Treatments For Depression

高危人群抑鬱症

2008-04-17T02:05:00.001-07:00

誰最有可能發展的抑鬱症？
據統計發病率顯示，婦女是主要的高危人群，確診為抑鬱症，至少是男子的兩倍。不過，這些統計數據可能有缺陷。一些專家指出，男人變得沮喪正如常作為婦女，但是，因為我們的社會期望男人會非常激烈，布雷和剛性上三緘其口，他們中的許多人覺得很難談的情緒困擾，或者示弱，而且更有可能比女人依傍'自我治療'與酒精或毒品，而不是訪問他們的家庭醫生。此外，男人是最有可能比女性重視社會的恥辱，以抑鬱症，因此不太願意承認自己是消沉。

有什麼其他群體處於危險之中的抑鬱症？
不奇怪的是，老人在機構，無論是長期護理或急症醫療設施，往往是嚴重抑鬱。概率，在這之間的10 ％和290 ％以上的人有抑鬱症;其他來源的雙重這項估計。

什麼是抑鬱症徵兆，在十幾歲？
它可以甚至更難被偵測到，在抑鬱症的青少年，因為這個發展階段的特點是相當的憤怒和撤出。心理學家坐在家長應隨時留意，為抑鬱症的時候，少年輟學，他們最喜愛的活動，降低學校，濫用藥物或溶劑中，尤其是談論死亡或自殺。

我如何能幫助保持憂鬱，從捲土重來

2008-04-13T21:18:00.000-07:00

最慘淡的人都覺得明顯好於後， 1或2個月的治療。不幸的是，抑鬱症有時回報特別是如果治療，如抗抑鬱藥物是停下還為時過早。一旦事情更好，你可以幫忙留意，為早日減退的跡象。如果抑鬱症開始悄悄回到一個人的生活，朋友或家人可能是第一個通告。你可以當場線索像睡眠問題，煩躁或退出社會狀況進一步惡化。當事情進展順利，它可能是一個好主意，一起坐下來，使名單預警跡象或線索，抑鬱症是恢復。談論一個時間表，定期進行自我評價一樣，在未來的文章" ，保持了收益和防止復發" 。它的最好aggress事先如何，你可以把你的關注，在最有用的方法。如果您已擬定一項計劃，在前面，你就能更遑論警告標誌的抑鬱而不似危急。我怎樣才能得到幫助？令人鼓舞的經常性活動物理和社會活動是有效的天然抗抑鬱藥物。抑鬱症水渠遠離能源和動機，所以抑鬱的人往往退出愉快的活動，使他們愉快或建立他們的信心。您能幫助人們的一個合作夥伴。嘗試附表一些有價值的每一天（例如，體力活動，娛樂或社交活動）。確定一個具體的時間，不採取"不"這個答案。啟動慢，但不斷穩步向前發展。提供了很多的鼓勵，並採取輕鬆就批評。有助於把山回molehills 以人感到沮喪，每道看起來像一個陡峭的上坡攀登。日常問題似乎十分熱烈，令它的努力開始得到任何解決辦法。即使是一點點的幫助，您能幫助收縮的一些問題下降至一個可管理的大小。這裡有一些簡單的步驟如下： 1 ）打破一個大問題分成小塊2 ）決定哪一部分的問題，以採取先3 ）確定一個或兩個小步驟，開始與4 ）確定一個具體的時間和地點獲得盯著

抑鬱症和其他疾病

2008-04-11T03:30:00.002-07:00

沒事兒，那是可悲的被壓抑。但它不是致命的，是吧？
可以。是有一個堅強有力協會之間的抑鬱症和身體上的疾病。研究表明，抑鬱個人有更多的身體疾病和使用醫療設施多的人，他們不消沉。
最近的一項研究對2組的醫院病人，其中抑鬱症和一個沒有發現，平均逗留時間為集團與抑鬱症是10天時間，亦較非抑鬱組。研究匹配人民的嚴重性，在身體上的疾病已導致其住院。

為什麼抑鬱症會導致身體上的疾病嗎？
因果關係，目前尚不清楚，而很明顯的關係會隨身體上的疾病的結果。不過，有相當多的證據表明存在一個嚴重憂鬱症患者，可以抑制免疫系統。此外，抑鬱症，可導致不健康的行為，例如酗酒，加劇了身體問題已經存在。
舉例來說，許多最近的研究發現，成人糖尿病患者的3倍更有可能被壓抑比成人的人沒有得到糖尿病。雖然現在還不清楚為什麼一些糖尿病的人得到沮喪，有的沒有，這是大家都知道的人，糖尿病人患上抑鬱症有更多的問題與血糖控制的，大概是因為他們不遵守作為忠實指引。由於貧窮糖尿病控制，往往會導致增加醫療並發症，這樣的人有較高的機會，發展更多的物理問題。

誰是最大的風險自殺呢？
自殺率較舊人，該集團的80至84歲，是比目前增加一倍率為一般人群傳播。老年男性則是風險最高。大部分這些男子患有他們首發的抑鬱症，這是唯一中度嚴重的，但他們的症狀去未被和未經處理的。

怎麼樣的孩子？他們在自殺的危險性呢？
自殺仍屬罕見，在兒童根據年齡為12歲。然而，許多兒童年齡介於5日和14日自殺，每年還有更多的嘗試。自殺率之間的青少年，年齡在15歲至19日增加了兩倍，在過去30年。自殺已成為死亡的第二大原因是老年少年。

