Childhood Depression By Chris Wong

Childhood depression is a very real but sometimes elusive illness that affects the young today. We take a look at what it actually means and how unity and support in the family can help fight its hold over a child.

At the recently concluded Asia Pacific Suicide Prevention Convention 2006, we learnt a few startling facts about children and suicide. For example, in a worldwide survey, 7.3% to 38% of the children surveyed demonstrated suicide ideation, which is the idea of wanting to kill themselves. In Singapore, close to 4.7% of children entertain this morbid thought. While the figure may be alarming, there is no need to panic as it is actually not uncommon to think about suicide.

Ask anyone in the street if he had thought about suicide before and the answer will most probably be a `yes'. Thinking about something as serious as killing oneself and actually doing it are two different matters. Out of all childhood suicides, approximately 23.5% are associated with mental illness such as depression, schizophrenia and others. Seeing the numbers and understanding that depression is one of the key causes that drive our young to suicide. It is time we understand a little more about this elusive illness called "Childhood Depression".

The Definition of Childhood Depression

In a 2004 article published by the American Academy of Child and Adolescent Psychiatry http://www.aacap.org/publications/factsfam/depressd.htm , childhood depression is defined as "an illness when the feelings of depression persist and interfere with a child or adolescent's ability to function."

Feelings of depression are represented in the forms of mood, physical, mental and behavioural changes in a child. Dr Ken Ung, Senior Consultant Child, Adolescent & Adult Psychiatrist & Psychotherapist at Adam Road Hospital describes the signs of childhood depression as persistent "irritability or loss of interest, loss of appetite and weight, poor sleep , lethargy, headache, stomach pain, loss of concentration, preoccupation with self-harm or suicide, refusal to go to school, increased temper tantrums and antisocial behaviours such as smoking, drinking and running away from home. Any combination of these changes that lasts for more than two weeks could spell a child falling into depression and warrants a closer look.

Many of the symtoms listed are actually applicable to both adults and children but there are telling differences. Age, in a non-categorical way, does make a difference in the presentation of depressive behaviour. "We don't tend to categorize (childhood depression) in terms of age groups," says Dr Ung, " but we can generally say that adolescent depression tends to look more like adult type depression , whereas, childhood depression can be more `a typical' perhaps manifesting in bodily pains and behaviour changes. The closer the age of a child to adulthood - the more we can expect to see an adult-type depression.

Types of childhood depression

There is no clear categorization of childhood depression. According to Dr Ung, "Typing depression is notoriously difficult and fashions come and go. We now tend to type it according to severity i.e. mild, moderate and severe. Sometimes, we use the term `reactive' depression to denote the type that is due to a reaction to some stress (such as the sudden passing of a loved one). Although very rare in children, `psychotic' depression refers to the presence of psychotic symptoms, which are symptoms that show that the person has lost touch with reality, i.e. hearing voices, believing irrational, bizarre or incredible thoughts."

Another childhood psychiatry expert, Dr Sharon Chan of Sharon Chan Child Guidance Clinic, who has been practicing child psychiatry since 1988 concurs, "I am not sure that there is such a categorization (of childhood depression).. because the entity is still controversial, it follows adult depression patterns (sic) - chronic, single episode or recurrent, adjustment disorder, bipolar etc."

Bipolar disorder, also known as manic-depression, is a type of mood disorder marked by extreme changes in mood, energy levels and behaviour. Symptoms can begin in early childhood but more typically emerge in adolescence or adulthood. Children with bipolar disorder usually alternate rapidly between extremely high moods (mania) and low moods (depression). These rapid mood shifts can produce irritability with periods of wellness between episodes, or the young person may feel both extremes at the same time. Parents who have children with the disorder often describe them as unpredictable, alternating between aggressive or silly and withdrawn.

Stages of childhood depression

According to a Harvard Medical School Publication, " The picture changes with age. Up to age three, the signs (of childhood depression) may include feeding problems, tantrums, and lack of playfulness and emotional expressiveness. AT ages 3-5, depressed children may be accident-prone and subject to phobias. Even before age 5, they may show signs of self-reproach by apologizing unnecessarily for minor mistakes and transgressions like spilling food or forgetting to put clothes away. Children of early school age (6-8) sometimes show depression with vague physical complaints and aggressive behavior. They may cling to their parents and avoid new people and challenges. At ages 9-12, some common symptoms are morbid thoughts and lying awake worrying about schoolwork. By then, children have enough intellectual capacity and social understanding to think about reasons for their depression , and they may blame themselves for disappointing their parents."

When asked for his opinion on this analysis, Dr Ung says, " I think that this is a good guide by and large. Nevertheless, this is merely a guide and should not ne taken as set in stone. For example, a 12 year old boy may show signs of depression by aggressive behaviour and phusical complaints."

For Dr Chan, "Depression before the age of six is very rare. In fact, I do not think that there is general agreement that it exists. In a young child, the common emotional condition is anxiety, not so much depression. From six years onwards, I would agree with the given description."

