Depression can strike anyone regardless of age, ethnic

Discussion in 'Health Care Benefits' started by rainvet, Nov 4, 2005.

  1. rainvet

    rainvet New Member

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    The National Institute of Mental Health (NIMH) to assess depression awareness, affects how one thinks about things, and one's self perception. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition one can will or wish away. People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. However, appropriate treatment, often involving medication and/or short term psychotherapy, can help most people who suffer from depression.

    “I can remember it started with a loss of interest in basically everything that I like doing. I just didn’t feel like doing anything. I just felt like giving up. Sometimes I didn’t even want to get out of bed.”

    -Rene Ruballo, Police Officer

    Depression can strike anyone regardless of age, ethnic background, socioeconomic status, or gender; however, large scale research studies have found that depression is about twice as common in women as in men.1,2 In the United States, researchers estimate that in any given one year period, depressive illnesses affect 12 percent of women (more than 12 million women) and nearly 7 percent of men (more than six million men).3 But important questions remain to be answered about the causes underlying this gender difference. We still do not know if depression is truly less common among men, or if men are just less likely than women to recognize, acknowledge, and seek help for depression.

    In focus groups conducted by the National Institute of Mental Health (NIMH) to assess depression awareness, men described their own symptoms of depression without realizing that they were depressed. Notably, many were unaware that “physical” symptoms, such as headaches, digestive disorders, and chronic pain, can be associated with depression. In addition, men were concerned that seeing a mental health professional or going to a mental health clinic would have a negative impact at work if their employer or colleagues found out. They feared that being labeled with a diagnosis of mental illness would cost them the respect of their family and friends, or their standing in the community.

    Over the past 20 years, biomedical research, including genetics and neuroimaging, has helped to shed light on depression and other mental disorders*increasing our understanding of the brain, how its biochemistry can go awry, and how to alleviate the suffering caused by mental illness. Brain imaging technologies are now allowing scientists to see how effective treatment with medication or psychotherapy is reflected in changes in brain activity.4 As research continues to reveal that depressive disorders are real and treatable, and no greater a sign of weakness than cancer or any other serious illness, more and more men with depression may feel empowered to seek treatment and find improved quality of life.

    Types of Depression

    Just like other illnesses, such as heart disease, depression comes in different forms. This booklet briefly describes three of the most common types of depressive disorders. However, within these types, there are variations in the number of symptoms, their severity, and persistence.

    Major depression (or major depressive disorder) is manifested by a combination of symptoms (see symptoms list below) that interferes with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. A major depressive episode may occur only once; but more commonly, several episodes may occur in a lifetime. Chronic major depression may require a person to continue treatment indefinitely.

    A less severe type of depression, dysthymia (or dysthymic disorder), involves long lasting, chronic symptoms that do not seriously disable, but keep one from functioning well or feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.

    Another type of depressive illness is bipolar disorder (or manic depressive illness). Bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression), often with periods of normal mood in between. Sometimes the mood switches are dramatic and rapid, but usually they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of depression. When in the manic cycle, the individual may be overactive, over talkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees and unsafe sex. Mania, left untreated, may worsen to a psychotic state.

    Symptoms of Depression and Mania

    Not everyone who is depressed or manic experiences every symptom. Some people experience only a few; some people suffer many. The severity of symptoms varies among individuals and also over time.

    Depression

    Persistent sad, anxious, or “empty” mood.
    Feelings of hopelessness or pessimism.
    Feelings of guilt, worthlessness, or helplessness.
    Loss of interest or pleasure in hobbies and activities that were once enjoyable, including sex.
    Decreased energy, fatigue; feeling “slowed down.”
    Difficulty concentrating, remembering, or making decisions.
    Trouble sleeping, early morning awakening, or oversleeping.
    Changes in appetite and/or weight.
    Thoughts of death or suicide, or suicide attempts.
    Restlessness or irritability.
    Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain that do not respond to routine treatment.
    “You don’t have any interest in thinking about the future, because you don’t feel that there is going to be any future.”

    -Shawn Colten, National Diving Champion

    “I wouldn’t feel rested at all. I’d always feel tired. I could get from an hour’s sleep to eight hours sleep, and I would always feel tired.”

