Depression

Written by Anne McNelis, L.C.S.W., Director of Clinical Services at Transitions Mental Health Services.

Winston Churchill referred to it as “the black dog.” Like an unwanted companion, or a shadow that moves with you, depression can feel like a darkness lurking in every corner of one’s life. Although those who suffer from depression may feel very isolated and alone, they are not. Depression affects one in four Americans. Families are impacted as well when a loved one is battling this illness.1

Depression is the second most common mental health condition on the spectrum of mental illness, with anxiety disorders only recently surpassing. As our society and culture grow evermore fast-paced, stressful, interpersonally disconnected and threatened, we may see this illness become more pervasive. Just in the past decade, we have seen a rise in the number of Americans seeking treatment for depression and anxiety, especially since September 11th occurred. This illness does not discriminate due to race, gender, socioeconomic status or age groups. Among all medical illnesses, major depression is the leading cause of disability in the U.S. and in many other developed countries.2

Depression can have several causes. Biological, psychological, or environmental factors can contribute to its development. A family may have a genetic predisposition to the illness, making one biologically prone to the illness. This can be traced by doing a medical history of one’s family tree. Psychological issues or life events can be contributing factors. A life change or stressor, such as a divorce, loss of a job or a loved one, triggers this type of depression. Depression can be seasonal in some cases, caused by a change in the weather pattern. For some, this may occur during the winter months, triggered by the change in daylight, the oppressive feeling of cold temperatures, and the tendency to isolate indoors in winter months. Others may be more prone to seasonal depression in the summer, triggered by the feeling of being oppressed by the hotter temperatures. Depression can also have a cognitive trigger. Self-defeating thoughts and belief systems can cause or feed a depression. Individuals who were raised in unstable and unsafe situations such as abusive or neglectful environments, poverty or crime-ridden areas, or surrounded by addictive behavior, can be more vulnerable to depression. This illness can have several root causes but to warrant a formal diagnosis of depression, one must experience a range of symptoms for a period of time. It is important to understand that emotional experiences of sadness or loss, and passing mood states are normal. In the case of depression, persistent symptoms will significantly interfere with one’s thoughts, behavior, physical health, and activity level. In order for a diagnosis to be made, multiple symptoms must be present and affect one’s ability to function. Frequent crying spells, irritability or agitation, change in sleeping or eating patterns, and loss of interest in pleasurable activities, are just a few of the criteria. It is important to seek an evaluation from a mental health professional if you or a loved one has been experiencing these symptoms frequently and persistently for two or more weeks. An evaluation can help determine if the depression should be treated with therapy, medication, or a combination of both.

Seeking help is sometimes the greatest barrier to overcome. This is understandable. Stigma surrounds this illness. Undesirable labels, such as “weak,” “lazy,” or “crazy” have been applied to those actively suffering depressive symptoms. Even a suffering individual can stigmatize him/herself with such thoughts as “I should be stronger,” “I just need to pull myself out of this,” or, “taking medication (or getting help) means I’m weak.” Often, taking that first step of acknowledging you have an illness and you need help provides great relief, hope, and a sense of power by taking charge of your mood and your life. Recovery is a very real possibility. Learning how and what triggers your depressive symptoms, taking medications if prescribed and incorporating healthy coping skills into your daily life, are essential steps to treating this illness. Therapy and counseling are avenues of help to explore patterns of behavior or thoughts that are contributing to depression. It is important to find providers that are knowledgeable about this illness; but they should also treat you as an active and capable participant in your treatment and recovery. In addition, having a system of support including friends and family is a vital component in recovery. Research shows that treatment for depression has the highest success rate when all of the necessary components are present.

Depression is a real illness and it is very treatable. Unlike ill-informed celebrity statements challenging the validity of mental illnesses, at least 9.9 million Americans3 know this condition is real and that is has a profound effect on their ability to get things done, interact socially, and experience joy and pleasure in everyday life. Questioning the validity of diabetes would be unheard of in this day and age. We know how this disease impacts the kidneys and are aware of the efficacy of insulin in helping them function effectively. Scientists who have studied depression believe, through their research of the brain, that the neurotransmitters, specifically norepinephrine, serotonin and dopamine are chemically imbalanced in the brains of individuals suffering with major depression. Neurotransmitters are the chemical messengers that transmit electrical signals between brain cells in our brains. Antidepressants are understood to work by increasing the availability of neurotransmitters, or by the changing the sensitivity of the receptors for these chemical messengers.4

As debilitating and devastating as this illness can be, depression has an 80-90% success rate in treatment, and individuals who seek help can return to their normal daily activities and mood functioning.5 If you or someone you know is suffering from this illness, or displaying persistent signs of depression, contact a mental health professional in your area. Organizations that specialize in mental health conditions, such as Transitions, will conduct a thorough assessment, provide treatment recommendations, and offer supportive services to guide you on your path to recovery.


1 NAMI website, “What is Major Depression,” by Ellen Frank, PhD, May 2003
2 NAMI website, “What is Major Depression,” by Ellen Frank, PhD, May 2003
3 NAMI website, “What is Major Depression,” by Ellen Frank, PhD, May 2003
4 NAMI website, “What are the causes of Major Depression,” by Ellen Frank, PhD, May 2003
5 NAMI website, “How is Major Depression Treated,” by Ellen Frank, PhD, May 2003

For more information, visit the Transitions Mental Health Services website at http://www.transrehab.org/ and go to the "Contact Us" page.