Children under stress, who experience loss , or who have attention , learning , conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families.

Lena's experience

Lena (not her real name) is a 17 year-old student who recently suffered a relapse and fell into depression once more. Lena has been troubled by depression since the age of 12. Once again, she has no appetite for food, is feeling listless and confused, lost alot of weight and is isolating herself from others.

Lena's mother, 49 year old clerical staff Sonia (not her real name), recounts her daughter's experience with depression, " It all started after Lena's father passed away. At first , nothing seemed wrong. SHe was very sad but she did not shed a tear at his funeral. It was a year after that she started to miss him badly. This was compounded by being bullied in school and stressed by schoolwork. Always a quiet child, Lena became even more withdrawn. She had trouble sleeping, would cry for no reason, refused to eat and talked about hurting herself."

Seeing her daughter's condition, Sonia brought Lena to a Polyclinic which referred them to a psychiatrist at a hospital. Lena was given antidepressants and started having regular therapy sessions with psychiatrists and counsellors. She tried to follow their advice of not thinking negatively, to focus on developing her interests and to make a timetable for each day. Everyday was a struggle but she managed to recover with time.

"She said she liked the counselling sessions where she could talk to someone about her feelings and problems." say Sonia of Lena's reaction to treatment. "Slowly, she got better to the point that she was more cheerful and could laugh and giggle like a normal young girl. She even enrolled in yoga classes that helped her gained fitness and to relax."

For Sonia, being supportive of Lena through the down times and being sensitive to her needs are her priorities. "I told her that her health is more important than studies. When I'm at work, I try to call her and talk to her whenever I can. She will tell me things like, " Mummy, I'm useless and I don't know what to do," and I will try to encourage her to look on the bright side, not to think too much..etc.. I have to try to give her lots of love, my full support and attention."

Treatment

What most doctors agree on is that medication should not be used unnecessarily on children and that when used, it should be accompanied with the right counselling and therapy. " It's interesting that recent studies have not been able to prove that antidepressants work in children. This could be because children are not mini adults and what works for adults may not work for kids," says Dr Ung.

There is also little research of how antidepressants work on children and prescription drugs may increase the risk of self-harm for some vulnerable ones. However, Dr Ung adds, "To keep a perspective on things, the increase of antidepressants prescriptions is small, probably around 2% in affected children given inactive medications (placebos) to about 4% of those on active medication."

Counselling, it seems , plays the key role in helping children recover from depression. "A good counsellor will try to get information from parents, child and school and will try his or her best to co-ordinate the counselling to incorporate all these parties. Cognitive-behavioural therapy is one of the commonest forms of counselling techniques used nowadays - it seeks to change the negative thoughts of the child to more realistic and positive ones and also t help the child make action/behavioural changes that will help lift the mood," adds the psychiatrist.

Cyber Help
With the computer-savvy generation of today, some children or teens may choose to express their thoughts and feelings in cyber space. http://www.depnet.com is a community website launced in March to provide information and counselling services for depression. A `diary' services allows members to post daily updates on their mental and emotional experiences while a `letterbox' service provides them with an opportunity to ask questions to a panel of experts. Most importantly, a service like this seeks to educate the public on the existence of depression and encourage those who are depressed to seek help. Following examples, depressed children may be inspired by a strong sense of community to step out of a possible state of isolation. Adults too, can visit to gather more information and advice before deciding how best to seek help.

Understanding is Key.

"Sometimes, depressed children are mistakenly labelled as lazy, stubborn or difficult," says Dr Chan. This is largely due to a lack of knowledge and understanding on the adults' part. Children, unlike adults are dependent on their families and guardians to identify their troubles and seek help.

Dr Ung adds," One common misconception is that the child is mad. This is totally not so. Another is that the child is `weak'. Some famous people who are strong of character and have suffered depression include Abraham Lincoln. Another misconception is that it is incurable or that the child is `bad'. Depression is a very treatable condition and the change of behaviour from depression should not be mistaken for `badness'.

Depression Treatment - 101 Ways to Beat Depression Naturally By Kriti Arora Platinum Quality Author

Depression is a mental health disorder which affects the way a person eats, sleeps, feels about oneself and the way he perceives things around him. Depression should not be considered as just a passing mood, because it is not. It is also not a personal weakness that can be wished away. It is a disease which is curable and from there you can start a new lease of life. If a depressive episode is left untreatable, it can last for months and even years. The worst thing about depression is that ignorant people don't consider it as a real disease at all and think that a person can actually snap out of it. Depression requires medical attention and treatment.

Below are 101 ways to beat Depression at home without any prescription drugs.

1)Find hope. Understand that today may be a bad day, but tomorrow will not be the same. Whenever feelings of depression hit you, find something you can look forward to. Start concentrating on things which you like.

