Depression is common. Symptoms can affect day-to-day life and can become very distressing. Treatments include psychological (talking) treatments and antidepressant medicines. Treatment takes time to work but has a good chance of success. Some people have recurring episodes of depression and require long-term treatment to keep symptoms away.
What is depression? The word depressed is a common everyday word. People might say "I'm depressed" when in fact they mean "I'm fed up because I've had a row, or failed an exam, or lost my job", etc. These ups and downs of life are common and normal. Most people recover quite quickly. With true depression, you have a low mood and other symptoms each day for at least two weeks. Symptoms can also become severe enough to interfere with normal day-to-day activities.
Who gets depression? About 2 in 3 adults have depression at some time in their life. Sometimes it is mild or lasts just a few weeks. However, an episode of depression serious enough to require treatment occurs in about 1 in 4 women and 1 in 10 men at some point in their lives. Some people have two or more episodes of depression at various times in their life.
What are the symptoms of depression? Many people know when they are depressed. However, some people do not realise when they are depressed. They may know that they are not right and are not functioning well, but don't know why. Some people think that they have a physical illness - for example, if they lose weight.
There is a set of symptoms that are associated with depression and help to clarify the diagnosis. These are:
Some people with severe depression also develop delusions and/or hallucinations. These are called psychotic symptoms. A delusion is a false belief that a person has, and most people from the same culture would agree that it is wrong. For example, a belief that people are plotting to kill you or that there is a conspiracy about you. Hallucination means hearing, seeing, feeling, smelling, or tasting something that is not real.
Severity of depression. The severity of depression can vary from person to person. Severity is generally divided as follows:
An episode of depression may also be triggered by a life event such as a relationship problem, bereavement, redundancy, illness, etc. In many people it is a mixture of the two. For example, the combination of a mild low mood with some life problem, such as work stress, may lead to a spiral down into depression.
Women tend to develop depression more often than men. Particularly common times for women to become depressed are after childbirth (postnatal depression) and the menopause.
A chemical imbalance in the brain might be a factor. This is not fully understood. However, an alteration in some chemicals in the brain is thought to be the reason why antidepressants work in treating depression.
Depression and physical conditions. Although the cause of depression is not clear, there are some useful things to remember about depression in relation to physical conditions.
Undiagnosed physical conditions. Various physical conditions may at first seem to mimic depression. Doctors aim to be on the lookout for these diseases and may order tests to rule them out if one is suspected. Perhaps the most common examples are:
Some myths and other points about depression. Depression is common, but many people don't admit to it. Some people feel there is a stigma attached, or that people will think they are weak. Great leaders such as Winston Churchill have suffered depression. Depression is one of the most common illnesses that GPs deal with. People with depression may be told by others to "pull their socks up" or "snap out of it". The truth is, they cannot, and such comments by others are very unhelpful.
Understanding that your symptoms are due to depression, and that it is common, may help you to accept that you are ill and need help. Some people ask "Am I going mad?". It may be a relief to know that you are not going mad, and that the symptoms you have are common and have been shared by many other people.
You may 'bottle up' your symptoms from friends and relatives. However, if you are open about your feelings with close family and friends, it may help them to understand and help.
What are the treatment options for depression? In general, treatments are divided into those used for mild depression and those used for moderate and severe depression.
What if I don't have any treatment? Most people with depression will get better without treatment. However, this may take several months or even longer. (The average length of an episode of depression is 6-8 months.) Meanwhile, living with depression can be difficult and distressing (and also for your family and friends). Relationships, employment, etc, may be seriously affected. There is also a danger that some people turn to alcohol or illegal drugs. Some people think of suicide. Therefore, many people with depression opt for treatment.
Treatment options for moderate or severe depression. Antidepressant medicines are commonly used to treat moderate or severe depression. A medicine cannot alter your circumstances. However, symptoms such as low mood, poor sleep, poor concentration, etc, are often eased with an antidepressant. This may then allow you to function more normally, and increase your ability to deal with any problems or difficult circumstances.
