Major Depressive Disorder: Recognizing Symptoms, Triggers, & Aspects for Treatment

Now that we are in the full swing of summer, it is a time for family and friends to come together and celebrate. Summer time provides us with the opportunity to take that overdue vacation, relax, and decompress from our hectic lives and enjoy ourselves! However, for some, this time may trigger feelings of sadness and loss as they may serve as painful reminders of loved ones who are no longer with us.

Perhaps you have suffered a major loss such as a breakup, divorce, separation, or experienced the death of someone close to you? These negative life events can be extremely stressful and difficult to cope with. But how can you tell if you are just 'down-in-the-dumps' and 'feeling blue' or may be experiencing something more serious like Major Depression?
Major depression is considered a serious medical condition and may be present when five (or more) of the following symptoms occur within the same 2-week period (or longer) and represent a significant change in functioning:
Symptoms of Major Depression
-Depressed Mood, Sadness, Feelings of Worthlessness, Emptiness, or Hopelessness
-Inappropriate Feelings of Guilt, Overly Sensitive to Criticism / Feelings of Rejection, Uncontrollable Crying, Loss of Self-Esteem or Self-Blame
-Irritability, Agitation, Increased Feelings of Restlessness, Difficulty Controlling Temper
[Note: In children and adolescents they may present with symptoms of irritable mood rather than depressed or sad mood]

-Apathy, Lack of Motivation, Boredom, Loss of Interest in Friends, Family or Lack of Enjoyment in Activities that were Previously Enjoyed
-Unexplained or Increased Body Aches / Pains
-Isolation, Avoidance, or Social Withdrawal
-Poor Appetite or Overeating; Change in Appetite with Weight Loss or Gain
-Insomnia or Excessive Sleeping
-Fatigue, Lethargy, Excessive Tiredness, Loss of Energy, Decreased Sex Drive
-Difficulty Concentrating, Forgetfulness, Poor Memory, or Indecisiveness
-Significant Decrease in Work / School Performance, Trouble Completing Tasks, Neglect of Responsibilities, Hygiene or Appearance
-Passive Thoughts of Suicide / Comments about Death / Excessive Feelings of Guilt (e.g., "I wish I was never born", "I am bad", or "Everything is my fault")
-Suicidal Thoughts, Comments, or Threats (e.g., "It would be better if I was not here", "I want out", or "No one cares if I live or die")
-Specific Plan for Committing Suicide or Suicide Attempt
-Self-Injury or Reckless Behavior

*NOTE: Seek Help Immediately if You or Someone You Know Has Thoughts of Suicide - call 911 or report to Emergency Room and inform them that you need immediate assistance.

National Suicide Prevention Lifelines:
1-800-273-TALK (1-800-273-8255)
1-800-SUICIDE (1-800-784-2433)
1-888-SUICIDE (1-888-784-2433)
1-877-SUICIDA (1-877-784-2432) (Spanish)
Common Triggers of Depression
Death of a loved one
Divorce
Job Loss
Financial Problems
Change in Health
New Baby in the Family
Move / Relocation
Change in Job / School
Family Conflict
Retirement
Substance Abuse
Isolation
Aging
Family History of Depression
Organic Causes
Low Levels of Serotonin, Norepinephrine, or Dopamine
Postpartum, Pre-menstrual, and Postnatal Hormone Changes
Genetic Basis / Positive Family History of Depression
High Levels of Cortisol
Prescription Drugs such as Reserpine, Beta-Blockers, Alpha-Methyldopa, Levodopa, Estrogens
Substance Abuse / Substance Dependence
Toxic-Metabolic Conditions such as Hyperthyroidism, Hypothyroidism, Cushing's syndrome, Hypercalcemia, Hyponatremia, Diabetes Mellitus
Neurological Conditions such as Stroke, Subdural Hematoma, Multiple Sclerosis, Brain Tumor, Parkinson's disease, Huntington's Disease, Uncontrolled Epilepsy, Syphilis, Dementia
Nutritional Deficiencies


Treatment for Depression
Anti-Depressant Medication: can ease symptoms of depression and allow you to return to normal functioning. However, it is important to note that medication alone will not cure the root cause(s) of your depression.
Cognitive-Behavioral Therapy (CBT): Cognitive-Behavioral Therapy is an empirically supported treatment that focuses on patterns of thinking that are maladaptive and the beliefs that underlie such thinking. People who seek CBT can expect their therapist to be active, problem-focused, and goal-directed.

Visit Your Doctor: It is important to evaluate whether your depression may be caused by an underlying medical condition; which will require an evaluation with a licensed mental health practitioner, psychiatrist, or medical doctor to assess your treatment needs. Because depression can vary in severity, your depressive symptoms may require treatment involving a combination of medication management and mental health counseling. For severe depression, this may require more intensive treatment such as hospitalization or intensive outpatient / partial hospitalization.

Patience with Anti-Depressant Medication: This can be difficult for some people as they are initially tried on anti-depressants and work with their physician to find the right medication, dose, or combination of anti-depressant medication.
You may experience some initial side effects; which are typically mild and eventually lessen over time. Regular communication with your healthcare provider will ensure that the medications are working to ease your symptoms. Keep in mind that anti-depressants need time to build up in your system before they reach therapeutic levels...it may take up to 4 - 6 weeks before you begin to feel better and experience a lessening of your depressive symptoms.
Medication and Counseling - The "Gold Standard" Although medication can quickly relieve some of the symptoms of depression, research has shown that other treatments, including counseling, regular exercise, and maintaining a healthy diet can also be effective in treating symptoms of depression. If you decide to try anti-depressant medication, please remember that medication works best when augmented with counseling as well.

Lifestyle Changes To Help Depression
Exercise: is an effective way to prevent the symptoms of depression. Regular exercise helps boost serotonin, endorphins, and other neurotransmitters that help regulate your moods by triggering the growth of cells and connections within the brain, similar to the way anti-depressant medications work.
Social Support: People who suffer from depression may isolate themselves or withdrawal from family and friends; which can exacerbate symptoms of depression. While you are depressed it is important to surround yourself with family and friends. Consider volunteering, joining a class, or a depression support group to ensure that you receive sufficient support and enhance your social interaction with others.
Sleep: has a significant impact on our mood. Depression can worsen if we do not get enough restorative sleep. If you become sleep deprived (or sleep too much), this can increase feelings of irritability, mood instability, and general fatigue. To ensure that you are getting enough rest, try to get at least 7 - 8 hours of sleep per night.
Reduce Stress: Make necessary changes in your life to ensure that you find healthy ways to effectively manage stress. Excessive or prolonged stress can worsen your depression and tax your immune system.

Nutrition: is important for both your physical and mental well-being. Eating small, well-balanced, nutritious meals throughout the day will help maintain your energy level and keep your moods stable.


Warm Regards,
Rich Schlauch, MSW, LISW-CP, LCSW

Palmetto Counseling & Consulting Services, LLC
454 S. Anderson Road
BTC Suite #115 Rock Hill, SC 29730-3392
Phone (803) 329-9639
www.palmettocounselingconsulting.com
email: info@palmettocounselingconsulting.com