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Author Message
DianeHaught
Post subject: Part #2 Serious Condition: Depression  PostPosted: Jul 18, 2005 - 12:02 AM





Sergeant
Part#2

Depression is a serious health condition affecting millions of people each year.

Medical Information
It is not the intention of Raptor-Pack to provide specific medical advice but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Raptor-Pack urges you to consult with a qualified physician for diagnosis and for answers to your personal questions and specific medical advice


source: National Institute of Health Publication No. NIH-99-3561
http://www.allaboutdepression.com/gen_01.html

<Helping Yourself When You Are Depressed

Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the situation. Negative thinking fades as treatment begins to take effect. In the meantime:

<Set realistic goals and assume a reasonable amount of responsibility.
<Break large tasks into small ones, set some priorities, and do what you can as you can.
<Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
<Participate in activities that may make you feel better.
<Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help.
<Expect your mood to improve gradually, not immediately. Feeling better takes time.
<It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition--change jobs, get married or divorced--discuss it with others who know you well and have a more objective view of your situation.
<People rarely "snap out of" a depression. But they can feel a little better day by day.
<Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.
<Let your family and friends help you.





<Helping a Relative or Friend Who is Depressed

The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication. The depressed person should be encouraged to obey the doctor's orders about the use of alcoholic products while on medication.

The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Report them to the depressed person's therapist. Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.

Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it." Eventually, with treatment, most depressed people do get better. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better.





<Antidepressant Medications

There are several types of antidepressant medications used to treat depressive disorders. These include newer medications--chiefly the selective serotonin reuptake

inhibitors (SSRIs)--the tricyclics, and the monoamine oxidase inhibitors (MAOIs). The SSRIs--and other newer medications that affect neurotransmitters such as dopamine or norepinephrine--generally have fewer side effects than tricyclics. Sometimes your doctor will try a variety of antidepressants before finding the medication or combination of medications most effective for you. Sometimes the dosage must be increased to be effective. Antidepressant medications must be taken regularly for as many as 8 weeks before the full therapeutic effect occurs.

Patients often are tempted to stop medication too soon. They may feel better and think they no longer need the medication. Or they may think the medication isn't helping at all. It is important to keep taking medication until it has a chance to work, though side effects may appear before antidepressant activity does. Once the individual is feeling better, it is important to continue the medication for 4 to 9 months to prevent a recurrence of the depression. Some medications must be stopped gradually to give the body time to adjust. For individuals with bipolar disorder or chronic major depression, medication may have to be maintained indefinitely.

Antidepressant drugs are not habit-forming. However, as is the case with any type of medication prescribed for more than a few days, antidepressants have to be carefully monitored to see if the correct dosage is being given. The doctor will check the dosage and its effectiveness regularly.

For the small number of people for whom MAO inhibitors are the best treatment, it is necessary to avoid certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles, as well as medications such as decongestants. The interaction of tyramine with MAOIs can bring on a hypertensive crisis, a sharp increase in blood pressure that can lead to a stroke. The doctor should furnish a complete list of prohibited foods that the patient should carry at all times. Other forms of antidepressants require no food restrictions.

Medications of any kind--prescribed, over-the counter, or borrowed--should never be mixed without consulting the doctor. Other health professionals who may prescribe a drug--such as a dentist or other medical specialist--should be told that the patient is taking antidepressants. Some drugs, although safe when taken alone can, if taken with others, cause severe and dangerous side effects. Some drugs, like alcohol or street drugs, may reduce the effectiveness of antidepressants and should be avoided. This includes wine, beer, and hard liquor. Some people who have not had a problem with alcohol use may be permitted by their doctor to use a modest amount of alcohol while taking one of the newer antidepressants.

Antianxiety drugs or sedatives are not antidepressants. They are sometimes prescribed along with antidepressants; however, they are not effective when taken alone for a depressive disorder. Stimulants, such as amphetamines, are not first-line antidepressants and share the habit-forming risks of antianxiety medications and sleeping pills.



