Depression

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way one eats and sleeps, how tired one feels, how much energy one has, whether one still enjoys participating in activities, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. This page describes three of the most common types of depressive disorders, major depressive disorder, dysthymia and bipolar disorder. Within these types of depression, there are variations in the number of symptoms, their severity, and persistence.

Types of Depression
Major Depression:
Major Depression is manifested by a combination of symptoms (see symptom list below) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.

Dysthymia:
Dysthymia is a less severe type of depression which involves long-term, chronic depressive symptoms that are not disabling but keep one from functioning well or from feeling good. Many people with dysthymia may go on to experience major depressive episodes at some time in their lives.

Bipolar Disorder:
There is a distinction between bipolar I disorder, also called manic-depressive illness, and bipolar II disorder, which is less severe. Not as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania, which is often characterized by irritability, distractibility, sleeplessness or grandiosity - see symptom list below) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overly talkative, and have a great deal of energy. Severe mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.

Symptoms of Depression and Mania
Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Depression
· Persistent sad, anxious, 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
· Decreased energy, fatigue, being "slowed down"
· Difficulty concentrating, remembering, making decisions
· Insomnia, early-morning awakening, or oversleeping
· Appetite and/or weight loss or overeating and weight gain
· Thoughts of death or suicide; suicide attempts
· Restlessness, irritability
· Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Mania
· Abnormal or excessive elation
· Unusual irritability
· Decreased need for sleep
· Grandiose notions
· Increased talking
· Racing thoughts
· Increased sexual desire
· Markedly increased energy
· Poor judgment
· Inappropriate social behavior

Causes of Depression
Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be particularly apparent in the case of bipolar disorder. Studies of families in which members of each generation develop bipolar disorder 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: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset. In some families major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.

People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.

In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) 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. Later episodes of illness typically are precipitated by only mild stresses, or none at all. This is why early treatment is very important.

Therapy Core can help - please contact us at 973.270.5757 or see our website www.Therapy-Core.com for more information.