2) Eat apples everyday. They contain Phosphorus, Vitamin B and potassium which build the nerve cells and help keep depression at bay.

3) Practice positive self-talk. Speak to yourself about the goodness in your and the people around you. Make yourself say everyday that you will enjoy life no matter what.

4) Believe in God. No matter what religion you follow, try to understand the meaning of the principles and draw happiness from its teachings. Get inspired by the beliefs.

5) Make new friends. Start conversations with people you like and form new friendships. Talk to them regularly and try to be a good friend.

6) Be around people. Try not to be alone. Chat, share a joke and laugh with friends or family. Make the home environment a pleasant one to be in. It is true that "An idle mind is a devil's workshop". So try not to give any chances for this.

7) Join a Social club, take a class, meet someone for lunch or just chat with your next-door neighbor. Simple mundane talking can take care of a lot of mental unhappiness.

8) Find a hobby. Collecting stamps, reading and listening to music are a few of the common hobbies people enjoy. Find out what you like and spend a few hours everyday doing it.

9) Do what makes you laugh. Watching a funny sitcom on television, reading the daily newspaper cartoons or watching a funny movie on DVD, do things regularly that make you giggle.

10) Make New Friends. Find people on the street who look like they are having a good time. Get the spirit from them and pump fresh energy when ever you meet people like that.

11) Listen to Music.If you listen to music, chuck the melancholy ones and listen to music that makes you feel happy. Music can actually lift your mood. This can touch your soul and give an immediate cure to most of the problems.

12) Volunteer for helping out somewhere. You can opt for a pantry centre that feeds the poor or an abused women's shelter. You will feel a peace within yourself that you have never known.
13) Go for a walk. Walking is the best thing to do when you are depressed because it does not require a lot of motivation and is healthy as well. Stop thinking about your past while walking. Try to enjoy the nature and motive yourself to be like a great leader.

14) Make exercise a part of your daily routine. Exercising releases the endorphins of the body and helps you feel positive. It will also make you feel happier. Choose an exercise you are comfortable doing everybody.

15) Physical closeness is a mood-lifter. Give somebody a hug when you are feeling low. It may be a friend, a colleague at work or your mom. It works wonders. This is the best medicine found for depression and most recommended by any physician. A sharing of love and care will lift your spirits. Try to get a hug from a person whom you love the most.

16) Spend time with nature everyday. Gardening, walking or just sitting and breathing in the fresh air early in the morning will make you feel thankful to god that he created you. It will definitely improve your mood.

17) Spend time with yourself. Meditate, pray or just think about the positive qualities you have and the people who love you. But do remember that too much solitude may make you more depressed.

18) A lot of people feel depressed because they feel they are guilty of something. Face your demons. Ask for forgiveness from the person concerned and then put the whole episode behind you. Don't drag out the issue everyday and brood about it.

19) Let go of grudges. If you feel someone has done you wrong, forgive him or her. This is important to make peace with yourself. For instance, divorced people often hold grudges against their ex-spouses and feel angry and depressed. It is important to let go.

20) Open yourself to love. Embrace the love of family members and friends and try to reciprocate it. Basking in the warmth of love is the best way to reduce depression. Sharing of thoughts and true love will change the face of problems. You can get so many shoulders to share the responsibility and all off a sudden, all your problems might be solved.

21) Count your blessings. Instead of thinking about the negative things in your life, spend time everyday thinking about the positives. It could be anything; a great job, your best friend, your loving family or even your beautiful skin.

22) Reduce stress. Find out the areas in your life that make you most stressed and think about how to improve them. Eliminating stress will give you greater control of your life.

23) Do not procrastinate. When you keep off till tomorrow the work that can be done today, you are spending time thinking about ways you can avoid working instead of doing the work. Don't waste your time and energy in doing something so useless. Try to make the best use of your time.

24) Eat fats which are good for the body. Eat foods like fish, pork, beef and dairy because these contain Omega-3 and Omega-6 which help in the creation of new brain cells. Healthy food habits will keep away ugly thoughts and make you fresh.

25) Eat granola, sweet potatoes, starchy vegetables, whole fruits, stone ground bread, potatoes with their skin and popcorn. They provide the necessary carbohydrates to the body.

26) Eat a balanced diet. Have little protein at night and instead have complex carbohydrates. They help in the production of serotonin.

27) Having fruit before going to bed is a very good idea. The fruit will help you sleep and keep your depression at bay. On the other hand, it will supply all the essential nutrients and keep you healthy.

28) Take Vitamin B-6 supplements everyday. It will increase the levels of serotonin in the body. If you have a medical condition, consult your doctor before starting.

29) Eat your meals at approximately the same time each day. This is important as your body will not be starved of energy at any point of time.

30) Don't skip meals. When you skip meals in the condition of depression, your body cannot produce energy. This will make you feel down. Skipping meals is something you just can't afford to do.