Lithium has for many years been the treatment of choice for bipolar disorder, as it can be effective in smoothing out the mood swings common to this disorder. Its use must be carefully monitored, as the range between an effective dose and a toxic one is small. If a person has pre-existing thyroid, kidney, or heart disorders or epilepsy, lithium may not be recommended. Fortunately, other medications have been found to be of benefit in controlling mood swings. Among these are two mood-stabilizing anticonvulsants, carbamazepine (Tegretol) and valproate (Depakote). Both of these medications have gained wide acceptance in clinical practice, and valproate has been approved by the Food and Drug Administration for first-line treatment of acute mania. Other anticonvulsants that are being used now include lamotrigine (Lamictal) and gabapentin (Neurontin).

Most people who have bipolar disorder take more than one medication including, along with lithium and/or an anticonvulsant, a medication for accompanying agitation, anxiety, or insomnia. Finding the best possible combination of these medications is of utmost importance to the patient and requires close monitoring by the physician.



<Depression and...Childhood Difficulties

People who become clinically depressed have generally experienced more severe difficulties in childhood than those who do not become depressed. These difficulties may include sexual or physical abuse, a turbulent upbringing, separation from a parent, or mental illness in a parent. Some researchers believe that a problematic childhood may trigger an early-onset of depression (first episode occurs before age 20). The most significant event that seems to be related to clinical depression is separation from or death of a parent before the age of 11.

It is not clear just how a difficult childhood can result in adult depression, but there are a few theories. One theory suggests that children who experience great unhappiness growing up have a harder time adjusting to changes in their life such as adolescence and the new roles of adulthood. Another theory is that these children may either lack appropriate emotional development or they become emotionally damaged making them vulnerable to developing depression. Experiencing great difficulties as children, these individuals may be more likely to have low self-esteem, feel powerless, and become dependent on others to make them feel good about themselves. These kinds of traits may increase a person's susceptibility to depression. Still another theory has to do with the developing brain of a young child. Early experiences may affect the development of the limbic system in the brain. If a child experiences great emotional distress, this could affect his or her ability to adapt to new environments and regulate emotions.

During World War II there were a number of children who were separated from their mothers. It was noticed that these children became depressed after going through several stages of grief. First, the children cried strenuously for their mothers. Then the children became very agitated. Afterwards, they became despondent and still. Lastly, they became very withdrawn. This severe reaction to losing their mothers is known as anaclitic depression. This same type of reaction to separation has been observed in studies with monkeys. In these studies, the monkeys secreted higher amounts of cortisol (a stress hormone) during the earlier stages of grief. It was found that the more cortisol that was released into the blood, the more intense the monkey's depression became later on. In approximately one-half of all depressed humans there are high levels of cortisol in the blood.


<Grief, Loss of a Loved One

Content is coming soon!. Read more...


<Medical Conditions

We all are vulnerable to depression, but people with some serious or chronic diseases may be at greater risk. It may also be true that those who are depressed could be at greater risk for developing certain medical conditions. Treatment for depression can help people manage symptoms of both diseases and thereby improve the overall quality of their lives.

Symptoms of depression may also signify the presence of a medical condition, which once treated may alleviate the depressive symptoms. A thorough medical evaluation by a physician is always an important part of the diagnostic process. Read more... http://www.allaboutdepression.com/gen_01.html


<Postpartum Depression
Postpartum depression is not really a separate mood disorder from major depression or bipolar disorder. The word, "postpartum" is a specifier used as additional diagnostic information to describe the onset or occurrence of the depressive episode associated with major depression or bipolar disorder.

Postpartum onset describes an uncommon depressive episode that begins within four weeks of giving birth to a child and may affect up to 10% of new mothers. It is very different than the "baby blues" that women can experience usually 3-7 days after delivery. Many women with postpartum depression may experience great anxiety, panic attacks, spontaneous crying, difficulty sleeping, and a lack of interest in their new child. A woman's mood may fluctuate and seem inconsistent, and there may even be the presence of psychotic features (delusions, hallucinations). If this is the case, a woman should receive immediate medical attention and hospitalization may be necessary. Whether or not psychotic features are present, a woman may have suicidal thoughts, continuous thoughts about violence towards her child, a difficulty with concentration, and she may feel and appear to be quite agitated. Read more... http://www.allaboutdepression.com/gen_01.html

<Stress

There appears to be a complex relationship among stressful situations, our mind and body's reaction to stress, and the onset of clinical depression. It is clear that some people develop depression after a stressful event in their lives. Events such as the death of a loved one, the loss of a job, or the end of a relationship are often negative and traumatic and cause great stress for many people. Stress can also occur as the result of a more positive event such as getting married, moving to a new city, or starting a new job. It is not uncommon for either positive or negative events to become a crisis that precedes the development of clinical depression.

