Depression

Margaret McCraw, Ph.D


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Depression is rage spread thin - George Santayana
When we are angry or depressed in our creativity, we have misplaced our power. We have allowed someone else to determine our worth,?and then we are angry at being undervalued. ~ Julia Margaret Cameron

A Common Problem

Depression is a very complex and serious condition, which is not the same as being

Have you been really down for a long period of time, not understanding the reason for your bad moods and lack of energy? Are you isolating yourself from others because you never know how you will feel from one moment to the next? Have you noticed that friends and family members avoid spending time with you? Is living from day-to-day increasingly becoming a burden, with no light in sight? If you have answered yes to any of these questions, you may be experiencing a medical condition known as depression.

Chronic Pain and Depressive Illness

Major depression significantly affects a patient's family and friendships, school or work life, eating and sleeping habits, and general health.

Chronic pain and depressive illness are two of the most common health problems that health professionals encounter, yet only a small percentage of studies have investigated the relationship between these conditions (Currie and Wang, 2004).

Stress and anxiety stemming from chronic pain, is frequently the source causing a major depression. Researchers estimate that depressive illness and anxiety occur in 20% - 50% of patients with chronic pain (source - www.backandneck.about.com). Major depression is thought to be four times greater in people with chronic back pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992).

In a recent study it was found that the rate of major depression increased in a linear fashion with greater pain severity (Currie and Wang, 2004). It was also found that the combination of chronic back pain and depressive illness was associated with greater disability than either of the two conditions on their own.

There are key differences between chronic pain and acute pain. The nervous system processes chronic pain differently that acute or "immediate" pain. Acute pain occurs as a result of an incident or event, e.g. you fall down the steps and sprain your ankle. Chronic or "long term" pain happens over time and wears on the individual physically, emotionally, mentally and spiritually, often with no end in sight, causing the individual to feel more and more pessimistic. Pessimism is a persistent negative thought pattern, resulting in a sense of hopelessness, and severely damaging ones sense of well-being.

Our emotions stem from our thoughts. When our "habit of thought" is negative, our emotions spiral downward, lowering our mood, energy level and spirit. In my opinion, depressive illness, simply put, is an extension of pessimism.

The first step in changing these thought patterns and associated emotions is to understand what you are going through when experiencing a depression. The good news is you have the ability to make changes that will affect the way you feel and experience life on a day-to-day basis. Are you ready to release the depressive condition and re-experience having fun, laughter and pleasure with your family and friends? Of course you are, so read on to begin shifting your life in an upward and more positive direction.

What is a Depressive Disorder?

A depressive disorder is an illness that involves the whole person; mind, body, spirit and emotions. It affects the way a person perceives himself as well as his perceptions of the world, resulting in pessimism, hopelessness, sadness and often times anxiety. Depressive illness associated with chronic pain often stems from fear of not knowing how you will feel from moment-to-moment.

Common Myths about depression

The following are some common misconceptions which misguided people hold about depression. They believe, incorrectly that depressive problems are:-

  • is a personal weakness

  • reflects laziness or unwillingness to actively participate in life

  • is a diagnosis that is untreatable and incurable

These myths are unfounded and represent the opposite of the truth about depression.

How Widespread Is Depression?

Depression affects men and women, young and old and individuals of all races, cultures, religions and incomes. Depression can occur at any age. Studies sponsored by the National Institute of Mental Health (NIMH) estimate that approximately 6 percent of children ages 9 to 17 in the U.S., and 10 percent of American adults, or about 19 million people ages 18 and above, experience some form of depressive illness every year. Although available therapies alleviate symptoms in over 80 percent of those treated, less than half of these individuals receive medical intervention (NIMH fact sheet on depression and cancer, 2002).

The Personal Impact of Depression

This condition has a catastrophic impact on the idividual:-

  • It is one of the most common psychological problems, affecting nearly everyone through either personal experience or through association with a depressed family member or close friend

  • It often causes insomnia, leading to fatigue, and agitation

  • It often leads to social isolation

  • It frequently leads to less participation in life and less enjoyment of meaningful activities

  • It can lead to job dysfunction and inability to work, causing financial difficulties

  • If coupled with chronic back pain, it may cause gastrointestinal distress caused by anti-inflammatory medication, resulting in a feeling of mental "dullness"

  • It can create memory and concentration difficulties

  • It can cause a lack of interest in sexual activity, creating stress in one's intimate relationships

  • It can interfere with significant relationships with family, friends, business associates, neighbors and co-workers

  • It can limit one's ability to do household chores and care-taking of young children, resulting in spouses and older children taking over responsibilities that were once managed by the individual with depressive problems and back pain

The Societal Impact of the Condition

There is also a tremendous impact on society:

  • It is directly experienced by approximately 19 million adults in America alone (many children also experience depression)

  • It adversely affects the lives of 10% of the American population (source: Donald J. Franklin, Ph.D., www.psychologyinfo.com/depression)

  • It intrudes upon the lives of millions of people throughout the world

  • It is the leading cause of disability among developed nations, including the United States ( source: U.S. Department of Health and Human Services, Mental Health: A Report of the Surgeon General – Executive Summary, 1999)

  • It often reduces work productivity, attendance, efficiency and overall job effectiveness. The pessimism experienced by a depressed individual often leads to a lack of commitment, enthusiasm and ability to address details, which may lower the quality of one's work

  • It lowers productivity and impacts our economy, resulting in an estimated $44 billion a year loss

(source: Donald J. Franklin, Ph.D., www.psychologyinfo.com/depression)

Are You Depressed?

depression is thought to be caused by an imbalance of brain and is not just something the patient can just

It is important to understand that depressive conditions and sadness are different. The death of a loved one, loss of a relationship, termination of a job, including retirement, will cause us to feel sad. Grief is a normal response to these situations. Individuals experiencing challenging times will often remark that he or she feels depressed. However, sadness, grief and depressive illness are not the same. Feelings of sadness and grief will lessen with time while depression can continue for months and years, if untreated. Does this seem like you?

Read the following list and put a check mark next to each symptom that you are experiencing:

  • I am really sad most of the time

  • I don't enjoy doing the things I've always enjoyed doing

  • I have difficulty sleeping at night

  • I often feel fatigued

  • Getting up in the morning is challenging.

  • I feel better as the day goes on compared to when I first awoke

  • My eating habits have changed: Generally, I eat more than usual or I eat less than usual

  • I have very little, if any, sexual energy

  • I am very forgetful throughout the day

  • I find it hard to focus on the simple things of life. Even counting change has become challenging

  • I often feel angry

  • I feel anxious, and fearful with no apparent reason

  • I prefer to stay alone rather than socialize

  • I feel pessimistic about life in general, and am not sure I want to continue living

  • I feel disappointed in myself

  • I feel bad (physically and emotionally) most of the time

  • I have thoughts about my death

  • I think about how I might kill myself

If you checked any of these boxes, call your doctor. Take the list to your physician and discuss options for treatment, if necessary.

Source for list - National Institute of Mental Health/NIMH; some of the items in this list have been slightly revised; new items have been added from the original list provided by NIH. Continue to page 2 - Treating Depression


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