I'm Blue, Soooo Blue (Depression, part 3)

Remember, everyone gets depressed at some time, but not everyone gets depression. Depression comes in many forms. Yesterday we talked about degrees of reactions to change. The same occurs in all symptoms of depression. The sympoms tend to run on a continuum: eating too much to not eating at all, or somewhere inbetween.

The Diagnositic and Statiscitcal Manual (DSM-IV-TR), which is the "bible" of diagnostic symptoms for mental health professionals, lists the symptoms of depression. According to the different levels, intensities, and symptoms, there are over 200 different combinations for depression.

The symptoms of major depression can be divided into three categories:

1. 
   Disturbances of emotion and mood.
2. 
   Changes in the "housekeeping" functions of the brain - those that regulate sleep, appetite, energy and sexual function.
3. 
   Disturbances of thinking and concentration.

Some of the most common symptoms of clinical depression include:

• loss of interest or pleasure in ordinary pleasurable activities, including sex.
• chronically sad or empty mood.
• irritability or excessive crying.
• social withdrawal or isolation.
• changes in energy levels, fatigue, feeling slowed down, slowed movements.
• agitated actions (pacing, hand-wringing, etc.)
• sleep disturbances (insomnia, early morning waking, or sleeping too much).
• changes in eating habits (loss of appetite, significant weight loss or weight gain).
• difficulty with focus or concentration, impaired memory, difficulty in making decisions.
• feelings of guilt, worthlessness or helplessness.
• feelings of hopelessness and despair.
• increase in addictive behavior.
• thoughts and/or talk of death and suicide.
• suicide attempts.
• chronic aches and pains that don't respond to treatment.

If some of these seem to apply to you, then think about them in terms of these three words - number, duration and intensity.

1) Number. The symptoms of depression are "additive" - that is, the greater the number of symptoms you have, the more likely you are to be clinically depressed. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), five or more of these symptoms should be present for a person or someone close to that person to consider him or herself "clinically depressed."

2) Duration. The longer you have been down in the dumps, the more likely it is that you are clinically depressed. According to the DSM IV, the five or more symptoms must exist for at least two weeks for a diagnosis of major depression to be made.

3) Intensity. Many of us can feel emotional pain and still cope with our daily existence. Some experiences of depression are within the normal course of living. The pain of major depression can be so great, however, that its intensity (along with the number and duration of symptoms) can significantly impair one's ability to cope.

If you feel like you are clinically depressed, GREAT! You know what you can do, talk to your primary physician or make an appointment with a mental health professional (psychiatrist, counselor, psychologist) to get started on a treatment plan. You can also go to one of these sites to assess your level of depression and share this information with your physician or MHP:
Zung Self Rated Depression Scale
Mayo Clinic Depression Screening
Psych Central Depression Quiz

Keep in mind these are SCREENING tools only and NOT a substitution for a thorough examination by your physician and/or MHP.


Remember, there is HELP and there is HOPE!


Next up: Treatment options.

I'm Blue, Soooo Blue (Depression, part 2)

So what causes depression? There are many factors that lead to depession. Often, more than one, and usually a combination of many factors combine to lead to depression.

Simply put, when one of the following factors occurs, it changes our brain chemistry in some way. Of course, the factors themselves can vary in intensity; so a job change can vary from moving to a new cube, getting a new boss, being transferred to new department, being transferred to a new city, getting a demotion, getting fired, getting arrested for imbezzlement, etc. So when you say job change, that can mean many different things.

Add to that, the way we react to that change. For some people, getting a new boss is a huge deal, others, its no biggie. It doesnt meant the former person is weaker or inferior than the latter, it just means that the person reacted differently.

So, a job change occurs and our brain chemistry changes somewhat depending upon the type of change and our reaction to it. If multiple things happen our chemistry can change to the point where we are getting low in them which is a common cause of depression.

Let's look at some of these factors:

Genetics and biology.
Like other medical conditions, for example heart disease, cholesterol, and cancer, depression tends to run in families. People can be born with a certain predisposition to depression or have lower levels of chemical neurotransmitters to begin with.

Childhood trauma and other psychological factors.
As we discussed, changes in our psychology (reactions to trauma, personal loss, rejection) can also alter the biochemistry of the brain and nervous system - sometimes permanently. How we adjust to traumas, or how we are taught to adjust, can have a huge impact on the likelihood of develping clinical depression.

