Depression


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Depression, aghh, depression. Just saying the word is such a debby downer (no pun intended), yet it is one of those words I've mentioned that are 'sexy diagnoses'. People use it as a term to describe, literally anything sometimes. Like it literally makes me cringe, how often people use the term per day, granted, they may not realize it but the word is thrown around so often and nonchalantly, it is time to put it to a stop.


Now, this is not to say we don't all slip once in a while, some more than others. Shit, I'm in the middle of midterm exams right now and starting term papers, having some future plans being put in the work for StephSpeaks and I have been dying to write but I simply haven't had the chance to and yesterday I caught myself saying "ugh, all of this stress is so f***ing depressing", in my head. Even though there is really nothing 'depressing' about that. Stressful and annoying, definitely, but not 'depressing'. It is very easy to use the term to describe a lot of things, but it does not make it appropriate.


People will receive their order wrong at McDonald's, realize when they get home that the order is incomplete and/or wrong and one of the first things they might think or say is, "ugh, how depressing". No, like that is so annoying *cringes*.


Everyone wants to talk about each other, rather than talking about real issues

Depression is a serious issue that cannot continue to be taken as lightheartedly as it continues to be. A lot of us feel low and sad at times, and that is fine, it is normal human emotions. Being sad is a normal reaction to difficult times in life. But usually, the sadness goes away within due time. However, we are not all diagnosed with ACTUAL depression, depression is different. Thus, why we should use the term less rather than using it as slang to describe sadness. Individuals who are diagnosed with a depressive disorder, experience manifestations of low moods much more often and they tend to persist longer.


Depression is one of the most common and serious mental health disorders in the United States. I am sure it is as big of an issue in other countries but not researched enough. Something I always find interesting is how depression is viewed in different societies. Little bit of a fun fact, did you know in rural regions of China do not necessarily 'believe' in depression or see it as the disorder it is. Not until recently did China begin to develop mental health services in vast rural areas of China due to the increase in suicides and cries for help.


As of February 2018, the National Center for Health Statistics (NCHS) Data Brief (www.cdc.gov) showed that more than 8 percent of adults over the age of 20 reported having depression during a given two-week period. Of that entire in totality, the prevalence of depression among women was twice as much than compared to men.


There have been differences in depression among men and women. In men, depression can manifest typically as tiredness, irritability, and anger. Men tend to abuse drugs and alcohol more than women. They also, contrary to popular belief, typically recognize that they are depressed but fail to seek help. One thing I cannot stand, is the ideology that men are less masculine when they share their emotions and thoughts. Men are just as likely to suffer from depression, but fail to seek help much too often because "it is not manly". Everyone needs to stop saying men should not be "little bitches", simply because they are expressing their internal concerns and conflicts. In women, depression tends to manifest as sadness, helplessness, worthlessness, and guilt. Adolescents tend to manifest depression as school refusal, anxiety when separated from parent(s), irritability, sulky, and end up getting into trouble at school. Frequently, it is co-morbid with anxiety, eating disorders, or substance use.


The data used from 2013-16 noted that the National Health and Nutrition Examination Survey, found that about 80 percent of adults with depression reported some, if not a lot, of problems achieving daily tasks. From that 80 percent, 50 percent of adults with depression reported to some degree, difficulty with work, home, or social activities because of their depressive symptoms.


Symptoms of major depression may include these symptoms:


  • Persistent sad, anxious or "emptiness"

  • Feelings of hopelessness

  • Pessimism

  • Feelings of guilt, worthlessness, helplessness

  • Loss of interest or pleasure in hobbies and activities

  • Lower sex drive

  • Decreased energy, fatigue, feeling "zombie" like

  • Difficulty concentrating, remembering, making decisions

  • Insomnia, early-morning awakening, or oversleeping

  • Low appetite and weight loss or overeating and weight gain

  • Thoughts of death or suicide, suicide attempts

  • Irritability

  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and pain for which no other underlying cause can be diagnosed


(List of symptoms were obtained via the Anxiety and Depression Association of America: https://adaa.org/understanding-anxiety/depression/symptoms)


Not everyone who is depressed experiences all the symptoms of depression described above. In order to be diagnosed with major depressive disorder or clinical depression, the individual must show at least five of the symptoms, persisting for over two weeks. The National Center for Health Statistics also found that the prevalence of depression did not differ by age and that the prevalence of depression decreased among families with low SES (Socioeconomic Status), income increased.



Chart obtained on the National Institute for Mental Health website: https://www.nimh.nih.gov/health/statistics/major-depression.shtml

More often times than not, you will notice I reiterate the importance of listening. As I have mentioned multiple times, in previous posts, listening is a big part of mental health recovery. But it also a big part of deciphering what people say and what they truly mean by it. Much too often, you will hear people around you say things subtly about how they are feeling (ex. "I just don't know what the point is anymore" or "soon enough this will all be over"). Social media has become a huge platform where sometimes, individuals say things that should raise flags, but rarely do others realize it or care to intervene.