    -Rene Ruballo, Police Officer

    Mania

    Abnormal or excessive elation.
    Unusual irritability.
    Decreased need for sleep.
    Grandiose notions.
    Increased talking.
    Racing thoughts.
    Increased sexual desire.
    Markedly increased energy.
    Poor judgment.
    Inappropriate social behavior.
    Co Occurrence of Depression with Other Illnesses

    Depression can coexist with other illnesses. In such cases, it is important that the depression and each co occurring illness be appropriately diagnosed and treated.

    Research has shown that anxiety disorders*which include post traumatic stress disorder (PTSD), obsessive compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder*commonly accompany depression.5,6 Depression is especially prevalent among people with PTSD, a debilitating condition that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural disasters, accidents, terrorism, and military combat. PTSD symptoms include: re experiencing the traumatic event in the form of flashback episodes, memories, or nightmares; emotional numbness; sleep disturbances; irritability; outbursts of anger; intense guilt; and avoidance of any reminders or thoughts of the ordeal. In one NIMH supported study, more than 40 percent of people with PTSD also had depression when evaluated at one month and four months following the traumatic event.7

    Substance use disorders (abuse or dependence) also frequently co occur with depressive disorders.5,6 Research has revealed that people with alcoholism are almost twice as likely as those without alcoholism to also suffer from major depression.6 In addition, more than half of people with bipolar disorder type I (with severe mania) have a co occurring substance use disorder.8

    Depression has been found to occur at a higher rate among people who have other serious illnesses such as heart disease, stroke, cancer, HIV, diabetes, and Parkinson’s.6,9 Symptoms of depression are sometimes mistaken for inevitable accompaniments to these other illnesses. However, research has shown that the co occurring depression can and should be treated, and that in many cases treating the depression can also improve the outcome of the other illness.

    Causes of Depression

    Substantial evidence from neuroscience, genetics, and clinical investigation shows that depressive illnesses are disorders of the brain. However, the precise causes of these illnesses continue to be a matter of intense research.

    Modern brain imaging technologies reveal that, in depression, neural circuits responsible for the regulation of moods, thinking, sleep, appetite, and behavior fail to function properly, and critical neurotransmitters*chemicals that brain cells use to communicate* are out of balance. Studies of brain chemistry, including the effects of antidepressant medications, continue to inform our understanding of the biochemical processes involved in depression.

    In some families, depressive disorders seem to occur generation after generation; however, they can also occur in people with no family history of these illnesses.10 Genetics research indicates that risk for depression results from the influence of multiple genes acting together with environmental or other nongenetic factors.

    Very often, a combination of genetic, cognitive, and environmental factors is involved in the onset of a depressive disorder.11 Trauma, loss of a loved one, a difficult relationship, a financial problem, or any stressful change in life patterns, whether the change is unwelcome or desired, can trigger a depressive episode in vulnerable individuals. Later episodes of depression may occur without an obvious cause.

    Men and Depression

    Researchers estimate that at least six million men in the United States suffer from a depressive disorder every year.3 Research and clinical evidence reveal that while both women and men can develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping with the symptoms. Men may be more willing to acknowledge fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances rather than feelings of sadness, worthlessness, and excessive guilt.12,13 Some researchers question whether the standard definition of depression and the diagnostic tests based upon it adequately capture the condition as it occurs in men.13

    “I’d drink and I’d just get numb. I’d get numb to try to numb my head. I mean, we’re talking many, many beers to get to that state where you could shut your head off, but then you wake up the next day and it’s still there. Because you have to deal with it, it doesn’t just go away. It isn’t a two hour movie and then at the end it goes ‘The End’ and you press off. I mean it’s a twenty four hour a day movie and you’re thinking there is no end. It’s horrible.”

    -Patrick McCathern, First Sergeant, U.S. Air Force, Retired

    Men are more likely than women to report alcohol and drug abuse or dependence in their lifetime;14 however, there is debate among researchers as to whether substance use is a “symptom” of underlying depression in men or a co occurring condition that more commonly develops in men. Nevertheless, substance use can mask depression, making it harder to recognize depression as a separate illness that needs treatment.

    Instead of acknowledging their feelings, asking for help, or seeking appropriate treatment, men may turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, angry, irritable, and, sometimes, violently abusive. Some men deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends. Other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm’s way.

