Understanding and Dealing with Depression
Revised: May 21, 2014
Depression is one of the most common psychological/psychiatric disorders. At one time or another, everyone will experience feelings of depression. Feeling sad or depressed is a normal reaction to a tragedy, change or a significant loss in our lives. For most people, the symptoms of depression are only temporary.
Depression is described in terms of the severity, duration and type of symptoms. The general feeling of depression is characterized by diminished motivation, low self-esteem, low energy, impaired thinking and emotional well-being. Depression affects a person's overall energy, mood, expressions of emotion and behavior.
Depression is commonly referred to as a Mood Disorder. Emotion is what you are feeling at a given moment. How you feel over a long period of time is your mood.
An estimated 1 out of 10 children have difficulty escaping the symptoms of depression for long periods of time. The rate of depression is markedly lower (1%) in children ages 1 to 6 years old. The rate is higher in older children ages 9 to 12 years (12%). Between 1 and 2 adults out of every 10 adults have significant symptoms of depression (10 to 20%).
There is reason to be concerned when symptoms of depression are severe, prolonged, unexpected, seem unusual or have no apparent cause. Recognizing the symptoms of depression can help you cope and seek help from a qualified mental health professional.
Symptoms Of Depression In Older Children And Adults
Additional Symptoms of Depression Found In Younger Children
The correct diagnosis of depression is complicated. There are many alternative diagnostic systems and criteria for depressive syndromes. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is often used to diagnose depression. There are growing concerns and criticisms of the DSM. For one thing, it was developed by consensus of opinions and not scientific research. There are four DSM primary diagnostic categories involving depression. They are,
There has been a tremendous amount of research regarding the biological and psychological basis of depressive disorders. Depressive disorders occur in approximately 15 to 25 percent of the population. Studies have found that 30 to 70 percent of all medical patients seen by physicians have depressive disorders in addition to their medical problems. Medical outcome studies have found that more than one half of these patients will not make significant improvement until their depression is recognized and treated. Depression appears to be inherited, although most people appear to inherit a vulnerability for depression. Approximately one half of all patients with depressive disorder have a close blood relative with depression. Studies of identical twins have shown that depressive disorder may occur with one twin but not the other. Most people become depressed purely from the impact of psychological, social or environmental influences. When people are overwhelmed and subjected to significant stress or loss, they can become depressed and stay depressed until they are treated.
Dealing with symptoms of depression requires an understanding as to whether the symptoms are a normal reaction, the result of a psychological disorder, or the result of a medical problem or condition. There are a number of medical conditions that can look and feel like depression. The symptoms associated with a psychological disorder or a medical condition are usually severe, unexplained, interfere with our ability to function or prolonged.
Common Treatment Approaches
A large number of treatment strategies have been developed for the treatment of depression. Many of these approaches can be implemented individually, in groups or family therapy environment. There is considerable evidence to suggest that interventions which emphasize treatment of the family, and not the "identified patient", are critical to positive treatment outcome. Peer group approaches have been found to be effective for children. Play therapy is sometimes appropriate with younger children.
In general, depression is very responsive to psychotherapy. Effective therapy must include an evaluation of the patients biological, psychological, social and cultural history. A treatment plan based on an evaluation is essential. Medications can be helpful, but the side effects of these medications and the potential for addiction in some medications must be considered and weighed against the potential benefits. Psychotherapy can be a very effective alternative to the use of medications. In most cases, there must be changes in the patients environment and social support system for treatment to be successful.
Families of people with depression often fail to see how they reinforce the disorder. They are often resistant to change despite expressed dedication of support and a desire to do whatever is necessary. Embarrassing or punishing a person who feels depressed will only make the disorder worse.
There are effective and ineffective therapies. Unfortunately, effective therapies are often used incorrectly by well intended counselors and therapists. Competence, commitment as well as outstanding interpersonal qualities in a counselor or therapist are crucial for treatment to be successful. Advice, directions and techniques are not effective unless their is positive therapeutic alliance between the therapist and patient.
Psychotherapy requires significant commitment where as treatment of depressive disorders with medication requires less effort. Since normal depression can improve over time and without therapy, a brief period of medication may not be of benefit. Some patients require an increase in their medication over time.
Psychotherapy requires significant commitment where as treatment of depressive disorders with medication requires less effort. Since normal depression can improve over time and without therapy, a brief period of medication may not be of benefit. It is important for consumers to know when medications are more effective that psychotherapy. Psychotherapy can be helpful in cases of normal depression and can help insure the condition does not become chronic.
Antidepressant medications require a substantial period of time before they take effect and several trials of different medications may be necessary to find a medication that actually works. Medications alone appear to be helpful in approximately 15% of case involving depression. However, the use of medications require a substantial commitment for period of time up to 9 months. In some cases, a patient can terminate their medications after 6 to 9 months without a risk of relapse. Unfortunately there is no way to know if a person will relapse of not. Side effects are the primary reason why people stop taking their medications. The side effects of antidepressant medications can vary greatly and can have a significant or even traumatic impact on self-esteem and quality of life.
Psychotherapy is almost always the first treatment of choice while except in cases where depressive symptoms are so severe or critical that immediate relief is necessary to restore functioning and to prevent immediate and severe consequences. Medication is usually the second choice after a comprehensive and competent trial of psychotherapy. Combined use of medications and psychotherapy at the onset of treatment can confound evaluation of treatment effectiveness and the observed source of change. It is harder in a combined medication and therapy approach to tell which approach is or is not helping and how much it is helping. However, research has found that combined psychotherapy and medication can be beneficial but not necessarily.
Psychotherapy, or the psychotherapist, can generally be considered ineffective if a trial of 3 months has not produced a measurable and noticeable improvement. A decision to change therapists or to start a medication may be necessary at this point. Several trials of psychotherapy or medications may be necessary to successfully treat depressive disorders.
The prognosis for treatment of depression is good especially if it is dealt with early. Positive treatment outcomes are primarily dependent on a correct diagnosis, and understanding of the etiology, and implementing an appropriate intervention.
Programs & Interventions
Outdoor Behavioral Health Programs. Involves short term or longer term participation in adventure, wilderness and other outdoor settings that provide a variety of experiential and personal growth opportunities. These include personal and group challenges, activities that require initiative, outdoor sports, wilderness or survival education, exercise, nutrition, and separation from unhealthy environments. Healthy and therapeutic group interactions are facilitated and practiced. Individual counseling and therapy is often a component of these programs.
Advice For Adults And For Parents Of Children Who May Have Depression
Copyright 1999 to 2008, Michael G. Conner