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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 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. Some of the common symptoms are: Trouble sleeping or sleeping too much Not caring anymore about work, hobbies, friends or sexual activity Self-recrimination for things in the past or present Feeling tired all the time or finding everything an effort Having trouble concentrating or making decisions Loss of appetite or loss of weight Eating more than usual and gaining weight Thoughts of suicide Considering a way of dying Other problems people experience during a clinical depression include: Frequently feeling on the verge of tears or weepy Waking up early in the morning, with difficulty returning to sleep Feeling worse in the morning Feeling anxious or irritable A gloomy view of the future Physical pain or headaches 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: Certain medical diseases, for example, Parkinson's Disease, thyroid diseases, anemia. Some medical drugs, for example, antihypertensive drugs. Drugs of abuse, for example, alcohol or cocaine. There is evidence for a genetic predisposition to having a depression. Often, someone with depression will have family members who also suffer depressive episodes. Other psychiatric conditions, such as panic disorder, obsessive-compulsive disorder. **Prolonged and severe stress in your environment such as relationship problems, unemployment, financial difficulty. **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 psychotherapy, behaviour therapy, and 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: Take your medication as prescribed. Report any problems with side effects to your doctor. Avoid alcohol and other mood-altering non-prescription drugs. Keep a regular schedule of sleeping and waking. Exercise regularly, for example, taking a daily half-hour walk. Avoid making any important decisions until you feel better. 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. Self-help groups can also be very helpful for depressed people and their families. Self-help on the internet is also available by e-mail, including alt.support.depression Read about depression. We have a short list of good books about depression. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Books About Depression ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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. 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. 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. 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. Depression: What Families Should Know by Elaine Shimberg, Ballantine Books, $5.99 A very readable guide for families struggling to help their loved ones. 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 [log in to unmask]