Everyone gets "the blues" or feels "down in the dumps" occasionally. Moods can fluctuate from day to day, or hour to hour, sometimes for no reason at all. Changes in environment can affects moods. Any significant stress, such as going to college, establishing and ending relationships, success or feelings of failure in school, or experiencing losses can result in a sad mood. Most often these "down" periods last a couple of days to a few weeks. Occasionally, a down mood persists longer than a few weeks and the feelings become more intense. As a result, changes in thinking, behavior, and self-esteem are evident. If these feelings persist and become more intense, a "clinical depression" may result. Signs of Depression
We know that depression is a "whole-body" illness, involving our body, mood, and thoughts. It affects the way we eat and sleep, the way we feel about ourselves, and the way we think about things. Below is a list of symptoms that are typical of clinical depression. Not all of the symptoms are required for a diagnosis of depression.
Types of Depression
- Persistent depressed, sad, or "empty" mood
- Lack of interest or pleasure in activities that were once enjoyable (from schoolwork to sex)
- Decreased energy, fatigue, being "slowed down"
- Frequent feelings of worthlessness, low self-esteem, hopelessness or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
- A substantial change in appetite, eating patterns, or weight
- Insomnia or hypersomnia nearly every day
- Recurrent thoughts of death or suicide
Depression comes in many forms and each individual can experience it differently. Depression might be in response to a stressor you can identify. This type of depression (Adjustment Disorder) usually resolves itself within six months. Major Depression is a more severe depressed mood that may not be in response to anything in particular and may last for a longer period of time. An episode of Major Depression may occur once, twice, or several times in one's lifetime. The episodes typically last 6 to 12 months. One type of Major Depression is Seasonal Affective Disorder (SAD) where depression is experienced during a certain time of the year (typically winter). This is more common in the northern latitudes (such as northern Idaho). Dysthymia is a persisting form of mild depression (lasting at least two years) where one's mood is not as down as Major Depression but one feels depressed for most of the day, for more days than not. A less common form of depression is Bipolar Disorder (formerly called "manic-depression"). Bipolar Disorder involves cycles of depression and elation or mania. Causes of Depression
Depression is a multi-determined disorder, caused by a combination of factors. Each person is unique and the relative contributions of each factor can be different. Some relevant factors are:
- Biochemistry: Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for some of the symptoms of depression.
- Genetic: Some types of depression run in families. If your parents or other relatives have depression, you may be more likely to struggle with depression.
- Psychological: Some ways of thinking and behaving can contribute to depression, i.e., negative thinking, unrealistic expectations, or all or nothing thinking.
- Environmental: Exposure to significant stressors or long-term exposure to stressful situations can increase vulnerability to depression. Also, the amount of daylight can trigger Seasonal Affective Disorder.
If your depression is not severe, or has not lasted for a long period of time, there are many things you can do to help yourself. These include:
- Reduce or eliminate use of alcohol and drugs (These are often used to feel better, but physiologically, they can increase depression.)
- Keep up your normal routine and activities even though you may not feel like it
- Get regular exercise
- Eat regular and nutritious meals
- Get adequate sleep
- Seek emotional support from friends and family
- Increase positive thinking
If your self-help efforts are not effective and your depression persists for several weeks, becomes more severe, or leads to self-destructive thoughts or behavior, you should seek professional help. Professional Help
The two primary ways of treating depression are psychotherapy and/or medication. Consultation with a mental health professional (psychologist, psychiatrist, counselor, or social worker) will help you determine the best treatment for you. There are currently a variety of highly effective interventions available for the treatment of depression. Eighty to 90% of people with depression improve with treatment. Psychotherapy/Counseling
A variety of psychotherapeutic approaches are available for treating depression. Cognitive (or cognitive/behavioral) approaches focus on helping people change the negative styles of thinking and behaving often associated with depression. Interpersonal therapy focuses on dissatisfying interpersonal relationships that both cause and exacerbate depression. Other therapeutic approaches include psychodynamic therapies, humanistic/existential approaches and narrative therapy. Most mental health professionals utilize a variety of techniques based on the individual needs and wants of the client. Medication
There are a variety of types of medication that are currently used to treat depression, each of which works a little differently. Your symptoms, medical history, and family history often give clues about the best medicine for you. Still, it may take time to find the one that works best for you and has the least side effects. Professional Help Available
The University of Idaho Counseling & Testing Center offers free group and individual psychotherapy/counseling for depression, bipolar disorder, and related issues for full time UI students. We provide referrals to Student Health Services or other physicians if an evaluation for medication is appropriate. For more information or to schedule an appointment, stop by the Counseling & Testing Center (Continuing Education Building, Room 306) or call 885-6716. All appointments are confidential.