Depression

Do you ever ask yourself or say to a friend, “Am I depressed?” Sometimes it is difficult to know if you are simply having a rough time or experiencing something more serious.

  • Do your feelings of sadness resolve within a few hours or days?
  • Do you feel hopeful that things will improve even if they are difficult right now?
  • Are you able to put your situation in perspective?
  • Despite feeling down, are you able to maintain your daily life by going to class or visiting with friends?

All of us have felt down, blue or discouraged at times throughout our life, but clinical depression is a significant disturbance in mood persisting for a minimum of two weeks at a time. Depression can affect people of all ages and ranges from mild to severe depending upon how many symptoms you experience, and how much it interferes with your daily functioning. In milder forms, depressed moods are usually brief and may have little effect on everyday activities. Moderate to severe depression includes symptoms that are more intense, last longer, and tend to interfere more with school, work and social functioning.

Depression is a medical illness that can be caused by a variety of factors, including biological, genetic, psychological or environmental factors. Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities such as sleeping, eating or working. Depression affects more than 16 million American adults each year according to the Mental Health America Organization, and is a leading cause of suicide.

Although depression might initially begin as a reaction to an event or situation, it is a serious disorder that requires treatment. For others, their mood swings can occur without identifiable causes. Depression is NOT a result of a personal failure, lack of will power or laziness.

It is normal and expected for us to have variations in moods over time and even day-to-day. A variety of things can affect how we feel each day. Some common triggers for mood changes include times in which we experience unpleasantness or distress, such as

  • Transitioning and adjusting to a new environment
  • Academic or employment stress and difficulties
  • Conflict or emotional distress in relationships (family or roommate problems)
  • The loss of a significant relationship (break up or death)
  • Concerns about the future
  • Financial stress

According to the Mayo Clinic, depression, a mood disorder, causes people to lose pleasure from daily life and have a persistent feeling of sadness and loss of interest that can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities and sometimes feel that life isn't worth living. Depression can occur to anyone at any age, and to people of any race or ethnic group.  Depression is never a “normal” part of life, no matter what age, gender or health situation.

More than just a bout of the blues, depression isn't a weakness and you can't simply “snap out” of it.  Depression may require long-term treatment.  But, don't get discouraged because most people with depression feel better with medication, psychotherapy or both.

While the majority of individuals with depression have a full remission of the disorder with effective treatment, only about a third of those suffering from severe depression seek treatment from a mental health professional. Too many people resist treatment because they believe depression isn't serious and that they can treat it themselves, or that it is a personal weakness rather than a serious medical illness.

Mayo Clinic:

Signs and Symptoms

Although depression may occur only once during your life, people typically have multiple episodes.  During these episodes, symptoms occur most of the day, nearly every day and may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as a back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Causes

The cause of depression is not exactly known. As with many mental disorders, a variety of factors may be involved, such as:

  • Biological differences. People with depression appear to have physical changes in their brains.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.
  • Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.
  • Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

The significance of these changes is still uncertain, but may eventually help pinpoint causes.

Risk Factors

Factors that seem to increase the risk of developing or triggering depression include:

  • Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic
  • Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship or financial problems
  • Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
  • Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation
  • History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
  • Abuse of alcohol or recreational drugs
  • Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
  • Certain medications, such as some high blood pressure medications or sleeping pills (Talk to your doctor before stopping any medication.)

Complications

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it is not treated, resulting in emotional, behavioral and health problems that affect every area of your life.

  • Excess weight or obesity, which can lead to heart disease and diabetes
  • Pain or physical illness
  • Alcohol or drug misuse
  • Anxiety, panic disorder or social phobia
  • Social isolation
  • Suicidal feelings, suicide attempts or suicide
  • Self-mutilation, such as cutting
  • Premature death from medical conditions

Prevention

There is no sure way to prevent depression.  However, these strategies may help.

  • Take steps to control stress, to increase your resilience and to boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis, to help you weather rough spells.
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening.
  • Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

Treatment and Therapies

Even the most severe cases of depression can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.  If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

Quick Tip: No two people are affected the same way by depression and there is no “one-size-fits-all” for treatment.  It may take some trial and error to find the treatment that works best for you.

Medications

Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.

Antidepressants take time, usually 2 - 4 weeks to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. Do not stop taking the medication without the help of a doctor.

Important Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behaviors when taking antidepressants, especially in the first few weeks after starting or when the dose has been changed. This warning from the U.S. Food and Drug Administration (FDA) also says that all ages of patients taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you or a loved one is having thoughts of suicide, call the toll-free NATIONAL SUICIDE PREVENTION LIFELINE at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week.  This service is available to anyone.  All calls are confidential.

What can I do when I'm feeling blue?

Try some of these techniques and coping skills to begin to reduce your symptoms. Pick one to experiment with for a week to give yourself enough time to begin to see positive changes:

  • Talk to someone you trust.

  • Take care of your body.

There are significant benefits when you feel socially connected to others. This emotional support is linked to the following: increased self-esteem, sense of belonging, ability to cope, and decrease in loneliness.

Eat healthy meals and get a good night's sleep each evening. Regularly exercise, particularly cardiovascular activity or weight lifting, as these often show benefits similar to taking an antidepressant medication.

  • Create balance in your day.

  • Practice gratitude.

Set aside a minimum of 10 minutes a day to do something for yourself that is not school related. Experiment with different activities to help you gain a sense of achievement, connection with others and enjoyment.

Gratitude is strongly associated with improving your level of happiness and broadening your perspective on life. For a week, keep a gratitude journal and write down three things each day for which you are thankful.

  • Get involved in free activities on campus.

The college campus offers many opportunities to participate in activities such as sporting events, clubs, lectures, student government, student newspaper or radio stations, theater and many more. Social interaction and connections help to boost self-esteem.