During any 6-month period, 10 million American adults suffer from a depressive illness (approximately one in five women and one in ten men). Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them. Most people with a depressive illness do not seek treatment, although the great majority can be helped. Ninety percent of those who are diagnosed with depression get better with a combination of medication and psychotherapy. Unfortunately, many people do not recognize that they have a treatable illness. It is hoped that the information presented here may help you learn if you are one of the many undiagnosed depressed people in this country or if you know someone who is.
What is a Depressive Disorder?
A depressive disorder is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.
- Persistent sad, anxious, or "empty" mood
- Feelings of hopelessness, pessimism
- Feelings of guilt, worthlessness, helplessness
- Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
- Difficulty falling asleep, awakening before you want to in the morning, or oversleeping
- Appetite and/or weight loss or overeating and weight gain
- Decreased energy, fatigue, being "slowed down"
- Thoughts of death or suicide; suicide attempts
- Restlessness, irritability
- Difficulty concentrating, remembering, making decisions
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Causes of Depression
There is no one cause of depression. Some types of depression run in families, indicating that a biological vulnerability can be inherited. Not everybody with the genetic makeup that causes vulnerability to depression has the illness. Apparently additional factors, possibly a stressful environment, are involved in its onset. Major depression also seems to occur, generation after generation, in some families. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with having too little or too much of certain neurochemicals.
Psychological makeup also plays a role in vulnerability to depression. People who have low self-esteem, who consistently view themselves and the world with pessimism, or who are readily overwhelmed by stress are prone to depression. A serious loss, chronic illness, difficult relationship financial problem, or any unwelcome change in life patterns can also trigger a depressive episode. Very often, a combination of genetic, psychological and environmental factors is involved in the onset of a depressive disorder.
Risk Factors for Depression
- Personal or family history of mental illness, including depression, suicide, and bipolar disorder
- Having a medical illness and/or chronic pain
- A recent loss or severe stress
- Unexplained physical problems
- History of using alcohol or drugs to feel better
- Being away from home for the first time
- Feeling overwhelmed
Ways to Help Yourself
Depressive disorders make you feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect your situation. Negative thinking fades as treatment begins to take effect. In the meantime:
Do not set yourself difficult goals or take on a great deal of responsibility.
Break large tasks into small ones, set some priorities, and do what you can as you can.
- Do not expect too much from yourself too soon as this will only increase feelings of failure.
- Try to be with other people; it is usually better than being alone even if it means studying at a library or café.
- Participate in activities that may make you feel better.
- You might try mild exercise, going to a movie, a ballgame, or participating in religious or social activities.
- Don't overdo it or get upset if your mood is not greatly improved right away. Feeling better takes time.
- Do not make major life decisions, such as changing jobs, getting married or divorced, without consulting others who know you well and who have a more objective view of your situation. It is advisable to postpone important decisions until your depression has lifted.
- Do not expect to snap out of your depression. People rarely do. Help yourself as much as you can, and do not blame yourself for not being up to par.
- Remember, do not accept your negative thinking. It is part of the depression and will disappear as your depression responds to treatment.
Ways to Help and be Helped by Others
Since depression can make you feel exhausted and helpless, you will want and probably need help from others. However, people who have never had a depressive disorder may not fully understand its effect. Although they won't mean to hurt you, they may say and do things that do. Therefore it may help to share information with those you most care about so they can better understand and help you.
Help Them Get Treatment
The most important thing anyone can do for the depressed person is to help him or her get appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor or therapist. It may also mean monitoring whether the depressed person is taking medication.
- Offer Emotional Support
The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Always report them to the depressed person's therapist or get help.
- Engage Them in Activities
Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.
- Acknowledge Their Depression
Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it." Eventually, with treatment, most depressed people do get better. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better.
Ways to Obtain Further Information
Staff at the Counseling Center encourage you to call 765-285-1736 if you have further questions or would like to talk to someone about yourself or someone you know. Contact the below resources for more information:
National Institute of Mental Health
Mental Health America
National Suicide Prevention Lifeline
The Trevor Project