Other Affective or "Mood" Disorders

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Major depression (or Depressive Illness)

A serious mental illness that can lead to:

• Inability to function
• Suicide
• Depressed mood
• Difficulty performing simple daily tasks
• Disinterest in usual activities
• Extreme fatigue
• Sleep problems
• Feelings of guilt & helplessness
• Likely to lose touch w/reality
• Delusions or hallucinations

Depression can strike at any age, including in childhood. Studies in the US show that:

• 1.8% of preteen children
• 4.7% of teenagers (14 to 17 years old)

Have some form of depression.

The most common time of onset is early middle age. Until recently it wasn't recognized as such a problem w/in our senior citizen population. Depression can be a reaction to:

• The facts of growing older
• The death of a spouse or friends
• Physical limitations of age
• The impending confrontation w/death

Elderly widowers are particularly susceptible to suicide. The highest percentage of suicide in the US is in elderly men. Difficult life transitions can trigger the onset of anxiety or depression.

It's truly alarming!!

The nearly 2/3 of depressed people that don't get proper treatment:

Being honest w/your primary care physician about your symptoms is a first step in recognizing that you need help. Remember you have nothing to be ashamed of. Mental illness is a medical disorder.

• Convey your concern that perhaps your symptoms are those of depression or anxiety or another mental illness.

Signs & Symptoms

While it's normal for most people to feel "down in the dumps" on occasion, a person w/major depression feels significantly depressed for a prolonged period of time, has difficulty enjoying acts that were once pleasurable & experiences at least 5 of the following symptoms for 2 weeks or more:

Symptoms of Depression & Mania

Not everyone who's depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies w/individuals & also varies over time.

Depression

• Persistent sad, anxious or "empty" mood

• Feelings of hopelessness, pessimism

• Feelings of guilt, worthlessness, helplessness

• Loss of interest or pleasure in hobbies & activities that were once enjoyed, including sex

• Decreased energy, fatigue, being "slowed down"

• Difficulty concentrating, remembering, making decisions

• Insomnia, early-morning awakening or oversleeping

• Appetite &/or weight loss or overeating & weight gain

• Thoughts of death or suicide; suicide attempts

• Restlessness, irritability

• Persistent physical symptoms that don't respond to treatment, such as headaches, digestive disorders & chronic pain

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

Factors that predispose someone toward depression. Many of us struggle for many years to overcome depression. At one end of the spectrum of prolonged depression are people whose depression is mild - they just consider themselves "not very happy."

At the other end are people who are often severely depressed & frequently consider suicide. Has this been a problem for you or someone you care about? What are some of the factors that predispose someone to feel depressed over a long period of time?

First, remember that these factors work by causing the person to frequently be in a state of underchallenge & underarousal. These factors keep them from harmonious functioning. Important values & parts of themselves aren't being engaged at a challenging, fun level or they aren't being satisfied at all.

The person may often be in a goal-less, "meaningless" mental state. These factors are dealt in other chapters, but this is the only place that they're summarized as a whole. I'll briefly discuss them & their solutions. Study the depression causes table.

1. Low internal control, coping skills, or assertiveness. People who are habitually depressed often lack internal control & assertiveness. Often assertion training can help them not only become more successful w/others, but can help them get out of their depression. People who are habitually depressed also often lack self-direction, initiative, or self-management skills.

Emotional coping skills is another area frequently lacking in people who are habitually depressed.

2. Negative world views & self views often cause depression. Depression may not be so much that you're really so inadequate or have too high expectations. It may be caused by how you view yourself or the world. If you view yourself as bad or stupid no matter what you do, then you'll feel depression.

If you view the world (or other people) as so negative, hostile, or different from you, that you "don't have a chance" to succeed, then you'll feel depressed.

3.Too much self-denial can cause depression. A woman I saw was a cardiac nurse. She knew the signs of a heart attack. She started getting those signs - such as excruciating chest pains -  3 days before her daughter's wedding. Yet she didn't tell anyone or see a doctor; because she knew it was so bad, he would hospitalize her.