我怎樣才能知道如果我是抑鬱？

2008-04-11T03:30:00.001-07:00

抑鬱症是一種綜合徵，或星座的症狀和體徵。一個很好的，並廣泛採用的一套標準診斷抑鬱症是包含在一個正式的美國出版物，診斷與統計手冊精神失常（ DMS的第四部分）的美國精神病學協會。這些準則，是用以和接受英國精神病學家，是
1 。抑鬱情緒（有時表現為煩躁不安，在兒童和青少年）一天的大部分時間，幾乎每天都有。
2 。顯著減少利息或高興在所有或幾乎所有的活動，一天的大部分時間，幾乎每天都有（如由主觀賬戶或他人的觀察受影響的人的冷漠態度，大部分的時間）。
3 。顯著的體重減輕或增益時，不節食（ 5 ％以上的體重在1個月內），或減少/增加食慾幾乎每天都有。（一個孩子，這是衡量條款未能符合預期增重）。
4 。失眠或hypersomnia幾乎每天都有。
5 。心理攪拌或精神發育遲滯，是一個不正常的加快或放慢的一個人的活動和心理過程中，幾乎每天都有，作為觀察其他（不只是主觀的感受，情緒不安，或正在放緩）。
6 。疲勞或損失能量，幾乎每天都有。
7 。感情不值錢，或過量或不適當的罪惡感（可能是錯覺），幾乎每一天（不僅僅是自我責備或罪惡感約生病）
8 。削弱思維能力或集中，或者猶豫不決，幾乎每天都有。
9 。經常思考死（不只是懼怕死亡），或自殺，沒有一個具體的計劃，而自殺。

我需要有這些症狀，要考慮抑鬱？
號資格成為痛苦的一個主要抑鬱症，你必須經歷至少5的症狀，在同一2週時期。此外，至少在第一個或第二個症狀必須在場。和條件，絕不可有正常的反應，舉例來說，最近去世的一位親人。
不是每個人的是沮喪的經驗，每一個症狀。有些人的經驗，少數症狀，有的很多。此外，嚴重的症狀不同，在個人和同種抑鬱從他們的痛苦。

防止復發

2008-04-11T03:29:00.000-07:00

每個人我認識的人有親身經歷的一個插曲的抑鬱症是可以理解的，恐怕連想回到通過該種地獄。在所有的可能性，你會不會來，如果你知道你將面臨的打擊，並準備採取行動。

持續或反复幕窪地上面介紹的情況非常普遍，所以這是很重要的把注意力集中在防止復發。有三個主要的途徑我想與你討論。

直接行動：這是非常有幫助的，以獲得清晰的了解，尤其是生活中的情況或事件，引發了抑鬱症，為你在過去的。或許最常見的情況，導致抑鬱症目前正在困擾，在人際關係，你可能會加以利用，忽視或虐待。另一套共同的活動可能誘發抑鬱症是減少參與有意義的活動（教堂，娛樂的追求，志願者工作等），健康的關係和社會參與提供了一個持續來源，有意義的生活情趣。如果讓其繼續惡化，這些wellsprings生命力的，可幹起來逐比特，逐步推回到抑鬱症。

想到這樣說：如果有一個火在你的家中，你可以打開窗戶，並讓出一些煙霧-但它的一個臨時解決方案。這是更好地撲滅大火直接。採取行動，直接改變生活的情況下，可能會挑起抑鬱症是一個重要組成部分，防止復發。我闡述了明顯？也許是。但太多太多的人產生了巨大的能力，更還是少忽視這些問題的情況，直到他們達到危機程度。

我想鼓勵你們採取這個角度來看，反而說： "我有責任向自己，以避免發生憂鬱症，在我的生活中，由於這樣做的一個辦法，我作出了承諾，就看任何及所有生命的情況下，有可能會傷害我在感情上，然後盡我所能直接解決這些問題，如果這些問題不容易解決，但我會考慮看到一個治療師，幫助我制定了一項行動計劃，我的情緒福祉就是在這裡，我不是願意忽視這些問題，如果他們來了我的生命" 。

如果關係問題，是從源頭上的窘迫，可能採取的行動是積極尋求解決這一問題，是劃分你。如果問題是嚴重的關係是非常重要的（例如，你的婚姻），解決的最佳方法是通過心理治療或婚姻輔導。

如果問題是缺乏有效的社會交往或社會人士參與，當然，更是直接：涉足。找人，在小群體中，有著共同的利益：教會，義工服務組織，音樂團體，業餘愛好俱樂部，體育，戲劇，社會團體...

Trends In Teen Depression: Part 2

2008-04-10T00:59:00.000-07:00

Trends in teen depression

Speech therapy
Psychological treatment, can make use of a cognitive or interpersonal approach to exploration activities and emotions, are suffering a teenage children. It can also help to develop new skills.

Recognizing that cognitive therapy, emotional health, and the mode of thinking and beliefs of the world and ideas, depression, trends in teen depression may be pessimistic and leading, the expected negative harmful consequences.

"I do not want to dance, because I believe that people will laugh I was stupid and said:" 14-year-old Danny to his treatment. "Every other children seem to know how to act, but I have two left, I would prefer to stay at home watching TV."

Cognitive therapy will help Danny knows his fear is to create a self-fulfilling prophecy, and teaches positive way of thinking for themselves and others. These conditions may include, for example, dance lessons and / or duplication of Affirmation, said: "I am very free and easy lovely", the day before on many occasions, is a mirror.

Interpersonal therapy focuses on practical problems and the development of healthy relationships,trends in teen depression at home and in schools. It can teach coping mechanisms loss and rejection, there are two important social problems of young people, or how to get along with their parents and brothers and sisters. It also helps young people cope with stress reduction and.

To Danny, is a focus of his fear of being rejected by his friend. Of the time may be spent role-playing with his treatment, to formulate a strategy to criticism. Because self-esteem improved, one part of the lift he is suffering from, he may attend another dance.

Collective psychological treatment

Cognitive and interpersonal therapy and the youth can occur in individual meetings or group settings with trends in teen depression. Each has its own advantages and many therapists prefer to allow customers to determine which format is more productive.

My experience is that most of the young people surveyed, but depressed, not to treat voluntary. Unlike their adult counterparts, they are not found in this area of their depressive symptoms do not damage their quality of life. When a reporter asked them why they were in the treatment, the answer is probably "she" (mother) or the "he" (father), so I came.

