Are You Depressed?
Although there is such a stigma around mental health and depression, it is also a condition that people in our society have made “fashionable”. Like anxiety, people love to say “oh my God I’m so depressed”. While some people may actually have a clinical diagnosis of depression, many individuals are getting confused with just being plain ole sad. Because lets face it, being sad at times is a part of life. Failing a test or getting broken up with doesn’t mean you’re actually depressed. It’s when you have a certain amount of symptoms for a certain duration of time that you are actually considered clinically depressed. It has been found that depressed individuals have a neurotransmitter imbalance within their bodies. Cortisol levels are increased whereas norepinephrine, dopamine and serotonin are decreased (this is why most treatment options increase serotonin levels). There are various forms of depression, and I will go through them below.
Major Depressive Disorder
MDD is the technical term for depression. You are termed clinically depressed when you have a depressed mood or loss of interest in things you normally do (anhedonia) + 4 or more of the following symptoms: sleep disturbances (too much or too little), guilt, loss of energy (fatigued), difficulty concentrating, increased or decreased appetite, psychomotor changes (restlessness, agitation, slowed) or suicidal ideation (feelings of hopelessness, worthlessness and helplessness). These symptoms are known as SIG E CAPS. When this occurs for more than 2 weeks it is considered MDD. In children it may not show as a depressed mood or loss of interest, but instead may show as irritability. The treatment for this is SSRI’s (selective serotonin reuptake inhibitors).
Dysthymia
Dysthymia, also known as Persistent Depressive Disorder, is when you have a decreased mood for more than 2 years but no period longer than 2 months without 2 or more of SIG E CAPS. The treatment for this is also SSRI’s.
Adjustment Disorder
Adjustment disorder is an inappropriate change in emotions or behaviour that affects your social functioning. This typically occurs within 3 months of a stressful event and resolves within 6 months of said event. The symptoms can include depression, increased sleep, substance use and anxiety. The treatment for this is psychotherapy.
Seasonal Affective Disorder
Seasonal Affective Disorder or SAD is when someone has signs of clinical depression that occur at specific seasons. This is usually in the fall and winter for most people. Some symptoms that can be seen (but not required for diagnosis) are increased carbohydrate cravings which leads to increased eating and weight gain. These patients will be in full remission when the season is over. Treatment options for people with SAD are anti-depressants, light therapy and cognitive behavioural therapy.
Post-Partum Blues
Post-partum blues occurs in the 2 weeks following delivery. The new mother may seem depressed, they still care for their baby but they are just down. The management for this is reassurance.
Postpartum Depression
Postpartum depression differs from postpartum blues because it occurs within a month following delivery. This is considered MDD with peripartum onset. They don’t have psychosis during this time, but they are unable to care for their baby and there is a risk of them potentially hurting their baby. The treatment is with anti-depressants like SSRI’s. If the mother is lactating then psychotherapy is the preferred treatment.
Grief
Grief typically lasts less than 12 months. It doesn’t affect your daily functioning. You seem hopeful and can see a future and you can be happy with your friends and family. You do however have depressive symptoms revolving around the person who is deceased. The symptoms come and go. You may have “psychotic” like symptoms which are things like talking to the deceased and maintaining rituals as if they were there. This could be something as simple as leaving an empty chair for them at the dinner table. The management for grief is time and reassurance. The most important thing is to talk to someone and not try to handle the grief alone.
Persistent Complicated Bereavement Disorder
Bereavement typically starts after 6 months and can go on for more than 12 months. The depression these patients have revolve around the person who is deceased. Although these individuals don’t meet the criteria for MDD, treatment is the same with SSRI’s.
Well there you have it, a run down of the majority of depressive disorders. I’m going to say that probably 8/10 of you (I’m making this number up) probably don’t have any of these depressive disorders, you may just be feeling sad about a particular thing. Patients that suffer from real clinical depression often times can be identified due to their inability to maintain normal functioning. Some people get to the point where they literally can’t get out of their bed for weeks on end. They may not eat, to the point where they have lost so much weight and are unable to properly care for themselves.
If some of this is starting to sound familiar to you, you should really think about seeking help. There is such a stigma behind mental health, but getting treatment for something like depression isn’t any different from getting treated for diabetes. At the end of the day it is all apart of your general well-being. Deciding not to take anti-depressants is like a diabetic deciding not to take insulin. While your illness may improve on its own if you make an effort, more times than not it doesn’t work out that way. Taking anti-depressants to reverse the changes in your neurotransmitters can make all the difference! It can be the step you need to live a happier life.