31) Chinese medical research suggests that acupuncture can help to balance the positive and negative energies of the body. You can try it as it is a well-known way of treating depression.

32) Try not to be anxious in your day to day life. Everyday you may feel that you are constantly fighting with certain situations and people. Have a composed life style and try to balance all your feelings.

33) Don't while away time doing nothing. If you are a student, make notes or study or go out. If you are a housewife, you can find a job or start a small business. Being busy does not let you have time to think any depressing thoughts.

34) Be Social. Go out with friends for shopping or coffee. Meeting people and talking about mundane things will release happy-hormones and make you feel good. Try to spread happiness like a forest fire. You will never be depressed.

35) Get a massage done. It is a mood lifter and it help in alleviating depressive symptoms. The anticipation of a massage is almost as good as the massage itself. The massage should be got from a professional person so as to relieve all the stress.

36) Eat dark chocolate. Eating a small square of chocolate everyday will not make you fat. It has anti-oxidants which will help your mood. Anti-oxidants will help you to keep fresh the whole day and you will never have the feeling of being tired or depressed.

37) Eat less of refined sugar. Your body craves sugar when you are depressed but in the long run it actually makes you more depressed. Cut it out from your life as much as possible.

38) Even if you are eating well, you may not be getting all the essential nutrients your body requires. Consult your doctor and have a multivitamin everyday. Health supplements are important and play a vital role to eliminate stress.

39) Go swimming. It is a great exercise and gives your body a natural adrenaline rush. You will be happy and refreshed after a half-hour spent in the pool. Time spent in the pool will pump in fresh energy.

40) Don't spend the entire day in a cold grumpy office or house. Get some sunlight for at least 15 minutes. It is a wonderful natural mood-lifter. Start enjoying the beauty of nature outside.

41) If you live in an area where there is little sunlight, buy yourself a light box and look into it everyday for 15-20 minutes. It a great way of relieving depression.

42) It is important that you get enough sleep. Though it varies from person to person, 8 hours sleep a night is enough for most of the people. Make sure to have a regular routine and timing to sleep. If you change it frequently, the body system will get confused and you might face sleepiness all the day.

43) Napping in the afternoon for 30 minutes does not make you lazy. It could actually energize you and make you ready to spend the rest of the day productively. However, make sure that you do not become an addict to it.

44) Do not hide from the world. Make friends. The internet is a wonderful place for making new friends. Find online friends with whom you can share your thoughts, dreams and passions.

45) Break up your goals into smaller achievable parts. It will be easier to achieve them and make you feel confident. Pat yourself when ever you achieve a short term goal. You are the best motivator for yourself and take pride of all your actions.

46) This is important. Do not blame yourself or anyone else for your depression. You have it in you to overcome it yourself.

47) Don't decide on important things of your life such as divorce, marriage and career before you get out of the depressive state.

48) Accept the love and support your friends and family offer you. Be grateful for it. Reciprocate in the same way. The feeling of helping others and to see a smile in their face is a great way to root out depression.

49) Don't hide your depressive state. Let people around you know you are depressed. Get the help from professionals.

50) Take steps everyday to build confidence and self-esteem. A confident person can beat all odds. It will give the power to win odd situations.

51) Always remember that there is someone who is less fortunate than you. You are a lucky person. Think that you are having 10 full fingers with which you can win the world.

52) Find happiness in little things such as a great book, your favorite TV show or just the fact that your mother made your favorite baked roast today.

53) Eat cashew nuts everyday because the Riboflavin and Vitamin B it contains is good for you.

54) Another option is to have Vitamin B supplements.

55) Whenever depression hits you, get up and get active. Don't while away time in your bed brooding. Do not let depression to depress your mind state. Get going with your daily routine inspite of difficulties.

56) Whenever you feel one of your moods coming, try to shift you attention to someone else's problems. Try to find solutions instead of worrying.

57) Pamper yourself by having a bubble bath or buying an expensive book you have been eyeing to get the happy hormones flowing.

58) Understand what it is that depresses you. Stop doing it. Getting to the core of the issue is important.

59) Try to have beautiful relationship with your partner. Bickering, arguments and quarrelling are no-no's. You can have them once in a while. If this persists for a long time, try to find an immediate long term solution.

60) Smile to yourself at the mirror everyday. It will make you want to do it all day. Start developing the sense of feeling that you are the most beautiful or handsome person in this world. It will boost your confidence level.

61) Smile to people around you. On the road, at your office or in the departmental store, smile! A gentle smile would pave way to beautiful relationships.

62) If you have diseases such as high blood pressure, diabetes, kidney or liver trouble get them treated as soon as possible. Make sure that you are under proper medication and do not feel the pinch of diseases.

63) Make a schedule of your daily life. Follow it religiously. Stick to your own rules. Act accordingly. It will give you a disciplined life and will make you fit.

64) Laugh everyday. Join a laughing club or just laugh looking at yourself in the mirror. This has become a rare commodity. However, you do not give a chance. Share a good joke with your friends and family members.