At this point, the meetings of the panel are often equally threatening, and can be taught social skills, in a more relaxed and less humiliating environment. Respect for the rules of sharing (not suspended), is forced, but unlike adults, food and beverages can be served, kids can sit on the ground or walking, and to encourage them to link treatment and the other between sessions.

This "relaxation" the classic rules of the collective psychological treatment, mainly for the purpose of the experience of "lighter", and trends in teen depression encourages deep, depression, juvenile find fun. The irritable young people have the opportunity to move some of the energy and unloading, are still listening to, as a part of the Group.

Family meetings are often used to supplement group, as are separate. Referral can be made to a doctor for evaluation of antidepressant drug treatment, if necessary.

Treatment of Adolescent Depression has come a long way in the past 10 years. When we know more about the natural, social, and emotional causes of this confusion for trends in teen depression, and even greater progress will be in the future.

Trends In Teen Depression: Part 1

2008-04-10T00:54:00.000-07:00

Trends in teen depression

Today, we recognize that depression is often from about 2.0% in early childhood education and the pre-adolescent and 5 per cent of the young people suffering from this disease. We also know that depression in young people, which is different from adults and some treatment modalities, but also may be different.

Trends in teen depression: Young people are not small adults
Depression has always been regarded as an adult disorder is characterized by loss of interest in life. In its extreme form, the patient's experience, the time and slow down the ability to think, and often go to bed as a safe haven. Appetite, desire, and communication, other people may have been seriously jeopardized. Even breathe may find difficult because of despair, fill every hole.

Depression in children and adolescents is not always manifested in the case. Instead of being sad and debilitating, depression, youth, trends in teen depression include excitement and irritability, physical symptoms, such as headache, stomach pain, or even to put forward and out of a depressed mood.

And adult depression usually their anger inward eyes, a flat emotional tone, or influence. Their teenage counterparts may be further acquisitions, friends and family members in the smallest things. "This is because, although I want to have everyone stay away from this is close to me, saying:" a recovering youth. "This I can do, which is to behave like a clean and jerk."

The most dismal of adults, there is a name for their mental disorder, I do not know when the "Great Depression" hit the target. Teenagers, is not because of a well-educated on the feelings and somatize (express their emotions through their body), rather than words. Therefore, trends in teen depression might be your child saying "I am the head injury" or "My stomach pain," saying: "I am hurt." Unfortunately, these complaints are often drug treatment, rather than treatment.

Finally, the adults is a serious depression usually continuously depressed. Teenage responsive to their external environment, and regularly leave their grief behind; a sign of trends in teen depression. Thus, a depressed young people, they are successful tickets, see a famous music groups, can enjoy the excitement of sprint / happiness before and during the competition concert, and then back to their homes in the emotional darkness.

Diagnosis may be difficult for doctors young people, because of these factors. The good news is that effective treatment of mental therapy, for those who can be properly identified as depression.

Getting Help For Depression

2008-04-10T00:09:00.001-07:00

Finding effective treatment for depression often starts with a visit to a health profession who specializes in primary care, typically a physician, nurse practitioner, or physician assistant. You know that fluctuations in mood are a normal part of life, but you may not be sure how to distinguish between ordinary sadness and depression that’s serious enough to warrant medical treatment or counseling. Talking with your doctor can help you decide.

Choosing a Doctor
Doctors frequently help patients deal with depression. The key is to choose one who makes you feel comfortable when discussing your problems and who is skilled in diagnosing and treating depression. If after talking to your doctor you don’t feel confident that the two of you can form a partnership to manage your depression, you may want to try someone else.

Communicating with your doctor
Talking with your doctor isn’t always easy. The two of you may sometimes have different ideas about what’s important. You may be nervous, or you may worry that you have a serious medical problem but feel afraid to ask about it. Maybe you want to discuss something but feel embarrassed to bring it up. Or you may be convinced that you’ll a hurry and doesn’t have enough time for them.
Fours steps can taken to prevent communication problems between you and your doctor:
1) Come prepared
2) Ask questins
3) Discuss problems
4) Ask for educational material

The Depression Helpbook Wayne Katon, M.D., Evette Ludman Ph.D., Gregory E. Simon, M.D., M.P.H.

Maintaining gains and Prevent Relapse

2008-04-08T17:31:00.000-07:00

Can Depression Return?
Most people with depression do get better after several months, or even sooner with effective treatment. Unfortunately, your depression may return months or years later. More than half the people who recover from an episode of major depression will have another episode someday. Three out of four people who have suffered from two or more episodes will expensive another one eventually.

Reducing the Risk of Relapse
Experiencing several episodes of depression in the past does not mean you are doomed to feel depression again. But it does not mean that you need to pay attention to your moods. Maintaining your gains and preventing a recurrence will require that you use these to hone self care skills

A Relapse Prevention Plan: Stress Reduction and Self Monitoring
A Relapse Prevention Plan that focuses on stress reduction and self monitoring can reduce the chance of recurrence. Your plan will permit you to intervene early, when you first begin to feel depressed and before your depression becomes severe.

Keep Doing What Works
Keep up successful depression fighting strategies such as increasing your pleasurable activities and maintaining a healthy lifestyle. These strategies will help protect you against being overwhelmed by the problems we all experience.

To take inventory of the problems that can trigger your depression, and the strategies that have helped you deal with tem, ask yourself:
1) What are some of my everyday stress builders
2) What coping strategies have worked for me in the past
3) Which strategies do I think will be most useful for combating my everyday problems
4) Are these skills that I can use everyday or very week
5) How can I remind myself to use these skills daily or weekly

The goal is to build these strategies into your day so that you can minimize the effects of life’s annoyances. Try to identify three or four specific acts that help you. Be realistic about what you can and will follow up on. The more specific you can, the more likely you are too follow through.

The Depression Helpbook Wayne Katon, M.D., Evette Ludman Ph.D., Gregory E. Simon, M.D., M.P.H.

