Depression

Winston Churchill called it "The Black Dog"; in "Breakfast at Tiffany's" Holly Golightly called it the "Mean Reds" Mostly, we call it "The Blues"--those low feelings that we all experience from time to time.

Episodes of depression may come in clusters or may be separated by long intervals-sometimes years-of normal functioning. But 1 in 4 Americans will suffer from depression at some time in their lives.

What distinguishes clinical depression from occasional melancholy is pessimism. Depressed people are not just sad; they believe their sadness will go on indefinitely, regardless of anything they do. These feelings of hopelessness, helplessness, and despair characterize the depression that has been called the leading mental health problem in America today.

Are You Blue?

• Who's Blue? - Jack is a large man who moves and talks slowly, sighing frequently. He has no complaints about his life other than occasional spats with his wife, but neither does he have any enthusiasm for his work or home life. When asked if he's happy, he shrugs and says, "I guess so; I'm getting by."
• Lauren cries easily and often, feels anxious and scared, and has difficulty sleeping. She's confused and frustrated about her love relationship. She hates her partner's criticism of her but feels intimidated and won't leave him because she fears being alone.
• Harry's wife left him suddenly, asking for a divorce. He feels abandoned and alternates between rage and hopeless depression. He continues to go to work but withdraws from friends and family and at times thinks of "ending it all."

Jack, Lauren, and Harry are among the 4 to 8 million Americans who are treated for depression every year. Their numbers are increasing, especially among people born since 1940; in a recent poll, 52% of the adults questioned admitted they felt "lonely and depressed."

What Is It?
In practice, the condition of depression tends to be defined by its symptoms which include:

• feelings of helplessness, hopelessness, worthlessness, & anxiety
• changes in thinking, such as poor concentration, confusion, forgetfulness, or indecisiveness
• decreased ability to enjoy life
• changes in usual sleep patterns and appetite; either sleeplessness or extreme fatigue, loss of appetite or overeating
• either unusually slow or rapid speech and physical movements.

Depressed people are pessimists. Expecting the worst from life, they magnify their failures and minimize successes. They tend to blame themselves for anything that goes wrong, even events over which they have no control.

Causes
Many factors may contribute to depression, among them personality characteristics; biochemical imbalances; genetic factors; learned patterns of thinking and acting; stressful life events; social economic class; age, and sex.

• Reactive depressions occur in response to a loss of some kind. Separation or divorce, job loss, retirement, children leaving home, or completion of a major life goal can all trigger reactive depression. Depressions may recur on the anniversary date of these events.
• Learned helplessness, generated by a lack of control over life, creates chronic low-level depression. When we believe we can't control what happens to us and our actions repeatedly fail to produce results, we feel helpless and become depressed.
• Repressed anger can become depression. Depressed people are dependent upon love, approval, and reassurance from others because they lack self esteem. Fearing that their anger will drive away those they love, they often deny angry feelings, resulting in depression.

Kids Get Blue, Too
10% of children under the age of 12 suffer from depression. Because they can't talk about their feelings as well as adults, it's more difficult to diagnose childhood depression but it is clear that children suffer from depression just as adults do.

Red Flags
Your child may be depressed if s/he displays any of the following signs:

• changes in normal sleep patterns or appetite
• school problems or refusal to go to school
• talk about feeling unhappy or not liking himself
• sadness lasting a week or more
• lack of enthusiasm for usual play activities
• any significant change in the child's usual behavior
• preoccupation with death or
• talk of suicide.

Prevention
Don't panic if your child is a little moody. While depression occurs more frequently in children than was once believed, it is not epidemic.

To help your child avoid depression or weather it successfully-

• Help your child like himself. Praise successes and provide extra help when needed.
• Be alert to changes in your child's usual disposition, especially if they last more than a week.
• Don't hide your feelings about family problems such as divorce or illness.
• Encourage your child to talk about what bothers him. Question for specifics and don't tease if the cause seems trivial to you.
• Take any mention of suicide seriously. Get professional help for any child who talks about suicide.

Children imitate parents, and depressed parents raise depressed children. If you are suffering from depression, the best way to protect your child is to seek prompt professional help for yourself.

Don't Let The Blues Get You Down...
The quiet, self-sufficient individual who tends not to ask for help has a higher risk for suicide from depression than those who reach out for support. Men who believe they should be totally emotionally self-sufficient are particularly at risk for successfully concealing their depression until suicide seems to be the only way out.

You don't have to fight depression alone. Consult your local mental health professional. Willingness to seek outside help shows emotional maturity. Depressed people often start to feel better just from having taken action rather than remaining helpless. If you find yourself thinking about suicide, psychotherapy is imperative.

Depression often makes even routine things seem enormous. If the task at hand seems overwhelming break it into smaller steps that are easier to handle. Instead of looking at the task of getting a job, for example, set a goal of making one phone call or typing one page of your resume.

Depression tends to isolate its victims. Push yourself to get involved in activities that include other people, even if it's just going to the movies. You don't have to be the life of the party; just get a little human contact.

If you are depressed in reaction to a loss of any kind, respect your need to grieve and give yourself adequate time to do so. Don't berate yourself, saying "I should be over that by now." Trying to cut short your time of mourning will only add to the length of time it takes to recover.

Regular aerobic exercise which raises the heart rate for 20 minutes or more has anti-depressant effects. Walking, jogging, tennis, weight lifting, and other exercise both lifts low spirits and increases self-confidence.

Clinical depression can be produced by certain physical illnesses and is associated with others. Illnesses known to cause depression include thyroid disorders, diabetes, some neurological disorders, multiple sclerosis and certain vitamin deficiencies. Others, such as hepatitis, influenza, anemia, endocrine problems asthma, and many infectious diseases, are often associated with depression.