Comprehensive Information on Clinical Depression
Depression: what every woman should know
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Definition [1]
We all experience emotional downs at times; it's very
common. But, these times of feeling blue should not
interfere with your ability to function, nor should they
linger for an abnormally long period of time. If you
are experiencing persistent sadness that's interfering
with school, work, and/or relationships, you might be
suffering from a common, serious medical illness called
depression. Many women may have their first
episode of depression during their college years.
Depression is a medical disorder, just like diabetes, high
blood pressure, and heart disease, that day after day affects
your thoughts, feelings, physical health, and behavior.
Depression is not just "feeling blue" or "down in the dumps."
[2]
About 1 in 20 Americans (over 11 million people) suffer
from clinical depression each year.
[3]
Depression is a pervasive, impairing illness that affects
women at roughly twice the rate of men. In fact, recent
studies suggest that one fifth of all women will develop clinical
depression at some point over the course of their lives.
[4]
Depression presents itself differently in different
people; they experience different symptoms that may vary in
severity and duration.
Having some depressive symptoms does not mean a person is
clinically depressed. For example, it is not unusual for
those who have lost a loved one to feel sad, helpless, and
disinterested in regular activities. Only when these symptoms
persist for an unusually long time is there reason to suspect
that grief has become a depressive illness.
Similarly, living with the stress of a college workload,
grades, social pressures or family problems may cause
irritability, sadness, and "the blues." Up to a point, such
feelings are simply a part of human experience. But when
these feelings increase in duration and intensity and start
affecting your ability to function at school and participate
in relationships, what started as a temporary mood problem
may have become a clinical illness. It is important to
remember that depression is a medical illness that
often occurs even when life is going well.
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Causes of Depression [5]
Depression may be triggered by as little as one or a
combination of the following factors:
- Family history and genetics
- Biochemical factors
- Various mental disorders
- Certain medicines
- Acute or chronic physical ailments
- Drugs or alcohol
- Life conditions, such as extreme stress, grief, or
relationship problems
Genetic factors may predispose an individual
to develop depression. A family history of the illness
may indicate that there is a biological vulnerability that
has been inherited. However, not everybody with a
family history of depression will develop the illness. And
clinical depression can occur in people who have no family
history of the illness.
Alterations in brain chemicals are significant factors in
depression, resulting in mood, appetite, and sleep pattern
changes.
Certain attributes such as having a low self-esteem, a
pessimistic view of life, a sense of having little control over
one's own life are key symptoms as well; general negative
thinking leads people with these attributes to have a
higher rate of depression than others without these
characteristics. Furthermore, people with the tendency
to excessively worry are also at a heightened risk of
developing the illness.
While fun, being in college can be extremely
stressful. Stress and every day life
"issues" can trigger mood changes. When
these changes persist, depression may occur. Dealing
with the stress of a college work load, relationships, major
life changes, financial worries, a job, possibly single
parenthood, a physical illness, a significant loss and many
other various stressful events all lead women to an immense
amount of stress that may trigger the onset of
depression. You must remember that you're not
alone. Depression affects more of us than you
think.
Your college may provide many resources to help students
deal with the stresses of college life. Take advantage
of them; they're there for you!!!
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Women and Depression; How We're Different
Women are at a higher risk for developing depression over
their lifetime.
Studies have shown that before adolescence there is little
difference in the rate of depression between boys and
girls.
[6]
Between the ages of 11 and 13, there is a significant rise in
depression rates for girls, eventually causing females to be
twice as likely to have experienced a major depressive
episode by the age of 15 as males.
[7]
This rise is observed at a time when roles and
expectations begin to be more strongly emphasized at the same
time as hormonal changes occur with the onset of
puberty. This may cause additional stresses for females
in that age group. Such stresses include:
[8]
- Forming an identity
- Emerging sexuality
- Separating from parents
- Making decisions for the first time
- Dealing with intellectual changes
- Hormonal changes
- Physical changes
Additionally, college women have to deal with other
stresses that include sexual activity, and competition issues
with both men and other women. The college experience
is the time one discovers oneself emotionally, which is a
stressful yet defining part of life.
[9]
Another
major factor causing certain people, especially women, to be
more highly predisposed to the illness is experiences of
having been molested as children. Similarly, women who
have been raped at any point in their lives have a higher
chance of developing depression during their lifetime.
Incidents of rape are much more prevalent in females than in
males, which is consistent with the subsequent depressive
illnesses that more women eventually experience.
Furthermore, women who experience other commonly occurring
forms of abuse such as physical abuse, sexual harassment, and
psychological abuse may also experience higher rates of
depression. Such abuse causes women to think and feel
negatively about themselves, often leading to social
isolation and, in some, eventually depression.
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Signs and Symptoms of Depression [10]
People who have major depressive disorder have a number of
psychological and physiological symptoms nearly every day,
all day, for at least 2 weeks. A combination of 3-5 of
the following symptoms may indicate the presence of
depression.
- Loss of interest in things you generally enjoy
- An overall sad, blue, or "down in the
dumps" feeling
- Feeling slowed down or restless
- Feeling worthless or guilty
- Experiencing an increase or decrease in appetite or
weight
- Loss of energy
- Constantly feeling tired
- Trouble sleeping or sleeping too much
- Having a hard time concentrating, thinking,
remembering, or making decisions
- Thoughts of death or suicide
- Headaches
- Digestive Problems
- Other aches and pains
- Being anxious or worried
- Sexual problems and/or disinterest
- Feeling pessimistic or hopeless
Episodes of depression can occur once, twice, or several
times in a lifetime.
