by Barbara Fane, LCSW, BCD
The Many Faces of Depression
Many people have a certain image of what they think depression looks like. Yet depression, like so many other human struggles is not one size fits all, and can look very different in each person.
Contrary to popular belief, it is not that every person who is depressed is also unable to function on a daily basis, or will become suicidal. While these are very real concerns for the severely depressed, and the risks can never be minimized, it must also be said that there are levels of depression which can make life merely difficult for some, while others may find it debilitating, even as others decide that life is not worth living. A realistic understanding of your own level of depression will be a great aid to effective depression therapy.
Major Depressive Disorder (MDD)
Depression falls under the general classification of a mood disorder, along with Bipolar Disorder (BD). Both are recognized as having varying levels of severity, from a Major Depressive Disorder (MDD) and manic depression, to dysthymia, a milder form of depression, and cyclothymic disorder, a milder form of BD.
People who suffer major depressive episodes, without the manic component of BD, are at “increased risk” of suicide, if left untreated. Treatment for MDD may range from antidepressant medications and psychotherapy, to brief hospitalization for those at risk of harming themselves, or who need time to stabilize after a personal crisis and adjust to medication.
“The diagnosis of major depressive disorder is based on the patient’s self-reported experiences, behavior reported by relatives or friends, and a mental status examination. There is no laboratory test for major depression, although physicians generally request tests for physical conditions that may cause similar symptoms. The most common time of onset is between the ages of 20 and 30 years, with a later peak between 30 and 40 years.” Wikipedia
The most common treatment for MDD is the use of antidepressants, especially Selective Serotonin Reuptake Inhibitors, or SSRIs. Most popular among these being Zoloft and Prozac. When combined with psychotherapy, the results of treatment for MDD can be as high as 70% remission of major depressive symptoms.
Other types of depression
Long thought to be normal baby blues, Postpartum Depression (PPD) is now recognized to affect 10-20% of new mothers. More and more physicians are now providing routine screenings for Postpartum Mood Disorders allowing women to get help earlier when they are most vulnerable.
Symptoms of PPD or PPMD include: sadness, fatigue, changes in sleeping and eating patterns, reduced libido, crying episodes, anxiety, and irritability. In addition, some women may have difficulty bonding and feeling connected with their baby and struggle with deep feelings of guilt and obsessive and scary thoughts. Studies have even found evidence of PPD in new fathers. Although medications can again be helpful, women often have to weigh the benefits and risks if they are breastfeeding. Supportive Counseling is generally recommended to build coping skills and facilitate postpartum adjustment recovery.
Seasonal Affective Disorder
Seasonal Affective Disorder, with the highly descriptive acronym SAD, once considered a mood disorder in its own right and related to the changing seasons, has been reclassified as what is known as a “specifier,” a type of qualifier for those with a depression which is more severe at certain times of the year. During the winter months when daylight is shortened and people spend more time indoors, many people experience an increase in feelings of depression, and have less energy and motivation. Some studies have shown Light Therapy and vitamin supplements to be helpful in easing symptoms of SAD.
While not as severe as a major depressive disorder, Dysthymia is a related form of depression which can lead to feelings of generalized indifference and melancholy. A pernicious condition, Dysthymia is characterized by a chronic lack of energy and motivation, periods of low self-esteem, and the inability to experience pleasure on a daily basis. Often, people will not seek treatment for this type of low-level depression, thinking instead that it is “just the way I am.” Yet counseling and therapy can be extremely helpful both in understanding the nature of their depression and beliefs about themselves, and can build new ways of coping and looking at themselves and their world.
Symptoms of depression can also be brought on by life stressors and life transitions; including divorce, loss, retirement, job or family changes. As with any emotional struggle, the sooner a person recognizes their distress and reaches out for help, the sooner they can move toward feeling better.
For more on my approach to treating Depression, please visit my Therapy and Counseling for Depression and Anxiety page.
If you live in the Monmouth County, New Jersey area, and are finding it difficult to cope with the pain depression, please contact me today for a consultation at my convenient Shrewsbury office.
BARBARA FANE, LCSW, BCD
THERAPY and COUNSELING SERVICES