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Understanding depression and its impact on relationships |
Two very different cases of depression |
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Depression affects the entire family...
Everyone experiences sad feelings or has "the blues" once in a while - that is a normal part of life. Sad or negative feelings that make it hard to function each day may signal a medical illness called depression.
Depressions can cause real suffering - both for the affected person and for family members and other loved ones. When a person is depressed, he or she can find it difficult to go to work, to keep up with daily chores, and even to get out of bed. Sometimes, the depressed person also finds it hard to take the first step in getting help. Often, the people who love a person with depression are "hidden victims," since the impact of depression on their lives is overlooked or underestimated. Depressed people may elicit feelings of frustration, guilt, and even anger in loved ones who may resent the problems of the depressed person or have trouble understanding their cause. These feelings are normal, but it helps to have healthy ways to deal with them.
How important are family relationships in depression?
Supportive relationships with family members (including spouses) are vital to daily management of this illness.
Depression affects a person's mood, outlook on life, behaviour and even some bodily functions such as sleeping, eating, or energy level. The depressed person nearly always feels sad or worried, and often is irritable or anxious. Many people with depression are also likely to have low self-esteem and negative thought (in other words, they may often think, "I can't do that" or "it won't work out").
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Although JoAnne, who was 19 years old, didn't think she was feeling tired, she did tell her physician that it had become difficult for her to keep up with her work and social commitments. Mark, who was 51 years old, reported that he was often "grouchy," and he felt like he and his wife were arguing all of the time. MArk also said that his wife was very critical of him, as well as often being hostile and angry. In addition, Mark was having difficulty sleeping at night and was losing weight. Increased irritability and arguing often go hand in hand with depressive illness; in part, this is why depression in one family member has a significant impact on the emotins and behavior of other family members - and on the functioning of the couple or the entire family.
A diagnosis of depression is usually made when a person experiences five (or more) symptoms that occur nearly every day for at least 2 weeks; at least one of the symptoms must be either depressed mood or loss of interest or pleasure. Children and adolescents may be irritable rather than sad. If some of these symptoms occur - and are not decreasing - it is important to talk to a health care provider about whether they may signal depression.
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Recognizing depression - the symptoms can sometimes be surprising |
Who is affected by depression? |
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Depression has many different symptoms - some that are easy to recognize and others that are more difficult. The importance of treatment
The good news is that depression responds well to treatment. Today, there are many effective treatment options for depression, and most depressed people can expect to feel much better as a result of treatment. The goal of drug therapy is usually to manage symptoms and treat the illness, allowing the depressed person to feel better and get back into a normal daily routine. Psychotherapy may be used to help the person and family to learn new behaviours and coping strategies. Psychotherapy, talking about emotions and depression with a qualified professional, can help reduce and treat symptoms. The right treatment program varies from person to person; each case should be evaulated on an individual basis. Sometimes a combination of treatments results in the greatest short-term and long-term improvement.
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Depression touches all types of people. Certain groups people may be more likely to become depressed. For instance, women are about twice as likely as men to have symptoms of depression. Children and teens can also become depressed. Symptoms of depression in an adolescent are similar to those in adults, but may also include inappropriate behaviors or a drop in school performance.
Nearly 18 million people a year suffer from some form of depression, and many more feel the effects of depression in the family. Fortuntately, treatment can reduce the severity and length of depressive episodes for most people.
Causes of depression
No single factor causes depression. Certain life events - such as divorce or loss of a loved one - may trigger the symptoms of depression. But some people become depressed even when their life is going well. The tendency to become depressed can run in families, and there appears to be a genetic (or inherited) factor in many cases of depression. For instance, if one identical twin has major depressive disorder, there is an approximately 50% chance that the other twin will also exhibit symptoms of depression at some point in his or her life. In addition, children, parents, and siblings of a person with a major depressive disorder are two to three times more likely to have this type of depression than are the first-degree relatives of people without the illness.
Physical causes may also contribute to the development of depression, and it is believed that symptoms may also be triggered by an imbalance or disruption in the level of important chemicals (called neurotransmitters - these include seotonin and norepinephrine) or the signals they carry into the brain. Many of today's antidepressant medications work by regulating the level of these neurotransmitters. Alternatively, another medical illness, use of certain medications, or excessive alcohol intake can contribute to the development of depression.
The causes of depression are unique to each individual. Nevertheless, it is important for all family members to realize that depression is not the person's "fault" and that simply "trying harder" will not solve the problem. And whatever the causes, most people who are treated for depression begin to feel better within several weeks. Depression is not caused by personal weakness or lack of control - it is a medical illness that can be treated. |
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Her mother reported that JoAnne was sleeping 10 to 12 hours every day, far more than her usual pattern of about 7 to 8 hours a night. JoAnne also had a problem with headaches, other aches and pains, and stomach problems. Although it may be surprising, physical symtoms like these are not uncommon in people who have depression.
The first sign of depression is often a change in the person's usual behavior - for instance, the person may become irritable and withdrawn or may begin having trouble with sleep or appetite. Common symptoms of depression include:
