October is Depression Awareness Month. It is a perfect time to refresh ourselves on where depression comes from, what it looks like (and does not look like) and what we can do about it in order to help ourselves and those around us.
The World Health Organization reports that over 300 million people around the world have depression as of 2017. According to the National Institute of Mental Health (NIMH), current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.
NIMH offers a free hardcopy book or PDF for download that highlights things everyone should know about depression:
· Depression is a real illness.
· Depression affects people in different ways.
· Depression is treatable.
· If you have depression, you are not alone.
Most mental health treatment providers use the Diagnostic and Statistical Manual of Mental Disorders, 5thEdition (DSM-V) in our diagnostic assessments. The symptoms of depressive disorders usually include the following:
· Persistent sadness or depressed mood (more often irritability in children)
· Loss of interest in pleasurable activities
· Loss of energy or presence of/ increase in fatigue
· Changes in sleep functioning
· Significant change in appetite or weight
· Impaired concentration or indecisiveness
· Restlessness or slow-moving body/ speech
· Feelings of worthlessness, hopelessness, guilt
· Thoughts of self-harm, suicidal ideation or death
It is very important to differentiate stress from depression. Many of us experience challenging days in our homes, at school and at work. We have busy lives taking care of others’ needs and not always prioritizing care for our own. Stress can be healthy when we are appropriately managing it. Depression is not healthy and has greater intensity and frequency of depressive symptoms than when we experience stress. Here are some examples of distinguishing stress reactions from depressive symptoms:
Response to stress: Crying after poor grades on a math test
When depressed, a child might have persistent crying, isolation from family and peers, low self-esteem about their abilities, refusal to attend school for weeks.
Response to stress: Being irritable for a couple days after not getting invited to a classmate’s party
When depressed, children and adults might not be able to sleep for weeks or have unusual difficulty getting out of bed. They might decline invitations out with friends. Daily interactions with them might include yelling, refusing meals. They might stop turning in homework or meeting deadlines at work.
Response to stress: Eating a pint of ice cream after a break-up with partner
When depressed, adolescents and adults might feel worthless at their job/school. Kids might quit after school sports and adults might stop going to the gym. They might gain or lose five percent or more of their body weight in two weeks. They might use substances several times a week to self-medicate.
Response to stress: Vaping with peers who are applying social pressure
When depressed, adolescents and adults might use marijuana/alcohol/other drugs “to forget about everything” at home. They might be burdened with excessive guilt and hide their overeating, substance use, self-harming behaviors. Their internal self-talk might be “I am worthless anyway. My life doesn’t matter. I am all alone.”
It is important to recognize and properly assess changes in behavior for our own wellness, and also for that of our loved ones. Please reach out to Haven Youth and Family services, to other mental health providers, to your general practitioners or pediatricians, to your school social workers and counselors for proper evaluation, referral and/or support.
And please read last month’s blog for stress management tools and self-care strategies for tips to cope with life’s challenges!