Depression Is a Treatable Disease

Life is a roller coaster, full of ups and downs. But if you start to feel like you’re always “down” or you start to have trouble just getting through the day, you may be depressed. More than 17 million people in the U.S. experience an episode of depression each year, twice as many women as men. Fewer than two-thirds of depression sufferers receive the medical help they need, yet in most cases proper treatment can alleviate symptoms of the disease.

Yes, depression is a disease. Depression is caused by an imbalance of chemicals in the brain. It is a whole body illness that affects you physically, mentally and emotionally. Depression is not a matter of trying harder, thinking happy thoughts, a sign of weakness or lack of will. People suffering from depression cannot just “pull themselves together.” Depression is a medical disease just like diabetes or heart disease. Without treatment, depression can last for months, even years. Some people have an isolated episode of depression triggered by a traumatic event like job loss, financial difficulties or the death of someone close to them. Chronic stress or anxiety can result in depression. Some people have periodic episodes of depression throughout their lives; for others, the disease is chronic.

The symptoms of depression are unique to each person. Depression causes changes in thinking, feeling, behavior and physical health. The severity of  symptoms differs with each individual. Symptoms of depression may include:

• Persistent feelings of sadness, emptiness, hopelessness or helplessness
• Loss of interest in normally enjoyed activities
• Irritability, restlessness, excessive crying
• Sleeping too much or too little, trouble getting out of bed in the morning
• Loss of appetite and weight loss or overeating and weight gain
• Fatigue, exhaustion, decreased energy.
• Difficulty concentrating or making decisions, memory lapses
• Thoughts of death or suicide

Although antidepressants help alleviate depression symptoms for many people, not everyone who is diagnosed with depression requires medication. The most effective treatment for depression is generally a combination of psychodynamic therapy, cognitive-behavioral therapy and medication management administered and coordinated by an experienced psychiatrist. 

If you or someone you know suffers from depression, don’t lose hope. Depression can be treated. With the support and guidance of a caring psychiatrist like Dr. Tracey Marks, you can rediscover joy in your life.

Are Stereotypes a Self-fulfilling Prophecy?

We all understand the peril of stereotyping. Judging any group by a single set of often negative characteristics ignores both the breadth of human experience evident in any group of people and the unique individuality of each member of the group. Yet, stereotypes persist. The problem seems to be how we exercise the human need to identify others by comparing them to ourselves — How is he like me? How is she different from me?  

When those comparisons are used to generalize groups of people, we tend to emphasize how we are different from the group. By focusing on differences, often by accentuating negative traits, we build stereotypes by defining ourselves as separate from others. However, when we apply the same process of differentiation to individuals we meet in daily life, we tend to emphasize positive traits, looking not for how the individual is different from ourselves, but how he is the same. By emphasizing commonalities, we break down stereotypes.

Psychologists have theorized that stereotypes can be a self-fulfilling prophecy, that people internalize stereotype messages, living up – or down — to those expectations. In a recent study published in the journal Experimental Aging Research, psychologists at North Carolina State University in Raleigh tested the theory, using the stereotype that older people have faulty memories. Seniors aged 60 to 82 were given a recall test. Triggering the stereotype, half the group was told the test would examine the effect of aging on memory. The other half was assured that age-related bias had been removed from the test. Those in the first group performed remarkably, fulfilling the negative expectations of the stereotype.

Stanford psychologist Claude Steele calls this phenomenon “stereotype threat.” Numerous studies have shown that when a message purporting to define who and what we are is repeated, we internalize and come to believe it, whether or not it is true. The phenomenon affects widely diverse groups from African Americans to jocks to teenage girls. The same phenomenon can be used to effect positive changes in self-image. By changing their internal message from negative to positive, cognitive-behavior therapists can help patients improve self-esteem and decrease anxiety and depression.

Stress, Depression Plague Collegiates

College students are feeling the pressure, and they’re not just worrying about grades. Money and relationships are creating as much stress and depression on college campuses as schoolwork, according to a recent Associated Press-mtvU poll of college students on 40 campuses. Of the collegiates polled, 85% reported daily feelings of stress, the Associated Press reported. In addition, 42% said they had felt depressed or hopeless within the past two weeks, 13% showed signs of mild depression, and 11% said they’d had suicidal thoughts.

While 74% of the students were stressed about grades, concern over financial matters ran a close second, worrying 67% of the survey group. Half of the students (52%) were stressed about the economy, many saying that financial problems brought about by the recession could impact their ability to register for fall classes. Fifty-four percent of the students surveyed were stressed about family issues, and nearly half (47%) were worried about finding a job after graduation. Across the board, collegiates felt they were under more stress this year than last year. In all categories, collegiates surveyed in 2009 expressed a 3% to 6% increase in stress levels over their 2008 peers.

Students experiencing high levels of stress said they lacked energy, were having trouble sleeping and/or felt hopeless; but few  said they had sought professional help. At the University of Maryland in College Park, two student suicides within two weeks shocked students last semester, but didn’t seem to change students’ views about seeking help.