How Can I Help Keep Depression From Coming Back

2008-04-07T00:19:00.001-07:00

Most depressed people feel significantly better after 1 or 2 months of treatment. Unfortunately, depression sometimes returns especially if treatment such as antidepressant medication is stopped too early.

Once things are better, you can help by watching out for early waning signs. If depression starts to creep back into someone’s life, friends or family may be the first to notice. You may spot clues like sleep problems, irritability or withdrawal from social situations.

When things are going well, it might be a good idea to sit down together to make a list of early warning signs or clues that depression is resuming. Talk about a schedule for regular self evaluations like the next articles “ Maintaining gains and Prevent Relapse”. It’s best to aggress in advance about how you can bring up your concerns in the most helpful way. If you’ve worked out a plan in advance, you’ll be able to mention warning signs of depression without seeming critical.

How Can I Get Help?
Encouraging Regular Activity
Physical and social activity are effective natural antidepressants. Depression drains away energy and motivation, so depressed people often withdraw from enjoyable activity that bring them pleasure or build their confidence.

You can help by being a partner. Try to schedule something rewarding every day (for example, physical activity, entertainment or social activities). Set a specific time and don’t take “no” for an answer. Start slowly, but keep a steady pace. Offer lots of encouragement, and take it easy on the criticism.

Help Turn Mountains Back Into Molehills
To someone who feels depressed, every road looks like a steep uphill climb. Daily problems seem so overwhelming that it’s hard to get started on any solutions. Even a little bit of help from you can help shrink some of those problems down to a manageable size.
Here are some simple steps to follow:
1) Break a large problem down into small pieces
2) Decide which part of the problem to taken on first
3) Identify one or two small steps to start with
4) Set a specific time and place to get stared

The Depression Helpbook Wayne Katon, M.D., Evette Ludman Ph.D., Gregory E. Simon, M.D., M.P.H.

Managing Depression Day By Day

2008-04-04T01:21:00.000-07:00

Self Care Essentials
Learning to manage your depression is much like managing other things in life. You need to be able to
1) Stand bank and look at your problems objectively
2) Set realistic goals and keep them in sight
3) Look at all the possible ways of solving a problem
4) Decide which solutions to try
5) Evaluate which solution are most effective and, if necessary, adjust them or try other solutions
6) Reward yourself to the progress you make

Self care for depression does not mean do-it-yourself treatment. But it does mean taking personal responsibility by try out new solutions to your problems, learning what works for you, and sticking with a plan to control depression and prevent relapse. Your first attempt to solve a problem may not work, and you many need to try something different. Developing self care skills usually helps people with depression achieve a better quality of life.

Monitoring Your Symptoms
How can you find out what works for you? One way is to keep track of your depression symptoms. Monitoring your symptoms helps you learn what works for you and what doesn’t. Monitoring can also be an early warning system that will alert you quickly if you are starting to get worse.

Using the list below make a check mark next to the symptoms that have bothered you more often than not in the past week. This is your baseline or starting point. You will be able to assess your status by comparing this baseline number with the number of symptoms you check at any other time.

Symptom Checklist For Recognizing Depression
____ Feeling sad, blue, irritable or tearful
____ Trouble sleeping or sleeping too much
____ Fatigue or loss of energy
____ Feeling slowed down or restless and unable to sit still
____ Changes in appetite or weight loss or gain
____ Loss of interest in activities you normally enjoy
____ Feeling worthless or guilty
____ Feeling pessimistic or hopeless
____ Problems concentrating or thinking
____ Thoughts of death or suicide
____ Aches and pains such as headache, stomach, back pain
____ Increased anxiety and tension or anxiety attacks.

The Depression Helpbook Wayne Katon, M.D., Evette Ludman Ph.D., Gregory E. Simon, M.D., M.P.H.

Risk Groups For Depression

2008-04-02T08:02:00.000-07:00

Who’s most likely to develop depression?
As the statistics on incidence show, women are the primary risk group, diagnosed with depression at least twice as often as men. But these statistics might well be flawed. Some experts point out that men become depressed just as often as women but that, because our society expects men to be tough mined and stiff upper lipped, many of them find it difficult to talk about emotional distress or to show weakness, and are more likely than women to fall back on ‘self treatment’ with alcohol or narcotics rather than visit their GP. Furthermore, men are most likely than women to attach a social stigma to depression, and thus are less willing to admit they are depressed.

What other groups are at risk of depression?
Not surprisingly, elderly people in institutions, whether long term care or acute care facilities, are often severely depressed. The probability in that between 10% and 290% of these people have a major depressive disorders; other sources double this estimate.

What are the signs of depression in a teenage?
It can be even harder to detect depression in teenagers because this developmental stage is characterized by considerable anger and withdrawal. Psychologists sat that parents should be on the look out for depression when teenagers drop their favorite activities, cut school, abuse drugs or solvents and in particular talk of death or suicide.

Depression - Sandra Salmans

Depression and Other Illness

2008-04-01T00:03:00.000-07:00

All right, it’s is miserable to be depressed. But it isn’t fatal, is it?
It can be. There is a strong association between major depressive disorder and physical illness. Studies show that depressed individuals have more physical illnesses and use medical facilities more than people who aren’t depressed.
A recent study of 2 groups of hospital patients, one with depression and one without, found that the average length of stay for the group with depression was 10 days longer than for the non depressed group. The study matched people for severity in the physical illness which had led to their hospitalization.

Why would depression lead to physical illness?
The cause and effect relationship isn’t clear, and obviously the relationship varies with physical illness that results. But there is considerable evidence that the presence of a major depressive disorder can suppressed the immune system. In addition, depression can lead to unhealthy behavior, such as heavy drinking, which exacerbates physical problems already present.
For example, numerous recent studies have found that adults with diabetes are three times more likely to be depressed than adults who haven’t got diabetes. While it’s not clear why some people with diabetes get depressed and others don’t, it is known that the people with diabetes who are depressed have more problems with blood sugar control, presumably because they don’t adhere as faithfully to the guidelines. Since poor diabetic control tends to lead to increased medical complications, such people have a higher chance of developing more physical problems.

