It is normal for everyone to have the blues now and then, but they usual pass in a day or so. There are several types of depressive disorders that interfere in daily functioning and causes pain everyday for the person and those around them. Before I specifically address major depressive disorder, I want to briefly tell you what the others depressive disorders are in this category. There is major depressive disorder, dysthymic disorder (low-grade chronic depression), psychotic depression (depression with a break in reality, hallucinations and delusions), postpartum depression (depression which occurs after the birth of one's baby), and seasonal affective disorder (depression which occurs when there is less natural sunlight). They are all chemical imbalances.
I was in psychotherapy for 12 years and then things were pretty good until November 2003 when I figured out I was depressed. Well, I know the symptoms, but I did not pick them up. I returned to therapy and to taking medications which I had done previously for about 7 years. Even so, my sleep is all disturbed. I wake up about 1 to 3 am almost every morning and nap during the day.
I actually cannot remember not having disruptive sleep ever except for maybe a one year period after I was married. My psychiatrist indicated that it is common for a person under my circumstances to have difficulties with sleep disturbances. At least, since I am not working it helps because I can sleep whenever I am tired then it is usually a 2-3 hour nap and sometimes two during the day.
During this second time in therapy with Gary, I began to have flashbacks and memories of neglect, physical, emotional and sadistic sexual abuse. I became incapacitated at home and would not leave the house except for work. Everything became overwhelming I couldn't shop (me not shop...you know it is serious), clean the house, cook, bake, etc. All I could manage to do was to work, which I kept up to date, and at the beginning no one noticed and went to therapy 5 times per week. Yes, I had long days. Work was my way of trying to prove that I was "okay," when I was anything but okay.
In 2006, working and going to therapy caught up with me and I was no longer able to work. It was continue to work and be hospitalized or stop working. I subsequently was hospitalized and then twice in 2009. With fragmenting and a new supervisor "re-traumatized" me due to her supervisory skills. Most of those under her left for other jobs. The unfortunate thing is that I loved my job and envisioned being there a long time. But, I figure that God knows what He is doing. Also, I would not have been able to do the tougher emotional work while being employed. This has been a good thing.
Now, I am a little better. But, I still have to gage if I can tolerate going out and handling the crowd without going away or becoming overwhelmed. Then, afterward and the next day I sleep and sleep and sleep. Also, there are days when I just don't want to get out of bed and if I do and don't have to go anywhere I don't brush my teeth, shower or get out of my pajamas. These are some specific examples of major depression versus dysthymia which is painful as well. Gary and I figure that I've been depressed my whole life with periods of major depressive episodes.
Depressive disorders are mental illness that are treatable and manageable, but need to be taken care of just as someone with heart disease would. No one would dare say or think any of the above about someone who has had a heart attack. But, somehow, everyone treats mental illness differently. Sometimes, it feels like some people are afraid they are going to catch it.
Major Depression is a serious medical illness affecting 18 million American adults, men and women of all ages, races and economic levels. Unlike normal emotional experiences of sadness, loss, or passing mood states, major depression is persistent and can significantly interfere with an person's thoughts, behavior, mood, activity and physical health. It is the leading cause of disability in the United States and usually strikes people between the ages of 25 and 44.
Twice as many women as men are diagnosed with Major Depression. It is not fully understood why. After a single episode, a person is more likely to have another one and after the second the percentage exponentially increases with each episode. There is evidence that the brain may make permanent changes making someone more susceptible to another episode. I've had a least five, but only two were diagnosed and treated. The others were before age 21. Without treatment, the frequency as well as the severity increases over time and can lead to suicide. However, with proper treatment a person can recover as long as they don't give up on the treatment.
persistently sad, anxious or irritable mood
pronounced changes in sleep, appetite, and energy
difficulty thinking, concentrating and remembering
physical slowing or agitation
lack of interest in or please from activities that were once enjoyed
sleeping too much or can't sleep
feelings of guilt, worthlessness, hopelessness and emptiness
recurrent thoughts of death or suicide
persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain.
Psychological, biological, and environmental factors may all contribute to the development of a depressive episode. Whatever the specific cause of depression, scientific research has firmly established that it is a biological, medical illness. Neurotransmitters are thought to be involved which is what medications address. There is also some evidence that there is a genetic predisposition. Also, discuss with your doctor your medical history as some illness may influence depression especially hypothyroidism.
Reportedly, between 80-90% of those treated for Major Depression return to their usual daily activities and feelings. I did so successfully for about five years, but this episode is much worse and I don't feel as hopeful. But, all indications are that I will recover to some degree although it is taking much longer than I want it to partly because it is complicated by post-traumatic stress disorder.
Treatment options include medications, psychotherapy (usually cognitive behavioral therapy and interpersonal therapy), and/or electroconvulsive therapy (ECT; it causes a seizure by means of an electrical current which may improve mood). I am taking medications and receiving psychotherapy, but it is the person with the illness that must make the decisions just like a cancer patient with the assistance of their support system and medical professionals. Be aware that many of the side effects from these medications go away after a short period and it may take time before the full effects are noticed.
Call 911, a suicide hotline or get safely to an emergency room if you have thoughts of suicide, a suicidal plan or thoughts of harming yourself or others. If a loved one expresses such thoughts, it is okay to let them talk about it. By not talking about it, it becomes a "taboo" subject, so they may not go to you if they are at risk. If they talk about it, you can be sure that they have been thinking about it.
Your doctor needs to be called right away if you hear voices, see things, smell things, feel things that are not there (psychosis which can accompany MDD; have frequent crying spells, if your work, school or family life is disrupted for two or more weeks; and if you or someone else thinks that you should cut back or stop drugs or alcohol. Side effects of some medication includes depression, but DO NOT stop taking it without talking to your doctor.
Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor. They maybe angry for awhile, but it is necessary. You don't want to end up at their funeral with regrets. Invite them out even if they decline, but don't push too soon or it will feel demanding or overwhelming and increase feelings of worthlessness and failure. Remind yourself and them that with time and treatment, that the depression will get better.
I hope this helps you or someone you love to have a better understanding and compassion for yourself and others with depression. I know it helped me to have more compassion for myself.
Most of the information in this post was compiled from www.nami.org, www.nlm.nih.gov, and www.healthyplace.com. You can also go to their websites for additional information and other resources. Remember there is treatment available and stick to it don't give up!!
Your can also go to PsychCentral for more information and to take a depression screening test.