Do you sometimes feel a little blue? Do you feel sad?  Do you have mood swings? If you are experiencing any of these feelings, you might have a form of depression.  A depressive disorder is an illness that affects your mind, body and mood.  You might see that it affects your eating and sleeping habits, as well as your energy levels.  You might begin to think differently about yourself or the activities you once enjoyed.  You can’t just shake this kind of depression by yourself.  Without treatment, you might feel this way for weeks, months or even years.  Seeking treatment is a sign of strength and a first step toward improving the quality of you life. 

What type of depression do I have?

All depression is not the same.  Three of the most common forms of depression are major depression, dysthymia and bipolar disorder (bipolar disorder will be discussed in a separate section below).  Within these classifications, there is a wide range of severity, persistence and number of symptoms.  For example, one person with bipolar disorder may be completely functional in their daily life, while another might be unable to work or even leave their house.  Regardless of the severity of your condition or your symptoms, there is always help.

Major Depression  

Do you feel like you are walking around with a cloud above your head—like you are unable to bring yourself out of a persistent sadness?  Are you no longer interested in activities you formerly enjoyed? Do you have difficulty concentrating? Are you having difficulty sleeping? Have you lost or increased your appetite? If you answered “yes” to these questions, you might be experiencing major depression. 

Check the ones that apply to your situation.  If you notice that you have one or more symptoms, you may have major depression: 

• Constant sad, anxious, or "empty" mood
• Decreased energy, lowered motivation or feeling "slowed down"
• Decreased or increased appetite or weight loss or weight gain
• Difficulty concentrating, remembering, making decisions
• Enduring physical symptoms that do not respond to treatment (including headaches, digestive disorders, or chronic pain)
• Fatigue
• Feelings of guilt, worthlessness, helplessness
• Feelings of hopelessness, pessimism 
• Insomnia, early-morning awakening or sleeping to much
• Irritability
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Restlessness
• Thoughts of death or suicide; suicide attempts

If you have answered “yes” to any of these symptoms, you may be experiencing a mild, moderate or severe depression.  These symptoms may interfere with your ability to sleep, eat, study, work and take part in activities you once found pleasurable.

Sometimes a bout of depression occurs only once in your lifetime, but it has been found that emotional and mental changes often coexist, precede or accompany physical changes.  Several medical problems, including cardiac conditions, stroke, heart attack, Parkinson’s disease, hormonal disorders and cancer might cause depression. This can cause the person struggling with illness to be indifferent to his physical needs.  At worst, the patient becomes so depressed that they become non-compliant with the medication regime prescribed. This turns into a cycle that prolongs recovery from both the physical illness as well as the depression.   

An additional cause of a depressive episode can be a life change, such as relationship stress, a loss of any kind, financial stress, relocation, change of job or any other significant change. Usually, a combination of factors can be considered in the cause of a depressive disorder, including genetic, psychological and environmental factors.  If the problem is left untreated, even minor stresses may bring about an episode.  It is, therefore, in your best interest to seek treatment as soon as possible. 

If this description sounds like you or someone you know, and you would like more information about depression or if you would like to make an appointment, call our office today to speak to someone. Call us at 212-996-3939.

See below for an expanded discussion about treatment for depression and information about including dysthymia, bipolar disorder, depression in women, depression in men, depression in teens, depression in children and depression in the elderly.  

Dysthymia

Do you feel like your feelings of depression are not as severe as those in major depression, but are still existent, almost as though there is a dull melancholia hanging over your head?  If this is the case, you may be suffering from dysthymia.  If you’ve ever watched Winnie the Pooh as a child, you might recognize this disorder in the character Eeyore.  Someone with dysthymia generally feels a mild form of depression, which is more long-term and chronic, but not disabling.  Often, people with dysthymia will experience bouts of major depression at some point.  You may function quite well despite the disorder, but is important to recognize that something is wrong.  You can feel better and we can help.

Individuals with dysthymia appear to be chronically depressed, but their symptoms do not reach the level of severity of someone who is suffering from a major depressive disorder. 

Patients suffering from dysthymia often do not seek treatment since their depression may never cause them great emotional pain and anguish.  Dysthymia doesn’t reach the depth of symptoms that are seen in major depressive disorder.

If this sounds like you or someone you know, and you would like more information about dysthymia, or if would like to make an appointment, call our office today to speak to someone. Our telephone number is 212-996-3939.

Depression in Women 

The risk of experiencing depression is doubled for women versus men.  Women are faced with the stresses and responsibilities of juggling home, work, single parenthood and often being in the “sandwich generation” (sandwiched in between caring for children and caring for elderly parents).  In addition, quite a few hormonal factors may cause an increased risk for depression in women.  These factors include changes in the menstrual cycle, pregnancy, miscarriage, post-partum period, pre-menopause, and menopause.