Who is at greatest risk of committing suicide?
The suicide rate among older people, the group of 80 to 84 year old, is more than double the rate for the general population. Elderly while men are at highest risk. Most of these men are suffering from their first episode of major depression, which is only moderately severe, but their symptoms go unrecognized and untreated.

What about children? Are they at risk of suicide?
Suicide is still rare in children under the age of 12. However, many children between the ages of 5 and 14 commit suicide each year, and many more attempt it. The rate of suicide among teenagers aged 15 to 19 has trebled in the past 30 years. Suicide has become the second leading cause of death among older teenagers.

Depression - Sandra Salmans

Incidence of Depression

2008-03-31T00:19:00.000-07:00

How common is depression?
It is certainly common. It has been called ‘the common cold of mental illness’ and, like the cold, it’s difficult to quantify. One has to be careful about psychiatric statistics, as these are very difficult to obtain. There is no clearly definable boundary between normality and disorder, between simple unhappiness and clinical depression. Epidemiological studies suggest, however, that in Britain the prevalence of depression is about 3% for men and about 7% for women. Other studies estimates lifetime prevalence to be much higher, up to 26% for women and 12% for men. Mood disorders, including depression, are also the most common single reason for referral to psychiatrists.

Why is depression increasing?
It could be just that the spotlight is on it now, and that it’s being diagnosed and studied more intently. Other possible reasons which have been suggested included increased drug and alcohol use, rising stress levels and increasing unemployment. Another possible cause is changing social and personal attitudes and beliefs. Some psychologists hold that our materialistic society has developed an unhealthy focus on ‘the self’ and that individuals are excessively concerned with their own gratifications and losses rather than with bigger issues. In the absence of commitment to family, community, country or religious, for instance, personal failures seem catastrophic and depression is inevitable.

Depression - Sandra Salmans

Becoming Aware of Your Cognitive Distortions

2008-03-30T23:02:00.000-07:00

Many times people are not aware of the inner thinking that occurs during times of emotional pain. What is noticeable is the feeling. An important and effective method of becoming aware of cognitions involves using feelings as signals or cues. Here's a step you can put into action the next time you notice an unpleasant feeling. As soon as you notice such a feeling - for example, sadness or frustration - use this emotion to let you know, "OK, something is going on in my mind." Then ask yourself one or more of the following questions:

"What is going through my mind right now?"
"What am I thinking?"
"What am I telling myself?"
"What am I perceiving about the situation that triggered this feeling?"

This is very important step. It's fairly simple, but often requires considerable practice. It is difficult if not impossible to change feelings directly, but you can very effectively alter your cognitions with practice. In order to do so, the first step is to make these inner thoughts and perceptions clear in your mind.

Remember, to become aware: sense a feeling, tune into thoughts, ask the questions and find the thought behind the feeling.

Challenging Your Distortion

The most effective way to directly alter maladaptive cognitions is to get a piece of paper and draw a line down the middle. After you ask yourself, "What is going through my mind?" jot down all thoughts, word for word, on the left hand side of the sheet. Dr. Burns, Dr. Aaron Beck, and other cognitive therapists have referred to these initial thoughts/perceptions as "automatic thoughts," because they flow through our minds so rapidly as to seem automatic.

The next step is to look at the thoughts, and ask these questions: "Does this sound like a cognitive distortion?" and, "Is this thought accurate and realistic?"

The next step is to challenge the thought. Your goal is to force yourself to evaluate situations or yourself in a realistic way, keeping in mind that the ultimate goal behind challenging cognitions is to reduce excessive or unnecessary emotional pain.

I want to emphasize that your goal is not to gloss over or sugar-coat your perceptions of reality. It is important to squarely face reality, even painful events.

In this situation, you might say to yourself, "That sounds like I am jumping to conclusions. What are the facts? I know they are late. I don't know why. There are many possible reasons that they are late. It's possible they were in an accident, but I don't know that for sure."

YOU CAN BEAT DEPRESSION, DR. JOHN PRESTON

Forms of Depressive Illness

2008-03-28T00:14:00.000-07:00

Are there different forms of depression apart from major depressive disorder?
Yes. There are a great many forms of depression, and numerous terms to describe them, some of them overlapping. For example, the term ‘clinical depression’ is used to characterize any depression where symptoms are severe and lasting enough to required treatment. The most common form of clinical depression is major depressive disorder.
There’s also a more severe form of major depression known as melancholic depression. DSM-IV defines melancholic depression as a condition in which the individual has lost interest or pleasure in all, or almost all, activities, and doesn’t improve, even temporarily, when something good happens. It’s a state of complete anhedonia, the inability to experience pleasure. By contrast, most people with classic major depressive disorder are able to be cheered up and even become animated temporarily.

Is melancholic depression the most serious type of major depression?
No, there is a condition known as psychotic depression, or depression with psychotic features, which carries a major risk of suicide. People with psychotic depression have delusions or hallucinations, usually consistent with their predominant mood. For example, a person may have the delusion that he or she has sinned in an unforgivable way. As many as 15% of people with major depression disorders develop psychotic depression.

Are there other kinds of depression?
There is an anomalous disorder known as atypical depression, which, despite its name, is not uncommon. It turns the typical symptoms of depression upside down. While people with typical depression sleep and eat less than normal, people with atypical depression tend to oversleep, overeat and gain weight rapidly.
Atypical depression tends to be persistent (chronic) rather than periodic, and usually dates from adolescence. People with this condition may show little energy or interest in anything, and are extremely sensitive to rejection, particularly romantic rejection.

