Imagine going through your day with a sixty-pound weight on your back. It would make it much harder to get out of bed each morning, get dressed, go to work, and take care of chores around the house—not to mention, bathe, brush your teeth, cook a meal, exercise, and care for loved ones. Now imagine that in addition to having that sixty-pound weight on your back, you cannot concentrate, make decisions, or motivate yourself to even do things that you once found highly interesting and pleasurable. You feel sad most of the time, your eating and sleeping patterns have changed (eating and sleeping much more or much less), and you feel hopeless about your situation. In addition, you feel worthless about yourself and you may even begin to ruminate about death and dying.
These symptoms are typical for individuals who suffer from depression. Symptoms range from mild to severe and can be chronic or episodic. At times, severe symptoms may include psychotic features where the person experiences hallucinations and/or delusions while depressed. Major depression is very common. An estimated nineteen million American adults are affected annually. Women are twice as likely (6.5 percent) as men (3.3 percent) to suffer from this illness. The good news is that depression is treatable. A combination of medication and talk therapy has proven successful for millions of people in treating this problem. If you believe you are suffering from depression, you should talk to your doctor immediately. Research shows that when left untreated, depressed individuals will experience symptoms more frequently and with greater severity.
Unfortunately, Joanne, fell into this category. She began struggling with depression when she was in middle school. However, it was not until she took a psychology class during her fourth year of college that she realized she was clinically depressed. By this time, (over the course of a decade) she had already experienced over five major depressive episodes. Although she was happy to learn she could do something about it, she was frustrated that it had taken so long to discover she had a true problem.
At times Joanne’s symptoms were mild and at other times they were much more severe. Due to this fluctuation in severity, she assumed she was having normal mood shifts. In addition, since the more severe symptoms presented themselves during critical life events such as going away to college, her godmother’s death, and a breakup with her longtime boyfriend, she simply assumed that everyone felt as she did under similar circumstances. When she learned that her symptoms were not “normal,” she sought help from a therapist. Her therapist referred her for a medication evaluation and she was prescribed an anti-depressant, which helped tremendously. With her therapist, she was able to explore and identify the patterns in her life which led to major depression episodes. With the exception of only two times, each major depression coincided with a large stressor in her life. Her psychiatrist believed the episodes not linked to situational factors were probably onset by a chemical imbalance in the brain.
In therapy, Joanne learned how to manage her moods and what she needed to do in order to prevent the onset of depression. This included recognizing symptoms early on before they became severe. For Joanne, fatigue, difficulty sleeping, and loss of appetite and motivation were usual precursors to a major depressive episode. Identifying these early symptoms meant early prevention for her. Joanne called her psychiatrist each time she experienced these symptoms for recommendations/instructions on a possible medication adjustment. She would also set up additional sessions with her therapist to work on cognitive and behavioral interventions that would combat her depressive thinking and actions.
For example, Joanne would force herself to be more active during these times. She learned that physical activity (exercise) releases beta endorphins into the brain giving the individual a “natural high” and sense of calm. She made a point to eat healthier at these times and avoid sleep deprivation. Joanne knew that these basic necessities were imperative for both her physical and mental well-being; however, they are sometimes the hardest things to put into action. Remember, when people are depressed, it feels as if they have a sixty-pound weight on their back, their thought process is skewed, and their motivation is greatly decreased. Therefore, even these simple tasks are not easy to accomplish. Having support from others during this time, therefore, is extremely helpful. After all, even the non-depressed individual finds it easier to workout, eat healthy, and go to bed early when she has a friend or loved one doing it with her.