65) Don't live in denial. Accept the fact that you are depressed and take steps to treat it. The state of being denied is very painful. Hence, find an immediate answer and try to analyze the causes for that.

66) Know your limitations and liabilities. It will help you look at life with a practical eye. A practical approach to all the problems would find the much awaited key. Do not be extravagant while finding a solution. Be calm.

67) Stop worrying about things that are not in your control. Do as much as you can and then let go. Accept the proceedings of fate. But do not be idle and a mute spectator.

68) Patience is a virtue you need to develop. You won't just snap out of depression one day, it will take time and effort but will surely go away. Have this in your mind. There can be no problems which are permanent in life.

69) Always take one step at a time. Everyday try to do a little bit more to get rid of your depression. Find out the ways and things that will cheer you up. So stick to activities of that kind.

70) Practice a healthy lifestyle. Sleep, eat a balanced diet and get proper exercise to stay happy. A life with a perfect combination of all these activities will give you more.

71) Avoid consuming alcohol. It will make you more depressed. Don't try burying your sorrows in alcohol. Consuming alcohol is not good for health. It means you are inviting problems on your own. There might be health complications too because of this problem.

72) If you are a smoker, quit. Nicotine may make you feel good as long as you have the cigarette in your hand, but it is actually bad for your mood in the long run. It will make you an addict to this habit.

73) Popping pills to treat everyday ailments without them being prescribed by a doctor will ultimately make you feel down. Stop this habit. This will further lead to complications. Do not encourage self medication.

74) Take a carrot and some spinach and put it in the blender. Drink the juice everyday. Prefer fresh juices instead of junk food items. You will get tons of energy and it will make good for the health.

75) Bananas contain serotonin, norepinephrine and potassium. Have two ripe bananas everyday. You can stay healthy for the life time.

76) Avoid having too much coffee. If you cannot do without it, limit yourself to a couple of cups everyday. The main ingredient will make you an addict which is not good.

77) Drinking ginger tea everyday improves the blood and oxygen circulation of the body and keeps you feeling good. Having a proper supply of oxygen is very important for the health. This will make you a fit personality and will keep you fresh round the clock.

78) Have sage tea with honey. It will sharpen your brain power and alleviate depressive symptoms.

79) Drinking peppermint tea will relax your system and improve your mood. Have it everyday. A happy mood will find a solution to any of the problems.

80) Do not have sugar with your tea. You can have honey or jaggery instead.

81) Have milk with apple and honey every alternate day. It may not sound very appetizing but the combination will improve your mood.

82) When shopping for groceries, load up on citrus fruits and vegetables. They help in lifting the mood. They will lift up your spirits.

83) Try yoga. A lot of people all over the world are effusive about the usefulness of yoga in treating depression. This will improve your concentration level and also will help you to remain calm at times of problems. A calm mind is very much essential to analyze the root causes of the problems.

84) If it is something in the earlier part of your life that makes you depressed, try to put it all behind you. Remember, tomorrow is a new day. Make your day as the best one as you will never get a chance to make a better yesterday.

85) Boil a cup of water and put fresh rose petals in it. Drink it after straining the petals. This is a nice way to enjoy the beauty of life.

86) A lot of people have found relief from depression by drinking 2-3 cups of liquorice tea everyday. Take the help of medicinal herbs like these and get rid of depression.

87) Dry root of asparagus, if eaten daily after being crushed and mixed with honey, is known to help in depression.

88) Have a good breakfast. All types of foods, that is, proteins, carbohydrates and fats should be a part of your daily breakfast.

89) Have a glass of orange juice early in the morning. The Vitamin C boost will be good for you.

90) Soak 5-10 almonds in water at night and eat them first thing in the morning everyday. This will make your body light and will keep you away from all the worries. You will never think about the problems and instead will solve it easily.

91) If tiredness and lethargy is what you feel even after waking up after 8 hours of sleep, you have to make the effort to get out of the cycle. Remember, the moment you decide you are going to give in, your depression wins over you.

92) Don't indulge in self-pity. It is a cycle that you have to end the moment it starts. Do not get in to this bad habit. You will never be able to come out of this problem and it might spoil your character too.

93) If you are depressed about a relationship with somebody, may be your spouse, a parent or a friend, speak to the person about it. You need to get it solved. Don't brood over it. A gentle conversation sparked will solve all the misunderstandings. Remember that communication is the shortest distance between two people.

94) Keep a diary. Vent all your frustrations, anger and moments of happiness in it. Keep a track of how you feel everyday. This will help you plan the next day better.

95) Research has shown that watching too much television can actually make you feel more depressed. You will be better off doing something productive. Those television programs will make you think about them and not about your problems. Do not waste much of your time. On the other hand, do not miss out on the entertainment too.

