Depressive Disorder – The Facts
We often use the word depression to describe feelings of sadness, feeling blue or being down. But more accurately depression is a term which describes many diagnosable depressive disorders.
With feelings of depression being so common in our everyday lives it is important that we understand the difference between feeling sad and the symptoms of a depressive disorder.
Emotional reactions such as feeling sad or unhappy to certain stresses such as the loss of a loved one, relationship breakdowns, or large disappointments, are appropriate to the situation and are generally experienced for a short time only. These reactions are a normal part of living and are not regarded as a depressive disorder.
Depressive disorders can seriously disrupt a person’s life and are characterized by long term or excessive depressed feelings and a lack of interest in participating in activities that used to be fun.
Depressive disorders are a serious medical concern and pose real risks to a person’s life. For this reason if you or someone you know shows signs of a depressive disorder it is important to talk to a doctor about it immediately.
The Main Types Of Depressive Disorder?
Major depressive disorder
(the most commonly diagnosed disorder)
A Person Suffering With Major Depressive Disorder:
- Loses enjoyment in everyday living
- Becomes low spirited
- Lacks concentration and energy
- Will have changes in sleep patterns and appetite
- Commonly have feelings of guilt, hopelessness and despair which can lead to suicidal thoughts
Major depressive disorder can happen to anyone at anytime, it can develop in people who are happy in their relationships and family, people who generally cope well and enjoy their work, it may “just happen” without any apparent cause. Although distressing events that the person has trouble coping with are known to induce major depressive disorder.
- If the symptoms of major depressive disorder become milder and fewer, but last for more than two years, the illness is classified as dysthymic disorder.
Adjustment Disorder With Depressed Mood
Adjustment disorder is an excessive, abnormal reaction to a life stressor such as marriage, divorce, starting school, a new job, flood, fire, having problems at work, or any other every day issue. The reaction is much more severe than what is considered normal and can lead to serious health problems.
To be an adjustment disorder the symptoms must start within three months of the beginning of the stressor and last no more than six months after the stressor has ended.
- Depressed mood
- Work and social problems
- Twitching or trembling
- Physical problems such as headache, stomach ache, chest pains and general aches and pains
- Palpitations (fast heartbeat)
- Conduct disturbances such as vandalism, truancy, fighting or reckless driving
- Anxiety, worry, tension and stress
symptoms can vary widely – the person may not know the stressor causing the problems.
Around half of all new mothers are affected by “postpartum baby blues” with symptoms that may include:
- Mood swings
- Crying spells
- Difficulty sleeping.
Baby blues usually start in the first two to three days after delivery, and can last for up to two weeks.
But some new moms experience postpartum depression, a much more severe, longer lasting form of depression with symptoms which may include:
- Severe mood swings or depressed mood
- Excessive crying
- Difficulty bonding with the new born baby
- Withdrawal from friends and family
- Loss of appetite or large gain in appetite
- Sleep problems (not sleeping or sleeping too much)
- Lack of interest in activities that used to be enjoyed
- Loss of energy / fatigue
- Irritability and anger
- Feelings of inadequacy, guilt and shame
- Problems concentrating and decision making
- Panic attacks and severe anxiety
- Thoughts of self harm or harming the baby
Postpartum depression untreated can last for many months or longer
Bipolar Mood Disorder
(previously called manic depression)
Bipolar disorder is a mental health condition which causes extreme mood swings ranging from emotional highs to lows. (Mania/hypomania to depression)
- Hypomania = less severe than mania
In the depressive phase you may feel hopeless, sad and have no interest in activities that would generally be pleasurable.
In the manic phase you may be full of energy, euphoric, or unusually irritable. These swings in mood can affect judgment, behaviour, sleep and decision making.
There are several types of bipolar and related disorders.
- Bipolar I disorder: You have experienced at least one manic episode followed by a hypomanic or major depressive episode.
- Bipolar II disorder: You have experienced at least one major depressive episode and at least one hypomanic episode, but you haven’t had a manic episode.
- Cyclothymic disorder: You have experienced a minimum of two years — or one year as a child or teen — of many periods of hypomania and depressive symptoms.
- Bipolar disorder can also be induced by drugs, alcohol and certain medical conditions such as Cushing’s disease, multiple sclerosis and stroke.
- Bipolar II disorder is not a milder form of bipolar I disorder, it is a separate diagnosis.
Bipolar disorder is usually diagnosed in the teen years or early twenties but can occur at any age and symptoms can vary from person to person.
What Causes Depressive Disorders?
- Genetic factors –depression runs in families
- Stress – personal tragedies, disasters and situations that people have difficulties coping with are associated with depressive disorders
- Major life transitions such as child birth, death and bereavement or menopause can trigger depressive disorders
- Depressive symptoms are more likely in people who are very anxious, emotional, sensitive, and people who have strong reactions or are easily upset by life events
- Perfectionists and self critical people are at a higher risk of developing depressive symptoms
- Optimistic people who practice positive thinking are less likely to experience depressive disorders.
What Treatment Is Available?
Depressive disorders can be very effectively treated. People experiencing feelings of sadness that have persisted for a long time, or that are affecting their lives to a great extent, should contact their family doctor or community health center.
Treatment will depend on each person’s symptoms, but will include one or more of the following.
- Psychological interventions, such as cognitive behavioral therapy (CBT), to help change behaviors, thinking patterns and beliefs associated with depressive disorders
- Interpersonal therapies – helping people understand relationships and their emotional effects.
- Anti-depressant medications to relieve depressed feelings help restore good sleep patterns and reduce anxiety.
Anti-depressant medications are not addictive. They gradually repair the balance of neurotransmitters in the brain. (Usually in 1-4 weeks)
- Medication for specific conditions such as mood swings in bipolar mood disorder.
- Lifestyle changes – healthy eating, increasing exercise and reducing alcohol and drug intake will help control depression
For some very severe forms of depression, electroconvulsive therapy (ECT), also known as shock treatment may be used.