Depression In bed, you toss and turn, unable to get a good
night’s sleep. You feel anxious and worried. There’s plenty to do, but the work
piles up because you feel listless and tired. You don’t even want to do anything
fun. Friends tell you to "pull yourself together," but you feel helpless and
hopeless. You have difficulty concentrating and making decisions. When you look
in the mirror, you hate yourself. You are definitely in one of life’s
valleys—you are depressed. Everyone gets the blues once in a
while. Emotional lows and highs are a normal part of life. The blues become
depression when you feel so sleepy and listless that you can’t function normally
in everyday life. Types of Depression
Depression can range from a mild panic to self-destructive or suicidal
behavior, It’s important to understand the various types of depression so that
you can recognize them. Depression occurs at all ages, although
major depressive episodes peak between the ages of 55 and 70 in men and 20 and
45 in women. About half of those who experience an episode of major depression
will have another within two years. For some people, episodes of depression are
separated by several years, while others suffer groups of episodes over a short
time span. Between episodes, such individuals feel well. Major
depressive disorder affects approximately 14.8 million American adults —or 6.7
percent of the U.S. population aged 18 years and older—in a given year. Major
depressive disorder is more common in women than in men. Although treatment can
help more than 80 percent of people with severe depression, most people with
depression do not seek treatment. ● Reactive depression.
This type of depression is a reaction to stressful events—divorce, death of a
loved one, a chronic illness, a personal tragedy, or even social isolation,
which the elderly frequently experience. The person is unable to recover
normally from the feelings associated with the event. Common feelings include
self-pity, pessimism, and loss of interest in life. It affects people of all
ages. ● Seasonal Affective Disorder (SAD). If you live in
the northern latitudes and suffer depression during the winter months, you may
suffer from seasonal affective disorder caused by a lack of exposure to
sunlight. Doctors aren’t sure exactly what physiological mechanisms are at work
in SAD, but they speculate that depressed feelings and other symptoms may be due
to an increase in the release of the hormone meltonin. SAD sufferers feel
lethargic and irritable. They may also suffer from chronic headaches, increased
appetite, weight gain, and an increased need for sleep. For unknown reasons, SAD
is truly a "woman’s depression," in that women make up 70 percent to 80 percent
of those affected. Since about half of all SAD sufferers have relatives who also
suffer from SAD or other emotional problems, researchers speculate that the
problem may be inherited. ● Biochemical depression.
Doctors aren’t sure why, but some people develop a biochemically based
depression sometime during midlife. It’s likely that this type of depression is
caused by biochemical problems within the brain. The problem usually responds
well to antidepressant medication. You may be more likely to develop this type
of chemical depression if other members of your family have also suffered from
this problem. ● Disease or drug-related depression. Some
diseases such as AIDS, stroke, chronic pain, and hypothyroidism
(甲状腺功能减退) can cause depression. In hypothyroidism, the thyroid
gland (甲状腺) malfunctions, leading to too little or no thyroid hormone
circulating in the bloodstream. In addition to depression, other symptoms of
hypothyroidism include fatigue, weakness, weight gain, impaired memory, and
shortness of breath. Fortunately, the depression and other symptoms of
hypothyroidism can be effectively treated with adequate doses of thyroid
hormone. Certain drugs such as alcohol, tranquilizers
(镇定剂), and heart and blood pressure medications, as well as withdrawal from some
street drugs like cocaine, can cause drug-related depression. Some women who
take birth control pills find the drugs make them irritable, anxious, and
depressed. And a deficiency in some nutrients has been linked to
depression. ● Teenage depression. Recognizing depression
in children is important. Depression in teenagers may appear somewhat different
from adult depression. The teenage years are a period of complicated conflicts
that lead many young people to develop negative self-esteem, anxieties, and
fears about their future. Some young people become overwhelmed by peer pressures
and feelings of isolation and powerlessness. Social expectations may be
unrealistic, and doing poorly in school can lead to a feeling of rejection. The
young person may have experienced a lack of support from family and other
significant people and a decrease in his or her ability to cope effectively. (As
is the case for adults, treatment for depression in teenagers may involve a
combination of therapies.) Causes of Depression
Depression may be related to many factors, including a family history of
depression, medical illnesses, alcohol, drugs, gender, and age. Additionally, an
individual’s self-confidence, personality traits—such as dependency on others or
perfectionism—and unrealistic expectations may lead to depression. Stressful
events, such as death of a spouse or loss of a job, also contribute to de
pression. Many people with major depression also suffer from intense
anxiety. ● Theories of Depression. There are many
theories about the causes of depression. The social learning theory, suggests
that lack of positive reinforcement from others may lead to negative
self-evaluation and a poor outlook for the future. The psychoanalytic theory,
suggests that a significant loss (such as of a parent) or a withdrawal of
affection in childhood (whether real or perceived) may lead to depression in
later life. Interpersonal theory emphasizes the importance of social connections
for good mental health. Other theories suggest that unrealistic expectations of
oneself and others and loss of sell-esteem are essential components leading to
depression. Some individuals may be biologically predisposed to
depression; in other words, they may have been born with a tendency to develop
depression. Researchers continue to investigate chemical reactions in the body
that are controlled by these genes. Depression often runs in families. For
example, if one identical twin suffers from depression, the other twin has a 70
percent chance of also having the illness. ● Environmental
Influences. Researchers view depression as the result of interaction between
environmental and biological factors. Depression can be endogenous (internally
caused) or exogenous (related to outside events). Major changes in one’s
environment, such as a move or job change, or any major loss, such as a divorce
or death of a loved one, can bring on depression. Feeling depressed in response
to these changes is normal, but when it becomes a severe long term condition
(longer than one month) and interferes with effective functioning, it requires
treatment. Some environmental factors relating to depression
include being unemployed, poor, elderly, or alone. Depression changes one’s way
of looking at ordinary life circumstances. A depressed person tends to
exaggerate negative aspects, which leads to feelings of hopelessness,
helplessness, and being overwhelmed. Symptoms of
Depression How do you recognize symptoms of depression in
yourself and others People who suffer from depression have a number of symptoms
nearly every day, all day, tor at least two weeks. De pressed people have
feelings of extreme sadness, hopelessness, despair, low self-worth, and
helplessness. For some people, depression is marked by anxiety, withdrawal from
others, loss of sleep or excessive need for sleep, constant fatigue, loss of
appetite or compulsive eating, loss of sexual desire, either lethargy or
agitation, an inability to concentrate and make decisions, and possibly
exaggerated feelings of guilt. Many depressed individuals have
mental and physical symptoms that seem endless and do not get better with happy
events or good news. Some depressed people are so disabled by their condition
that they don’t have enough energy to call a friend, relative, or medical
professional for help. If another person calls for them. these people may refuse
to go because they have no hope that they can be helped. However, family and
friends should keep trying to get the depressed person to seek help, because up
to 15 percent of those who suffer from severe clinical depression commit
suicide. Major depressive episodes happen to women earlier than men.