[11]
Alcohol and other substance abuse, or an addiction, often
coexists with depression.
Suicidal thoughts and behaviors may occur when a person is
severely depressed. These tendencies may lead someone to
commit an irreversible action. If you're feeling suicidal,
tell a trusted friend, teacher, staff member, family member,
or health care professional; tell anybody you trust. Ask
this person to help you get professional help and medical
attention immediately. These thoughts will go away with
treatment. For more information on suicide prevention,
check out: www.safeyouth.org
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Treatment for Clinical Depression
You should know that depression is a very treatable illness.
One major aspect of depression is the hopelessness that
accompanies it, including the notion that some people hear
that the condition is untreatable and "will never go away."
Treatment cannot begin without an appropriate
diagnosis. A thorough physical examination should be
conducted to rule out any physical illnesses that may produce
depressive symptoms. You should tell your doctor about
all medications (both prescription and over-the-counter), as
they may be the cause of depressive symptoms. Also, tell your
doctor about any alcohol or drug use and any dietary
supplements that you are taking. Once the physical
examination has concluded and a physical cause of the disease
has been ruled out, you should turn to psychological evaluation;
this can be conducted by the same physician or a mental
health professional.
Early treatment of depression leads to more effective and
longer-lasting results.
Common treatments for depression include one or a
combination of the following, depending on the nature and
severity of the condition:
- Psychotherapy
- Medications (usually antidepressants)
- A combination of Medication and Psychotherapy
- Electroconvulsive therapy in treatment-resistant severe
depression
Of course, treatment will not eliminate life's inevitable
stresses and ups and downs. But it can greatly enhance a
person's ability to manage school, work and relationship
challenges and lead to greater enjoyment of life.
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Psychotherapy [12]
In mild to moderate cases of depression, psychotherapy is
an important treatment option. Some short-term (10-20 week)
therapies have been very effective against several types of
depression. The different types of psychotherapy include
"talking" therapies and "behavioral"
treatments. "Talking" therapies help
patients gain insight into their problems and resolve them through
verbal give-and-take sessions with a therapist.
"Behavioral" treatments help patients learn new
behaviors that lead to more satisfaction in life and to an
"unlearning" of counter-productive behaviors. Research has
shown that two short-term psychotherapies, interpersonal and
cognitive-behavioral, are helpful against some types of
depression. Interpersonal therapy works to change
interpersonal relationships that cause or exacerbate
depression. Cognitive-behavioral therapy helps change
negative styles of thinking and behaving that may contribute
to depression.
Antidepressants
[13]
Antidepressants act on different chemical pathways in our
brain that affect our mood.
Antidepressants are non habit-forming medications.
Improvement can be seen as early as the first few weeks of
medication. Typically, these medications need to be
taken regularly for 4-8 weeks until their full effects
are experienced. A relapse may be prevented by staying
on the medication for about a year under a doctor's
supervision. For some people who have experienced several
episodes of depression, they may need to stay on medication
indefinitely to improve their mood, much in the same way as
people with DIABETES
take regular medications to treat their illness.
You should inform your doctor of any other prescriptions,
over-the-counter medications, or diet supplements you
may be taking that may affect the potency of the medication
or result in interactions causing potentially harmful side
effects. As with all medications, be extra
cautious if you're pregnant or suspect you might be
pregnant.
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Electroconvulsive Therapy [14]
For individuals whose depression is severe or life
threatening or for those who cannot take antidepressant
medication, electroconvulsive therapy (ECT) may be useful.
This is particularly true for patients with:
- Extreme suicide risk
- Severe agitation
- Psychotic thinking
- Severe weight loss
- Physical debilitation as a result of physical illness
A muscle relaxant is given before treatment, which is done
under brief anesthesia. Electrodes are placed at precise
locations on the head to deliver electrical impulses. The
person receiving ECT does not consciously experience the
electrical stimulus. At least several sessions of ECT are
required for full therapeutic benefit.
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Things You Can Do to Help Yourself
A discouraging part of depressive illnesses is the general
feeling of exhaustion, worthlessness, helplessness, and
hopelessness. These feelings make many patients want to
give up on life. One of the most important things your
can do to help yourself is recognize that these negative
feelings are part of the depression and will fade as
treatment begins to take effect.
Some people find that some of the following strategies
will help you get through depression:
- Partaking in activities that make you feel better
- Exercising
- Joining a support group
- Spending time with other people
Remember not to expect too much from yourself right away;
you're only human and feeling better takes time!
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Dealing With a Recurrence of Depression [15]
One of the most important things to remember
when experiencing a recurrent episode of depression is that
depression is treatable; you've gotten through it before,
you'll get through it this time! You must
remember the methods you used that were most helpful with
your previous treatment, including seeking help again.
The sooner the recurrence is treated, the shorter its
duration will be.
As in many other illnesses, depression is a recurrent
disease. The best way to prevent such a recurrence is
continuation of the treatment that was successful with the
initial episode, which is most often the same dose of
antidepressant medication that was initially prescribed. For
patients not taking antidepressants for their depression,
monthly interpersonal psychotherapy help can prevent
recurrent episodes.
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Where to Go for Help
Listed below, and in the Other Resources
section of this fact sheet, are the types of people and
places that can either help you or make referral to more
qualified professionals who may better assist you.
- University Health Center
- Community Health Center
- Primary care physicians
- Mental health specialists
- Social workers
- Local Emergency Room
- Crisis Hotlines
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References
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