain chemicals may cause or contribute to clinical depression.
- Cognitive – People with negative thinking patterns and low self-esteem are more likely to develop clinical depression.
- Gender – Women experience clinical depression at a rate that is nearly twice that of men. While the reasons for this are still unclear, they may include the hormonal changes women go through during menstruation, pregnancy, childbirth and menopause. Other reasons may include the stress caused by the multiple responsibilities that women have.
- Co-occurrence – Clinical depression is more likely to occur along with certain illnesses, such as heart disease, cancer, Parkinson’s disease, diabetes, Alzheimer’s disease and hormonal disorders.
- Medications – Side effects of some medications can bring about depression.
- Genetic – A family history of clinical depression increases the risk for developing the illness.
- Situational – Difficult life events, including divorce, financial problems or the death of a loved one can contribute to clinical depression.
Symptoms of Clinical Depression
National Mental Health Association
- Persistent sad, anxious or "empty" mood
- Sleeping too much or too little, middle of the night or early morning waking
- Reduced appetite and weight loss, or increased appetite and weight gain
- Loss of pleasure and interest in activities once enjoyed, including sex
- Restlessness, irritability
- Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
- Difficulty concentrating, remembering or making decisions
- Fatigue or loss of energy
- Feeling guilty, hopeless or worthless
- Thoughts of suicide or death
If you have five or more of these symptoms for two weeks or more, you could have clinical depression and should see your doctor or a qualified mental health professional for help.
How Family and Friends Can Help the Depressed Person
National Institutes of Health - National Institute of Mental Health
Many things can contribute to clinical depression. For some people, a number of factors seem to be involved, while for others a single factor can cause the illness. Oftentimes, people become depressed for no apparent reason.
The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication.
The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Report them to the depressed person's therapist. Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.
Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it." Eventually, with treatment, most people do get better. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better.
Additional Resources
- National Mental Health Association
www.nmha.org
- National Institutes of Health
www.nih.gov
- Yahoo
http://dir.yahoo.com/Health/Diseases_and_Conditions/Mental_Health_Disorders/
- Surgeon General’s Report on Mental Health (issued in 1999), and the supplemental report Mental Health: Race, Culture, and Ethnicity (issued in 2001)
http://sgreports.nlm.nih.gov/NN/Views/AlphaChron/alpha/10006/
A Few Books Recommended by Niki:
- The Deepest Blue: How Women Face and Overcome Depression, by Lauren Dockett and Matthew McKay
- The Beast: A Journey Through Depression, by Tracy Thompson
- Prozac Nation, by Elizabeth Wurtzel
- Unholy Ghost: Writers on Depression, edited by Nell Casey
- Darkness Visible, by William Styron
- An Unquiet Mind, by Kay Redfield Jamison
- The Power of Positive Living, by Norman Vincent Peale
- For a recent op-ed piece on depression in The Washington Post, see "Misguided Mental Health," by Timothy A. Kelley http://www.washingtonpost.com/wp-dyn/articles/A14366-2002Jul28.html
- For an interesting look at how the pharmaceutical industry funds research behind and popular perception of mental illness, read "Disorders, Made to Order," in the July/August issue of Mother Jones
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