So many responded to my articel The Importance of Understanding Cultural Practices and Beliefs When Treating Depression that I thought it would be helpful to start this discussion.

Depression

Snap out of it. Pull yourself up. What do you have to be depressed about? It’s all in your head.

Depression is so common that it is referred to as “the common cold of psychiatric disorders.

Depression is higher in young women and has a tendency to decrease with age.

With men, depression is lower in younger men and increases with age.

Depression is higher in those who are divorced or separated. Higher in married women, lower in married men.

19 million Americans suffer from depression each year.

Depression can severely disrupt an individual’s life, affecting appetite, sleep, work performance, and relationships.

The cause of depressive disorders is not entirely known. INCLUDE: genetics, biochemical influences, and psychosocial experiences.

Depression is more than just a passing sad mood.

Depression is an illness that affects the way you feel about yourself, other people and things in life, day after day.

Feeling down once in a while is normal, especially when something bad happens, such as losing a job.

BUT: if you feel down for a long time, no matter what’s going on in your life, you could be depressed.

RED FLAGS

• Two questions: Have you felt down, depressed, or hopeless for MOST of the past 2 weeks?

• Have you felt little interest or pleasure doing things for most of the past 2 weeks?

• Prolonged sadness and feelings of hopelessness

• Loss of interest in activities that once provided pleasure

• Poor appetite or overeating

• Trouble sleeping or sleeping too much

• Agitation

• Difficulty concentrating

• Difficulty with making decisions

• No energy

• Feeling worthless

• Thoughts of death or suicide

• Headaches, stomachaches, diarrhea, and pains that don’t respond to treatment

A diagnosis of depression is made when at least 5 of these “red flags” have been present for more than 2 weeks.

Types of depression

If you can’t work, sleep, eat, or enjoy activities, you may have major depression.

A constant form of depression that’s not as severe as a bout of major depression is known as dysthymia. You may continue to work and do things you like, even though you feel sad inside.

WHY WOMEN ARE AT HIGHER RISK FOR DEPRESSION

Nearly twice as many women as men experience depression.

Family History:
Genetics accounts for one-third to one-half of the risk of developing depression. If you have a mom, dad, brother, or sister with depression, you are 2-4 x more likely to develop depression.

Women may be more vulnerable because of sex-specific genes linked to depression.

A recent study of 81 families with severe recurring depression identified four chromosome regions that are associated more strongly with depression in women than in men.
More than 80% of the women in the study who inherited a particular form of a gene called CREB1 developed depression.

Body Chemistry

Depression is related to a shortage of the neurotransmitter serotonin, which acts as a messenger b/t brain cells and help regulate mood.

Men may be somewhat protected b/c they produce about 52% more serotonin in their brains than women do.

Women not only make less serotonin, they also experience fluctuations of estrogen and progesterone throughout their reproductive lives, which then cause fluctuations in their stores of the neurotransmitter.

Social Factors

Work and family roles, relationships, and stress are also typical triggers of depression, more so in women than men.

Women tend to base their self image on the success of their relationships in a way that is less true for men.

Women are more apt to replay stressful events and conversations in their heads endlessly, fixating on possible negative consequences.

Getting Help

Depressed people improve the most on a combination of therapy nd antidepressants.

Women tend to respond best to a class of drugs known as selective serotonin reuptake inhibitors, which increase the brain’s serotonin.

Be sure to ell your doctor how you really feel. and how much ETOH you drink, and if you take drugs.

You can find help in the phone book under “mental health services.

It may take as long as 6 weeks for some medicines to work.

If you feel as if you want to die or if you have a plan to kill yourself, call your doctor immediately or go to an ER.

Depression is a big topic, I believe even after my posting the other day on the atricle you wrote that I am beginning to show the signs again but this is because of the divorce I am going through and then the conflicting feelings that I do not want to divorce him now and I want to be back with my ex. I am not so sure I am depressed or becoming depressed as much as I am just emotionally torn inside of me. I do not have anyone to talk to about it which makes it worse. For things like this I believe that I am strong enough that I can work through it myself. it has worked in the past by really sitting down and thinking things through and thinking of all the good things in my life. Thank you for all your wonderful posts and such cd.

Lenix, good points. Yes, sometimes it is difficult to get a family history because so many people go undiagnosed and untreated. Often, a patient will say something like “My mother never went to a doctor but I think she was nuts/depressed/manic” Most of the patients will be pretty open about ETOH dependence. You will be very surprised what patients tell you if you ask. I have heard so many nurses and students say that they could not ask about ETOH or drug use and suicide or depression. Yet, they have no problem asking if someone has burning when they pee or what color their BMs are. (: There is still a lot of shame with mental illness and addictions. We are in the position to help society get over this. Family history of depression is important because often if the immediate family member was on medication the same med will work for your patient.

Yes I know it is. I am not currently on any meds, I have survived thus far without. Right now I am just inturmoil as I do not know if I really want to be away from him anymore. It has been almost a year now and I miss him. I do need to find a counseler or something of some sort but do not know where to start, who to ask, and if I can afford it hehe.

Thanks alot for directing me to this article. It helps, I know I am depressed, and have been since I lost the job I loved in the LTC setting. They always say if youcould turn back time. I know I can't so I will be strong for me 1st and then my child. I have been going to counceling for the past 3-4 months and that has helped I like my going. Its starting to get cooler outside I hate that the winter months stuck inside and also my parents are snow birds so they will be leaving soon. They have been great support for me. I was on depression medication for about 2 months then my insurance ran out at first I didn't notice a diffrence, now I do notice. All I know is that I need to be strong and stay positive.

Thanks for the info. I found out from my lawer today that my charges that had put me on the dependant abuse registry have been dismissed which is awesome. I think after I find a job it will help me out of my depression mode. I will finally use the $ I earn instead of taking it out of my stocks and bonds that I had been saving for retirement. Thank goodness my dad always taught me to save or I really don't know how I would have made it through not having any income for 6-7 months. Oh I do get $131.00 a monthfrom my ex. but you know how todays $$ is, it cost my son $150.00 to go to preschool every month. I just want to be able to support myself and my son and I will do what it takes. Thanks again

penny, glad to hear things are turning around for you. Getting back to work and feeling productive will give you a boost. It is tough for those with a strong work ethic to be out of work.

penny: glad things are looking up for you. I suffer from depression. The last year has been hard since my mom"s death. I feel like I have been in a fog. Now it's almost the 1 year annivesary of her death and it's all coming back to "haunt" me (she died on Oct. 30) I still have my sense of humor and that will get you through alot. I have been working erratically-1-2 days a week - sometimes not at all (I work for a temp agency). Just recently, I was placed in a job I like 3 days a week. I do feel much better having something to focus on rather than my problems. I have a better self image. Winter months can be depressing too. I have one of those lamps that supposedly give out artificial sunlight. It really works! Watching something funny on TV will lift your spirits too. Laughter IS the best medicine. Most importantly-don't give up. Things have a way of turning around. It's also good to focus on your blessings. (I don't know about painting a room orange tho!)

charlita, sorry about your mom I don't know what i would have done without there(my parents) support. Buy the way I am remodling and my master bath is orange when people visit they love it or hate it. Its pretty powerful. I think its a good pick me up in the morning and at noc I just tone down the lighting. I don't have a job yet but hopefully soon. Being with my family helps me alot with my depression (they do make me laugh) and just being with my 4 year old we like going to the park, but it is getting cooler out.