Is it really depression or just a case of the “blues”? It’s not always easy to tell the difference, especially when an older adult has what seems like good reason to be depressed, such as a chronic illness or loss of a loved one. But depression is very different from the blues in terms of duration and severity.
Most cases of the blues resolve on their own and don’t prevent a person from finding some enjoyment in life. The key components of depression are:
Duration: The symptoms are present almost all the time and last for more than a few weeks.
Severity: Depression is usually more severe, causing symptoms that are difficult enough to deal with that they interfere with daily life.
Here are 11 different warning signs of depression. Keep in mind that depressed people don’t all experience the same symptoms, and the severity of symptoms may vary. But if someone exhibits several of these symptoms for more than two weeks, he may need help.
1. Persistent sad, anxious, or “empty” feelings
2. Feelings of hopelessness, worthlessness, or helplessness
3. Frequent crying episodes
4. Increased agitation and restlessness
5. Fatigue and decreased energy
6. Loss of interest in activities or hobbies that once were pleasurable
7. Difficulty concentrating, remembering details, and making decisions
8. Sleeping too much or not enough
9. Poor appetite or overeating
10. Expressing thoughts of dying or suicide
11. Persistent aches or pains, headaches, cramps, or digestive problems that don’t ease with treatment
I’m always on the lookout for articles that touch on ways to communicate to a friend or family member who is depressed. It’s a delicate issue and one that deserves some serious attention. What follows is what you should, and should not say to a loved one struggling with depression. — Bryan
1. Snap out of it!
Your loved one hasn’t left the house in what seems like days. Should you tell him to pull himself up by his bootstraps and just snap out of it?
Don’t say it.
You may be tempted to tell someone who’s depressed to stop moping around and just shake it off. But depression is not something patients can turn on and off, and they’re not able to respond to such pleas. Instead, tell your loved one that you’re available to help them in any way you can.
2. What do you have to be depressed about?
In a world full of wars, hunger, poverty, abuse, and other ills, you may feel impatient when someone you love feels depressed. So do you remind him how lucky he is?
Don’t say it.
You can’t argue someone out of feeling depressed, but you can help by acknowledging that you’re aware of his pain. Try saying something like “I’m sorry that you’re feeling so bad.”
3. Why don’t you go for a nice walk?
Exercise is a known way to lift your mood. Is it a good idea to suggest that your loved one with depression go out and enjoy some fresh air and activity?
Say it — but with a caveat.
By definition, depression keeps you from wanting to engage in everyday activities. But you can show your support by offering to take a walk, go to a movie, or do some other activity with your loved one. How about: “I know you don’t feel like going out, but let’s go together.”
4. It’s all in your head.
Some people believe that depression is an imaginary disease and that it’s possible to think yourself into feeling depressed and down. Should you tell your loved one that depression is just a state of mind — and if she really wanted to, she could lift her mood with positive thoughts?
Don’t say it.
Suggesting that depression is imagined is neither constructive nor accurate. Although depression can’t be “seen” from the outside, it is a real medical condition and can’t be thought or wished away. Try saying instead: “I know that you have a real illness that’s causing you to feel this way.”
5. Seeing a therapist is probably a good idea.
You think your loved one could benefit from talking to a mental health professional. Should you say so?
Reinforcing the benefits of treatment is important. Encourage the idea of getting professional help if that step hasn’t yet been taken. This is especially important if your loved one has withdrawn so much that she is not saying anything. Try telling her, “You will get better with the right help.” Suggest alternatives if you don’t see any improvement from the initial treatment in about six to eight weeks.
If you notice periods of depression that seem to accompany seasonal changes during the year, you may suffer from seasonal affective disorder (SAD). This condition is characterized by recurrent episodes of depression – usually in late fall and winter – alternating with periods of normal or high mood the rest of the year.
Most people with SAD are women whose illness typically begins in their twenties, although men also report SAD of similar severity and have increasingly sought treatment. SAD can also occur in children and adolescents, in which case the syndrome is first suspected by parents and teachers. Many people with SAD report at least one close relative with a psychiatric condition, most frequently a severe depressive disorder (55 percent) or alcohol abuse (34 percent).
What are the patterns of SAD? Symptoms of “winter SAD” usually begin in October or November and subside in March or April. Some patients begin to slump as early as August, while others remain well until January. Regardless of the time of onset, most patients don’t feel fully back to normal until early May.
Their depressions are usually mild to moderate, but they can be severe. Very few patients with SAD have required hospitalization, and even fewer have been treated with electroconvulsive therapy.
The usual characteristics of recurrent winter depression include:
oversleeping,
daytime fatigue,
carbohydrate craving
and weight gain, although a patient does not necessarily show these symptoms.