An antidepressant does not usually work straight away. It can take 2-4 weeks before the effect builds up fully. A common problem is that some people stop the medicine after a week or so as they feel it is not helping. You need to give it time. Also, if it is helping, follow the course that a doctor recommends. A normal course of an antidepressant lasts for at least six months after symptoms have eased. Some people stop their medication too early and the depression may then quickly return.
There are several types of antidepressants, each with various pros and cons. For example, they differ in their possible side-effects. (The leaflet that comes in the medicine packet provides a full list of possible side-effects.) If the first one that you try does not suit, then another may be found that will suit. So, tell your doctor if you have any problems with an antidepressant. Antidepressants are not tranquillisers and are not thought to be addictive.
People with moderate or severe depression have a good chance of improving within a few weeks of starting an antidepressant. But, they do not work in everybody. However, some antidepressants work better in some people than in others. Therefore, tell your doctor if symptoms do not start to improve after about 3-4 weeks of taking an antidepressant. In this situation it is common to advise either an increase in dose (if the maximum dose is not yet reached) or a switch to another type of antidepressant.
At the end of a course of treatment it is usual to reduce the dose gradually over about four weeks before finally stopping. This is because some people develop withdrawal symptoms if an antidepressant is stopped abruptly.
Psychological (talking) treatmentsVarious psychological treatments have been shown in research trials to be good treatments for depression. These are briefly listed below. In general, a combination of an antidepressant plus a psychological treatment is better than either treatment alone. Therefore, if available, you should consider having both treatments. However, there may be a shortage in some areas of trained therapists who can perform psychological treatments. Typically, most psychological treatments for depression last in the range of 12-20 weekly sessions of 1-2 hours per session.
Those most commonly used for moderate or severe depression are:
What about exercise? In addition to the above treatments, until recently it was thought that regular exercise helped to improve symptoms (if you are able to do some exercise). Regular exercise is generally a good thing to do for all sorts of reasons. However, recent research does not support the idea that exercise is a useful treatment for depression. A large research trial found that the addition of an exercise programme to the usual care for depression did not improve the outcome of depression or reduce the use of antidepressants compared with usual care alone.
Treatment options for mild depression. The following are the commonly used treatment options for people with mild depression. Also, for people with subthreshold depression that has lasted a long time and not shown signs of improving. Some people prefer one type of treatment to another. So, personal preference for the type of treatment used should be taken into account when discussing the best treatment for yourself with your doctor.
A guided self-help programme. There are various pamphlets, books, and audio tapes which can help you to understand and combat depression. The best are based on the principles of CBT, as described earlier. Ideally, a guided self-help programme is best. That is, a programme where the materials are provided by a trained practitioner such as a doctor, and where a practitioner monitors your progress. A self-help programme takes some motivation and effort to work through - a bit like doing homework. A typical guided self-help programme consists of 6-8 sessions (face-to-face and via telephone) over 9-12 weeks.
Computer-based cognitive behavioural therapy. Computer- and internet-based self-help CBT programmes are recent innovations. They are supported by a trained practitioner who monitors progress. A programme typically takes place over 9-12 weeks, and you are given tasks to try out between sessions.
Group-based cognitive behavioural therapy. This is CBT but in a group setting of 8-10 participants. Typically, it consists of 10-12 weekly meetings.
Group-based peer support. This is an option for people with depression who also have an ongoing (chronic) physical problem. This allows sharing of experiences and feelings with a group of people who understand the difficulties and issues facing group members. Typically, it consists of one session per week over 8-12 weeks. Ideally, it should be supported by a facilitator who has knowledge of the physical health problem, and who reviews progress with people taking part in the group.
Antidepressant medicines. Antidepressant medication is not usually recommended for the initial treatment of mild depression. However, an antidepressant may be advised for mild depression in certain circumstances. For example, in people:
What about St John's wort (hypericum)? This is not advised. St John's wort is a herbal antidepressant that you can buy, without a prescription, from pharmacies. It recently became a popular treatment for depression. However, national guidelines for depression do not advise that you take this because:
Some related conditions. Postnatal depressionSome women develop depression just after having a baby. See separate leaflet called 'Postnatal Depression' for details.