The post-partum period, or the time after the birth of a baby, is an extremely vulnerable point in many women’s lives.  Along with the responsibility of caring for a new life, hormonal and physical changes can lead to post-partum depression.  While a slight, fleeting feeling of “blues” is frequent in new mothers, a period of full-blown depression is abnormal and needs to be treated immediately. Post-partum depression is simply a major depression that occurs after the birth of one’s baby.  It results from an interaction of biochemical and psychological changes that occur after the birth of a baby.  Although quite common, it needs to be treated.  The sooner the treatment begins, the sooner the symptoms will be alleviated.  In truly serious conditions, you, yourself, or the life of your child could be in danger.  Along with treatment by a qualified and caring therapist, the emotional support of your family is necessary to change your state of mind so you can truly take part in the joy of caring for a new life.  Your baby is counting on you, and we can help.

There are many new effective treatments for depression in women. Psychotherapy is the treatment of choice for depression. It is often combined with medication, especially when the symptoms are severe.  It is important for a woman with symptoms of depression to seek psychotherapy as soon as possible from a licensed psychologist, psychotherapist, clinical social worker, psychiatric nurse practitioner or psychiatrist.  The sooner the issues are addressed, the sooner the individual can achieve remission and return to her former level of functioning. In a confidential, supportive, non-judgmental atmosphere, psychotherapy or counseling with a psychologist, psychotherapist, clinical social worker or psychiatrist can help the woman with depression gain awareness, achieve positive behavioral change and improve functioning in academic settings, at work and in relationships.

See below for an expanded discussion of treatment for depression and information about depression in men, depression in children depression in teens and depression in the elderly.

Depression in Men

Although women are more likely to be diagnosed with depression, about 4 million American males also suffer from this condition.  Diagnosis of depression in men is usually not as frequent because men are much less likely to acknowledge that they are depressed, and doctors are often less likely to look for it.  In addition, although women are more likely to attempt suicide, the rate of self-inflicted death is much higher in men.  These rates increase as men age.

The symptoms of depression in men are a bit different both physically and mentally.  Rather than feeling outright hopeless, men express their depression though anger, lack of motivation, lack of interest in formerly enjoyed activities and irritability. Physically, depression often appears differently in men than women.  Men have a high death rate due to an increased risk for coronary heart disease associated with depression.  In addition, men may mask their depression through substance abuse, or by working long hours.  It is more difficult to recognize the disease in men, and they are less likely to seek help.

It is important to learn that depression in men is common and needs to be treated. It is vital to have the support of family members in order for a man to understand and accept that depression is a medical illness that needs to be treated. Admitting that you are depressed is the first step on the road to health.  Seeking professional care means that you are strong, wise and courageous enough to take the proper steps to reduce your symptoms and improve your situation. Seeking professional psychotherapy and possibly medication shows a proactive approach and a take-charge attitude.

See below for a discussion of treatment for depression and information about depression in children depression in teens and depression in the elderly. 

How can you tell your child is depressed?

In recent years, more attention has gone to children and the depression that is sometimes present in their lives.  Signs of your child being depressed can be evident by the following:  

• faking illness
• argumentativeness
• poorly academic performance, especially a drop in grades
• avoidant behavior with other children and teachers
• school refusal       
• constant concern about abandonment, that the parent will leave them or die   

If you have an older child, closer to adolescence, he or she may show his or her depression in different ways. These children may mope, act out in school or with authority, have a negative attitude, become edgy and irritable, become fearful and feel that nobody understands them.

See below for a discussion of treatment for depression and information about depression in teens and in the elderly.

Depression in Teens

Are you a teenager who feels hopeless about life?  Are you a parent concerned about your adolescent child?  About 40% of all teens become seriously depressed each year, and about 1/3 have thought about committing suicide.  Those are staggering and alarming statistics.  Many believe that it is normal for teens to have mood fluctuations and, therefore, ignore the signs of serious depression.  Many teens are calm, cooperative, content, succeed in school, have friends, don’t smoke, don’t do drugs and don’t drink alcohol to excess.  It is important to understand that teens, like any other age group, are just as susceptible, if not more so, to serious mental illness.

Signs that there might be a serious issue: 

• Relationships with family are problematic
• Relationships with friends are minimal
• Lowered academic performance and grades in school
• Problems with alcohol, drugs or sex
• Difficulty controlling behavior, rebelliousness or acting out

You may have noticed these signs in yourself, your friends or your adolescent teen.  Many teens do not tell adults about the problems their friends are having because they do not want to betray trust.  It is far worse if your friend suffers because you do not tell their parents or guidance counselor.  A true friend tries to do what is in the best interest of his friend.