96) Painting, clay modeling, stitching and knitting make you feel at peace with yourself. Do take out sometime everyday for any one of these everyday. People who have interests on these kinds of activities might pursue this. This will give those good hopes and satisfaction.

97) Reading good books is a great mood enhancer. But when you are choosing books, make sure you don't choose depressive dark and sad books. Comics are something that will always help.

98) Consult your doctor and ask him to recommend a good calcium and magnesium supplement that you can take everyday.

99) Cooking is something that will make you happy whether you are a man or a woman. Cook with love, involve your partner and get creative with your cooking. It will make you a lot happier.

100) Drinking green tea is another home remedy that works to treat depression. Green tea contains natural antioxidants which will help you deal with stress better.

101) It`s a good idea to look for a professional counselling. Depression is a disease which is completely treatable. A therapist or counsellor can lead you to the path of complete recovery.

A huge percentage of people around the globe are suffering from depression and the number is increasing everyday. The one thing worse about depression is not to take any steps to treat it. If you are depressed, follow the tips given here. Depression if left untreated may even lead to self-harm and suicide. Don't wait before it's too late. A lot of people will be cured by following the tips, but some may need professional help. If you deal with depression with courage and confidence, nothing can stop you from winning the battle. Have a wonderful life ahead of you free of depression.

Causes of Depression and the Bad Side of a Possible Good By Jay Wyshak

Let there be no doubt that depression is a serious mental illness that sometimes requires months and years of treatment on the road to a cure. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

Each year, millions of people come to the realization that they suffer from depression. To make things worse it is estimated that only a third of those who suffer the disease will ever seek treatment. Because depression is considered a mental affliction, many sufferers shy away from seeking help from a doctor. Instead of being considered mentally ill, people try to manage the problem themselves. Depression is more common- place than you might think and it will not go away on its own.

Depression has no single cause; often, it results from a combination of things. You may have no idea why depression has struck you.

Whatever its cause, depression is not just a state of mind. It is related to physical changes in the brain, and connected to an imbalance of a type of chemical that carries signals in your brain and nerves. These chemicals are called neurotransmitters.

Some of the more common factors involved in depression are:

* Family history. Genetics play an important part in depression. It can run in families for generations.

* Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.

* Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).

* Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.

* Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.

Why do people get depression? The answer can get very complicated because you have to take many factors into consideration. The list is quite long. Let's list a few of the contributing factors to depression. A chemical imbalance is widely considered to be the main cause for depression. Why does this chemical problem in the brain happen? Typically the causes stem from biological, genetic, physical, mental and environmental implications. In many cases the underlying cause is never identified. Depression often follows diagnosis of other medical conditions, particularly those that result in imminent death or are chronic.

Scientists do not know why the hippocampus is smaller in those with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or poisonous effect on the hippocampus. Some experts theorize that depressed people are simply born with a smaller hippocampus and are therefore inclined to suffer from depression.

Another cause of depression can be the emotional pain felt after losing a loved one. In many cases the loss can be very traumatic. Long periods of emotional, sexual or other physical abuses can result in depression. When people abuse drugs and/or alcohol the result is often depression. People's mental states are fragile. If exposed to the wrong pressures, depression can result. There can also be a genetic element to depression. Those afflicted have a family history of the disease . Oddly, many drugs including those that regulate depression or anxiety can cause depression. High blood pressure medication can result in depression.

One of the major causes of depression is stress. Stress can derive from many different areas in our life. It's not well known, but it's true, that stress can result from the pressures associated with positive events such as a new, high paying job. The unknown is often the root cause of this stress, whether it be positive or negative. Arguments with family members, disputes with business clients can both cause stress.

The causes of clinical depression are likely to be different for different people. Sometimes a depressive episode can appear to come out of nowhere at a time when everything seems to be going fine. Other times, depression may be directly related to a significant event in our lives such as losing a loved one, experiencing trauma, or battling a chronic illness.

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters-chemicals that brain cells use to communicate-appear to be out of balance. But these images do not reveal why the depression has occurred.

Scientists believe genetic factors play a role in some depressions. Researchers are hopeful, for instance, that they are closing in on genetic markers for susceptibility to manic-depressive disorder.

Depression in adolescence comes at a time of great personal change-when boys and girls are forming an identity distinct from their parents, grappling with gender issues and emerging sexuality, and making decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, disruptive behavior, eating disorders or substance abuse. It can also lead to increased risk for suicide.

Teen depression cannot always be prevented, but there are some things that can help reduce the chances of an episode of depression in a teen who is at risk.

Teen Depression is presented for troubled teens or parents of teens. We offer information on teenage depression, issues, and other teen problems. Our articles were written to educate parents and teens about adolescent depression, the warning signs, and various treatment options available.

Some of the causes of depression in teenagers seem to be genetic, and those cannot be changed, but other triggers of teen depression can be avoided. Some of the risk factors for teen depression include:

* A family or personal history of depression
* A long-term illness or disability, whether physical or mental
* Experiencing a trauma or loss, including abuse, divorce of parents, death of a loved one, or a break-up
* Difficulties at home, at school, or with friends

If you know a teen who suffers from or is at risk for depression, you can help the teen by:

* Talking and listening to him or her
* Encouraging him or her to be involved in positive activities and to take good care of him or herself
* Being fair when dealing with or disciplining the teen
* Setting a good example by taking good care of yourself and getting help if you feel depressed or overwhelmed.

The majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both.18 Research has shown that medication alone and combination treatment are both effective in reducing the rate of depressive recurrences in older adults. Psychotherapy alone also can be effective in prolonging periods free of depression, especially for older adults with minor depression, and it is particularly useful for those who are unable or unwilling to take antidepressant medication.

Additional research data indicate that people suffering from depression have imbalances of neurotransmitters, natural substances that allow brain cells to communicate with one another. Two transmitters implicated in depression are serotonin and norepinephrine. Scientists think a deficiency in serotonin may cause the sleep problems, irritability, and anxiety associated with depression. Likewise, a decreased amount of norepinephrine, which regulates alertness and arousal, may contribute to the fatigue and depressed mood of the illness. Other body chemicals also may be altered in depressed people. Among them is cortisol, a hormone that the body produces in response to stress, anger, or fear. In normal people the level of cortisol in the bloodstream peaks in the morning, then decreases as the day progresses. In depressed people, however, cortisol peaks earlier in the morning and does not level off or decrease in the afternoon or evening.

There is mounting evidence that depression takes a serious toll on physical health. The most recent studies exploring health and depression have looked at patients with stroke or coronary artery disease. Results have shown that people with depression who are recovering from strokes or heart attacks have a more difficult time making health care choices, following their doctor's instructions, and coping with the challenges that their illness presents. Another study found that patients with depression also have a higher risk of death in the first few months after a heart attack.

Some people have a low threshold for stress. They're affected by events and activities that to others seem to not be stressful. The good news is that very effective treatments are available to help those who are depressed. However, only about one-third of those who are depressed actually receive treatment. This is unfortunate since upwards of 80-90% of those who do seek treatment can feel better within just a few weeks. Many people do not seek treatment for depression for a variety of reasons. Some believe that depression is the result of a personal weakness or character flaw. This is simply not true. Like diabetes, heart disease, or any other medical condition, clinical depression is an illness that should be treated by a mental health professional or physician. Another reason why many people do not seek help for depression is that they simply do not recognize the signs or symptoms that something may be wrong.

About Depression By Michelle Ooley

I have recently created a blog about depression, called Depression Hurts. Feel free to visit my blog frequently. I will be updating it frequently with new information about depression, treatments, articles, etc.

For years I have suffered from depression, at different levels, some of them being major episodes and some more on a dysthymic (low-grade chronic) level.

What is depression?

There is a tendency to use the word depression to describe periods or episodes of sadness that each of us experience from time to time. And for many of us, during these periods it is not always easy to discern where normal sorrow ends and clinical depression begins. Yet, anyone who has ever experienced an episode of major depression knows - at least after the depression has lifted - that what they feel is more than just ongoing or persistent sadness.

Clinical depression is an illness characterized by a cluster of feelings, thoughts and behaviors that are remarkably distinct from a person's normal range of feelings and functioning. Caused by a complex interaction of biologic, psychological and social factors, a major depressive disorder can make a person extremely sensitive to life circumstances, the least of which can throw him/her into total loss of hope.

During a major depression, someone can become surrounded by feelings of sadness, hopelessness, helplessness, and emptiness, and these feelings can distort every thought and experience, making life seem hopeless and unworthy. Feelings of being deeply and continually deprived, unworthy, insignificant, and guilt-ridden build on feelings of sadness. At the same time, a person may feel chronically irritable, often exploding into anger and frustration.

While a major depression may be triggered by some life event or circumstance, a person's mood reaction may seem greatly exaggerated. However, depression has less to do with life's events than with an individual's existing vulnerability to the condition.

In some cases, someone may experience a major depression as a single episode, but in most cases, clinical depression tends to recur periodically, reactively or cyclically. A major depressive episode could possibly last up to 2 or more years.

When someone experiences milder depressive episodes, this is called dysthymia. For someone suffering from dysthymia, certain life circumstances, such as loss of a job, divorce, or relocating to a new environment, may provoke a much deeper depression.

For some individuals, there is a seasonal component to their depression called Seasonal Affective Disorder (SAD). This is a form of reactive depression that is more prevalent in northern parts of the country where climatic extreme changes are greater. SAD usually affects people in the fall or winter and is characterized by fatigue, carbohydrate cravings, overeating, lack of energy or motivation to do activities normally enjoyed, and oversleeping. While the exact etiology or cause of SAD is not certain, it is possible that it may be related to the way in which the light responsive pineal gland in the brain functions.