Aren’t there some people who get depressed only in winter?
Yes. Some people suffer from a condition known as seasonal affective disorder (SAD), which usually begins in the autumn and lifts dramatically in the spring. People with SAD report that their depression worsens the further north they live and the more overcast the weather. While SAD has been linked mainly to dark winter days, in some cases, it’s been associated with dark indoor workplaces, unseasonable cloudy spells and vision difficulties.
Some expert believe the high rate of alcoholism and suicide in northern countries such as Sweden may be due to SAD. Other doctors, however, say that the idea of SAD as a formal medical concept is seriously flawed.

Depression - Sandra Salmans

How can I tell if I’m depressed?

2008-03-27T00:35:00.000-07:00

Depression is a syndrome, or a constellation of signs and symptoms. An excellent and widely used set of criteria for diagnosing depression is that contained in an official American publication, the Diagnostic and Statistical Manual of Mental Disorders (DMS-IV) of the American Psychiatric Association. These criteria, which are used and accepted by British psychiatrists, are
1. Depressed mood (sometimes manifesting as irritability in children and adolescents) most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated either by subjective accounts or others’ observation of the affected person’s apathy most of the time).
3. Significant weight loss or gain when not dieting (more than 5% of body weight in a month) , or decrease / increase in appetite nearly every day. (In a child, this is measured in terms of failure to meet expected weight gains.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or psychomotor retardation, an abnormal speeding up or slowing down of one’s activities and mental processes, nearly every day, as observed by others (not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthless or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. Diminish ability to think or concentrate, or indecisiveness, nearly every day.
9. Recurrent thoughts of death (not just fear of dying) or of suicide without a specific plan for committing suicide.

Do I have to have all these symptoms to be considered depressed?
No. To qualify as suffering a major depression disorder, you must experience at least 5 of the symptoms during the same 2 week period. In additional, at least the first or second symptom must be present. And the condition must not be a normal reaction to, for example, the recent death of a loved one.
Not everyone who is depressed experiences every symptom. Some people experience a few symptoms, some many. Also, the severity of symptoms varies within individuals and with the kinds of depression from which they’re suffering.

Depression - Sandra Salmans

Getting Down to Depression

2008-03-26T03:42:00.000-07:00

What is depression?
It might be better to say immediately what depression is not. It’s not just feeling temporarily ‘blue’ or ‘down in the dumps’. It’s more than being sad or felling intense grief after the loss of a loved one. Sadness and grief are normal and relatively temporary reactions to life’s stresses. In a comparatively short time (days, weeks, or in some cases, slightly longer) these types of moods lift, and the person is able to function normally again.
In contrast, depression often referred to as clinical depression, mood disorder or affective disorder, affects people for many months or even years. Depressive illness affect feelings, thoughts, behavior and physical wellbeing.

How serious is depression, really?
Doctors describe depression as a disorder requiring intervention and treatment, just as any physical illness would. There is general agreement that clinical depression is the most incapacitating of all chronic conditions, in terms of social functioning. It ranks second only to advanced heart disease in exacting a physical toll, measured by days in bed and bodily upset. It is more disabling than many of the major chronic organic disorders, and its economic cost, in terms of lost working time and poor performance, is enormous. Most serious of all is the high incidence of suicide among suffers.

Are there certain psychosomatic problems characteristic of depression?It’s common for people with depressive disorders to complain to their doctors about recurring headaches, backaches, abdominal pain, chronic fatigue, insomnia or indigestion. It’s been found that 70% to 90% of people who seek medical help for irritable Bowel Syndrome, a very common gastrointestinal disorder characterize by loose and frequent stools, also have psychiatric problems, usually depression.

Depression - Sandra Salmans

Preventing Relapse

2008-03-26T02:48:00.000-07:00

Everyone I've known who has lived through an episode of major depression understandably is afraid even to think of going back through that kind of hell again. In all likelihood you won't have to if you know what you're up against and are prepared to take action.

The continuous or repeated episodic depressions described above are very common, so it is important to focus our attention on relapse prevention. There are three primary approaches I'd like to discuss with you.

Direct Action: It's very helpful to get clear about the particular life circumstances or events that have triggered depression for you in the past. Perhaps the most common situations that lead to depression are ongoing, troubled relationships in which you may be taken advantage of, ignored or mistreated. Another common set of events that may ignite depression is reduced involvement in meaningful activities (church, recreational pursuits, volunteer work, etc.) Healthy relationship and social involvements provide an ongoing source of meaningfulness in life. If allowed to deteriorate, these wellsprings of vitality may dry up bit-by-bit, gradually pushing you back into depression.

Think of it this way: If there is a fire in your home, you can just open the windows and let out some of the smoke - but it's a temporary solution. It's better to extinguish the fire directly. Taking action directly to alter life circumstances that may provoke depression is an important part of relapse prevention. Am I stating the obvious? Perhaps. But far too many people have a tremendous capacity to more-or-less ignore such problem situations until they reach a crisis level.

I'd like to encourage you to adopt this perspective instead: "I owe it to myself to prevent recurrence of depression in my life. As one way to do this, I'm making a commitment to be on watch for any and all life circumstances that have the potential to hurt me emotionally, and then to do my best to directly address them. If the problems are not easily resolved, I'll consider seeing a therapist to help me formulate a plan of action. My emotional well-being is at stake here, and I'm not willing to ignore such issues if they come up in my life."

If relationship problems are the source of distress, maybe the action to take is to actively pursue resolution of the issues that are dividing you. If the issues are serious and the relationship is very important (e.g. your marriage), resolution might best be accomplished through psychotherapy or marital counseling.

If the problem is a lack of social contacts or community involvement, the course is even more direct: get involved again. Seek out people in small groups with common interests: church, volunteer service organizations, music groups, hobby clubs, sports, theater, social group...