See below for a discussion of treatment for depression and information about depression in the elderly.

Depression in the Elderly

The elderly, by far, have the highest suicide rate.
• People ages 65 and older make up about 16% of all suicides in the United States.
• When functioning capacity decreases, the rate of suicide skyrockets.

Some people have the mistaken idea that it is typical for the elderly to feel depressed. However, the majority of older people feel satisfied with their lives. Sometimes, though, when depression develops, it may be dismissed as a normal part of aging. Depression in the elderly, undiagnosed and untreated causes needless suffering for the family and for the individual who could otherwise live a fruitful life. When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often reluctant to discuss feelings of despair, unhappiness, loss of interest in usually enjoyable activities, or extremely prolonged grief after a loss. Recognizing how depressive symptoms in older people are often missed, many health care professionals are learning to recognize and treat the underlying depression. They recognize that some symptoms may be side effects of medication the older person is taking for a physical problem, or they may be caused by an illness.

If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Recent research suggests that brief psychotherapy (talk therapies that help a person with day-to-day relationships or in learning to counter the distorted negative thinking that commonly accompanies depression) is effective in reducing symptoms in temporary depression in older persons who are medically ill. Psychotherapy is also helpful in older patients who cannot or will not take medication. Efficiency studies show that elderly depression can be treated with psychotherapy alone.

Improved recognition and treatment of depression in late life will make those years more enjoyable and fulfilling for the depressed elderly person, the family, and caretakers.

Can family and friends help the depressed individual?

If you are a family member or friend of a depressed individual, the most important thing you can do is encourage them to seek professional help. Emotional support and a positive attitude will also go a long way. Above all, instill hope that things can and will get better. Take the depressed individual out to do things they might enjoy. Also, try to encourage them to spend time with others and on projects or courses. You can help by being patient, listening, caring and giving them encouragement to continue the therapy or medication as prescribed. This may take a lot of your time, but it is a small price to pay for a loved one.

What treatments are available for individuals diagnosed with depression? 

If you feel or suspect that you may have depression, you should call a licensed mental health professional that can help you assess your symptoms and situation.  You and your psychologist or psychotherapist can decide on the best course of treatment.  You might embark on a course of psychotherapy, also known as “talk therapy,” which can help you change your cognitions (patterns of thinking) so that your negative, depressing or helpless thoughts will become more realistic, positive and optimistic.  Through the process or psychotherapy, your depressed feelings, symptoms, and behavior will lessen and will be replaced by ones which are more functional, healthy, proactive and optimistic. In addition to psychotherapy, another type of therapy that helps depression is known as Cognitive Behavioral Therapy (CBT).  Other types of psychotherapy that help reduce the symptoms of depression include interpersonal psychotherapy, psychodynamic psychotherapy, family psychotherapy, and integrative psychotherapy.  

During the course of your psychotherapy or counseling, you and your therapist may decide that you should have a general physical and blood work to make certain you are in good health.  Additionally, you might benefit from medication, which will help alleviate many of the bothersome symptoms of depression.  Medication is an option decided upon by you and your therapist.  Some individuals do not want to take medication and only wish to pursue psychotherapy, while others want medication only.  However, many opt for both. If medication is an option you decide to pursue, your therapist will recommend a psychiatric nurse practitioner or psychiatrist who you will see monthly while you continue your weekly psychotherapy sessions.

Your specific treatment depends on your particular evaluation, diagnosis and preference. Mild depression can usually be treated with psychotherapy alone.  However, moderate to severe depression is usually treated by combination of medication and psychotherapy. When psychotherapy is augmented with medication, the medication can often hasten remission of the symptoms of depression, as well the anxiety and physical symptoms (headaches, back aches, etc.) that often accompany depression. Usually, psychotherapy and medication work simultaneously to help the individual. Whatever the diagnosis, your particular preference is respected, as there are several different effective ways to treat depression

It is most important for an individual who is depressed to seek psychotherapy or counseling services as soon as possible from a licensed psychologist, clinical social worker, psychotherapist, psychiatric nurse practitioner, or psychiatrist.  In a confidential, supportive, non-judgmental atmosphere, psychotherapy can help the individual gain awareness, achieve positive behavioral change, and improve current functioning. Medication can be prescribed by a psychiatric nurse practitioner or psychiatrist. The sooner the treatment is begun, the sooner the depression can go into remission.   

If you or someone you know is suffering from depression and you would like more information about treatment for depression, want to discuss your specific needs, or make an appointment, call our office today to speak to someone. We have licensed psychologists, psychotherapists, psychiatrists, counselors, clinical social workers, and psychiatric nurse practitioners, qualified and experienced in effectively treating depression, and can suggest the psychotherapist that best meets your needs.  Our telephone number is 212-996-3939.