Whether a stressful event itself can actually cause a person to become depressed is not fully known. There are times when we all must struggle with very painful situations in our lives. More times than not these changes do not result in a person becoming clinically depressed. In fact, sometimes people become depressed even when there is little or no stress in their lives and everything seems to be going very well. And, no single stressful event will cause depression to develop in every person. The same type of stressor may lead to depression in one person, but not another.

If a stressful experience causes a person to become depressed, it may happen indirectly. In other words, if a young woman with a family history of major depression suffers the death of a loved one, she may become clinically depressed. In this situation it is not necessarily the traumatic loss itself that caused the development of depression, but the combination of a genetic predisposition with the stressful event that made her vulnerable to becoming depressed.

For those who struggle with more chronic depression, the effects of stress may be more complicated. A stressful event such as a job loss or the death of a loved one is more likely to come before a first or second depressive episode. After that, further depressive episodes may develop spontaneously. It is not certain why stress may lead to depression in this way. However, researchers have theorized an explanation called the "kindling effect," or "kindling-sensitization hypothesis." This theory surmises that initial depressive episodes spark changes in the brain's chemistry and limbic system that make it more prone to developing future episodes of depression. This may be compared to the use of kindling wood to spark the flames of a campfire. Since early episodes of depression make a person more sensitive to developing depression, even small stressors can lead to later depressive episodes.

Some people may become depressed as a result of having to struggle with chronic stress. These constant difficulties may come in the form of having to juggle multiple roles at home and work, making major changes in lifestyle, being in an abusive environment, etc. They may also come with important and normal transitions in life such as late adolescence and early adulthood when many people separate from their families to establish their own independence. Middle age may require adjustment to changes in fertility and virility, children leaving the home, concern about job advancement, and a re-evaluation of accomplishments in life. Retirement is another time of major change as some people struggle with a reduction of position and finances. If a person is under continuous stress, a single difficult event may be more likely to induce a depressive episode. For instance, if a middle-aged woman is in an unhappy marriage, she may be more likely to become depressed after her youngest child leaves home for college. The event of her child leaving home may not by itself have been enough to lead to depression, but the constant stress of an unhappy marriage combined with this event may be enough to trigger clinical depression.

In studying how stressful events may lead to depression, researchers have developed a theory called, "learned helplessness." This theory states that when people experience chronic or repeated stressful events, they learn to feel helpless. This feeling of helplessness is strengthened when a person believes he or she has no control over the stressful situation. Although the research to support this theory was initially done with animals, the effects of learned helplessness may be seen in depressed humans. People who are depressed very often have negative beliefs about their ability to manage aspects of their lives based on perceived failures in the past. For example, imagine an adolescent girl living in a home with verbally abusive parents who tell her that she is stupid and cannot do anything right. Over time the young girl may believe her parents and come to doubt her abilities and self-worth. She may begin to feel helpless and believe that most things are beyond her control. This feeling of helplessness may make her vulnerable to developing clinical depression at some point in her life.


<Trauma

Many times, people who become depressed report that a single traumatic event happened just prior to their becoming depressed. Painful experiences such as the death of a loved one, divorce, a medical illness, or losing everything in a natural disaster may be so impactful as to trigger clinical depression. Events like these take away a sense of control and cause great emotional upheaval. Some traumatic events may cause more distress for one person than for another. For instance, a man who loses his wife to death may be more prone to becoming clinically depressed than a woman who loses her husband. This may be because the loss of a wife can lead to additional losses for a man. He might lose contact with children and other family members. He may also become more emotionally distressed and isolated if he has difficulty reaching out to others. Women who lose their husbands may be more willing to seek out emotional support.

A person's recovery from depression may also be affected by traumatic events. The more stress and difficulty a person experiences, the longer a recovery from depression may take. For example, imagine a depressed woman in an unhappy marriage who finally decides to file for divorce. If the process becomes prolonged with disputes over finances or custody of the children then her recovery from depression could be slowed down greatly. On the other hand, if the same woman perceived the divorce as something positive in her life, perhaps she was leaving an abusive relationship, then she might have a more speedy recovery.




<Workplace

Depression affects all aspects of life, including the workplace. Read about The Effects of Depression in the Workplace and What to Do When an Employee is Depressed: A Guide for Supervisors.

