The mental health profession categorizes depression as a mood disorder, but also recognizes that its symptoms can vary widely from one person to another. It is also accurate to think of depression 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 alcohol or drug abuse, suicide attempts, and other socially or self-destructive behaviors. It can affect interpersonal (social and family) relationships, leading to aggression, withdrawal, or marital and family distress. The main forms of depression are: major depressive disorder, also called "unipolar" for its affecting only one end of the mood continuum -- depression; and bipolar disorder, formerly called manic-depressive illness, ("bipolar" for its affecting both ends of the mood continuum -- depression and euphoria, or mania.) Depression can also present itself as dysthymia, a less intense and more chronic form of depression. Major depression is far more common than bipolar disorder, and has a much wider range of contributing factors.
What are depression’s effects on personal and family life?
The symptoms of depression described above make it clear: To be depressed is to suffer. The hopelessness and helplessness that people experience when they are depressed is more than just a frame of mind at such times -- it is an entire way of being. People stop trying, they stop caring, they withdraw from life, and of course, this makes them feel even worse. Their lives deteriorate, and it affects others as well. Family members are not immune to the depressive’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. Spouses can feel hurt and alienated, and children may feel guilty, resentful, and as if they are to blame. 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.
To be more specific, take into account the following factors when deciding to seek professional treatment:
- Feeling emotionally disconnected from or invalidated by their parents
- Wanting to "fit in" within a particular peer group that encourages and rewards self-harming behavior
- Feeling emotionally dead inside or feeling invisible in their parents' eyes. Self-harm makes them feel alive inside and helps confirm their existence in reality.
- For girls, self-harm may be used as a coping strategy with overly demanding parents, especially in situations where the father is the dominant voice when it comes to discipline and decision-making
Since adolescents often engage in self-harming behaviors in privacy or with their friends, parents may not be aware that this problem exists. In addition, parents also need to be aware that there is a big difference between self-decorating and self-harming behavior. It is a popular fad among youth today to body pierce and tattoo as a form of self-decorating. Teens who self-harm are seeking relief from emotional distress, they are not self-decorating.
Here are some signs that might indicate that a teen has a problem with self-harming behavior:
- Suicidal thoughts or feelings: Suicide is a terrible and irreversible solution to specific problems. The depressed person and his or her family need to think preventively, and get help immediately if someone is suicidal.
- Acute depression turning chronic: Before settling into "life as a depressed person," the depressed person, and family if possible, should do all they can to resolve it early on. Every day spent suffering is too costly.
- Lifestyle disruption: The depressed person, and his or her family, can prevent bad circumstances from getting worse by acting quickly. 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 depressed member 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 two most commonly used treatments for managing depression. Many people use a combination of the two. People’s responses vary, of course, but these approaches hold good promise for providing relief. Most people have already heard of the popular antidepressant medication, Prozac. It is only one of the many "newer generation" medications that do, in fact, help the majority of people who take them. Medication is a valuable tool for reducing symptoms and "raising the floor" on depression. Speaking to a psychiatrist about the use of medications in your particular case is the best way to explore whether medications are viable for you. A psychotherapist can also help you with this decision.
Psychotherapy is an non-drug alternative that is generally as effective as medication, and in some ways is even superior (though not quite as fast-acting). For example, people who receive therapy tend to have a lower relapse (recurrence) rate, and tend to feel better as an active participant in the recovery process. Psychotherapy can help individuals and families who are dealing with depression. The most effective psychotherapies are called cognitive therapy (which teaches how to identify and correct distorted thinking), behavior therapy (which teaches how to behave more effectively), and interpersonal therapy (which teaches relationship skills). All of these are short-term therapies, and all focus on changing things in the present.
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 good treatment, and good treatment is available from a variety of sources.
The text for this brochure was written by Michael D. Yapko, Ph.D. (www.yapko.com)
Use the AAMFT Consumer Update "Depression" pamphlets to market your practice.