Additionally, there are the usual features of depression, especially decreased sexual interest, lethargy, hopelessness, suicidal thoughts, lack of interest in normal activities, and social withdrawal.
Treating your SAD
Light therapy is now considered the first-line treatment intervention, and if properly dosed can produce relief within days. Antidepressants may also help, and if necessary can be used in conjunction with light. In about 1/10th of cases, annual relapse occurs in the summer rather than winter, possibly in response to high heat and humidity. During that period, the depression is more likely to be characterized by insomnia, decreased appetite, weight loss, and agitation or anxiety.
Interestingly, patients with such “reverse SAD” often find relief with summer trips to cooler climates in the north. Generally, normal air conditioning is not sufficient to relieve this depression, and an antidepressant may be needed. In still fewer cases, a patient may experience both winter and summer depressions, while feeling fine each fall and spring, around the equinoxes. The most common characteristic of people with winter SAD is their reaction to changes in environmental light.
Latitudes effect attitudes
Patients living at different latitudes note that their winter depressions are longer and more profound the farther north they live. Patients with SAD also report that their depression worsens or reappears whenever the weather is overcast at any time of the year, or if their indoor lighting is decreased. SAD is often misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections.
Women experience twice the rate of depression as men.
Women have twice the chances as men
Everyone experiences disappointment or sadness in life. When the “down” times last a long time or interfere with your ability to function, you may be suffering from a common medical illness called depression.
Major depression affects your mood, mind, body and behavior. Nearly 15 million Americans — one in 10 adults — experience depression each year, and about two-thirds don’t get the help they need.
Women experience twice the rate of depression as men, regardless of race or ethnic background. An estimated one in eight women will contend with a major depression in their lifetimes.
Researchers suspect that, rather than a single cause, many factors unique to women’s lives play a role in developing depression. These factors include: genetic and biological, reproductive, hormonal, abuse and oppression, interpersonal and certain psychological and personality characteristics.
Symptoms of depression include:
Little interest or pleasure in doing things
Feeling down, depressed or hopeless
Trouble falling or staying asleep or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself, that you are a failure or have let yourself or your family down
Trouble concentrating on things, such as reading the newspaper or watching television
Moving or speaking so slowly that other people could have noticed or the opposite in that you are so fidgety or restless that you have been moving around a lot more than usual
Thoughts that you would be better off dead or of hurting yourself in some way
Women may be more likely to report certain symptoms, such as…
anxiety
somatization (the physical expression of mental distress)
increases in weight and appetite
oversleeping
outwardly expressed anger and hostility
Stay close to your friend
Helping a Woman with Depression
People with depression aren’t the only ones who suffer. Their friends and loved ones may experience worry, fear, uncertainty, guilt, confusion or even be more likely to go through depression themselves.
The situation may be especially trying if your loved one doesn’t realize that she is depressed. You can help by recognizing the symptoms of depression and pointing out that she has changed.
Recognize even atypical signs of depression. Women may be more likely to report certain symptoms, such as anxiety, physical pain, increases in weight and appetite, oversleeping and outwardly expressed anger and hostility. Women are also more likely to have another mental illness-such as eating disorders or anxiety disorders-present with depression, so be alert for depression if you know a woman with a history of mental illness.
To point out these changes without seeming accusatory or judgmental, it helps to use “I” statements, or sentences that start with “I.” Saying “I’ve noticed you seem to be feeling down and sleeping more” sounds less accusatory than “you’ve changed.”
Talking to a Woman with Depression
If a friend or loved one has depression, you may be trying to figure out how you can talk to her in a comforting and helpful way. This may be difficult for many reasons. She is probably feeling isolated, emotionally withdrawn, angry or hostile and sees the world in a negative light.
Although you may feel your efforts are rebuffed or unwelcome, she needs your support. You can simply be someone she can talk to and let her share her feelings.
It’s important to remember that depression is a medical illness. Her symptoms are not a sign of laziness or of feeling sorry for herself. She can’t just “snap out of it” by taking a more positive outlook on life.
Helpful responses include, “I am sorry you’re in so much pain” or “I can’t imagine what it’s like for you. It must be very difficult and lonely.” Instead of simply disagreeing with feelings she conveys, it is more helpful to point out realities and hope.
A woman with depression often expects to be rejected. You can reassure her that you will be there for her and ask if there’s anything you can do to make her life easier.
If your loved one is not diagnosed or not in treatment, the most important thing you can do is encourage her to see a health care professional.
*Never ignore statements about suicide.* Even if you don’t believe your loved one is serious, these thoughts should be reported to your friend’s doctor. If this is an emergency, call 9-1-1.
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