“It was pretty scary,” admitted UM junior Aimee Mayer, a psychology major. While she said the university provides students with plenty of information and help with mental disorders, Mayer told the Associated Press, “there’s still a stigma associated with mental health issues and so a lot of people don’t want to go to those services. They feel like they’re less cool or something like that it they go. It’s like a sign of vulnerability.”

That’s an unfortunate attitude because depression can be successfully treated using a combination of cognitive-behavioral therapy, psychodynamic therapy and sometimes medications. When given the opportunity to intervene, psychiatrists can also identify potential suicide victims and help them before they act. Many mental health disorders begin early in life, so it is not unusual for symptoms to emerge under the stress of college life. Parents should talk to their children regularly to gauge their mental health.

June Bride, July Blues

There’s something about June and brides. Surpassed only by Valentine’s Day as America’s most popular wedding date, thousands of brides choose to be married in June. For the typical year it takes to plan a modern American wedding, these women, and often their mothers (and to a slightly lesser extent their intended and both families), immerse themselves in the myriad details necessary to plan the perfect wedding.

Of course, weddings are exciting; and today’s typical wedding includes scores of intricate details and “crucial” decisions. It’s easy to get so caught up in the details of planning the wedding that brides and grooms forget to focus on the importance of the life change they are making. Though it often becomes an all-consuming event, in reality the wedding is just a small moment in a marriage. Moving from the autonomy of being single to the shared decision-making and compromise necessary to build a successful marriage is a major life change. Unfortunately, the cultural pressure to create the perfect wedding often overshadows the true meaning and challenges of this life-changing event.

Some women become so immersed in the bride role that the return to normalcy is such a let-down that it triggers a type of depression called “wedding withdrawal” or “post-wedding blues.” Once the big day is over and the honeymoon ended, the humdrum reality of newlywed life sets in. In a short week, brides go from being the center of attention with a full planning calendar and social agenda to the ho-hum daily reality of fixing meals, going back to work, and adjusting to married life. From sharing the bathroom to pooling money and making decisions together, marriage is filled with new challenges. Many newlyweds, however, find the role of wife less glamorous and exciting than the role of bride and depression can set in.

If you find yourself feeling sad after the wedding is over, talk to your spouse. Talk about the reasons you chose to get married, your commitment to each other, and your love for each other. Seek help from a psychiatrist skilled in cognitive-behavioral therapy if your depression lasts. As you plan your wedding, work to keep the event in its greater perspective. Your wedding day is just the first step in a lifelong celebration of your life together with your new spouse.

Depression Twice as Likely to Strike Women

Women are twice as likely as men to suffer major depression, according to a new report released by the U.S. Department of Health and Human Services. Analyzing the most recent research on women’s mental health issues, the report, Action Steps for Improving Women’s Mental Health, examines the role gender plans in treating and coping with mental illness issues such as depression, anxiety, and post traumatic stress disorder brought on by trauma and violence.

Analysis discovered that not only are women twice as likely as men to suffer depression, but women suffer anxiety disorders at a rate two to three times greater than men. Women are also at far greater risk than men for post traumatic stress disorder, a discovery that could significantly impact the treatment of female war veterans returning from Iraq and Afghanistan. In fact, the study found that any history of violence, trauma or abuse increased a woman’s risk of developing depression, post traumatic stress disorder, anxiety and panic disorders. It also increased the tendency to engage in risky behaviors.

In a press release, Acting Surgeon General Dr. Steven Galson said, “Mental illness is often incorrectly perceived as a weakness, which prevents women from recognizing the signs and symptoms and seeking treatment. In order to reduce stigma, we need to encourage open, honest conversations.”

Depression, anxiety, panic disorders, and post traumatic stress disorder are treatable conditions. In a key finding, the federal report found that family and interpersonal relationships in a woman’s life not only play a significant role in a woman’s ability to cope with and recover from mental illness, but that strong, positive relationships offer women some modicum of protection from mental illness.

In an effort to encourage dialog about women’s mental health issues and address stigmatizing misconceptions about mental illness, the U.S. Office of Women’s Health (OWH) has produced a free, downloadable booklet to educate women about steps they can take to improve their health and reduce their risk for many diseases, including depression, anxiety, panic disorders, and post traumatic stress disorder. Click here to download the free OWH consumer booklet Women’s Mental Health: What It Means to You.

Routine Depression Screening Advised for Teens

With more than two million U.S. teens affected by depression, an influential medical panel is urging physicians to routinely screen their teen patients for depression. According to the U.S. Preventive Services Task Force, a government-appointed blue-ribbon group of medical experts that sets health guidelines for doctors on a wide range of health issues, most depressed teens struggle with their condition undiagnosed and untreated. The task force’s recommendations, which exceed teen depression screening guidelines suggested by the American Academy of Pediatrics’, were published in the April issue of the journal Pediatrics.