Bipolar disorder. In some people, depression can alternate with periods of elation and overactivity (mania or hypomania). This is called bipolar disorder (sometimes called manic depression). Treatment tends to include mood stabiliser medicines such as lithium. See separate leaflet called 'Bipolar Disorder' for details.
Seasonal affective disorder. Some people develop recurrent depression in the winter months only. This is called seasonal affective disorder (SAD). For people in the UK with SAD, symptoms of depression usually develop each year sometime between September and November, and continue until March or April. You, and your doctor, may not realise for several years that you have SAD. This is because recurring depression is quite common. You may have been treated for depression several times over the years before it is realised that you have the seasonal pattern of SAD. Treatment of SAD is similar to other types of depression. However, light therapy is also effective. See separate leaflet called 'Seasonal Affective Disorder' for details.
Other mental health problems. Depression sometimes occurs at the same time as other mental health problems.
Further help and information: Depression Alliance, 20 Great Dover Street, London SE1 4LX
Tel: 0845 123 2320 Web: www.depressionalliance.org
Provide information, support and understanding to those who are affected by depression.
The British Association of Behavioural and Cognitive Psychotherapies (BABCP): Imperial House, Hornby Street, Bury, Lancashire BL9 5BN. Tel: 0161 705 4304 Web: www.babcp.com
Maintain a register of CBT practitioners. Their website also provides information about CBT.
Ultrasis Web: www.ultrasis.com - produce interactive, computer-based CBT programmes.
FearFighterWeb: www.fearfighter.com - a method for delivering CBT on the internet.
Oxford Cognitive Therapy Centre (OCTC). Web: www.octc.co.uk
Their website gives details of how to order a number of self-help booklets with a CBT approach for conditions such as OCD, anxiety, panic, depression, phobias, etc.
Northumberland, Tyne & Wear NHS TrustWeb: www.ntw.nhs.uk/pic/selfhelp
Provide a range of self-help booklets with a CBT approach for various mental health problems, such as anxiety, phobias, OCD, etc. The self-help booklets have been written by clinical psychologists with contributions from service users and healthcare staff from Northumberland. They can be downloaded from their website.
Recommended books using CBT self-help techniques. See www.patient.co.uk/books.asp
What Is Anxiety Exactly?
Although almost everyone has surely heard the word anxiety - and has somewhat of an idea of what it means - exactly what is anxiety? Generally assumed to be nervousness or worry, having anxiety is actually a much more complex state of being than simply feeling nervous or worried about something. It is a very complex and multifaceted syndrome in not only putting a name to it, but diagnosing and treating as well. There are countless reasons - ranging from environmental causes to physical and mental causes - that people get anxiety, each one affecting every person differently. It can be a very difficult concept to explain, both for the sufferer and those trying to help, too.
On the brighter side though, there are some key factors about anxiety that can point toward this diagnosis - at least in the generalized sense - as well as numerous ways to deal with it. People can learn various ways to cope with their anxiety on their own, or with the help of friends, family, and of course professionals. Anxiety can be controlled through methods such as talk therapy, meditation, medication, diet and many other ways. Fortunately, for a condition that can present itself in seemingly endless ways, and with an infinite number of symptoms depending on the individual, there also seems to be a good variety of ways to handle it; the main concern is to figure out which methods work.
The Major Anxiety Classifications
"Anxiety," per se, is just a generalized, easy to use term for what is a group of mood disorders of various different causes, symptoms and names. Since there are so many causes attributed to different types of "anxiety", and so many individual symptoms, these main classifications have come about to be better able to both diagnose patients, as well as understand the groups of symptoms that are possibly present and being referred to in regard to someone's anxiety. For those still asking themselves "what is anxiety?", this summarization of these major types should be somewhat helpful:
Generalized Anxiety Disorder (GAD) - Just as it sounds by its name, GAD is anxiety caused by general stressors in which sufferers experience general anxiety-related symptoms such as feeling scared, worried or filled with tension, either when there is no reason to feel that way, or feelings that are in excess about actual concerns.
