DEPRESSION AND MOOD DISORDERS

Charles E. Martin, Ph.D.

Note:  This information is provided for informational purposes only.  It is not intended as treatment advice or to replace personal psychological care or medical attention if needed.  There is no substitute for the experience and judgment that a professional can provide to evaluate and treat any psychological,  emotional, mood, or mental problem face to face.  Many medical conditions have symptoms that are similar to psychological disorders and it is always good judgment to have a medical checkup as a first step.   If you are, or have been, in professional counseling or treatment and any information given in this site is contrary to advice you have received, you should consult your therapist or doctor.

Life is full of emotions.  Most of us feel both joy and sadness.  If, however, a period of sadness hangs on for weeks, gets more intense, or begins to interfere in daily activities, then it may be a kind of depression classified as Clinical Depression.  Having Clinical Depression doesn't mean a person is "crazy."  It merely means that they have a serious depression that needs attention and professional help.

The purpose of this web page is to acquaint you with the types of depression and other mood disorders, the symptoms that are usually present, and what can be done to get help.  There is also information about what families or friends can do to help a depressed person.

Depression vs. Sadness:

When is sadness, gloom or "feeling down" normal and when is it a more serious problem?  Clinical Depression differs from normal sadness or "the blues" in both the severity of symptoms and in duration.  Normal sadness usually does not affect all areas of a person's life and goes away in a few hours or days.  Sometimes a shopping trip or being with friends will cause sadness to disappear.  Clinical depression lasts for much longer periods of time and has more symptoms.  The rule of thumb is that if sadness lasts for longer than two weeks, it is probably clinical depression.  This type of depression often interferes with everyday functioning.  Clinical depression is a serious disorder which needs to be evaluated by a professional and usually requires some form of treatment.

The Types of Depression or Mood Disorders:

        Situational depression - occurs when the depression is a reaction to some event or circumstance in a person's life.  This form of depression is usually associated with some loss or perceived loss, such as loss of job, divorce, death, breakup of a relationship, or children leaving home.

        Biological depression - is caused by a chemical imbalance in the neurochemistry of the brain and is not associated with events occurring in a person's life.  

        Dysthymic Disorder - is a long term, sometimes serious, sometimes low grade, form of depression.  it often appears like a "depressed personality."  Often people with this disorder report feeling depressed most of their life, starting in childhood or teenage years.  The symptoms may not interfere with daily functioning, but the person just doesn't feel well.

        Cyclothymic Disorder - a mood disorder characterized by more than normal moodiness and changes of affect.  Often appears as an extremely moody person with mood shifts from serious depression to overly energetic and almost manic behavior.  However, the mood shifts are not enough to cause the individual to be unable to function.

        Bipolar Disorder - used to be called Manic-Depressive Disorder.  This is caused by a chemical imbalance in the brain and usually is characterized by periods of extremely low depression and feeling "at the bottom" which cycles into periods of boundless energy, grandiose planning, elated moods and being "on top of the world."  The mood shifts are so extreme as to cause the person to be unable to function, cope or make good judgment decisions.  The moods can cycle form one phase to another quite rapidly or very slowly, lasting for weeks or months.  Bipolar disorder almost always requires medication as part of treatment.

        Seasonal Affective Disorder - a kind of depression that results from changes in the body chemistry due to reduced periods of sunlight, and therefore more common during winter months and in northern areas.

        Post-partum Depression - may occur after the birth of a child and is often called the "baby blues."

        "Masked" Depressions - these are forms of depression that do not appear as depression on the surface, but have behaviors present that serve to treat, cover, or "mask" an underlying depression.  This is sometimes true of some forms of drinking, drug use, sexual acting out, some risk-taking behaviors, and other forms of self-destructive behavior. 

The Symptoms of Clinical Depression:

Following is a list of the most common symptoms of depression.  Most people will not experience all of these symptoms, but generally the more symptoms that are present, the more serious the depression probably is:

        (1) A sad or depressed mood most of the time

        (2)  Some form of sleep disturbance - either sleeping poorly or sleeping for long periods.  The sleep problems often occur as frequent awakenings during the night or early morning awakening.