Environmental factors.
Poor nutrition, hormonal imbalances, toxins in the environment, brain injuries, stress, substance abuse, and can lead to depressive states. Good nutrition, decreasing stress, healthy lifestyles are keys to minimizing depressive symptoms. Alcohol depresses the nervous system, thus drinking too much, too often can lead to depressive states. Thus, moderation in drinking alcohol is essential.

Prescription medications
Many people do not realize that many common prescription drugs have side effects that can induce depression. These include cardiac drugs and hypertensives, sedatives, steroids, stimulants, antibiotics, antifungal drugs and analgesics.

Sociological factors.
Many changes in modern society, such as the breakdown of traditional communities (people don't stay in one spot for very long any more), the dissolution of extended families (with mobility in the world, often families are spread throughout the country or world), the widening gap between rich and poor, and our increased isolation due to technology (we text/email people instead of calling or visiting), may play a part in the rising rates of depression worldwide.

Spiritual crises.
People can suffer from an existential depression when life loses its meaning and purpose. Any significant transition, especially a change of roles in family or work, can trigger this crisis in meaning. Connection to a "Higher Power"has been shown to increase mood and levels of neurochemicals.

Next, we'll look at symptoms of clinical depression...

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Dealing with Boredom

The human mind thrives on novelty. What was once a source of pleasure can become tedious after a time. Though our lives are full, boredom lurks around every corner because we innately long for new experiences. Yet boredom by its very nature is passive. In this idle state of mind, we may feel frustrated at our inability to be productive or engage in tasks. We may even attempt to lose ourselves in purposeless or self-destructive pursuits like addictions or overeating.

While this can be a sign of depression, it can also be an invitation to challenge yourself. Boredom can become the motivation that drives you to learn, explore the exotic, experiment, and develop your true potential.

In some religious traditions, boredom is perceived as a pathway to self-awareness. Boredom itself is not detrimental to the soul—it is the manner in which we respond to it that determines whether it becomes a positive or a negative influence in our lives. When you respond by actively filling the emptiness you feel lurking in yourself, you cultivate creativity and innovation. If, when in the grip of boredom, you have difficulty acknowledging the merits of any activities you might otherwise enjoy, generate your own inspiration.

Before you find yourself beset by boredom, sit down now and create a list of tasks you can consult when it feels like there is simply nothing to do. Referring to a list of topics you want to learn more about, projects you’ve yet to begin, or even pending chores can spark your creativity and reawaken your zest for life.

When we are troubled by boredom, it is not that there is nothing to do but rather that we are not stimulated by the options before us. A bored mind can be the canvas upon which innovation is painted and the womb in which novelty is nourished. When you identify boredom as a signal that you need to test your boundaries, it can be the force that presses you to strive for opportunities you thought were beyond your reach and to indulge your desire for adventure.

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Encouraging Hope

What is hope? It is not just positive thinking, a good mindset, or optimism.



Webster's Online dictionary defines hope as "to desire with expectation of obtainment" and "to expect with confidence". It is the feeling that what is desired can be obtained. We can get what we want and that events will turn out for the best.



Other examples or descriptions of hope:

• An adventure, a going forward, a confident search


• A multidimensional dynamic force, characterized by a confident yet uncertain expectation of achieving a future goal. Which, to the hoping person, is realistically possible and personally significant.


• The elevating feeling we experience when we see, in our thoughts and dreams, a path to a better life, a brighter future...with the understanding that significant barriers may exist along the way.


• A non-linear path with many twists and turn of doubt and fear that can negatively affect the view of it


• The feeling of knowing how to get what you want out of life and the desire to make it happen.


• A faith in the unseen


• A spiritual certainty

Without hope there is despair. Studies show that when there is no hope then there often people contemplating death and suicide. When people choose to stop living in their current realm of pain, fear and negative circumstances and seek help (counseling, a friend, a pastor) they are seeking a more hopeful life. We have two paths when dealing with people in despair. We can focus on their mistakes (those twists and turns along the non-linear path), what is wrong with them or we can focus on strengths, their potential for right, so that they may regain hope. Research shows that depressive symptoms decrease as hope is increased.



