original posted on 970718
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dear syber-siblings

i've had a lot of positive feedback on my 'perceptions' posts
about clinical depression [cd - as i like to call it]

as i understand it
clinical depression is not simply feelings of sadness

it is a chemical imbalance
which can be triggered by stress
and which can affect one's thought processes and emotions
in the same way that
the chemical imbalance of pd can affect one's mobility

this is the clearest detailed description i've found on the web
[from the university of british columbia, eh?]


------------------------------
What is a Clinical Depression?
------------------------------

Clinical depression is sometimes referred to as a major depressive episode.

Episodes are usually a result of Major Depressive Disorder, but they can
also be associated with other disorders.

It appears that clinical depressions can be caused in a number of ways.

Clinical depression is not just feeling unhappy.

A clinical depression can include a low mood, hopeless feelings, and loss of
interest or pleasure in almost all usual activities and pastimes.

[ed. note: i relate it to a damp blanket thrown over one's 'spark'

Some of the common symptoms are:

1.      Trouble sleeping or sleeping too much
2.      Not caring anymore about work, hobbies, friends or sexual activity
3.      Self-recrimination for things in the past or present
4.      Feeling tired all the time or finding everything an effort
5.      Having trouble concentrating or making decisions
6.      Loss of appetite or loss of weight
7.      Eating more than usual and gaining weight
8.      Thoughts of suicide
9.      Considering a way of dying

Other problems people experience during a clinical depression include:

1.      Frequently feeling on the verge of tears or weepy
2.      Waking up early in the morning, with difficulty returning to sleep
3.      Feeling worse in the morning
4.      Feeling anxious or irritable
5.      A gloomy view of the future
6.      Physical pain or headaches
7.      Cravings for certain foods

Most people experience these symptoms for months before seeking treatment.

Being depressed is painful and it may feel like it will never end.

Without treatment symptoms can last for months, sometimes years.

Appropriate treatment can help over 80% of those who suffer from depression.


----------------------------------
What Causes a Clinical Depression?
----------------------------------

There is evidence that a combination of factors produces a depression.

These include physical problems, environmental stress, and psychological
factors.

Factors that can contribute to the cause of depression include:

1.      Certain medical diseases, for example, Parkinson's Disease,
        thyroid diseases, anemia.
2.      Some medical drugs, for example, antihypertensive drugs.
3.      Drugs of abuse, for example, alcohol or cocaine.
4.      There is evidence for a genetic predisposition to having a depression.
        Often, someone with depression will have family members who also suffer
        depressive episodes.
5.      Other psychiatric conditions, such as panic disorder,
        obsessive-compulsive disorder.
6.      Prolonged and severe stress in your environment such as relationship
        problems, unemployment, financial difficulty. **
7.      Any situation in which one feels helpless. **


----------------------------------------------------
What Treatment is Available for Clinical Depression?
----------------------------------------------------

Some depression will disappear eventually without any treatment, though
this can take many months or sometimes years. Currently there is no sure
way of predicting when an episode of depression will end. Treatment may be
recommended, rather than simply waiting.

Since depression may be caused by a combination of factors, a combination
of treatments may be necessary.

Some of these are:

1.      psychotherapy,
2.      behaviour [cognitive] therapy, and
3.      medication.

An individual treatment plan is organized between patient and doctor.

Psychotherapy is a method of talking about your concerns with your
therapist to identify problems and seek solutions.

Cognitive-behavioural therapy focuses on the negative beliefs and behaviours
commonly seen in depression.

Antidepressant medication is prescribed to get the mind and body working in
a reasonable way again, allowing you to think clearly about problems in
your life that may be contributing to the depression.

Some patients with severe depression do well with electroconvulsive therapy.

Winter depression (seasonal affective disorder -SAD) and manic depression
(bipolar disorder) have specific treatments. Light therapy is often
employed in SAD. Mood stabilizing medications or antimanic agents are used
for bipolar disorder.

There are things that depressed individuals can do help themselves,
including reading more about depression.


----------------------------------------
What About Psychotherapy for Depression?
----------------------------------------

The "talking therapies" assist individuals to discuss and resolve problems
through emotional support, insights and understanding gained through the
verbal "give and take". These psychotherapies can be individual-, family-,
marital-, or group-oriented. Interpersonal and cognitive-behavioural therapies
have been the most scientifically evaluated psychotherapeutic treatments for
depression.