Panic Disorder - A panic attack, or any sudden fear or panic which tends to strike from out of the blue, either in response to real stressors or other reasons, much like GAD; symptoms of an actual panic attack can be much more severe than those of GAD and include racing heart, sweating, inability to catch one's breath and feelings of having a heart attack, among others.
Social Anxiety (social phobia) - Extreme stress caused by uncontrollable feelings of self-consciousness and being judged when around other people, and fears of doing or saying something that will be deemed unacceptable by others and cause embarrassment; those with social anxiety tend to avoid social situations even while normally aware that their feelings are largely irrational.
Post Traumatic Stress Disorder (PTSD) - An anxiety based condition caused by having experienced traumatic events in life which then continue to affect a person's emotional and mental state; symptoms of PTSD can include fear, avoidance and an endless re-living of events or rehashing of memories, due to the inability to cope with these past events and the pain (emotional or physical) or fear they caused.
Obsessive-Compulsive Disorder (OCD) - An anxiety disorder in which sufferers cope through uncontrolled, repeated behaviors and extreme obsessions with actions, things, etc... ; OCD can become quite severe and debilitating, especially if it is interfering with someone's lifestyle to the point of the sufferer being unable to break out of their cycle of repetition to lead a normal life.
Specific Phobia - Affecting many people in different ways, phobias of all kinds create anxiety in sufferers due to irrational fears and panic about seemingly normal things; phobias can range in severity from mild to so severe that a sufferer's entire lifestyle is affected, such as in severe cases of agoraphobia (fear of public places) or claustrophobia (fear of enclosed space).
Though these are the major classifications of anxiety disorders, there are many sub-classifications that fall within the main ones. Therefore, when someone asks, "what is anxiety", it can frequently be difficult to explain without getting further into a more detailed set of symptoms and diagnosis.
By David Rodrique. Visit website for more articles on anxiety and how to treat it at http://www.anxietycured.net. Article Source: http://EzineArticles.com/?expert=David_Rodrigue
What Is Stress and How Does the Body Respond to It?
Stress affects millions of Americans every year and the daily demands from family and work wear and tear on the spirit, mind and body. Many people are so used to feeling stressed out that they do no longer listen to the signs of danger in their bodies and continue pushing and over doing.
Outside forces acting on our organism are called stressors. Stress has consequences for different areas of our body. Sometimes the body stores stress in different places. Other times our bodies respond aggressively to the continuous effort or over activity.
Stress is a universal response resulting from the perception of an intense distressing experience (divorce, losing a job, moving, death, excessive demands). The body sometimes is conditioned to respond to stress with nervousness or aggression and other times it goes totally numb. This is one is the most serious symptom of stress because it is hard to heal something that is not obviously impaired. Stress might also be caused by an non-real distressing event, like thinking of finding a snake in a path, fear of having bears visiting a tent. In these cases the stress response results from the idea that something could happen to us but it is not really there.
In this article I will refer to the most common reactions to stress and causes, real stimuli and response. I will not talk about other causes of serious distress or mental health cases. We all have experienced stress at one time or other. However, the way we handle stress is linked to our psychological strength, mind and body strength and our ability to endure challenges. Each one of us will respond differently to the same event, this doesn't mean that some are stronger than others, it just means that we are different with our overall health, immune system and personality.
How does stress occur?
When a threat or the perception of a danger is encountered the whole body stress response will be activated. This mobilization will start a series of physiological events like segregation of hormones like adrenaline and the activation of flight-or-fight response when the body feels threatened by the stressor. Our bodies will start secreting the flight-or-fight hormones in ways that are not healthy for our bodies. When this happens stress will manifest sooner or later with symptoms like headaches, anxiety, lack of sleep, hypertension, muscle spasms, and etc.
People with certain personality types who over do and overwork ignore the signs of stress and keep pushing and working extensive hours without giving themselves a break. These are the personalities that are mostly likely to feel stressed out. In addition, people with perfectionist traits or who call themselves perfectionists have obsessions that make them prone to stress. They have standards of achievements that are unrealistically high and beyond reason. This is most noticeable in the workplace.
When a situation is perceived as potentially dangerous to our bodies some other internal and external indicators will show like perspiration, rapid heart beats, and mental confusion. These are the body's defense mechanisms to deal with the stress in the best way possible. Sometimes these indicators are just the beginning of a series of detrimental effects on our health. When we are faced by a danger our autonomous system starts reacting fast, these systems are the cardiovascular system, respiratory system, endocrine and reproductive to mention the most relevant ones to stress.
In the stress response mode the hypothalamus stimulates the nervous system and allows the release of hormones in the blood stream. This is when stress become serious and we want to make sure that our bodies are not in this stress mode too long. These hormones are preparing our bodies to activate muscle tissue, ready to run away or attack. These hormones also create more room in our lungs so that we can absorb high volumes of oxygen in case we need to run, our hearts start to beat faster because the may need to pump more blood rapidly to our whole body. Our intelligent body create a chain of physiological events to keep our bodies in great shape for a flight-or-fight response. This is sometimes not necessary when we see the situation with realistic eyes, but for our body and brain, what is perceived as a threat creates a different story to our bodies.
If you feel that this is your case, please seek the help of your general physician, certified or a hypnotherapist.
Stress affects our health in many ways, sometimes in non-perceptible ways and creates long-term illness or even death, for example from a heart attack.
Even though it is sometimes impossible to remove all the stressors from our lives, we can try to remove ourselves from dangerous or stressing situations. We need to use our common sense and use our inner feeling system as a guide.
• Prepare a list of stressful situations. Rank the stressful situations from 10 (the most stressful) to 1 (the least stressful). Then for each stressful situation:
• Ask yourself, "How do I feel when... (fill in the blank)?"
• Ask yourself, "What could I do to diminish these feelings?"
• Pay attention to your body and how you respond to different events.
• Pay attention to your diet and eliminate caffeine and excessive sugars
• Follow your doctor's guidelines about diet and proper exercise
It is really important to learn how to prevent stress and to deal with it in the best way possible. For example it is important to find time for recreation, healthy activities and sports and with the assistance of alternative therapies like progressive muscle relaxation, guided relaxation for health, practicing yoga or any other sports that stabilize our different energetic centers.
• Certain diets can help improve stress related situations and or illnesses created by stress, if you are in a special diet follow your doctors recommendations.
• Oat bran, fish oil and vitamin B will help you deal with irritability and general nervousness.
• Those who practice breathing exercises and yoga are able to handle stress much better.
• Certain relaxation practices such meditation, guided relaxation techniques, hypnosis, and the use of biofeedback equipment can help people manage their stress or eliminate it completely.
• Finding time for relaxation, self-nurturing activities and enjoyment is critical for a balanced life.
Rosa C. Murphy, M.Ed. is a certified relaxation therapist, artist and mentor. She writes articles about mind body connection, wellness and healing. For more information about her services, teachings or to contact her please visit her web site at: http://www.whisperingtranquilitystudio.com
What is Emotional Intelligence?
Emotional intelligence (EI) refers to the ability to perceive, control and evaluate emotions. Some researchers suggest that emotional intelligence can be learned and strengthened, while others claim it is an inborn characteristic.
Since 1990, Peter Salovey and John D. Mayer have been the leading researchers on emotional intelligence. In their influential article "Emotional Intelligence," they defined emotional intelligence as, "the subset of social intelligence that involves the ability to monitor one's own and others' feelings and emotions, to discriminate among them and to use this information to guide one's thinking and actions" (1990).
The Four Branches of Emotional Intelligence. Salovey and Mayer proposed a model that identified four different factors of emotional intelligence: the perception of emotion, the ability reason using emotions, the ability to understand emotion and the ability to manage emotions.
According to Salovey and Mayer, the four branches of their model are, "arranged from more basic psychological processes to higher, more psychologically integrated processes. For example, the lowest level branch concerns the (relatively) simple abilities of perceiving and expressing emotion. In contrast, the highest level branch concerns the conscious, reflective regulation of emotion" (1997).
A Brief History of Emotional Intelligence