|
By Julie R. Hergenrather, Ph.D., A.C.T.
About 18 million American adults suffer from clinical
depression in any given year, and by some estimates,
25% of women and 12% of men will experience a major
depressive episode during their lifetime. Depression
is a very common illness, but still often misunderstood.
Thankfully, contemporary treatment is highly effective
and easily accessible.
What depression isn't:
Depression isn't simply having a bad day or feeling
down and blue. Depression isn't something you should
just be able to get over if only you were strong
enough. It's not just the way "everybody"
feels sometimes and not "everybody" gets
depressed. It's not a sign of weakness or lack of
character. When you are depressed, you're not just
feeling sorry for yourself.
Some depression facts:
Depression is a disease of the brain that affects
the whole person: how one feels physically, what
one does day to day, a person's mood and the way
a person thinks about himself, about other people
and the future. Depression can sometimes be fatal.
The suicide rate in Montana is the second highest
in the nation. There are many people in this state
and community whose depression remains unidentified,
untreated, or under-treated.
Depression tends to run in families so we think
genetics plays a role in the disease. Depression
can also develop in conjunction with important life
changes or stresses. Depression can develop in a
person with chronic low self-esteem, and general
feelings of worthlessness. Finally, some chronic
illnesses like heart disease and stroke, as well
as medications used to treat disease, can cause
depression.
How do I know if I am clinically depressed?
The symptoms of depression fall into four broad
categories.
- Physical symptoms include appetite changes
(either loss of appetite or eating more then usual),
sleep problems (either sleeping too much or not
being able to sleep), problems with concentration,
lack of sexual desire, poor energy and lack of
motivation. Sometimes people also develop aches
and pains like headaches, stomach upset or back
pain.
- Mood or emotional symptoms include sadness,
depression, irritableness, guilt and anxiety.
- Behavioral symptoms include social withdrawal,
disengagement from previously enjoyed activities,
frequent crying, changes in hygiene, and changes
in daily routine.
- Cognitive symptoms involve the way a
person thinks about oneself, others and the future.
Cognitive symptoms of depression include hopelessness,
rumination, extreme self-criticism, and pessimism
about the future. People who are depressed are
often certain that others view them critically
and negatively, and believe they are failures.
Sometimes depressed people have thoughts about
suicide.
When we use the word "depression" medically
then, we aren't talking just about feeling sad and
blue. We are describing a disease that causes a
range of uncomfortable symptoms, which interfere
significantly in daily life, which reoccur periodically
throughout the lifespan and can sometimes result
in death.
Treatment: Medication
With the introduction of the Prozac about 20 years
ago, and since then, other antidepressants such
as Wellbutrin, Effexor, Zoloft, Paxil and Lexepro,
depression treatment immediately became more effective,
and symptom relief with few uncomfortable medication
side effects became a reality. In 1987, only 37%
of people diagnosed with depression were taking
antidepressants. By 1997, fully 75% were. These
are good drugs that have literally saved lives,
lowered treatment costs and given hope.
Which symptoms of depression are treated by
medication?
Generally speaking, medication normalizes sleep
and appetite patterns, restores energy and motivation,
and improves concentration. Once these important
symptoms are better, people usually experience improvement
in mood and begin to feel more optimistic. Unfortunately,
the symptoms usually return when medication is discontinued.
Treatment: Cognitive Behavior Therapy
As effective as antidepressants are, for the most
part, they are only effective as long as the client
takes them. In fact, one study suggests that 80%
of patients relapse within a year of discontinuing
medication. Since relapse or recurrence is a part
of the depression disease picture, treatment for
long-term remission of the disease is vitally important.
Cognitive
Behavior Therapy specifically targets behaviors
and beliefs that maintain depression. In CBT, clients
learn to identify beliefs that lead to depressed
mood, as well as lifestyle and behavioral patterns
that might maintain depression. Many studies have
shown CBT to be one of the most effective treatments
for depression, and particularly to prevent relapse.
The current standard of care for depression treatment
is a combination of psychotherapy and medication.
CBT focuses on teaching skills and techniques that
the client uses to better understand what keeps
him or her depressed, and what leads to improvement.
These skills, once learned, can be helpful in many
stressful situations over a person's lifetime. These
skills include:
- Recognizing the thoughts and beliefs that are
connected to depressed mood
- Identifying, challenging and changing dysfunctional
beliefs
- Interpreting events in a more balanced, less
negative way
- Learning to devise and carry out "behavioral
experiments" to test both old and new beliefs
- Developing action plans to solve problems
- Making lifestyle changes (e.g., exercise, recreational
activities) that lead to improved mood
Which symptoms of depression are treated by
CBT?
Generally speaking, with Cognitive Behavior Therapy,
people experience improvement in mood, hopefulness
and self-perception. People also report feeling
more "empowered" and confident. Often,
eight to fifteen sessions is sufficient for treatment
of depression.
What matters most:
The most important thing is to recognize that depression
is a disease of the brain that can and should be
treated. If you suspect that you're suffering from
depression - or that someone you know and love is
suffering from it - please get professional help
as soon as you can. There is no reason to live with
depression … and every reason to defeat it.
|