    “When I was feeling depressed I was very reckless with my life. I didn’t care about how I drove. I didn’t care about walking across the street carefully. I didn’t care about dangerous parts of the city. I wouldn’t be affected by any kinds of warnings on travel or places to go. I didn’t care. I didn’t care whether I lived or died and so I was going to do whatever I wanted whenever I wanted. And when you take those kinds of chances, you have a greater likelihood of dying.”

    -Bill Maruyama, Lawyer

    More than four times as many men as women die by suicide in the United States, even though women make more suicide attempts during their lives.15,16 In addition to the fact that men attempt suicide using methods that are generally more lethal than those used by women, there may be other factors that protect women against suicide death. In light of research indicating that suicide is often associated with depression,17 the alarming suicide rate among men may reflect the fact that men are less likely to seek treatment for depression. Many men with depression do not obtain adequate diagnosis and treatment that may be life saving.

    More research is needed to understand all aspects of depression in men, including how men respond to stress and feelings associated with depression, how to make men more comfortable acknowledging these feelings and getting the help they need, and how to train physicians to better recognize and treat depression in men. Family members, friends, and employee assistance professionals in the workplace also can play important roles in recognizing depressive symptoms in men and helping them get treatment.

    Depression in Older Men

    Men must cope with several kinds of stress as they age. If they have been the primary wage earners for their families and have identified heavily with their jobs, they may feel stress upon retirement*loss of an important role, loss of self esteem*that can lead to depression. Similarly, the loss of friends and family and the onset of other health problems can trigger depression.

    Depression is not a normal part of aging.18 Depression is an illness that can be effectively treated, thereby decreasing unnecessary suffering, improving the chances for recovery from other illnesses, and prolonging productive life. However, health care professionals may miss depressive symptoms in older patients. Older adults may be reluctant to discuss feelings of sadness or grief, or loss of interest in pleasurable activities.19 They may complain primarily of physical symptoms. It may be difficult to discern a co occurring depressive disorder in patients who present with other illnesses, such as heart disease, stroke, or cancer, which may cause depressive symptoms or may be treated with medications that have side effects that cause depression. If a depressive illness is diagnosed, treatment with appropriate medication and/or brief psychotherapy can help older adults manage both diseases, thus enhancing survival and quality of life.

    “As you get sick, as you become drawn in more and more by depression, you lose that perspective. Events become more irritating, you get more frustrated about getting things done. You feel angrier, you feel sadder. Everything’s magnified in an abnormal way.”

    -Paul Gottlieb, Publisher

    Identifying and treating depression in older adults is critical. There is a common misperception that suicide rates are highest among the young, but it is older white males who suffer the highest rate. Over 70 percent of older suicide victims visit their primary care physician within the month of their death; many have a depressive illness that goes undetected during these visits.20 This fact has led to research efforts to determine how to best improve physicians’ abilities to detect and treat depression in older adults.21

    Approximately 80 percent of older adults with depression improve when they receive treatment with antidepressant medication, psychotherapy, or a combination of both.22 In addition, research has shown that a combination of psychotherapy and antidepressant medication is highly effective for reducing recurrences of depression among older adults.23 Psychotherapy alone has been shown to prolong periods of good health free from depression, and is particularly useful for older patients who cannot or will not take medication.18 Improved recognition and treatment of depression in later life will make those years more enjoyable and fulfilling for the depressed elderly person, and his family and caregivers.

    Depression in children and adolescents is associated with an increased risk of suicidal behaviors.25,34 This risk may rise, particularly among adolescent males, if the depression is accompanied by conduct disorder and alcohol or other substance abuse.35 In 2002, suicide was the third leading cause of death among young males, age 15 to 24.36 NIMH supported researchers found that among adolescents who develop major depressive disorder, as many as 7 percent may die by suicide in the young adult years.25 Therefore, it is important for doctors and parents to take seriously any remarks about suicide.

    http://menanddepression.nimh.nih.gov/infopage.asp?id=10
  2. Kingsley

    Kingsley Guest

    When we face the number of the problem at the same time and no solution of this problem then we have to face the problem of the depression. But it is important to note that tension is not the solution of the problem.

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