Blue? Jack moves and talks slowly, sighing frequently. He has no complaints
about his life other than a few marital spats, but neither does he have
any enthusiasm for his work or home life. When asked if he's happy, he
says "I guess so; I'm getting by."
Lauren cries easily and often, feels anxious and scared, and has trouble
sleeping. She's confused and frustrated with her boyfriend; she hates
his criticism of her but feels intimidated and won't leave him because
she's afraid of being alone.
Harry's wife left him suddenly. He feels abandoned and alternates between
rage and hopelessness. He continues to go to work but withdraws from friends
and family and at times thinks of "ending it all".
Jack, Lauren and Harry are among the 4 to 8 million Americans who are
treated for depression every year. Their numbers are increasing, especially
among people born since 1940;in a recent poll, 52% of the adults questioned
admitted that they felt "lonely and depressed".
What is it? In practice, clinical depression tends to be defined by its
symptoms, which include:
· Feelings of helplessness, hopelessness, worthlessness and anxiety
· Poor concentration, confusion, forgetfulness or indecisiveness
· Decreased ability to enjoy life
· Sleeplessness or constant fatigue
· Loss of appetite or overeating
· Unusually slow or rapid speech and physical movements.
Depressed people are pessimists. Expecting the worst from life, they magnify
failures and minimize successes. They tend to blame themselves for anything
that goes wrong, even events over which they have no control.
factors may contribute to depression, among them personality characteristics;
chemical imbalances; genetic factors; learned patterns of behavior; stressful
life events; social or economic class; age and gender.
Learned helplessness, stemming from a lack of control over life, creates
chronic, low-level depression. When we believe we can't control what happens
to us and our actions repeatedly fail to produce desired results, we feel
helpless and become depressed.
Repressed anger can become depression. Chronically depressed people are
dependent upon love, approval, and reassurance from others because they
lack self-esteem. Fearing that expressing their anger will drive away
those they love, they often deny angry feelings, resulting in depression.
Reactive depressions occur in response to a loss of some kind. Job loss,
divorce, retirement, empty nest or completion of a major life goal can
trigger reactive depression. Depression may recur on the anniversary date
of these events.
HELPLESSNESS CAUSES DEPRESSION
Long recognized as a symptom of depression, an attitude of helplessness
can also cause depression.
animals placed in boxes where they received inescapable electric shock
soon gave up trying to escape. This helplessness persisted even when they
were later placed in boxes where they could escape the shock. In contrast,
animals that could control shocks did not become helpless.
with humans revealed dramatic parallels between experimentally induced
learned helplessness and major depressive symptoms. From these studies,
researchers concluded that when our actions make no impact and produce
no results, and when we attribute our failure to lack of ability, we feel
depressed and perform poorly.
to helplessness is influenced by-
· Success or failure of previous attempts to control life.
· Passivity. People who consistently "let life happen to them"
are at greater risk for feeling helpless than those who believe that they
control their own destiny.
· Sex role. Research shows clear parallels between the way girls
are raised and training for helplessness. One recent study suggests that
strongly stereotyped sex roles in either sex increases susceptibility
to learned helplessness.
· Low self-confidence. Seeing yourself as a "loser" and
a failure fosters development of helplessness.
MEN, WOMEN AND DEPRESSION
It is estimated that 1 in 4 women and 1 in 10 men will experience a serious
bout with depression at some point in their lives. Theories on why women
experience more depression include:
Women experience depression differently than men. Depressed women report
feelings of loneliness, helplessness, and despondency, and want external
reassurance. Men report more depression due to self-criticism and the
failure to live up to expectations. Mild depression in women is correlated
with the number of visits to physicians; for men, it correlates with absenteeism
Marriage seems to protect men against depression, but more married women
are depressed than single women. Research consistently finds that married
women are more depressed than married men, but widowed and never-married
men are more depressed than their female counterparts.
Loss of an emotional attachment is the single most frequent cause of depression
in women. Women tend to judge themselves by the quality of their relationships
with others and hold themselves responsible when relationships do not
go well. Too often, the failure of a relationship is equated with being
a failure, and depression is the result.
and women may have different expectations about life. Men seem to expect
that if all goes well, they won't experience major unhappiness; women
expect to be happy, leaving them open to greater disappointment and more
vulnerable to depression.
BEATING THE BLUES
80% of those suffering from depression can be helped. Psychotherapy (plus
anti-depressant medication when appropriate) relieves depressive symptoms,
keeps them from coming back, and helps clients function normally
Therapy for depression includes
· Recognition of the negative and self-destructive thoughts and
attitudes that both accompany and perpetuate depression.
