Wednesday, January 8, 2014

Winter Blues or Clinical Depression?

As colorful lights come down and fun-filled festivities end, the remainder of winter stares us in the face. It's a time when many people feel low or down.

Normally, people experience a wide range of moods. However, we generally feel in control of them. Understanding that such feelings are temporary, most people are not distressed by them. Blue periods are natural.

In fact, the "winter blues" may be more prevalent, regardless of age or gender, than previously thought according to a recent study. Participants reported more depression, anxiety, hostility, anger and irritability in winter than any other season. Even those not clinically depressed or suffering Seasonal Affective Disorder (SAD) can experience seasonal depression and other negative feelings. Transitory low periods are not serious; prolonged periods of feeling distressed are.

So what is the difference between "the blues" and a more serious case of depression?

Various disappointments and a calendar bereft of things to look forward to, compounded by bleak weather, can precipitate the blues. Certain life events like serious illness, job loss, death of a loved one, divorce, major financial reversal and the like negatively impact our lives. It's natural to grieve when such incidents occur. Normally, the associated feelings of sadness and loss decrease over time. Most of us move through these periods and on to better feelings. When feelings of sadness and loss don't go away, it's possible depression has set in.

Depression manifests itself in many ways. Sometimes the ways are outwardly obvious, sometimes not. The National Institute of Mental Health (NIMH) estimates 17 million American adults (some 10% of us) suffer from depression in any given year.

Many possible triggers can precipitate depression: relationship difficulties, memories of happier times, unfulfilled (sometimes unrealistic or lofty) expectations, loss of a loving relationship (may be the first holidays without them), anniversary of a happy or sad event, medical problems (one's own or another's), even weight gain.

Depression occurs when a person's feelings of despair, hopelessness and sadness extend for two weeks or more. When such feelings begin to impact work, sleeping, eating, socializing or physical well-being, it's time to get professional help. Unfortunately, those with depression tend to isolate themselves from the outside world and do exactly the opposite of what would be best for them. That's when family and friends can step in to assist the depressed person.

Depression falls into the broad class of mental health difficulties called mood disorders. They include Major Depressive Disorder, Dysthymic Disorder [Dysthymia can be defined as despondency in mood], Bipolar Disorder [Bipolar Disorder was formerly called Manic-Depressive Disorder], Cyclothymic Disorder [Cyclothymia is a tendency toward alternating periods of elation and depression] and Substance-Induced Mood Disorder. A mood disorder can also be the result of certain medications or a general medical condition, although sometimes depression can mask another serious illness such as thyroid disease.

Since depression impairs interpersonal, social and occupational functioning, it can be particularly hard on relationships. People with mood disorders, such as depression, have a very high rate of divorce. Because patients with depressed mood have a loss of energy and interest, feelings of guilt, difficulty concentrating, loss of appetite and thoughts of suicide or death, being with them can be difficult. That's why the relationships a depressed person has are so important. People who truly care about the depressed will help them find relief.

What's a person to do?

To find help for yourself or someone else, it's important to know the signs of depression. They often include: feelings of "emptiness" or hopelessness, undue feelings of guilt or helplessness, trouble sleeping (early morning waking or oversleeping) and significant weight loss or gain. Additionally, the depressed may have decreased energy and fatigue, thoughts of death or suicide, loss of interest or pleasure in activities once enjoyed, difficulty concentrating and persistent medical problems or pain that does not go away.

If you or a person you care about has several of the above symptoms, it's best to talk with someone who can professionally evaluate what's going on. Depression is not due to personal weakness nor a condition that will correct itself. Without treatment, it could last for weeks, months or years.

In the meantime, it can be beneficial to take scenic walks, look up into the sunlight, appreciate nature, volunteer to help others. Also try to exercise, eat properly, and minimize caffeine and other foods that interfere with restful sleep. Avoid alcohol (a depressant) and non-prescribed drugs. They may provide a temporary "high," but actually exacerbate depression.

While a combination of medication and psychotherapy can work well (particularly in the elderly), a recent study found cognitive-behavioral therapy as effective as antidepressants in treating the severely depressed. An estimated 4 out of 5 people with depression improve with the appropriate form of treatment.

The winter can be happy time if we remain aware of our needs and seek appropriate assistance when it's warranted. Sometimes a family member or friend can accompany the person to see they get properly evaluated for the difficulties they're experiencing. After all, it's that caring that makes good relationships great.

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