Evidence suggests that teen depression can be accurately diagnosed in primary-care settings with the aid of simple but detailed questionnaires. Because routine school/sports physicals, illness and injury send most teens to their primary-care doctor several times a year, the task force believes that increased screening by primary-care physicians has the greatest potential to dramatically increase the number of teens receiving help for depression. An estimated 6 percent of U.S. teens suffer from clinical depression that requires psychotherapy and, in some cases, medication.

Teen depression can lead to social isolation, persistent sadness, school problems, and even suicide. Screening for early detection and treatment is crucial to improving symptoms and helping teens cope, the panel said. While other medical groups have recommended screening high risk teens, the panel experts recommend screening all teens at least once a year. “You will miss a lot if you only screen high-risk groups,” Dr. Ned Calonge, task force chairman and chief medical officer for Colorado’s Department of Public Health and Environment told the Associated Press.

The teen years are a time of volatile emotions, individualization, separation from family, and boomeranging self-confidence that can quickly spiral down into depression. With families always on the go, teens’ natural emphasis on spending more time with their friends, and the normal teen desire for privacy, parents can often miss early signs of depression. Teens, too, can be adept at hiding depressive feelings and suicidal thoughts from their families and friends. However, simple questionnaires that focus on depression indicators — mood, anxiety, appetite, drinking, substance abuse — have proven remarkably accurate in helping physicians diagnose teen depression.

In light of highly publicized links between antidepressants and teen suicide, Calonge stressed that the panel is not promoting drug treatment alone. The panel specifically recommends routine depression only when psychotherapy is readily available to immediately help teen patients.

Is Lack of Sleep Making Us Crazy?

“Economic insomnia” is one more complication of America’s financial meltdown, and psychiatric experts warn that it could be making us crazy. People are losing sleep worrying about job loss, foreclosure and bankruptcy. The longer the recession continues, the greater the chance that the financial boogeyman will creep out of the closet and steal away our ability to provide basic necessities for our families. Nearly everyone knows someone who has lost their job to economic demons, and most of us have had to make lifestyle changes. Worry is making for a lot of restless nights. Researchers warn that lack 0f sleep increases the risk of depression and other serious psychiatric conditions.

“When you are tired, when you’re worn out, then everything becomes more of a challenge for you,” Dr. Adam Moscovitch, medical director of the Canadian Sleep Institute in Toronto, told Calgary Herald reporter Sharon Kirkey in an April 12, 2009 online article. ”Your confidence is affected, your ability to trust yourself. So there is a higher likelihood you’ll be ruminating about, are you doing things right? It significantly affects, from the psychologic standpoint, the [risk] of mental illness developing.”

Researchers have proven that lack of sleep has a negative impact on physical and mental health. People who get six hours of sleep or less per night increase their risk of high blood pressure, heart attack and stroke. Chronic sleeplessness weakens the immune system, causes changes in appetite, interferes with sexual interest, decreases the ability to concentrate, and negatively affects function and judgment. Growing evidence indicates that not getting enough sleep can also trigger mental illness, particularly depression, anxiety and mood disorders.

In a 20-year study of 591 young adults published in 2008 in the journal Sleep, Dr. Daniel Buysse of the University of Pittsburgh found that insomnia lasting two weeks or longer often triggered depression. The link between sleep and mental health appears to reside in the amygdala, the brain area that governs emotions. Harvard Medical School and the University of California-Berkeley researchers found that sleeplessness stimulates the amygdala, causing increased brain activity associated with depression, anxiety and other mental illnesses. 

Because of the risk to mental and physical health, chronic insomnia that persists for weeks or months at a time should never be ignored. If worry is regularly interfering with your sleep, talk to your health professional today.

Am I Depressed or Just Not Manic?

Sometimes it’s difficult for bipolar patients to tell when they are in a depressed mode or if they have simply lost their manic high.  For many, mania can be a very destructive phase, but for some, mania or hypomania (milder form of mania) can feel very good and be a very productive time.  Sometimes this loss of the elation can make patients not want to take their mood stabilizer.  Some will say they experience the non-manic period as being flat or as if they are living a generic version of themselves.  They may then conclude they are “depressed” when in fact, they may not be depressed, they are just experiencing the middle ground.

Some patients may swing between cycles so often that they may not know how to recognize the middle ground.  This is why it is important for patients with bipolar disorder to stay in regular contact with their health care provider so they can have someone keeping an eye out for their mood states.  It’s not always as easy to recognize the beginning of a manic state as it is to recognize depression.  A person who is hypomanic may appear happy, upbeat and busy.  On the surface, that doesn’t seem so bad.  But it is usually the people close to them that recognize the more destructive behaviors such as functioning on little sleep, making impulsive decisions, etc.  So, although the hypomanic state may seem desireable and some even try to prolong the state (by avoiding medication), mania can spiral out of control.  Therefore it is important to keep a careful watch and welcome periods of non-mania and middle ground.