Healer Dealer

Health Advice and Information on Depression

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10:52 10-Sep-2010

Depression is now the most common psychological problem in the whole mental health field. The incidence has risen year on year over many years. Fortunately, many therapies, ranging from orthodox and alternative medication to talking therapies have emerged from the research effort over those same years and there is considerable evidence of the effectiveness of many of them.

Clinical Depression

The word "depression" is used in everyday language for a wide range of mood states, often just a low mood for a brief period. Excluding these usages, formal depression takes many forms. The most prevalent is "clinical" depression, and more so bi-polar disorder, where all or many of the following apply:

Feeling low or unhappy most of the time
(often a little better in the evening, a little worse in the morning)
Increasing loss of interest in everything
Loss of energy
Loss of concentration
Loss of short-term memory
Difficulty in making decisions
Restlessness or agitation
Not going out as often as before
Loss of self confidence
Less care about appearance
Appetite (and sometimes) weight down significantly
(occasionally the reverse happens)
Waking early am
Sometimes general sleep disturbance
Crying easily
Lower emotional resilience
Loss of interest in sex
Suicidal thoughts, perhaps self-harming

Modern Definition of Manic-Depressive Illness

A manic-depressive illness or "bipolar mood disorder" is a disturbance of a person's mood characterized by alternating periods of depression and mania. Switching from one mood to another is referred to as a mood swing. Mood swings can be mild, moderate or severe and are accompanied by changes in thinking and behaviour. The course of the illness varies from patient to patient. Without treatment, the frequency and severity of this recurring illness can increase over the years.

Although lay people will ordinarily use the term "manic-depressive illness', psychiatric professionals are increasingly using the term "bipolar mood disorder" as is demanded by current diagnostic manuals. Bipolar refers to the "two poles" of the continuum of mood or "spirits" with depression or feeling down at one end and mania or feeling high at the other end.

It must be emphasized that many people with this illness continue to enjoy productive and fulfilling lives during the periods between episodes. Modern treatment and community supports have done much to create possibilities for optimal adjustment to this illness.

Symptoms of Manic-Depressive Illness

Depression or mania is diagnosed if a person demonstrates a certain number of symptoms. Interestingly, a mood change is not a necessary symptom for the diagnosis of depression or mania.

Depression
Because feelings of sadness, disappointment and frustration are a part of normal living, the diagnosis of severe depressive states is made only if such states are intense, pervasive, persistent and interfere with usual social and physiological functioning.

Symptoms affect feelings, thinking, body, behaviour; they may include some or all of the following:

Feelings

• depressed mood remorseful by feeling sad, low, blue, hopeless, helpless, useless, guilty, ashamed, remorseful
• loss of interest in work
• loss of feelings for family or friends
• anxiety, fears, worries
• worthlessness, undeserving even of help
• pessimism
• loss of interest in sex
• inability to experience pleasure, have fun

• slowed thinking, difficulty in concentrating, in making decisions, mixed-up thoughts
• preoccupation with failures, loss of self-esteem, obsession with certain thoughts that one cannot seem to turn off
• loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions)
• thoughts of suicide, of homicide (Approximately 15% of untreated or inadequately treated patients with an affective illness commit suicide, often just as the depression is lifting and more energy and activity is experienced.)

• changes in appetite and weight (70% lose weight, others gain); sometimes a craving for sweets and carbohydrates develops
• sleep problems: although insomnia is most frequently reported, about 15 to 30 percent feel the need to sleep excessively and never feel rested in spite of 12 to 14 hours of sleep
• loss of energy, fatigue, lethargy
• bodily complaints e.g. headaches, muscle aches
• sour taste in mouth, blurred vision, indigestion
• agitation or restlessness

• slowed talking, moving
• withdrawal from social contacts
• crying easily or not at all even though one might like to
• excessive use of alcohol and/or non-prescription drugs

1. normal states: happiness, pleasure, joy

2. moderate elations: hypomanic or cyclothymic personality; here a person experiences heightened self-esteem, increased creativity and work ability, decreased need for sleep

3. mania: symptoms start interfering with social and physiological functions

4. "delirious" or psychotic mania: severe overactivity, hostile attitude, destruction of property, assaultiveness, paranoid delusions or hallucinations

Specific symptoms again influence areas of feelings, thinking, body, behaviour, all of which have a quality of being in high gear, and bursting at the seams:

Feelings

• elevated mood, feeling high, elated, euphoric, ecstatic
• irritability, excessive anger over trivial things, overreacting to stimuli
• labile, rapid emotional changes: feeling happy one minute and then angry the next for no apparent reason
• hostile

• inflated self-esteem, grandiosity, thinking one is more powerful than one really is
• ideas pour in at an incredible pace and mental associations after associations occur so that speech can be full I of jokes, plays on words and amusing irrelevancies
• misinterpretation of events, distortion of the meaning of ordinary comments
• distractibility
• racing thoughts, flight of ideas, jumping quickly from one topic to another
• poor judgment, one will probably not recognize that one is ill and is apt to refuse treatment, will blame others for things that go wrong
• loss of touch with reality - hearing voices (hallucinations) or having strange ideas (delusions) about being persecuted, controlled

• excessive energy
• decreased sleep sometimes only a couple of hours a night
• a heightening of all the senses, especially in the perception of colours and light