Interpersonal therapy is based on a concept that depressive symptoms occur
in the context of disturbed personal and social relationships. Therapists
help patients understand their illness, their feelings, and how
interpersonal problems and conflicts relate to their depression. Patients
are encouraged to identify and better understand such problems and to
develop more adaptive ways of relating to others.

Cognitive/behavioral therapy is based on the premise that peoples' emotions
and behaviours are determined by how they view the world and interpret
their experiences. The therapist helps patients correct maladaptive beliefs
and negative thought patterns.

The most widely used forms of psychosocial therapy are those referred to as
psychodynamic. They are based on the assumption that internal conflicts are
at the heart of the patient's disorder. Treatment brings the conflict into
the therapeutic situation where it can be dealt with and resolved.

For some patients, the most effective treatment is a combination of
medications to control symptoms and restore functioning, plus psychotherapy
to address social and behavioral problems.


------------------------------------------------
How Can I Help Myself with Clinical Depression?
------------------------------------------------

You can help yourself get better. Here's some advice:

1.      Take your medication as prescribed. Report any problems
        with side effects to your doctor.
2.      Avoid alcohol and other mood-altering non-prescription drugs.
3.      Keep a regular schedule of sleeping and waking.
4.      Exercise regularly, for example, taking a daily half-hour walk.
5.      Avoid making any important decisions until you feel better.
6.      Don't expect too much of yourself at work or at home. As you will
        be feeling better within weeks, try to delay any major
        responsibilities or get help from others.
        If your depression is severe, you may be unable to do
        much else for yourself until you begin to feel better.
        Start with small tasks, then build up to bigger tasks.
7.      Self-help groups can also be very helpful for depressed people
        and their families.
8.      Self-help on the internet is also available by e-mail,
        including alt.support.depression
9.      Read about depression. We have a short list of good books about
        depression.


-----------------------
Books About Depression
-----------------------

1.      Overcoming Depression
by Dr. D.F. Papolos and Janice Papolos,
HarperCollins Publishers, $18.75.
Excellent, practical overview of the symptoms and cause of depressive
disorders with much useful advice for the patients and families. Highly
recommended.

2.      Depression and its Treatment
by Dr. John H. Greist and Dr. James W. Jefferson,
Warner Books, $5.99
A brief but excellent review of the current status of the biological
treatment of depression.

3.      The Feeling Good Handbook
        by Dr. David Burns, Avon Books, $16.99.
A persuasive self-help guide for treating depression by a cognitive
therapist. Includes charts, homework assignments to offer mechanisms for
coping with problems such as procrastination, loneliness and negative
thinking. Highly recommended.

4.      The Depression Workbook:
        A Guide for Living with Depression and Manic Depression
        by Mary Ellen Copeland,
New Harbinger Publications, Inc., 1992, 304 pages, $17.95
Another workbook that many people with depression will find useful.

5.      Depression:
        What Families Should Know
        by Elaine Shimberg, Ballantine Books, $5.99
A very readable guide for families struggling to help their loved ones.

6.      On the Edge of Darkness
        by Kathy Cronkite,
Doubleday, about $30.00
An inspirational book by a journalist recovered from depression, filled
with personal observations about depression from well-known patients (Joan
Rivers, Mike Wallace, Rod Steiger, etc), clinicians, and researchers.

Raymond W. Lam , MD, FRCP(C), 1996
http://www.psychiatry.ubc.ca/mood/md_dep11.html

------------------------------------------------

**
the two items which i marked ** under 'Causes'
are the key ones for me:

three years of financial/business/shareholder troubles
where i have finally had to allow the company
i started six years ago to die a quiet death;
hence, i may now be technically unemployed
but i sure am happy about it!

all my feelings of anger and frustration and helplessness
were stuffed down inside
where they fermented nicely
and bubbled up predictably and inevitably in a fog
of london/jack/the/ripper proportions
and a downward spiral of non-functioning/hermitting
aided and abetted
by what i refer to as
those yadda yadda monkeys yammering at me in the background
with a running negative commentary on everything

[dr. david burns refers to these 'monkeys'
with a somewhat more professional term: 'automatic thoughts']

when i put that business stress together with
a probable genetic tendency towards cd in my family
and the apparent bio-chemical relationship between cd and pd

blammo
i was hit with a triple whammy [dr. whammi, d.s.o.]

and now i can't tell you how wonderful it is
for me to be able to say 'was'


janet


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