It is important that we all maintain an attitude of hope. Our attitude and behavior is what helps elicit hope and positive behavior in others. It is important that we express our faith in others and their ability to succeed. We must encourage and empower those we come in contact with to see beyond the discouraging circumstances. We must give them another picture to view, one of possibilities and potential. Hope is contagious, forward-thinking and goal oriented.



Still more essential is that we help others restore their faith in themselves. Once they believe in their own ability to change, then they can see that the circumstances are only temporary and they can get back on the road to hope.



When we encourage exploration of alternatives to the discouraging situation, we are instilling hope. We can do this by validating their feelings of despair, but not giving credence to the lie of despair. We can give them power over the situation by exploring options and alternatives and providing a sounding board for problem-solving. When they learn to develop hope from the inside out, even in one small aspect of their life, they can take that seed of hope and water it into a whole garden of hope. They can take that sliver and generalize it to a whole host of other life situations. They will begin to see possibilities that were once invisible to them.



When people restore hope they can explore where they were and derive meaning from it. They can learn from the past and move forward. They have the ability to set and achieve realistic goals. When the feeling of hope is restored people often feel more capable; they can do what is needed, see beyond today, and visualize their future.





Additional resources:



http://en.wikipedia.org/wiki/Hope

http://researchnews.osu.edu/archive/apahope.htm

http://www.suicideinfo.ca/csp/assets/alert63.pdf

http://www.attcnetwork.org/userfiles/file/11%20Pages%20from%20AM_v7_Series_4[1].pdf

http://division39.org/pub_reviews_detail.php?book_id=22

http://psy.psych.colostate.edu/courseweb/SUM2008/PY729YalomsTherapeuticFactors.pdf

http://www.merriam-webster.com/dictionary/hope

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Healthy Lifestyle Balance on Vacation

Prepare for old friends or relatives you haven’t seen in a while.
Decide how and when you will want to be assertive with them about eating and activity. Consider talking with them in advance.

Plan for pleasures after your vacation.
Coming back from a vacation is often a let-down. Try to get back to regular activities gradually and plan some extra pleasures to offset post-vacation blues. Consider allowing an easy day at home before getting back to work full-steam.

Even MORE Great Resources!

Cholesterol

General Info on Cholesterol
http://www.americanheart.org/presenter.jhtml?identifier=4488

Checklists for Lowering Your Cholesterol
http://www.americanheart.org/presenter.jhtml?identifier=514

Cholesterol: The best foods to lower your cholesterol and protect your heart
http://www.mayoclinic.com/health/cholesterol/CL00002

Lowering Your Cholesterol With TLC
http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf

How You Can Lower Your Cholesterol Levels
http://nhlbisupport.com/chd1/lifestyles.htm

Free Diet and Weight Loss Journal

http://www.fitday.com/
www.everydiet.org/diets.htm
http://www.calorie-count.com/
http://www.calorieking.com/
http://www.sparkpeople.com/

Calculating BMI (Body Mass Index)

http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/about_adult_BMI.htm#Interpreted


Emotional Eating

Overeaters Anonymous
http://www.oa.org/index.htm

“Get a Handle on Emotional Eating” article
http://sparkpeople.com/resource/wellness_articles.asp?id=55

Binge Eating Disorder information
http://win.niddk.nih.gov/publications/binge.htm

Good article on binge eating disorder and emotional eating
http://www.cfah.org/hbns/newsrelease/eatingdisorder3-14-02.cfm

Fitness Center Locator

http://www.gymticket.com/

General information (articles, self-evaluation tools)

http://www.magellanhealth.com/

Fun sites

Freestuff

Freebies 4 U 2

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WELCOME

Thanks for visiting my blog! I hope you will find the information contained herein useful and helpful in your daily life. I willl add information every weekday (I take weekends off to relax and rest and enjoy my family) on various topics. Sometimes I will add a running series, one each day on the same topic.

I welcome any and all comments, requests, flames (do we use that term anymore?). If you have question or concern, please let me know. I'll do my best to address it.

My ultimate goal in doing this blog is to help you help yourself to achieve the highest level of quality in your life. My tips may not work for you specifically, but generally they have helped countless others in some way. I ask you to consider the information and decided if it would benefit you.

A caution: before you start any weight loss, diet, or health-related change, I STRONGLY recommend you talk with your physician or other healthcare professional. You never know how a change will affect your health. Most often, change is good, but it's always best to ask someone who knows, like your doctor. See my disclaimer on this page.

Best of health and well-being to you!