• involvement in grandiose money making schemes
• compulsive desire to be socially involved prompting telephone calls to friends at all hours of the night often to discuss plans
• overspending, giving money away, going on shopping sprees, incurring heavy debts, moving from one activity to another without stopping
• socially intrusive, headstrong, targeting the self-esteem of others, alienating family members
• angry and demanding
• talking more than usual, sometimes loudly and quickly
• a new interest in collection of clothes, possessions or other objects
• increased sexual activity, may want sexual intercourse several times a day, may pick up partners indiscriminately

Characteristics of the Illness

Duration of a Manic-Depressive Episode
How long a person remains depressed or manic varies and usually ranges from a few days to several months. The intervals between episodes range from days to months to years. An individual will eventually recover from depression or mania without treatment but usually recovers more quickly with treatment. Before 1940 the average duration of a depressive episode was about four months, of a manic episode about three months. Some periods of depression lasted as long as a year or more. After 1960, in response to the use of new medications, episodes tended to be shorter.

Recurrence of Episodes
Some people discover a predictable pattern, others do not. In a 1973 study of 400 patients who had a manic-depressive episode only two did not have a recurrence. Other studies reveal that before the introduction of the drug Lithium, about 75% of manic patients had more than one episode in their lifetimes.

Onset
The first episode of manic depressive illness usually occurs in young adulthood. The occurrence of manic episodes in people over 50 is often indicative of some other medical illness or of some effects of drugs, alcohol or steroids.

Incidence and Prevalence
Men and women are equally susceptible to this disease. 1 to 2 percent of the population is expected to develop manic-depressive illness in a lifetime. The risk increases among first degree or immediate relatives where there is a 15 percent chance of developing manic-depressive illness.

To mention but a few historical figures who have had this illness, Abraham Lincoln, Theodore Roosevelt and Winston Churchill were all reported to have experienced manic episodes followed by black periods of depression. Other well known people with manic-depressive illness, both in the past and present, include authors E Scott Fitzgerald and Ernest Hemingway, and actresses Patty Duke and Vivien Leigh (Scarlett O'Hara in "Gone With the Wind").

Causes of the Illness

Researchers have not identified a single cause of manic-depressive illness. Genetic investigations have shown that biological factors play a major role in producing the illness. Often manic-depressive illness tends to concentrate in families. Currently researchers are looking for genetic markers that would identify people at risk.

It seems to be "just a matter of time" before they find such markers. Much research has also focused on such physiological aspects as brain chemistry, the endocrine and the hormonal systems. Also there have been studies relating stressful events to biological changes. An excellent detailed account of such studies can be found in Chapter 4 of the book, "Overcoming Depression" by Papolos, pages 55-84.

In summary, genetic, biological, environmental, stress and personality factors can all contribute to a manic-depressive episode.

Response to the Illness

Unfortunately, only one in three people suffering from a mood disorder (this includes depression and manic-depressive illness) seeks help. Only one in ten seeks help from a psychiatrist who is trained to diagnose such illnesses and treat them medically. This may be due to a person's desire to "go it alone', or to a lack of knowledge and understanding of what it is that is going on inside of him or her. In any case, many people tragically deny themselves the substantial relief from crippling symptoms that medical treatment could give them.

Medication

Normally millions of brain cells transmit messages to one another using chemical messengers - about 100 have been identified so far. In depression two of those at least are reduced - Serotonin (or 5 HT) and Noradrenalin. Medications boost concentrations. Is medication effective ? Yes , in about 50% of first episode cases but increased doses may be needed to get things right. First episode medication tends to be for three months with the first evidence of response about two to four weeks after starting taking the medication.

Talking therapies

Some, such as CBT and CAT (cognitive behaviour therapy and cognitive analytic therapy) have been shown when appropriate to be as effective as medication in trials, sometimes more so, and of course medication if often combined with talking therapies. Finding a good counsellor, psychotherapist, CBT therapist can diminish and dispel the recurrance of depression as well as other problems. These therapies need not necessarily go on week in week out for years as in the past. Modern therapies are encouraging to mostly look at the present. Changing thought and actions and reactions that we have been used to with more satisfactory ones that can go on to chagne the cycle that we may have experieced in the past.


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Complementary Treatments that heal and deal with Depression

Western Herbalism- for example St. Johns Wort has proved links to easing depression
Bach Flower Remedies- mustard if depression for no immediately apparent reason, gentian if you know the cause, gorse for a sence of helplessness, sweet chestnut for utter despair, willow for bitterness and self-pity.
Art, dance, movement, drama and music therapies enable freefoom of expression of feelings
Counselling as greater understanding of emotions can lead to greater esteem and motivation
Aromatherapy oils are effective and include neroli, rose, jasmine and bergamont.
Nutritional therapy including suppliments such as Vit B in all its forms
Spiritual Healing
Cymatics
Yoga
Hypnotherapy
Tai Chi
Acupuncture
Auricular Therapy
Alexander Technique
Homeopathy
Ayurveda
Chakra Balancing
Mediatation
Aura and crystal healing
Massage
Group therapy and activities
Internet support and counselling

All the other therapies can go a long way to creating less stress, improving clarity and self esteem and self confidence.

Depression is an illness and the side effects are debilitating and bring on a stress burden of their own. Thus all the therapies will help heal and deal greatly and each of us will find our own combination that we find best helps our own situation. Physical exercise is also helpful. Avoidance of crutches such as alcohol, drugs, people, self medication, which lead to their own problems rather than solutions