Defining Depression:

The difficulty with many mental disorders, it is hard to tell when you need more than just a positive attitude to manage your feelings. Depression is a common problem that many people simply think they need to live with, something they need to 'tough out' in order to come out better for it. But this is not necessarily the best treatment plan for this mental illness. Here's what you should know.

What's difficult about dealing with depression is that it can manifest itself in a number of different ways. For some people, depression is merely a short bout of sadness that resolves on its own. But for others, it's a long running presence that makes them feel ineffective, as well as hopeless. Some of the more common symptoms of depression include:

o Feeling sad

o Feeling hopeless

o Becoming irritated for no reason

o Anger and frustration

o Loss of interest in favorite activities

o Change in eating habits

o Change in sleeping habits

o Thoughts about suicide

Diagnosing depression is tricky because it requires that you have these symptoms for extended periods of time - normally for at least two weeks continuously. And while some people can easily identify their down times, others might not recognize symptoms like anger as being consistent with depression.

When you have depression, what can you do?

During the time that you feel despondent, seek the emotional support from family and friends. For milder episodes of depression of short duration, the support of loved ones may be able to help you work through it. But in most cases, you will not be able to fight depression on you own, and you should not try to. Like diabetes or asthma, depression is an illness and requires medical attention so it can be managed effectively and appropriately. If you are suffering from depression, it is imperative that you seek professional help.

If you suffer from SAD (Seasonal Affective Disorder), you may very well respond to spending at least an hour a day outdoors, even during the wintertime. Increasing the amount of natural light in your house may also help. Some psychiatrists even recommend obtaining a special light to put in your room that kind of resembles sunlight. Whenever possible, take trips in winter to warmer and sunnier climates.

When to seek treatment for depression:

If you are in a major bout of depression, you may feel like you are beyond help. However, depression can be treated and managed. If you state of gloom persists more than two weeks, you feel that you cannot get out of bed, you are increasingly isolated from family and friends, and you have lost any sense of enjoyment or interest in your usual activities, call your doctor right away. Also, if you find yourself ruminating about death and the meaningless of life and you are considering suicide, SEEK HELP IMMEDIATELY.

Treatment of Depression:

Mild depression can be treated effectively through psychotherapy. Even short-term therapy can help you understand your natural inclination towards more negative and low moods. Also, you can learn to cope better with life's disappointments and triumphs. When depression is triggered by a seasonal change, light therapy, which extends exposure to bright light for measurable periods of time, may work to relieve symptoms.

In cases of more severe depression, medication will provide the main avenue for treatment. At the same time, psychotherapy is usually an important complement to medication. By restoring chemical balances within the brain, psychotropic medications will help lift the "veil of sorrow." The most commonly used anti-depressant medications are SSRIs (selective serotonin reuptake inhibitors), which include fluoxetine, sertraline, paroxetine and fluvoxamine, and TCAs (tricyclic anti-depressants), which include imipramine, nortriptyline, amitriptyline, and desipramine. Although general practitioners can usually prescribe these types of medications, it is usually best to consult with a psychiatrist or psychopharmacologist, who is specially trained to evaluate and monitor the need for and use of anti-depressant medicines.

For lots of different reasons, treatment with anti-depressants takes time to work. Because every person and his depression differ, finding the most effective medication is often a process of trial and error. While the process may be frustrating, you and your doctor will eventually find the right treatment.

During a severe episode of depression, there may be severe paranoid persecutory delusions or even hallucinations. There may even be suicidal behavior. When these occur, hospitalization, antipsychotic medication or electroconvulsive therapy (ECT) may be necessary. After the acute phase has subsided, psychopharmacologic treatment should be continued to decrease the likelihood of relapse or future recurrence.

Unlike medications for physical illness, psychotropic medicines do not work to cure the depressive illness; rather, they work to relieve acute episodes and prevent recurrences. For many people, medications work most effective in conjunction with psychotherapy. Insight-oriented therapy can allow you to consider how such contributing factors as early experiences of loss and cumulative negative life circumstances and disappointments have colored your disposition. Cognitive techniques can also provide significant relief insofar as they address the negative and distorted thinking that typically characterizes depression.

Prognosis for Depression:

Prognosis is good. Recent progress in the development of new medicines that act directly on specific parts of the brain make the treatment of depression even more positive. SAD responds well to light therapy.

In some instances, one course of treatment is sufficient to manage or remedy major depressive illness. However, for many others, depression is a chronic lifelong condition that requires continued or episodic intervention. Ever after a successful round of treatment, it is important that you remain sensitive to stresses that are likely to trigger a depression. If you are able to recognize early signs, you will be able to contact your physician or clinician before you find yourself deep into another depressive episode. Learning to manage depression through therapy, medications and lifestyle will lessen the likelihood that it will take over your life.

Again, please visit my blog as I will be updating frequently with interesting news, treatments, recommended books and much more.