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Depression is a difficult entity to measure let alone accept, but the frequency of diagnosis on the frontlines of family medicine continues to creep upward. Normal human existence occurs in cycles of good and bad days. When those bad days accumulate and start to interfere with daily functioning, then we may start to consider a possible diagnosis of depression. It is not an exact science. The classical signs of depression have been felt by all of us at one time or another, but when it all happens at once and repeatedly, then we enter the grey zone toward depression.
Depression is considered a treatable disease. Feelings of worthlessness, guilt and lack of hope consume us. Our mood becomes flat and we lose interest in activities that are usually enjoyed. Concentration is affected and as a result, we forget simple things, have trouble reading or even watching television. Even speech slows down as we take longer to gather and express ourselves. In more serious instances, negative thoughts about our existence tend to intrude recurrently into our consciousness. In addition to self-esteem being battered, physical symptoms also begin to appear. We become plagued with body aches, various pains appear and we lose energy. Things slow down and we get frustrated, often short tempered and agitated. Sleep is more difficult, and its rejuvenating effects diminish. The symptoms wax and wane, and some days you feel fine, but most days you don't.
Physically, we tend to explain the symptoms by referring to depleted transmitter levels in the brain. Others often notice the change in our function before we realize it. Diagnosis starts by ruling out numerous other conditions that can cause depression. Various questioning techniques have been developed to help with the diagnosis. The diagnosis comes a little easier if the patient is well known to me. The risk of harm to oneself and those around him or her significantly increases when clinical depression is present.
Suicide is a feature sometimes associated with depression. It is not the norm, but more of an extreme. There is some evidence for clusters within families to occur. Vocation seems to be a factor. Doctors, soldiers and dentists seem to be more afflicted on average. Depression can also be the result of other disease states such as cancer and the frailty that sometimes comes with age. Even sunlight is a factor, since we see more depression when the days get shorter. We are all at risk.
Occasionally, an over-helpful Human Resources person will suggest a "stress-leave." Stress is a symptom and not a diagnosis. It is extremely difficult to define, but goes far beyond the inability to get along with co-workers, or being yelled at a great deal, or generally not enjoying a poor-paying job. A medical diagnosis like "depression" is needed before an insurance company will consider paying time away from work.
Depression is a global entity, which means it affects many spheres of our lives. Screaming kids and spouses should theoretically be as noxious as screaming co-workers. It cannot be turned on and off by punching a time card. When depression is diagnosed, many family practitioners are trained to commence short-term interventional psychotherapy along with medication. Ideally, a referral to a psychiatrist is in order, but very difficult in reality. Psychiatry is under-valued in our health care system and there continues to be a shortage of available psychiatrists. Depression is a real entity, and sufferers often feel the misguided anger of those around them. It can result in disastrous consequences and was the prevailing theme of the last suicide investigation that I conducted! There are no negatives in sitting down with your doctor and doing an occasional reality check.
● Major depressive disorder from Wikipedia, the free encyclopedia.
● Teen depression from Mayo Clinic. Overview, Symptoms and causes, Diagnosis and treatment, Doctors and appointments.
● Is there a relationship between chocolate consumption and symptoms of depression? A cross-sectional survey of 13,626 US adults by Sarah E Jackson, Lee Smith, Joseph Firth, Igor Grabovac, Pinar Soysal, Ai Koyanagi, Liang Hu, Brendon Stubbs, Jacopo Demurtas, Nicola Veronese, Xiangzhu Zhu, and Lin Yang, National Library of Medicine, Pubmed.NCBI.NLM.NIH.gov, Oct. 2019.
● Mental Health Meter: Characteristics of Mental Health from Canadian Mental Health Association. Understanding the characteristics that make up good mental health will help you determine how mentally fit you are.
● Depression: Causes, Treatment, Symptoms, Types and Diagnosis from MedicineNet.com.
● Depression from National Institute of Mental Health (NIMH). What Is Depression? What are the different forms of depression? What are the signs and symptoms of depression? What illnesses often co-exist with depression?
● Depression from MedlinePlus.
● Depression Is Common from Kids Health. "Some people mistakenly believe that depression is just an attitude or a mood that a person can shake off."
● Depression in Children from MedicineNet.com
● Depression in Children from WebMD.
● Dealing With Depression: Antidepressant Skills for Teens by Dr. Dan Bilsker, Dr. Merv Gilbert, Dr. David Worling, and Dr. Jane Garland.
● Depression in Adolescents / Teenagers from Psychology Info.com. "Approximately 4 out of 100 teenagers get seriously depressed each year." Other topics: What is depression? Symptoms of Depression. Symptoms of a Manic Episode. Treatment for Depression. What About Suicide? Why do people get depressed? Alcohol, Drugs and Depression. Myths About Depression.
● Depression: A Guide for Teens from Young Women's Health. Who gets depressed? What are the symptoms of clinical depression? What are the effects of depression?
● Teen Depression from MedlinePlus. What is depression in teens? Teen depression is a serious medical illness. What causes depression in teens? Which teens are at risk of depression? What are the symptoms of depression in teens? How is depression in teens diagnosed? How is depression in teens treated?
● Factsheet: Depression in Teens from Mental Health America (NMHA) - formerly known as the National Mental Health Association.
● Teenage Depression: Signs, Causes and What You Can Do. Teenage Depression Statistics. What Is Teenage Depression? Signs of Depression in Teens. Less Common Signs of Depression. Warning Signs for Suicide. How Are Teens Diagnosed With Depression? Options for Treating Teenage Depression. Other Treatments for Depression. How You Can Help Your Teenager.