Depression is characterized as mood disorder and its symptoms can vary widely from one person to another. It is as a complex problem that can affect many different aspects of the sufferer’s life. It can affect the body, and generate such physical symptoms as insomnia, fatigue, appetite disturbances, diminished sex drive, and anxiety. It can affect the mind, interfering with the ability to think clearly, notice and remember details, and make good decisions. It can affect emotions, causing feelings of sadness, despair, guilt, worthlessness, and apathy. It can affect behavior, leading to such self-destructive practices as alcohol or drug abuse, suicidal ideation, attempted suicide, or worse, suicide itself. It often affects interpersonal relationships with family and friends leading to aggression, withdrawal, and/or marital and family distress.
Depression manifests in different ways and its symptoms range from mild to severe. Major depressive disorder, for example, presents more often than other forms of depression and has a wider range of contributing factors. It affects only one end of the mood continuum – depression. Whereas, bipolar disorder affects both ends of the mood continuum—depression and euphoria, or mania, as it often described. Depression can also present itself as dysthymic disorder, which is a less intense but more chronic form of depression.
What are depression’s effects on personal and family life?
To be depressed is to suffer. The hopelessness and helplessness that people experience when they are actively depressed is more than just a frame of mind—it is an entire way of being and can be a vicious circle for the suffer as well as their loved ones. The person who is experiencing depression stops trying, they stop caring, and they withdraw from life, which makes them feel even worse. If left untreated, their lives will deteriorate, negatively impacting the lives of everyone around them.
Family members are not immune to the sufferer’s negativity—the never-ending complaints, the steady stream of criticisms, the lack of emotional closeness, and the loss of the ability to have fun together are some of the unintended consequences of depression. Spouses or partners can feel hurt and alienated, and children may feel guilty and resentful, or worse, they may blame themselves for the sufferer’s symptoms. In turn, family relationships can also exacerbate depressive symptoms.
How do you know when to seek help?
As a general answer, you should seek help when depression is starting to affect your life (your family, your job, your outlook) in negative ways, and you are not very clear about what you need to do to prevent things from getting worse. You should seek help—for yourself, loved ones, or both—long before things get really bad.
Here are some signs that might indicate that you or someone you love may be struggling with self-harming behavior:
- Suicidal thoughts or feelings: The sufferer and their family need to think preventively, and get help immediately if someone is suicidal—the cost of losing a loved one to suicide is a terrible and irreversible solution to specific problems that can be potentially thwarted with treatment.
Unfortunately, there are cases when even the most diligent and involved supporters could not prevent a tragic outcome. In such cases, the survivors will need support and will benefit from prompt treatment to help them manage a complexity of emotions that can potentially lead to a depressive episode.
- Acute depression turning chronic: In such cases, early intervention is often the best approach to helping someone manage their depression more effectively—each day spent suffering is too costly.
- Lifestyle disruption: By acting quickly, the sufferer, and his or her family, can prevent bad circumstances from getting worse. The depressed person does not have to ignore his or her health, lose a job, or hurt or alienate family and friends.
- Reality testing: If a family and their loved one who is experiencing depression do not have someone good to talk to, someone with whom they can share their private thoughts, then how will they know whether what they are thinking makes sense? A good therapist is a valuable partner for "reality testing."
What kinds of treatments are commonly used?
Psychotherapy and antidepressant medications are the most commonly used treatments for managing depression. Many people use a combination of the two, while trying to integrate holistic techniques such as meditation and mindfulness, regular exercise, sleep-regulation, and proper nutrition. It is also recommended that the sufferer have a complete physical to rule out anything, like a thyroid condition, that can mimic depression. Treatment outcomes will vary, of course, but these approaches yield positive outcomes for providing relief.
Medication is often used to help reduce acute symptoms of depression. Marriage and family therapists can provide referrals to a psychiatrist for a medication evaluation. Many people resist medication because of the stigma that exists with depression. In cases of severe depression, medication is often necessary to help neurotransmitters in the brain connect in ways that restore a sense of balance to the sufferer. For some, medication is a life-long part of treating depression while others may only need medication for a period of time. Either way, it is important to remember that depression is something that happens to the sufferer not a choice he or she is making. Being supportive and non-judgmental, while also encouraging the person to engage in his or her competencies are ways of offering support to the entire family system.
Psychotherapy with a marriage and family therapist is as effective as medication, and in many ways better than medication alone. While it may take longer to see results than it does with medication, people who receive therapy tend to have a lower relapse rate, and tend to feel better as an active participant in the recovery process.
Because depression affects the entire family, marriage and family therapists can help individuals and families by empowering them as a unit. By educating families, stigma is reduced and families can focus on developing skills to manage their difficulties during times of depression in the family. One of the most effective treatment models for depression is cognitive behavioral therapy (CBT), which teaches clients and their family members how to identify and correct distorted thinking and how to behave more effectively.
In recent years, clinicians like marriage and family therapists have been using mindfulness in conjunction with CBT to help those suffering from depression. Mindfulness aims at being in the present moment while focusing on reframing one’s relationship with depression. The sufferer, for example, can benefit from a better understanding of depression‑-one that does not label or define the person as depression.
The fact that long-term research shows the effectiveness of medication and psychotherapy for treating depression can be wonderfully reassuring for depression sufferers and their families. Depression is highly responsive to integrative treatments that may include medication, psychotherapy, and psycho-education. Marriage and family therapists are trained to work relationally, which is most helpful when working with depression.
The American Association for Marriage and Family Therapy (AAMFT) is the professional association for the field of marriage and family therapy representing the professional interests of more than 25,000 marriage and family therapists throughout the United States, Canada and abroad. www.aamft.org
The American Psychiatric Association is a medical specialty society recognized worldwide. Over 35,000 U.S. and international member physicians work together to ensure humane care and effective treatment for all persons with mental disorders, including mental retardation and substance-related disorders. Its vision is a society that has available, accessible quality psychiatric diagnosis and treatment. www.psych.org
Association for Behavioral and Cognitive Therapies. Cognitive-Behavior Therapy (CBT) is psychotherapy based on modifying everyday thoughts and behviors. In CBT, the therapist and client work together to determine the goals for therapy, and how long to continue therapy. www.aabt.org
Depression and Bipolar Support Alliance (DBSA) provides information and available resources including support groups for depression and bipolar disorder. www.dbsalliance.org
Families for Depression Awareness This is a non-profit organization dedicated to helping families recognize and cope with depressive disorders. The organization provides education, outreach, and advocacy to support families and friends. Families for Depression Awareness is made up of families who have lost a family member to suicide or have watched a loved one suffer with depression. www.familyaware.org
The Family Resource Network was established in response to the need of families to access information about the behavioral health system and the support groups who educate them. www.frnfamilies.org
National Alliance on Mental Illness (NAMI) is the nation's largest grassroots mental health organization dedicated to improving the lives of persons living with serious mental illness and their families. www.nami.org
National Institute of Mental Health (NIMH) is the lead federal agency for research on mental disorders. NIMH is one of the 27 Institutes and Centers that make up the National Institutes of Health (NIH), the nation’s medical research agency. NIH is part of the U.S. Department of Health and Human Services (HHS) https://www.nimh.nih.gov
Use the AAMFT Consumer Update "Depression" pamphlets to market your practice.