· Replacement with more positive, optimistic attitudes.
· A positive relationship with a therapist who will not "
give up", no matter how depressed the client becomes.
· Support and encouragement for taking control over your life.
therapy offers the added advantages of feedback and encouragement from
other group members; a forum for learning and practicing interpersonal
skills, and the nucleus of a support group that can be carried into clients'
someone close to you is depressed
· Listen without being judgmental
· Offer alternatives for dealing with practical problems
· Tell them you care about them'
· Share daily activities such as meals, shopping or work tasks.
Avoid advising a depressed person to "cheer up" or "snap
out of it"; these statements may be interpreted to mean that you
think their depression is invalid, or a burden to you.
can lend moral support by accompanying a depressed friend or family member
on their first visit to the therapist. Your presence may be the extra
push needed to take that important first step toward getting help.
KIDS GET BLUE, TOO
children under the age of 12 suffer from depression. Because they can't
talk about their feelings as well as adults do, it can be more difficult
to diagnose childhood depression.
· Signs of depression in children include:
· Changes in sleeping/eating patterns
· School problems or refusal to go to school
· Unhappiness or talk of self-hatred
· Sadness lasting a week or longer
· Lack of enthusiasm for usual activity
· Any significant change in the child's usual behavior.
· Preoccupation with death, or
· Talk of suicide.
panic if your child is a little moody. While depression occurs more frequently
in children than was once believed, it is not epidemic.
To help your child avoid depression or weather it successfully
· Help your child like himself. Praise successes and provide extra
help when needed.
· Be alert to changes in your child's usual disposition, especially
if they last more than a week.
· Don't hide your feelings about family problems like divorce or
· Encourage your child to talk about what bothers him. Ask specific
questions and don't tease if the cause seems trivial to you.
· Take any mention of suicide seriously. Get professional help
for any child who talks about suicide.
Children imitate parents; depressed parents raise depressed children.
If you yourself are suffering from depression, protect your child by promptly
seeking professional help for yourself.
LET THE BLUES GET YOU DOWN
The quiet. Self-sufficient individual, who tends not to ask for help,
has a higher risk for suicide from depression than those who reach out
for support. Men who believe they should be emotionally self-sufficient
are particularly at risk for successfully concealing their depression
until suicide seems to be the only way out.
don't have to fight depression alone; willingness to seek outside help
shows emotional maturity. Depressed people often start to feel better
just from having taken action rather than remaining helpless. If you find
yourself thinking about suicide, psychotherapy is imperative.
can make even routine things seem enormous. If the task at hand seems
overwhelming, break it into smaller steps that are easier to handle. Instead
of looking at the task of getting a job for example, set a goal of making
one phone call or typing one page of your resume.
tends to isolate its victims. Push yourself to get involved in activities
that include other people, even if it's just going to a movie. You don't
have to be the life of the party; just get a little human contact.
you're depressed in reaction to a loss of any kind, respect your need
to grieve and give yourself adequate time to do so. Don't berate yourself,
saying "I should be over that by now." Trying to cut short your
time of mourning will only add to the length of time it takes to recover.
aerobic exercise that raises the heart rate for 20 minutes or more has
anti-depressant effects. Walking, jogging, tennis, weight lifting, and
other active exercise lift low spirits and also increase self-confidence.
depression can be brought about by certain physical illnesses and is associated
with others. Illnesses known to cause depression include thyroid disorders,
diabetes, some neurological disorders, multiple sclerosis and certain
vitamin deficiencies. Other, such as hepatitis, influenza, anemia, endocrine
problems, asthma, and many infectious diseases, are often associated with
DEPRESSION AND YOUR JOB
affects job performance and career advancement as well as personal lives.
Signs of on-the-job depression include lack of enthusiasm and initiative,
dependency on others for direction, and lack of ambition.
work environment itself can be depressing. Restrictive unsupportive job
situations that offer little chance for advancement increase vulnerability
of depression. Lack of recognition and rewards increase feelings of powerlessness
and resentment that feed depression.
employers actively support employees who seek help for depression. They
know that the time and money spent on treatment will result in increased
productivity and morale, and decreased employee turnover.
BLUE ARE YOU?
National Association for Mental Health defines depression as "an
emotional state of dejection and sadness, ranging from mild discouragement
and downheartedness to feelings of utter hopelessness and despair."
Normal low moods are separated from clinical depression by intensity,
severity, and duration of these symptoms: