Items Tagged With depression

Depression is more damaging to everyday health than chronic diseases such as angina, arthritis, asthma and diabetes, researchers said on Friday.

And if people are ill with other conditions, depression makes them worse, the researchers found.

"We report the largest population-based worldwide study to our knowledge that explores the effect of depression in comparison with four other chronic diseases on health state," the researchers wrote in the Lancet medical journal.

Somnath Chatterji of the World Health Organisation, who led the study, said researchers calculated the impact of different conditions by asking people questions about their capacities to function in everyday situations -- such as moving around, seeing things at a distance and remembering information.

In many cases, depression is a deciding factor for men and women considering retirement, according to new research.

Middle-aged men who suffer with symptoms of depression are more likely to retire early, while retirement-age women often take the leap even if their depressive symptoms are mild.

According to researchers at the University of Pennsylvania, one in 10 working adults will experience a bout of depression over the course of the year.

The research team came to these conclusions after examining data from almost 3,000 adults participating in the Health and Retirement Study, a long-term study of mental health and work status drawing from 48 states. The adults were between the ages of 53 and 58 and completed a survey every two years between 1994 and 2002.

This condition is increasingly being referred to as "caregiver syndrome" by the medical community because of its numerous consistent signs and symptoms. In the pamphlet, "Caring for Persons with Dementia," Dr. Jean Posner, a neuropsychiatrist in Baltimore, Maryland, referred to caregiver syndrome as, "a debilitating condition brought on by unrelieved, constant caring for a person with a chronic illness or dementia."

An increasing number of Americans are finding themselves taking care of someone who's aging or ill or both. According to the American Academy of Geriatric Psychiatrists, one out of every four American families cares for someone over the age of 50. As America's population ages, that number is expected to skyrocket. In 2000, the Census Bureau reported, just under 35 million Americans were 65 or over; by 2030, the number is projected to more than double, to more than 71 million.

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Finding the effective antidepressant for the depressive is at this point far from an exact science, although the outlook is improving as we discover more about depression. Doctors for the most part take their best guess based on their experience and the prevailing wisdom. They consider the type of depression the patient suffers from, other medications he or she is taking, the patient's age, how well he or she will deal with the side effects, and other factors. Some patients have to try three, four or more medications before one "clicks" with their chemistry. Some, like me, are successful with the first medication they try. Remember that the chances are very good that your doctor will be able to find an effective medicine for you. As hard as it is, be patient and hopeful and keep trying different medications.

I hear again and again of doctors who start a patient out at a low dosage, and keep the patient at that dosage even when the medication is not working. Before switching you to another medication, your doctor should check the level of medication in your blood and try raising the dosage if it's not sufficient. I had to have the level of both the antidepressants I was on raised not once, but several times. Buy a medication "bible" like The Pill Book, and find out what the normal range of dosage is for your medication.

Your best bet, as with other aspects of this illness, is to educate yourself about the medications available. You are then, in essence, your own "second opinion." I have known of doctors who forget to tell patients of possible side effects of medication, or what other medication or foods should be avoided while taking their antidepressants. Make sure you know what questions to ask the doctor to attain the maximum effect from your medication.

Introduction

A few years ago, my mother unearthed some pictures of me as a baby which I had never seen before. One showed me at about eight months old, crawling on the grass of Golden Gate Park. I was looking directly at the camera, my tongue sticking out of the corner of my mouth, and I was laughing. My face was lit from within, and looked happy, confident and even a little mischievious.

I was absolutely transfixed by that photograph for days. I would continually take it out of my wallet and stare at it, torn between laughter and tears. For a while I couldn't figure out what it was about the picture that drew me. Finally it hit me; this was the only picture of myself as a child that I had seen which showed me laughing. All the photos I had ever seen depicted a child staring solemnly or smiling diffidently, but never laughing. I looked at the Golden Gate Park picture and wished that I had remained that happy, and that depression had not taken away my childhood.

When I first was diagnosed with depression in 1990, I discussed my childhood with my doctor. Although it is hard to diagnose a child twenty years in the past, it seemed clear to both of us that I had suffered from dysthymia (mild, long-term depression) probably from the time I was a small child. I read up on children and depression and wished futilely that I had been diagnosed years ago.

While I was studying to be a teacher a few years ago, I gave a presentation on childhood depression to my classmates, many of whom had been teachers for years. I was saddened, although not surprised, by the number of them who told me after class that they had no idea children could suffer from depression. Although many myths and misunderstandings surround adult depression, even more surround childhood depression, and these people who dealt with children for hours each day knew no more about the topic than anyone else.

Misconceptions About Children and Depression

One of the most common responses to hearing that a child has depression is, "But what does he/she have to be depressed about?" This statement reveals two major misconceptions. One is the lack of understanding about clinical depression. It is not the same as the "blues" or "down" moods that everyone has from time to time, which may actually be caused by unhappiness with one's job, home life or other factors. Clinical depression may resemble these emotional dips, but it is much more pervasive, long-lasting, and life-threatening. It is not necessarily caused by an event or state of affairs in a child's life. The other misconception is that childhood is a carefree, trouble-free period in our lives. How many people can say that they didn't worry about peer acceptance, grades, or parental expectations? Adults often forget that children are powerless and have no control over their own lives. This can be a frightening and frustrating state of affairs to live through day after day.

Causes of Childhood Depression

As with adult depression, diagnosis of depression in children is not as clear-cut as it is for other ailments. There is no test that can be given which will positively say that an individual has depression, much less pinpoint the cause(s). The medical community still knows relatively little about the brain, how it works, and what makes it malfunction. In fact, anti-depressant properties of certain medications were discovered by accident in the 1950s while seeking a cure for tuberculosis.

We do know that certain children have risk factors in their lives which could predispose them to depression or could "trigger" depression. Among these are a family history of mental illness or suicide, abuse (physical, emotional or sexual), chronic illness and the loss of a parent at an early age to death, divorce or abandonment. However, some infants exhibit depressive symptoms at an early age before most of these factors come into play, so there is an argument to be made for depression being wholly chemical in some children. Each child's depression is individual, and causes will be different for each one. The depression could be wholly chemical, wholly due to psychological factors, or a combination of the two. More important than the cause is identifying the illness and treating it.

Symptoms of Depression in Children

• Persistent sadness and/or irritability.
• Low self-esteem or feelings or worthlessness. A child may make such statements as, "I'm bad. I'm stupid. No one likes me."
• Loss of interest in previously enjoyed activities.
• Change in appetite (either increase or decrease).
• Change in sleep patterns (either increase or decrease).
• Difficulty concentrating.
• Anger and rage
• Headaches, stomachaches or other physical pains that seem to have no cause.
• Changes in activity level. The child either becomes more lethargic or more hyperactive.
• Recurring thoughts of death or suicide.

Any change in a child's behavior that seems to have no external or physical cause should be looked at. A low mood which results from a loss (death of a loved one, moving, changing schools) which lasts more than a few weeks should be considered possible depression and checked out.

If the child has bipolar disorder, also known as manic depression, these symptoms could be present:

• abrupt, rapid mood swings
• periods of extreme hyperactivity
• prolonged, explosive temper tantrums or rages
• exaggerated ideas about self or abilities

Bipolar disorder is often mis-diagnosed as attention-deficit disorder with hyperactivity (ADHD), obsessive-compulsive disorder (OCD), oppositional defiant disorder or conduct disorder.

Related Disorders

Depression often goes hand-in-hand with other mental illnesses or disorders such as Attention Deficit Disorder, and, especially in teenage girls, eating disorders and self-injury. If any of these conditions are present, they need to be treated along with the depression for treatment to be effective.

Depression Treatment

The parents of any child who is in immediate danger of harming himself or others should consider hospitalization. This is a tough choice for parents to make, but it must be emphasized that children do commit suicide.

Once a child has been diagnosed with depression, both psychotherapy and medication could be options. More and more, doctors are realizing that chemical imbalances often account for mental illness, but at the same time, the importance of psychotherapy cannot be discounted. If a child's depression has been caused wholly or in part by psychological factors, medication may relieve the depression, but the underlying cause will not be "cured" by medication alone. Therapy can help the child deal with his past in a healthy manner, and also in learning ways to cope with the very difficult process of growing up.

Antidepressant medication for children is a controversial topic. There are no long-term studies that show what kind of impact this medication will have on a child's development. The maker of the antidepressant Effexor, in fact, has warned against it being prescribed for children, and the U.S. Food and Drug Administration has issued the same warning for Paxil. There has also been some question as to whether the older tricyclic antidepressants are effective with children. Most professionals will recommend therapy as a first line of defense for a child with depression, except in cases where the child is severely depressed or suicidal.

But keep in mind that it is almost a certainty that depression will have negative long-term effects on the child and his family. From my own experience, I am positive that my growing up with depression had negative effects on the development of my personality. For instance, even with my successful treatment with antidepressants, it's very hard for me to completely shake the crippling shyness I grew up with. The decision of whether to treat a child with medication is wholly individual, depending on the severity of the child's depression and what toll it will take on the child's life without successful treatment. Parents should educate themselves as much as possible in order to make an informed decision.

Note: Bipolar disorder must be ruled out before a child is prescribed antidepressants for depression or stimulants, as these can trigger mania.

Parents of a child with depression should start looking for a child psychiatrist by contacting the nearest university medical center, mental health clinic or organization.