Depression, It’s More Than “The Blues”

All of us have experienced feelings of sadness, emptiness, or feeling “down” as a part of our everyday lives. The events of the past few months due to COVID-19 certainly haven’t made things any easier. Many of us have lost loved ones, experienced impacts to our jobs, and experienced isolation due to the need to quarantine or practice social distancing. These events can cause us to feel depressed. These feelings are completely understandable and generally pass quickly with only minor impact to our day-to-day routine. However, many people, at some point in their lives, experience symptoms of depression that last longer and impact their mood, behavior, and physical health. These symptoms can be the result of depression. Let’s take a closer look at depression, along with its causes, symptoms, and treatments.

What is Depression?

Depression is the general name given to a group of mood disorders that can cause unpleasant physical and cognitive symptoms that impact our ability to function. According to the National Institute of Mental Health, medical research seems to indicate that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression also accompanies some diseases such as diabetes, cancer, heart disease, or Parkinson’s disease, as well as other mental illnesses, such as anxiety disorders, panic disorder, social phobia, and generalized anxiety disorder. Certain medications can also cause depression, One example is benzodiazepines, such as alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), and temazepam (Restoril), which are used to treat anxiety and insomnia. Your risk for developing depression may also be greater if you have experienced major life changes, have a family history of depression, or have experienced trauma or stress.¹

Rudoy Medical practitioner, Christine Chollak, PMHNP, explains that the ongoing COVID-19 pandemic is affecting many people because it has brought about major life changes, stress, and in some cases, trauma. She says, “Depression is caused by a variety of factors including genetics and environmental stressors. COVID and the subsequent quarantine/social distancing measures can create circumstances that leave individuals more vulnerable to experiencing depression. Social isolation, financial stressors, and limited access to healthy coping skills such as exercise, can all elevate the risk of psychological disorders, including depression.”

There are many different types of depressive disorders. In this article, we’ll be mainly dealing with Clinical Depression or Major Depressive Disorder, which causes severe symptoms that occur for a minimum of two weeks. (We’ll take a look at some of the other types of depression in separate blog posts.) Other depressive disorders include:

• Persistent Depressive Disorder (or Dysthymia), in which symptoms of depression last for a minimum of two years
• Postpartum Depression, which women may experience after the birth of a child making it difficult for them to care for themself or their baby
• Seasonal Affective Disorder, which causes major mood changes including depression during the winter months and typically improves during spring and summer

You can learn more about these and other types of depressive disorders from the National Institute of Mental Health.

Depression is a common mental health challenge. In fact, according to MentalHealth.gov, more than 20 million people in the U.S. have depression, which often starts between the ages of 15 – 30, and is more common in women than men.²

Symptoms

Depression has a wide variety of symptoms. Some people experience many of them, while others may only experience a few. The National Institute of Mental Health offers the following list of common symptoms of depression¹:

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts

• • Note: If you or someone you love are contemplating suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), En Español 1-888-628-9454, for support.

• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Diagnosing Depression

If you are experiencing symptoms of depression, you should talk to a medical professional such as your primary care provider or a mental health provider. Generally speaking, those who are diagnosed with Clinical Depression would be experiencing symptoms of depression most of the day, nearly every day, for at least two weeks. Even if you are not diagnosed with a depressive disorder, but you are experiencing symptoms of depression that are affecting your day-to-day life, you may still benefit from treatment. Your healthcare provider can evaluate your risk factors for depression, rule out any medical conditions or medications that may be causing your symptoms, and use various screening tools to evaluate your symptoms or diagnose you with depression. Here at Rudoy Medical, our professionals often evaluate patients for depression. Depression can look different for different people. Therefore, it is important to evaluate for symptoms of depression beyond a decline in mood. By speaking to patients and understanding the symptoms they would like to target, we are more able to determine if depression is relevant to their current state.

Treatment for Depression

If you have symptoms of depression, you’re probably thinking about therapy, which is a good first step. There are many effective treatments available to help you recover. Your healthcare practitioner can help you develop a plan for treatment based on your symptoms. Treatment for depression typically involves psychotherapy (“talk” therapy with a psychologist or counselor), the use of antidepressant medications prescribed by a doctor or psychiatrist, or both therapy and medication together. Given the social distancing challenges posed by COVID-19, your provider may use telemedicine or teletherapyfor your initial evaluation visit and for follow-up visits or therapy sessions.

Medications

If your doctor prescribes antidepressant medications, or if you are already taking them, it is very important to take them as prescribed. Here are a few additional things to be aware of when it comes to the use of antidepressant medications.

• Do not stop taking antidepressant medications without first talking to your doctor. Stopping antidepressant medications suddenly can lead to unpleasant side effects and worsening of depression.
• You should tell your provider if you are pregnant, planning to become pregnant, or are breastfeeding in order to protect the health of your baby.
• Be sure to talk to your provider about the safe use of antidepressants in children, teens, and young adults due to the possibility of an increase in suicidal thoughts or behavior in younger patients.

Next Steps

If you or someone you love may be experiencing symptoms of depression, don’t hesitate to reach out for help from your healthcare provider. In the meantime, here are some additional informational resources that you can use to learn more about various types of depression and treatments that are available.

• MentalHealth.gov
• National Alliance on Mental Illness
• National Institute of Mental Health
• Substance Abuse and Mental Health Services Administration

Are You or a Loved One Experiencing a Crisis?

Rudoy Medical does not provide crisis services and is not staffed to respond to people in crisis. If you or someone you love are in crisis, below are some resources that may be helpful.

• If you are in danger or are having a health- or mental health-related emergency, please call 911 or go to the nearest emergency room.
• If you or someone you love are contemplating suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), En Español 1-888-628-9454, for support
• If you are experiencing a crisis, text HOME to 741741 from anywhere in the U.S. to reach a trained crisis counselor with the Crisis Text Line.

Sources

1. National Institute of Mental Health. Depression. Retrieved 7/11/20. https://www.nimh.nih.gov/health/topics/depression/index.shtml
2. MentalHealth.gov. Depression. Retrieved 7/12/20. https://www.mentalhealth.gov/what-to-look-for/mood-disorders/depression