        (3)  Some form of appetite disturbance (either loss of appetite or overeating to compensate for sad moods)

        (4)  Difficulties in concentration

        (5)  Loss of energy or feelings of fatigue

        (6)  Periods of crying or tearfulness

        (7)  Feeling hopeless or helpless

        (8)  Increased irritability, anger or hostility

        (9)  Difficulty making decisions

      (10)  Thoughts of suicide or death.

      (11)  Social withdrawal or isolation from friends or social acquaintances

      (12)  Loss of interest in activities that are usually pleasurable

      (13)  Physical problems that appear to have no medical cause

      (14)  Feelings of failure, worthlessness,  or excessive guilt

      (15)  Loss of sexual desire

      (16)  Memory problems

      (17)  Passive behavior

      (18)  Often results in inabilities to cope on the job or in the family

The Symptoms of Mania (in Bipolar Disorder):

        (1)  Elevated or excessively "high" mood

        (2)  Irritability or hostility

        (3)  High levels of energy

        (4)  Racing thoughts

        (5)  Decreased need for sleep

        (6)  Grandiose and expansive ideas

        (7)  Poor judgment

What to do about Depression or Mood Disorders:

The main thing is to get help.  Any of the mood disorders are serious because of both the possibility of suicidal thoughts or actions and the overall inabilities of the individual to cope with life.  

Depression may be evaluated and treated by a mental health professional: 

        Clinical Psychologist

        Psychiatrist

        Clinical Social Worker

or by your family physician.  The most important thing is not to let depression go undiagnosed or untreated.  Depression is a treatable disorder and can usually be helped.

What to expect during your initial session with Dr. Martin:

Many people are somewhat anxious or nervous during their first session.  This is quite normal.  Once you start, you will probably notice that your anxiety decreases as we begin to discuss the problems.  Dr. Martin will want to know the history of the depression -  how long it has been present, whether it appears to be connected to some situation in your life, the symptoms you are experiencing, and what has and has not helped.  As you both begin to zero in on the problem, Dr. Martin will suggest a strategy for treating it.  If relevant, he will also discuss the role medications might play in recovery and which professional should prescribe them.  

With the patient's permission, family members are always welcome to participate in either the initial or later sessions.  Often family involvement is very significant to helping depression improve. 

 Marriage Problems, Family Conflict, and Depression:

Often depression stems from marriage problems or conflict in relationships.  For additional information, click on the button below.  You will be taken to Dr. Martin's website which has information and Frequently Asked Questions concerning marriage and couples counseling.

What families or friends can do to help the depressed person:

                (1)  Be an action person.  Get the person to a mental health professional for evaluation and treatment.  If the depressed person won’t do it himself, take the initiative and make an appointment for him.  Go with him to the appointment if necessary.  Insist.  Be assertive.  Do whatever is necessary. 

                (2)  If he or she is already on medication, make sure they are taking the medication properly.

                (3)  Provide emotional support.  Point out the realities to them.  Depressed persons often do not see things is a realistic light.  Offer hope.  Get them to talk.  Talking helps tremendously.

                (4)  Be an action person by getting the person into activities.  Be an exercise partner.  Invite him to go walking, exercise, or do recreational activities such as movies.  One of the characteristics of depression is that it causes a kind of emotional paralysis.  The depressed person quits doing activities and often withdraws from friends.    

                (5)  Help them develop and keep a positive attitude.  A positive attitude, especially if laced with humor, is a wonderful antidote to depression.

                (6)  Make sure the person is eating properly.  Depression usually kills appetite, and the depressed person often loses a great deal of weight because they do not take in enough nourishment.  

                 (7)  Share personal struggles and victories.  Sharing stories of how you or others have overcome similar tragedies will be a source of strength.

                 (8)  Do not be afraid to ask about suicidal thoughts.  Often a person has fleeting suicidal thoughts but comes to terms with these feelings in a positive way.  Sometimes these thoughts are very frightening to them.  By approaching the subject, the person often feels relieved to talk about it.  Of course, if serious suicidal thoughts are present, you must get professional help immediately.  If a person is seriously suicidal, take them to the emergency room of any hospital.

                (9)  Don’t expect a depressed person  to “snap out of it” themselves.  They can't do this.  Don’t accuse them of being lazy, or just wanting attention.  Get them help.