Depression and mental health issues need to be humanized

Depression is stigmatized, we all know this. But self-stigma, is the worst stigma. Being depressed is a very vulnerable feeling. A feeling no one should have to experience but unfortunately, a lot of people do and their lives are affected by it. One too many people to this day, continue to believe that the long-lasting and overwhelming symptoms of depression are “not real” or that the person  should “try harder to be happier” and simply “get over it,” which sustains and enables the stigma of depression and mental health issues. If you are a friend or family member of a person with depression, you can offer emotional support, understanding to be patient, and encourage their bettering. You should never dismiss someone's feelings. That is how we discourage others from seeking help.


There is absolutely nothing wrong with seeking help for depression

Let's talk a little bit about different depressions. There are so many forms of depression, but the most commonly diagnosed form of depression is major depressive disorder. Most individuals with major depression also show some signs of anxiety. Depression is a mood disorder, therefore moods are prolonged and enhanced. Other depression disorders include disruptive mood, dysregulation disorder, persistent depressive disorder

(dysthymia), premenstrual dysphoric disorder, substance/medication-induced depressive (substance includes alcohol, folks) disorder, and depressive disorder due to another medical condition.


I wanted to touch base on premenstrual dysphoric disorder (PMDD) because as a woman, it is good to be informed on this, and very little women know about it and have possibly gone through multiple months of these feelings and don't realize it is an actual issue. I am sure most of my readers are women, so if you haven't heard of PMDD, let's get into it a little more. Even if you are a man, it should be known because I am sure a lot of us women have had our feelings belittled by men when we say we are feeling low or sad to our menstrual cycle. Premenstrual dysphoric disorder is a form of manifestation of depression which is severe and often times, an extension of, something all women are familiar with *drum roll* premenstrual syndrome (PMS). Imagine PMSing but literally 12 times worse (I am not exaggerating).


Typically PMDD can be self-diagnosed by just looking at the symptoms and criteria that must be met, in the DSM-5 (that's how I did, but I tend to research and look into things, if you haven't noticed I am obsessed with knowing things), but if symptoms are persistent and debilitating monthly, you should definitely see a doctor for it.


Although, we are all different physically and biologically, if you are anything like me, I literally begin to PMS 16 days before my period. I then begin to feel moments of extremely low moods and rapid fluctuations of moods, eight days before my period. Then the first two days of my period, I get super ridiculously sad. In both PMDD and PMS, symptoms usually begin seven to 10 days before the start of menstruating. Premenstrual dysphoric disorder is a set of not only physical and psychological symptoms that start about 7 to 10 days before a woman gets her monthly period. PMDD can intervene with your business and personal life. Although PMS and PMDD both have physical and emotional symptoms, the mood changes in PMDD are much more severe and can disrupt social, occupational, and other important areas of life.


If you are currently struggling with what might be PMDD, seek help from a therapist. There is nothing wrong with seeking help, especially when it is something that effects your daily life. The severeness of sadness, anxiety or tension, extreme moodiness, irritability or anger, can become crippling. Symptoms must be prevalent for at least one year.


Symptoms of Premenstrual Dysphoric Disorder: (American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: The American Psychiatric Association.)

  • Lasting irritability or anger that may affect other people

  • Feelings of sadness or despair, or even thoughts of suicide

  • Feelings of tension or anxiety

  • Panic attacks

  • Mood swings or crying often

  • Lack of interest in daily activities and relationships

  • Trouble thinking or focusing

  • Tiredness or low energy

  • Food cravings or binge eating

  • Trouble sleeping

  • Feeling out of control

  • Physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain


Severe depression, often times cannot be helped on its own. Although it is widely believed that a lack of serotonin plays a role in depression, there is little research to back up that hypothesis because there is no way to measure its levels in the living brain... All that is know is the correlation of low serotonin levels and depression, but correlation does not equal causation. Severe depression typically is treated through psychotherapy (talk therapy) or CBT (cognitive behavioral therapy). Individuals may sometimes be treated with antidepressants, called selective serotonin reuptake inhibitors (SSRIs). According to The Medical Letter (2003), SSRIs change serotonin levels in the brain. The Food and Drug Administration (FDA) approved three SSRIs to treat PMDD (p.45)


There is absolutely nothing wrong with seeking help for depression, or any other disorder. What is wrong is feeling like that and not having anyone to turn to or confide in, and we should all have someone to talk to. Depression can literally hurt you. If you feel like you may be depressed but do not necessarily want to reach out to anyone because you may be confused or conflicted with the thought of letting someone have a glimpse into your thoughts, it is always worth seeing a therapist or talking to a close friend. There is nothing shameful about having a diagnosis. People don't ask us "hey, do you have a diagnosis?" when you initially meet them. Even once you are close to an individual, rarely do they even ask how you are emotionally and mentally. Take care of yourself, never be ashamed of what you may be going through or may have gone through.





"Strength does not come from winning. Your struggles develop your strengths. When you go through hardships and decide not to surrender, that is strength. " - Arnold Schwarzenegger



Sources:

1. (The Medical Letter. (2003). Which SSRI?(link is external) Med Lett Drugs Ther; 45(1170):93-5)


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