DepressionIn the normal course of life, everyone has times when they feel somewhat less than happy and optimistic. Although many people attribute their feelings of sadness or lethargy to the onset of depression, it's important to understand that medical professionals have specific indicators that they use to make a diagnosis of clinical depression.

By definition, a condition is clinical if it is directly observed. That is, the professional does not count on a patient's self-report, but is more likely to check for symptoms of depression that can be observed and documented.

Clinical depression is a phrase used to describe a condition serious enough to require clinical (professional) intervention. Clinical depression, according to medical sources, lasts more than two weeks and is usually not precipitated by anything external.

For example, if you've just lost your job and have no money in your bank account, you may feel stressed, anxious, panicked, and unable to function. However, most of your friends and family would reasonably conclude that it's quite normal to feel that way. Although your reaction might match the symptoms of depression, a traumatic event precipitated them and your state of anxiety would not be diagnosed as clinical depression. Clearly, a new and better job would probably end the negative feelings in an instant.

People who suffer from depression are not "just sad" or "weak" or "grief-stricken." Grief is thought to be one of the leading causes of depression, but the act of grieving is often appropriate and healthy, and not a sure indicator of actual depression. Also, grief is not just about the impact of the death of a family member or friend. Many people grieve when they lose pets, jobs, opportunities, and even political or social causes.

Symptoms of Depression

  • Irritability
  • Sadness
  • Exhaustion
  • Low self image
  • Destructive self criticism
  • Shame
  • Guilt
  • Manic behaviour
  • Suicidal thoughts or acts

Possible Causes of Depression

  • Genetics
  • Personal experience
  • Chemical imbalances in the brain
  • Extreme stress

Clinical Depression is not

  • Sadness
  • A sign of weak will
  • "Just" grief
  • Incurable

No one is entirely certain whether personal experience or biochemical imbalances cause depression. Both therapy and drug treatments have proven effective in combating major depression, so the answer may lie somewhere in between.

It is important to know that you can get help for depression. Start with your GP. Based on your individual circumstances, your GP may advise treatment that includes therapy, antidepressant medication, or both.

Depression in women
Depression occurs in women twice as often as in men. Rates of seasonal affective disorder and chronic depression in women are also higher. While alcohol and substance abuse in conjunction with depression is lower in women, depressed women suffer more often from eating disorders, migraine headaches, and anxiety disorders. Women are also more likely than men to seek help for their symptoms.

Baby Blues vs. Postnatal Depression
Postpartum depression is often confused with the "baby blues" - that feeling of being overwhelmed, combined with the sudden mood swings that occur after the birth of a child. Just after birth, a woman's hormonal levels change. Couple this with the intense demands of caring for a newborn, and the baby blues is the result. A week or so of the blues is fairly normal. If the signs of depression last longer, or if the mother seems likely to harm the baby, immediate medical attention is called for.

Postnatal Depression Symptoms

  • Excessive sleep
  • Increased crying
  • Feelings of worthlessness, like a "bad mother"
  • Low energy level
  • Sudden weight fluctuations
  • Suicidal thoughts
  • Thoughts of hurting the baby

Beyond Postpartum Depression
While postpartum depression in women is common, it isn't the only mood disorder suffered by women. Anxiety disorders occur with some frequency, sometimes manifested in obsessive cleanliness or panic attacks. Often, anxiety disorders go hand-in-hand with depression.

Women with pre-menstrual dysphoric disorder (PMDD) suffer the symptoms of depression only during the pre-menstrual period, or these symptoms will become more severe during this period. PMDD is a debilitating condition affecting 3 to 5% of women and manifests itself as a combination of depression and anxiety coupled with both physical and mental symptoms. Unfortunately, women often mistake PMDD for PMS (pre-menstrual syndrome) and don't seek help. If you are experiencing debilitating pre-menstrual symptoms, talk with your doctor about treatment.

Depression and the menopause
A woman who feels depressed and thinks she may also be entering the menopause should be evaluated by a gynaecologist to determine whether her symptoms could be related to the hormonal transition. She should also see a psychiatrist or other mental health professional, especially if her depression is severe or if she has been depressed in the past. As part of the evaluation, the doctor will:

  • Take a careful history of current and past symptoms, both emotional and physical.
  • Perform a physical exam and do blood tests to evaluate the function of the woman's ovaries (if she is still having some menstrual periods) and thyroid gland (which may cause depression when underactive).
  • Ask about life stressors that may be affecting the woman.

Treatment recommendations for major depression that occurs in association with the menopause depend on how severe the woman's symptoms are and whether she has had previous episodes of depression.

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