YOU CAN BEAT DEPRESSION, DR. JOHN PRESTON

Types of Mental Health Therapists

2008-03-24T02:46:00.000-07:00

Psychiatrist (M.D.): Psychiatrists are medical doctors who have received specialized training in the treatment of emotional problems, including both medication and psychological treatments. (It is possible for a physician to practice psychiatry without specialized training, however very few do so. Again, it is appropriate to ask about any professional's background of training and experience in dealing with your condition.) Most psychiatrists treat depression and other emotional disorders with medications. Some psychiatrists also can provide psychotherapy, behavior therapy, or cognitive therapy. "Board certification" is an advanced designation granted by the profession to those psychiatrists who are especially well prepared.

Non-Medical Psychotherapists: These professionals treat emotional problems using various non-medical, psychological approaches (such as psychotherapy, cognitive therapy, behavior therapy). Many non-medical psychotherapists are well versed in psychiatric diagnosis and can make referrals for medication treatment. They do not prescribe medication, however (there are exceptions to this in some states). Among the non-medical specialists:

Psychologists: Hold a doctorate degree in psychology (Ph.D., Psy.D., Ed.D.), have three or four years postgraduate training in psychological methods, and in most states are licensed to practice. They also have specialized training in the administration and interpretation of psychological tests. The most advanced designation for a psychologist is that of "Diplomate" of the American Board of Examiners in Professional Psychology.
Clinical Social Workers: Generally hold a masters degree (M.S.W.), have considerable supervised experience, and are usually licensed by the state (hence the designation, "L.C.S.W." - Licensed Clinical Social Worker).
Marriage, Family and Child Counselors/Therapists: Some states grant a license to Marriage, Family and Child Counselors (or Marriage, Family and Child Therapists). Such therapists generally have at least a masters degree in counseling (M.A. or M.S.), usually with specialization in treatment of marriage and family problems or problems of children and adolescents.
Mental Health Counselors: Some states also provide licensing for Mental Health Counselors. These therapists generally hold a masters or doctors degree in psychology or counseling.
Pastoral Counselors: Some clergy have received training in counseling and may provide supportive therapy to members of their church or to others desiring a therapists who addresses both emotional and spiritual concerns.

YOU CAN BEAT DEPRESSION, DR. JOHN PRESTON

Get Moving

2008-03-21T03:48:00.000-07:00

Regular exercise is one of the most important and powerful things you can do to decrease depression. Regular exercise (especially aerobic-level exercise) has been associated with increases of certain brain chemicals - endorphins and serotonin - both of which can reduce depressive symptoms. Also, exercise has been clearly shown to have a positive impact on sleep.

Recent research suggest that the "dose" of exercise necessary to combat depression is thirty minutes, three to four times a week. It is important to be certain that the intensity of exercise required is in keeping with one's fitness level (i.e., for less fit people, walking if fine, while jogging, swimming, or running is appropriate for those who are in better athletic shape). This strategy alone has been shown to reduce depression after two to three months of exercising or it may be a useful adjunct to antidepressant medication treatment and relapse prevention. For a "quick fix", try ten to fifteen minutes of brisk walking (this often can reduce negative thinking, low energy, and depressive mood almost immediately, and the effects can last for sixty to ninety minutes). Daily exercise in the form of three ten-minute periods of exercise may also be preferable to the thirty minutes, three to four times-a-week strategy for this purpose. It is prudent to consult your primary health care professional before beginning any rigorous exercise program, even if the goal is to counter depression.

Most people who are depressed find it very difficult to get started with an exercise program. It's especially hard to do it on your own. However, joining a class or getting into regular exercise with a friend or relative can make getting started easier. Doing so may be one of the single most important actions you can take to combat depression.

YOU CAN BEAT DEPRESSION, DR. JOHN PRESTION

Support Groups

2008-03-20T02:17:00.001-07:00

Mental health organizations run support groups for sufferers of unipolar and bipolar depression, and also for their friends and family. When I inquired about attending the friends and family group run by the Mood Disorders Support Group in New York City, I was put by mistake in a support group for depression sufferers. I was in good spirits at the time, but at the end of an evening spent with people so drained by their illness, I could hardly sit upright. Three weeks later, in the right group at last, I discovered that a well-run friends and family group can be an emotional godsend and a source of invaluable advice; if there is such a group within striking distance of your home, take advantage of it. The group's facilitator had taken a mandatory course in the treatment of depressive illness and was a walking encyclopedia. His skill and compassion made every weekly session a lesson in how to cope with fallout, and soon transformed me from observer into active participant.

However, attendees at depression group may, if their depression is mild, react as I did to three hours in the company of people far worse off and complain that they don't want to sit around with a bunch of "deadbeats" who speak in a monotone. But they will also see firsthand how devastating the illness can be, which in turn can translate into a determination to control their own. The more severely afflicted will feel a sense of solidarity that is invaluable in dispelling the guilt and social isolation that depression fosters. A support group is also a repository of information about old and new medications, side effects, good and bad doctors, insurance, and coping skills. Members know the importance of complying with treatment and are better at policing backsliders than are family members. The most likely to backslide are the bipolar sufferers, whose illness alternates between heady ups and dismal downs and is difficult to control.

DEPRESSION FALLOUT, ANNE SHEFFIELD

Biological Factors That Cause Depression: Part 1

2008-03-18T20:34:00.000-07:00

Medication Side Effects
Some prescription medications can inadvertently cause a change in the chemistry of the brain that triggers a severe biological depression. Such side effects are relatively rare, but they do occasionally occur. If there is no logical reason for depression (i.e., no major life changes or losses) and the onset of depression followed the beginning of treatment with medication, then the medication is suspect. In such cases, the physician who prescribed the medication should be contacted.

