After anxiety, depression is the second most common of all mental health conditions. Research indicates that between 5-20% of the general population of the United States will suffer depression over the life span. Much of my practice consists of depression treatment.
Mood may be elevated, normal or depressed. Depression is a complex issue. It comes in many forms. The causes are often unclear and symptoms can vary widely. In spite of the challenges, a number of therapies offer hope for those who suffer from depression.
If you suspect you or someone you know might be depressed, the following sub-topics provide a digest of information to help with depression.
The two main depression symptoms are:
- Depressed mood
- Loss of interest in daily activities
Besides at least one of these two, some of the following would be present for two weeks or more for a diagnosis of depression
- Weight change
- Increased weight gain or loss or unexplained changes in weight.
- Sleep disturbances
- Sleeping too much or too little, trouble getting to sleep, waking up during the night, not being able to go back to sleep.
- Agitation, or slowing of body movements
- Restless, irritable, agitated, easily annoyed, “short fuse.” Feeling like bodily movements are slower than usual, lack of vocal inflection.
- Fatigue Low energy. Weariness, feeling tired upon arising, low energy level nearly every day. Activities of daily living seem harder.
- Feeling worthless
- Random or recurrent thoughts of past mistakes or failures, feelings of hopelessness, excessive guilt.
- Inability to concentrate or make decisions, problems with memory (misplacing things, forgetfulness, etc.)
- Thoughts of death
- A persistent negative view of the self, situation and the future. Thoughts of death, dying or suicide may be present.
Additional Depression Symptoms Resources
If you want to read more about the symptoms of depression from a medical web site…
Another perspective on symptoms can be gained from a general health web site…
Depression and Suicide
Depression can run the gamut from a mild case of the blues to a major depressive episode and suicidal thinking. When people, including teens and children, are severely depressed, a professional assessment could save a life. If you or someone you know is depressed, don’t take a chance. Seek professional help. Better to be safe.
For more on depression and suicide…
Depression in Children and Teens
When considering children and teens, it is important to remember that they often exhibit irritability, aggression, or withdrawal instead of the depressed mood that adults experience. Consequently, it is quite possible for parents, teachers and other adults to misinterpret the symptoms.
If your child or teen is showing these symptoms, play it safe and have them treated by a professional. Every year thousands of teens and, increasingly, children attempt suicide in the United States. At Bill Jacobs LPCC we work hard to connect with children and teens.
Teen depression is on the rise in the United States. If a teen becomes depressed, immaturity, and high hormone levels can contribute to producing severe symptoms.
Distinguishing Features of Depression in Teens and children
Besides understanding the general depression symptoms, it is good to bear in mind that teenage depression is often marked by an irritable rather than a down mood.
A drop in grades or problems getting along with peers or teachers can be indications of depression in children and teens, as well as grumpiness, tantrums, irritability. Teens may sleep more.
Other mental health issues, such as ADHD, and conduct problems often mask depression in children and teens.
Children sometimes manifest physical symptoms such as stomach ache or headache, etc.
Causes of Depression in Children and Teens
The causes of childhood depression are essentially the same as for adults.
Children generally face much more stressful situations than a decade ago. Teen stress is especially intense. The following considerations may also prove helpful:
Stressors that can cause Depression in Children and Teens
Stressors to consider:
- changing schools
- peer problems
- family problems
- loss of a pet
- loss of a loved one
- teen romantic break up
Insecure attachment may also be a factor in depression. Most children who have suffered insecure attachment also have problems regulating their moods and emotions.
Hormones and Brain Development in Children and Teens
Children and teens are growing. Their brains are wiring a furious rate. All this growth is orchestrated by hormones, which also affect brain function and mood.
Self-Help for Depression in Children and Teens
Parents can spend extra time with depressed children and teens, attuning to them and listening.
Proximity and affection also communicate love and support to teens and children. We can recommend books by Ross Campbell, How to really Love your Child and How to Really Love Your Teen, to help parent-child relationships.
More on depression in children and teenagers…
Here I am only going to cover the therapies I use. We refer clients to others for some forms of “talk therapy,” group therapy, medication, etc.
Eye Movement Desensitization and Reprocessing therapy is a well-researched approach to dealing with some types of depression. It won’t help biologically based depression. But it can be very effective with depression caused by early environment and present life circumstances. From my experience, these two are responsible for most depression.
The principle behind EMDR is the use of rapid eye movement to adaptively reprocess previously unprocessed depressing memories. Reprocessing usually occurs much more rapidly than with the talk therapies. Such processing frequently helps with a person’s sense of self.
Learn more about EMDR from the official EMDR website.
Cognitive, Emotional, Behavioral, Spiritual therapy (CEBS)
Depression is about loss, losses sustained in the present and in the past. Losses can be material, as the loss of a job; or relational, like the loss of a loved one or pet; or of a state, such as safety; or to the sense of self, such as losing a sense of self-worth.
We help people explore their life to restore past losses or adapt to them. Some times simply helping people grieve the losses of life is enough to move past them. Sometimes restoring previously more adaptive states or sense of self resolves the depression. Sometimes people need to think differently about their lives and experiences. Even emotional pain can be a good thing, pointing to issues that need to be resolved.
Much of this work is often done during EMDR. Sometimes after EMDR, there still needs to be some talk to redefine, reorder, reprocess. Our CEBS approach helps with this work.