She feared it would disrupt her daughter's wedding. While she was dancing at the reception, her chest pains were so bad, she thought she would probably die right there.

That is self-denial - putting her own life at risk to make sure her daughter's wedding was undisturbed. What would you do in a similar circumstance?

When we make choices that deny important parts of ourselves -important biological needs, values, or goals - it can cause those parts to feel depressed & lower our overall motivation & happiness (even when other parts may feel happy).

People may habitually choose self-denial when they put all their energy into meeting long-term goals such as working exceptionally long hours to get a college degree or obtain career success.

Another cause of habitual self-denial is a belief system that puts too high a value on sacrificing ones own values & happiness for others. Many parents teach their children that their children's needs aren't important or teach them that they "don't deserve" to be happy.

These children may grow up believing a dark cloud follows them; they're so "bad" or incompetent that they don't deserve anything good. Therefore, they automatically feel guilty whenever they think about something fun for themselves & often choose to not pursue such "selfish" goals. The result is a life of self-deprivation & depression.

What if you're one of these people? What do you do about it? The solution is to confront the original belief systems that cause the self-denial & strengthen belief systems (such as the Higher Self) that support personal happiness.

Focus on areas of greatest deprivation (sex? fun? play? artistic interests? spending money on yourself? taking time to be alone? etc.) Then make practical goals & plans for leading a more personally rewarding life. Schedule these new activities into your daily & weekly & monthly plans.

Depression Intensifies From One Generation to the Next

Children with family history more than twice as likely to develop mood disorders, study finds

WEDNESDAY, Jan. 12 (HealthDayNews) -- Depression intensifies from one generation to the next, says a study in the January issue of the Archives of General Psychiatry.

The study found that nearly 60% of children whose parents & grandparents suffered depression experienced anxiety disorders during their prepubescent years & developed depression as they became adolescents.

That's more than double the number of children (about 28%) with no family history of depression who developed anxiety & depression.

Researchers from Columbia University Medical Center (CUMC) & the New York State Psychiatric Institute (NYSPI) began studying 47 first-generation family members in 1982 & interviewed 86 of their children as they grew into adulthood.

They then collected data from 161 members of the third generation, average age 12.

"We have shown that the risk of depression is carried thru several generations & that it intensifies as more generations are affected," study author Myrna Weissman, a professor of psychiatry & epidemiology at CUMC & chief of the department of clinical & genetic epidemiology at NYSPI, said in a prepared statement.

"Children with a two-generation family history of depression develop anxiety disorders earlier than other children & tend to experience more impairment," she said.

"Children of parents & grandparents with depression are at extremely high risk for mood & anxiety disorders even when they're very young. They should be considered for treatment if they develop anxiety disorders, or at least monitored very closely," Weissman said.

More information

The U.S. National Institute of Mental Health has more about depression (www.nimh.nih.gov ).

Pain Affects Black Women More Intensely

Men & Women w/Depression

• Men are less likely to suffer from depression than women, although there are 3 to 4 million men in the US who're affected by the illness.
• Men are less likely to admit to or seek help for depression & doctors are less likely to suspect it
• Men often mask depression by self medicating w/alcohol or drugs
• Men work excessively long hours (become workaholics) hiding their depression in a socially acceptable manner
• Feelings of hopelessness & helplessness aren't usual indicators for men, instead they project as being irritable, angry & discouraged
• Men are also less willing than a woman to seek help, although they do realize that they're depressed
• They have extreme difficulty in asking anyone for help because they would have to openly admit to being depressed
• Men tend to believe that depression is a character weakness instead of a "mental illness."
• Support & encouragement from family & friends can make a difference

Campaign Seeks to Educate Hispanic Men About Depression  An estimated 54% suffer at least one major episode in their lifetime

Love Beats Depression for Women, Not Men

Relationships study found big gender differences

"However, among the men we found virtually no effect. In this large sample, we could find no relationship in men between their levels of social support & their risk for depression. These findings suggest that men may be more 'immune' or less sensitive to aspects of their social environment w/respect to their risk for depression," Kendler said.

The study appears in the February issue of the American Journ