Feelings of sadness can be normal, appropriate and even necessary during life's setbacks or losses. Or you may feel blue or unhappy for short periods of time without reason or warning, which also is normal and ordinary. But if such feelings persist or impair your daily life, you may have a depressive disorder. Severity, duration and the presence of other symptoms are the factors that distinguish ordinary sadness from a depressive disorder.
Depression can happen to anyone of any age, race, class or gender. It afflicts almost 19 million Americans each year, and up to one in five American women will suffer from clinical depression at some point in her life. Women are two to three times more likely than men to suffer from depression. Many women first experience symptoms of depression during their 20s and 30s. Once you experience depression, there's a 50 percent chance that you'll be depressed again at some point in your life.
A complex combination of physiological, social, environmental, cultural, hormonal, biological and psychological factors may contribute to the reasons why women experience depression at a higher rate than men.
Depression affects both mind and body. If you are depressed, you feel a sense of helplessness, hopelessness or despair. You lose interest in your favorite activities, may experience changes in appetite, weight and sleep patterns, have difficulty concentrating and may be preoccupied with death or suicide. Research sponsored by the National Institute of Mental Health (NIMH) suggests that depression may be a major risk factor for osteoporosis. A phase IV clinical trial is currently underway that will determine whether women with major depression lose bone mass at a faster rate than women without depression. This study will also determine if the drug alendronate (Fosamax) can maintain or increase bone mass in premenopausal women with major depression and osteoporosis. Additionally, depression often occurs in conjunction with certain chronic illnesses, like diabetes, and after a heart attack or stroke. It also can develop as a result of conditions that cause unrelieved pain. Left untreated, the depression contributes to increased complications, prolonged recovery time, and a greater chance of death.
The good news is that depression is a treatable illness; however, according to a major study published in the June 18, 2003 issue of the Journal of the American Medical Association (JAMA), just one in five women with depression ever receive adequate treatment. Adequate treatment is defined as at least one month on adequate doses of antidepressant medication or eight sessions of therapy.
One reason that treatment for depression is inadequate is that many people do not know or are confused about where to seek mental health treatment. Another reason is that many individuals do not perceive depression as a real medical condition that should or can be treated. Also, there is still a social stigma attached to mental illnesses like depression. These perceptions are wrong. Depression is a potentially life-threatening disorder and a woman does not have to "just live with it."
Types of Depression
Depression is classified as a mood disorder. The primary types of depression are major depression and dysthymia, a chronic and low-grade form of depression. Other forms of depression include postpartum depression (PPD), premenstrual dysphoric disorder (PMDD) and seasonal affective disorder (SAD).
Major depression is marked by a loss of interest in previously pleasurable activities and depressed mood that represents a change from previous behavior or mood.
Chronic, but low-grade depression, or dysthymia, is marked by low energy, a general negativity and a sense of dissatisfaction and hopelessness. A person suffering from dysthymia may experience many of the same symptoms that occur in major depression, but they are less intense and last much longer-at least two years. Sometimes, women with dysthymia also suffer from episodes of major depression, a condition known as double depression.
The "baby blues" are common feelings for many women within the first few days or weeks following pregnancy and childbirth. Emotional ups and downs during this stressful period are normal, but temporary. However, for some women, symptoms become more severe and long lasting. These symptoms are known as postpartum depression. This condition typically occurs from three days to six weeks after the baby is born, but can appear anytime within the first year. About eight to 15 percent of women report diagnosable PPD within three months of delivery. If you've had prior depressive episodes, you have a much higher risk. Postpartum depression can seriously interfere with a mother's ability to care for herself and her child. Symptoms should be reported immediately to a health care professional for further evaluation.
The syndrome of more severe depression, irritability and tension occurring seven to 10 days prior to the start of the menstrual period is known as premenstrual dysphoric disorder (PMDD) (also called late-luteal dysphoric disorder). It affects an estimated five to seven percent of women of childbearing age. Though PMDD shares many of the characteristics of premenstrual syndrome (PMS), particularly the timing of the symptoms, there are differences between the two conditions. Mood-related symptoms and not physical symptoms are key to a PMDD diagnosis and are significantly more severe. PMS symptoms may include both mood and physical symptoms. Experts say the difference between PMDD and PMS is similar to the difference between a mild tension headache and a migraine.
Also called winter depression, SAD is a form of depression that affects an estimated five million Americans. Women in their 20s, 30s and 40s seem particularly susceptible to SAD, and outnumber men three to one in clinical studies of the disorder. The key feature of SAD is your response to decreasing availability to light during the winter months. Experts believe that brain chemistry in some individuals is affected by diminished daylight, triggering depression at this time of the year. It is episodic--it comes and goes--and many people who experience SAD recover in the spring. These individuals, however, are at higher risk of becoming bipolar.
Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by intense episodes of elation and despair, with any combination of mood experiences in between, including periods of normal moods. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. Symptoms during the manic cycle include a decreased need for sleep, increased talkativeness, racing thoughts, increased activity, including sexual activity, excessive spending or having a great deal of energy. Sometimes manic episodes may include extreme irritability. Women who are bipolar usually have more episodes of depression than mania.
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Out of Darkness & Into the Light
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