A young woman came to me once with hives from head to toe, literally. She had many of the classic symptoms of PTSD, including debilitating depression. When she came in for her seventh session, she said, “Can you tell I have lost weight?” I commented on her success and asked how she did that. She said, “I don’t know. I started exercising again. Maybe that’s what helped me get back on my diet.” I said, “And this from the one who told me just a few weeks ago she was too depressed to get out of bed most days. Can you think of anything you have done to bring about this change?” “No,” she said. “Everything is the same.” I replied, “I see that your hives are gone too. How did you do that,” I asked? “I have no idea,” she replied. “I don’t even know when they left.” “Well,” I said, you have done six sessions of EMDR.” The light of awareness shone on her face, as she made the connection between all the hard work she had done and the elimination of her symptoms. This kind of cognitive work augments and reinforces the work clients do with EMDR.
Types of Depression
Chronic depression can be so subtle that it can sometimes be difficult to tell if a person suffers from this form of depression.
Chronic Depression is also called dysthymia, which means “ill-humored” and is used to describe a chronic state distinguished from major depression by the following:
- Has continued for two or more years rather than two weeks for major depression
- Remitting for less than a two month period
- Does not generally include thoughts of suicide or the need for hospitalization
People who have other mental or physical problems are often dysthymic as well.
Dysthymia is common relative to other mood disorders:
- Affecting 3 -5 percent of all people.
- In psychiatric clinics that number rises to 33 -50 percent of patients
- In adolescents: 8 percent in boys and 5 percent in girls
- More common in women 64 and younger than in men of any age
- More common among unmarried than married
- More common among those of low income
Dysthymia frequently coexists (technical term: Comorbid) with other mental disorders, especially major depressive disorder and borderline personality disorder, and can also accompany chronic physical illnesses.
Causes of Chronic Depression
The causes of dysthymia, as with other mood disorders, seem complex.
It is likely that a combination of factors, rather than a single factor, can cause dysthymia.
Twenty percent of Americans will suffer some form of depression over the life span. More women suffer symptoms than men.
This type of depression, calledÂ major depressive disorder lasts more than two weeks but has not been chronic. Symptoms may be more severe than with chronic depression.
Symptoms may include overwhelming feelings of sadness, guilt, grief, feelings of worthlessness. This type of depression may result in disturbed sleep patterns, change in appetite, fatigue, concentration problems. Severe depression may include thoughts of death and suicide, thereby increasing the risk of suicide.
Self Help for Major Depression
Because Major Depression includes the potential for suicide, Â we urge professional treatment.
If you or someone you know is so depressed that thoughts of death are present, don’t try to treat it alone.
Additional Resources for Major Depression
A medical web site. offers a slightly different perspective…
Another resource is the National Alliance on Mental Illness (NAMI)…
There is no solid research on the prevalence of Seasonal Affective Disorder (SAD). Some evidence indicates that people who live in northern latitudes may be more frequently affected.
Distinguishing Features of Seasonal Depression
When onset is in winter, the following symptoms often occur:
- General depression symptoms
- Social withdrawal
- Craving for foods high in carbohydrates or other appetite changes
- Weight gain
When onset is in the spring or summer, the following symptoms are more likely:
- Weight loss and poor appetite
- Increased sex drive
Infrequently people have a reverse form of seasonal affective disorder, experiencing the following symptoms that relate to elevated mood:
- Persistently elevated mood
- Increased social activity
- Elevated mood or enthusiasm beyond the normal range
For more information on symptoms…
Melatonin, a hormone that affects sleep is suspected by some, as the body naturally produces more of it during winter. Serotonin, a brain chemical, may also play a part, as reduced light causes a drop in serotonin levels.
The body’s natural clock, called the circadian rhythm, may be disrupted by the short days and long nights of winter by and cause depression.
Other general causes of depression may also apply.
Professional Treatment for Seasonal Depression
Psychotherapy, light therapy, and medication are all used to treat Seasonal Affective Disorder. A mental health professional may indicate the need to begin taking an antidepressant several weeks before the onset of symptoms.
For more information on the treatment of seasonal depression…
Approximately 10% of mothers experience some degree of postpartum depression.
Distinguishing Features of Postpartum Depression
After the birth of a child, mothers sometimes feel some mild disturbance of mood. Symptoms can include:
- Feelings of inadequacy
Beyond these, some new mothers also experience more severe symptoms beginning soon after to six months after birth. These symptoms include symptoms of major depression:
- Excessive anxiety about baby
- Lack of concern for self or baby
- Numbing of emotions
- Withdrawal from family and friends
- Difficulty concentrating
- Sleep disturbance (beyond that caused by tending an infant)
Causes of Postpartum Depression
The obvious cause would be hormonal — from the hormonal disruption of childbirth.
This major factor may be complicated by other factors, such as financial pressures, health issues, feeling inadequate as a new parent or marital issues.
Professional Treatment for Postpartum Depression
If symptoms become severe professional treatment is important. Infants need their mothers to be emotionally available, something that is more difficult to accomplish while depressed. I can help with postpartum depression. The cause is hormonal, but the good mental health practice of self-expression reduces the symptoms.
Additional Resources for Postpartum Depression
Here is the Postpartum Support International support web site: Postpartum.net…
MedlinePlus, a government-sponsored site, has additional information on Post Partum Depression.