Drugs that May Cause Depression:

Anti-Hypertensives (for high blood pressure or migraine headaches)

Generic names:

Reserpine (Serpasil, Ser-Ap-Es, Sandril)
Propranolol hydrochloride (Inderal)
Methyldopa (Aldomet)
Guanethidine sulfate (Ismelin sulfate)
Clonidine hydrochloride (Catapress)
Hydralazine hydrochloride (Apresoline hydrochloride)

Corticosteroids

Generic names:

Cortisone Acetate (Cortone)

Hormones

Generic names:

Estrogen (Evex, Menrium, Femest)
Progesterone (Lipo-Lutin, Progestasert, Proluton)

Antiparkinsons

Generic names:

Levodopa & carbidopa (Sinemet)
Levodopa (Dopar, Larodopa)
Amantadine hydrochloride (Symmetrel)

Anti-anxiety Drugs

Generic names:

Diazepam (Valium)
Chlordiazepoxide and others (Librium)

Birth Control Pills

(Various brand names)

Chronic Drug and/or Alcohol Abuse

A second common cause of biological depression is long term or heavy use of alcohol or other drugs. Certain so-called recreational drugs, for example cocaine and amphetamines, are well known for their ability to produce euphoria. However, with long term abuse, many drug users will experience serious depressive symptoms when they come down from a drug "high." Even more common is the effect of long-term or heavy alcohol abuse. Alcohol can produce very severe depressions; often such depressions lift after several weeks once alcohol use is stopped. (Note: If you have been using alcohol heavily and decide to stop, this should generally be done with medical assistance and guidance to avoid withdrawal symptoms).

Physical Illness

The third biological trigger for depression, physical illness, can contribute to depression in two ways. They may cause brain-chemistry changes, and/or one may become depressed because of the effect of the illness. For example, a person with arthritis may have to endure daily physical pain. Serious heart problems cause people to dramatically alter their lifestyles. A person with a terminal illness will be facing increasing diability and death. Any such debilitating physical illness is likely to trigger psychological/emotional responses. However, in addition to these expected emotional reactions to illness, such disorders may actually cause chemical changes in the brain that set off a biological depression.

Thyroid disease is likely the most common medical cause for depression (possibly being a factor in up to 10 percent of people with major depression). Especially common and often missed is sub-clinical hypothyroidism which is diagnosed by a blood test which shows an elevation of TSH (thyroid stimulating hormone). Because of its high prevalence rate, it is good idea for all people experiencing depression to have basic thyroid screening.

YOU CAN BEAT DEPRESSION, DR. JOHN PRESTON

Psychological Symptoms of Depression: Part 2

2008-03-17T23:22:00.000-07:00

Interpersonal Problems: When people are depressed, they often become especially sensitive to criticism or rejection. They may feel uncomfortable or inadequate around other people, or experience increased feelings of loneliness. Depressed people may not feel "Okay" about being assertive (i.e. it may be hard to stand up for yourself, to voice your opinions, feelings or beliefs, to ask others for help or support, or to say "no"). Many people have these problems when they are not depressed, but such concerns become more intense during depression. Also, some people are relatively at ease with others most of the time, and notice these problems only when depressed. One depressed man told me, "I usually feel fine when talking with others but lately I've lost confidence in myself. I worry about how I'm coming across, I feel inhibited about saying what I really think or feel. I feel as if there is something wrong with me."

Guilt Feelings: It is normal and appropriate to experience feelings of regret or remorse when you make a mistake or inadvertently hurt someone. However as Dr. David Burns has pointed out, guilt is a feeling that contains not only regret or remorse, but also a belief that "I am a bad person." It is this belief in a "badness of self" that makes guilt a painful and destructive emotion.

Negative Thinking: The term "cognitive distortions" is used by psychologists to refer to a tendency to think in negative and pessimistic ways. (Cognitions are thoughts and perceptions.) Distortions or errors in thinking and perceiving are seen in almost all types of depression. As a person begins to feel depressed, thoughts and perceptions become extremely negative and pessimistic. Such distortions not only are a symptom of depression but also are a major cause of depression, and in fact are probably the most potent factor that prolongs and intensifies depression.

Suicidal Thoughts: Thoughts about suicide are extremely common in depression. Although most people who think about suicide do not commit suicide, nevertheless, suicidal ideas must always be taken seriously. Most of the time, suicidal ideas reflect a view of the future which is colored by excessive pessimism and a sense of hopelessness.

YOU CAN BEAT DEPRESSION, DR.JOHN PRESTON

Psychological Symptoms of Depression: Part 1

2008-03-17T22:45:00.001-07:00

Sadness and Despair: Often these are the symptoms of depression that hurt the most and are most noticeable. Other related feelings may include feelings of emptiness, disappointment, gloom, feeling "down" of "blue". Heaviness - especially in the put of the stomach - and literal "heartache" are physical aspects of this symptom. About forty percent of people experiencing serious depression do not really feel sad. Rather, the primary change in mood is to begin feeling very irritable and easily frustrated. In such cases, even very minor problems or frustrations may feel overwhelming and may lead to outbursts of temper and irritability. Many people suffering from depression do not feel especially sad or depressed, but when asked "Are you happy?" The answer clearly is "No."

Low Self-Esteem: includes feelings of worthlessness, inadequacy, lack of self-confidence, and self-hatred. "I can't do it," "I'm no good," and "I never do anything right" are examples of self-talk which are common amoung people who low self-esteem. These folks have often grown up unable to please themselves, their parents, their teachers. They have often experienced failure in school, in relationships, in sports, and on the job. They typically value other people above themselves, and usually defer to others' opinions and guidance. Sometimes the feelings are temporary - perhaps in relation to losing a job or relationship - but often they are a lifelong burden.

Apathy is the lack of motivation to do things, social withdrawal, decreased level of activity, and/or restriction of life activities. This symptom can, in itself, lead to more serious problems in a sort of depressive vicious cycle. For instance, feeling apathetic could lead you to conclude, "What's the use, I just don't feel like going out and being with others." Yet failure to engage in social or recreational activities eventually leads to life's becoming more and more void of enjoyable, meaningful activities. A life relatively empty of pleasure is felt by some researchers to be a major cause of depression. Also decreased activity itself leads to physical changes, like fatigue and constipation, which cause additional discomfort.

YOU CAN BEAT DEPRESSION, DR.JOHN PRESTON