<National Organizations
Please call or write to the following organizations for more information or for local chapters in your area.

Agency for Health Care Policy and Research (AHCPR)
AHCPR Publications Clearinghouse
P.O. Box 8547
Silver Spring, MD 20907-8547
phone: 1-800- 358-9295
e-mail: info@ahcpr.gov
web site: http://www.ahcpr.gov/

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Avenue, NW
Washington, DC 20016-3007
phone: 1-800- 333-7636
web site: http://www.aacap.org/

American Psychiatric Association
1400 K Street, NW
Washington, DC 20005
phone: (202) 682-6220
web site: http://www.psych.org/

American Psychological Association
750 First Street, NE
Washington, DC 20002-4242
phone: (202) 336-5500
web site: http://www.apa.org/

AMI Quebec
5253 boul. Decarie
bureau 150
Montreal, Quebec
H3W 3C3
phone: (514) 486-1448

Anxiety Disorders Association of America
11900 Parklawn Drive, suite 1200
Rockville, MD 20852
web site: http://www.adaa.org

Canadian Medical Association
1867 Alta Vista Drive
Ottawa, ON
K1G 3Y6
phone: (613) 731-9331
web site: http://www.cma.ca

Depression and Bipolar Support Alliance
730 North Franklin Street, suite 501
Chicago, IL 60610-3526
phone: 1-800-826-3632; (312) 642-0049
e-mail: myrtis@aol.com
web site: http://www.ndmda.org

Depression and Related Affective Disorders Association (DRADA)
Meyer 3-181
600 N. Wolfe Street
Baltimore, MD 21287-7381
phone: (410) 955-4647 (Baltimore); (202) 995-5800 (Washington, DC)
e-mail: drada-g@welchlink.welch.jhu.edu
web site: http://www.med.jhu.edu/drada

Federation of Families for Children's Mental Health
1021 Prince Street
Alexandria, VA 22314-2971
phone: (703) 684-7710
e-mail: ffcmh@crosslink.net
web site: http://www.ffcmh.org

Health Canada
A. L. 0913A
Ottawa, Canada
K1A 0K9
phone: (613) 941-5336
web site: http://www.hc-sc.gc.ca

National Alliance for the Mentally Ill
Colonial Place Three
2107 Wilson Blvd., Suite 300
Arlington, VA 22201-3042
phone: 1-800-950-NAMI, (703) 524-7600
web site: http://www.nami.org

National Foundation for Depressive Illness
P.O. Box 2257
New York, NY 10116
phone: 1-800-248-4344 or 1-800- 239-1265
web site: http://www.depression.org

National Institute of Mental Health
Information Resources and Inquiries Branch
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
phone: (301) 443-4513
fax: (301) 443-4279
free brochures: 1-800-421-4211
e-mail: nimhinfo@nih.gov
web site: http://www.nimh.nih.gov/

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
phone: 1-800-969-6642, (703) 684-7722
fax: 1-703-684-5968
web site: http://www.nmha.org

Center for Mental Health Services
P.O. Box 42490
Washington, DC 20015
phone: 1-800-789-2647
TDD: (301) 443-9006
e-mail: ken@mentalhealth.org
web site: http://www.mentalhealth.org/

National Organization for Seasonal Affective Disorder (NOSAD)
P.O. Box 40133
Washington, DC 20016

Postpartum Support International
927 North Kellog Avenue
Santa Barbara, CA 93111
phone: (805) 967-7376
e-mail: THONIKMAN@compuserve.com





source: National Institute of Health Publication No. NIH-99-3561

http://www.allaboutdepression.com/gen_01.html

Medical Information
It is not the intention of Raptor-Pack to provide specific medical advice but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Raptor-Pack urges you to consult with a qualified physician for diagnosis and for answers to your personal questions and specific medical advice


Wave

Hug

Diane

Taking a depression-screening test is one of the quickest and easiest ways to determine whether you are experiencing symptoms of clinical depression. The depression-screening test on this site is completely anonymous and confidential.

http://www.depression-screening.org/screeningtest/screeningtest.htm

The depression-screening.org web site is NOT designed to respond to suicide crisis. If you believe you are at risk for suicide, dial "911" or go immediately to the nearest hospital Emergency Room for an evaluation.



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