Depression – What it looks like and What to do about it

“The National Institute for Mental Health has estimated that ten million people in the United States suffer from depression each year, and about two thirds of those do not get the help they need”.

Depression is a condition, which when detected and properly diagnosed is both manageable and treatable. Without proper intervention, depression can be cyclical and recurrent across our life span. There are many different classifications for depression but I will touch on the three primary types.

Major Depressive Disorder is characterized by the DSMIV (Diagnostic Statistical Manual for Mental Health Professionals) as:

• Persistent feelings of sadness most of the day, nearly every day
• Lack of interest or loss of pleasure in activities which one previously enjoyed
• Sleep and appetite disturbance
• Decreased energy, or increased restlessness or agitation
• Decreased ability to concentrate and make decisions
• Increased irritability
• Feelings of hopelessness and helplessness
• Feelings of excessive guilt and worthlessness
• Thoughts of death and dying

It is important to mention that an individual does not have to exhibit all the symptoms to meet the criteria for depression. In addition, depression can present itself differently with women, men and children. With men, excessive anger can, at times, be an indication of an underlying depression. While with children, an agitated type of depression may resemble ADHD, where the child is restless, fidgety and struggling to focus. There can also be an increase in aggressiveness with more yelling, crying and acting out behaviors.

A second type of depression is called BiPolar Disorder(or Manic Depression). With BiPolar Disorder, there are episodes of Major Depression, in addition to periods of mania. Mania can present differently depending on the person. Often individuals will experience increased energy, decreased need for sleep, become highly talkative, with racing thoughts and expansive ideas. There may be a sense of increased confidence and creativity, with grandiose thinking. Individuals may engage in behaviors to an extreme, that have potential for negative consequences (for example shopping excessively, sex, risky business ventures). It is important to mention that for some, their manic episodes are marked by extreme irritability, aggressiveness and erratic behaviors.

A third type of depression is called Dysthymia. The symptoms of Dysthymia are not as severe as with Major Depressive Disorder. There is a long term, persistent feeling of sadness, and an absence of true joy, but not to the extent that the individual is unable to function. Often people with Dysthymia do not realize they have a diagnosis. Rather they believe “it’s simply the way I am”. Dysthymia , once diagnosed, can have a good treatment outcome.

I would like to emphasize the value of a Depression Screening to detect and diagnose a mood disorder. Currently, we do offer a free Depression Screening at The Summit Counseling Center. This service is an opportunity to meet with a licensed therapist, who will conduct a careful assessment, including the use of diagnostic tools, which are then scored to insure we have an accurate diagnosis. Once this process has occurred, then appropriate treatment recommendations are provided.

A plan for treatment is determined by the severity, duration of symptoms, and type of depression an individual is experiencing. Studies have indicated that a very effective treatment approach for clinical depression is combining medication therapy and talking therapy. The medication, over time, is able to impact the depressive symptoms, often increasing a person’s energy so they may tackle the process of change. While the talking therapy provides support, self awareness and builds preventative, lasting skills that help the person effectively mange and take control of the depression – breaking the cycle and deflating its power. It can be so difficult to reach out and seek help, but doing so is a first step on a path towards change, and the opportunity for an improved, more joyful, more fulfilling quality of life.

Posted by: Danielle MacMillan, LCSW