Depression

1. A Daily Affirmation
2. Anxiety Disorders
3. BDSM & Child Abuse
4. Holiday Depression
5. Depression Checklist
6. Depression
7. Different Types of Depression
8. If Someone is Suicidal
9. Mood Disorders
10. Reasons Not to Kill Y/yourself
11. Surviving Life
12. Thoughts on Depression

1. A Daily Affirmation

Here is an excellent affirmation written by Zig Ziglar. well known motivational speaker and author.

"I,_______...am a person with integrity, a great attitude, and specific goals. I have a high energy level, am enthusiastic, and take pride in my appearance and what I do. I have a sense of humor, lots of faith, wisdom, and the vision and courage to use my talents effectively.

I have character, and am a smart, talented person. My beliefs are strong, and I have a healthy self-image, a passion for what is right, and a solid hope for the future. I am an honest, sincere, and hard-working. I am tough, but fair and sensitive. I am disciplined, motivated, and focused. I am a good listener and am very patient. I am an encourager, a good-finder, and a forgiving person. I am caring, unselfish, and committed to doing the right thing.

I am family oriented, open minded, and an excellent communicator. I am a student, a teacher, and a self starter. I am obedient, loyal, responsible, and dependable. I have a servant's heart, am ambitious and a team player. I am personable, optimistic and organized. I am consistent, considerate, and resourceful.

I am intelligent, competent, persistent and creative. I am health conscious, balanced and clean. I am flexible, punctual and thrifty.

I am an honorable person who is truly grateful for the opportunity life has given me. These are the qualities of the winner I WAS BORN TO BE, and I fully intend to develop these marvelous qualities with which I have been entrusted by God.

Tonight I am going to sleep wonderfully well. I will dream powerful, positive dreams. I will awaken energized and refreshed, and tomorrow's going to be magnificent.

God, my family and my true friends love me no matter what!"


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2. Types of Anxiety Disorders

Anxiety is feeling excessive fear, nervousness or worrying that something bad might happen, even though there is no logical or specific reason to be afraid. Many times depressive illnesses and anxiety go hand in hand.

Various types of anxiety disorders include:


Panic Disorder
Panic attacks occur with symptoms of dizziness, rapid heart beat, feelings of faintness or detachment from body, shortness of breath, nausea, diarrhea, numbness or tingling in arms/legs, trembling, flushes or chills, fear of dying, the immediate need to flee the situation which has triggered the attack.

Phobias
Intense fear of an object (animal, insects), activity (flying, heights, driving), or situation (public speaking, eating or writing in public) that causes an individual to avoid these things at all costs. Phobias may result in agoraphobia causing a person to never leave the security of their home.

Obsessive-Compulsive Disorder
Characterized by having continuous thoughts or doubts (obsessions) that keep playing over and over again in a person's mind, in an annoying and bothersome way, interfering with everyday functioning. Obsessions are repetitive, irrational thoughts such as excessive fears of germs. Also may have a need to do something over and over again (compulsion), such as checking appliances, cleaning, washing hands, counting, repeating tasks or performing rituals in order to ease anxiety.

Post-Traumatic Stress Disorder
This disorder can occur as a result of an emotional or physical trauma such as a car or plane crash, physical/sexual assault, war, or natural disaster. Symptoms such as flashbacks or nightmares may suddenly begin happening years after the event took place, resulting in social isolation, panic attacks, angry outbursts or substance abuse, which may be an attempt to forget.

Generalized Anxiety Disorder
People who worry constantly about anything and everything (money, health, safety of their children taken to extremes) may have GAD. Possible symptoms include trembling, pain in arms & legs from muscle tension, chronic fatigue, stomach problems, dizziness, inability to concentrate, irritability, jittery and nervous appearance. May have problems with eating and sleeping.

Social Phobia
Anxiety about appearing foolish or acting in such a way as to embarrass oneself. Examples may be speaking in a group of people or to someone with authority, anxiety in social situations, writing in public, or eating in public.


The following signs and/or symptoms may be a result of possible unipolar depression, bipolar illness, anxiety disorders, or attention deficit disorder with or without hyperactivity. A person may have as few as 2 or 3 symptoms or many of the symptoms.

* * * IT IS NOT UNCOMMON TO HAVE A COMBINATION OF ILLNESSES WITH OVERLAPPING SYMPTOMS * * *


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3. BDSM & Child Abuse


This is a topic that comes up very often in discussing BDSM. It is guaranteed to cause some very emotional responses. Many try to link a submissive personality to past child abuse. Saying that a submissive personality is a psychological remnant of the past abuse. Some try to say that BDSM is just a way for survivors to continue in the victim mindset created by that past abuse. Some also say that those who are into BDSM are more likely to abuse both children and adults.

Saying that being submissive due to past abuse just doesn't completely hold water. I believe that submission is an inborn trait. This inherent trait may preclude the person to being abused or victimized both as a child and an adult. But, from personal experience, I must say that BDSM can give the survivor the tools he/she needs to heal such abuse. By advocating SS&C, learning your own needs and those of your partner, by advocating strength and independent thought, this lifestyle teaches the submissive that she does indeed have control over what happens to her body. That she doesn't have to be a victim and it is her choice whether or not to submit to a dominant. A victim of abuse had no choice.

It is a possibility that some survivors get into BDSM because their past abuse trained them to be submissive, but from what I have seen the majority of those who entered this lifestyle as a direct result of abuse in their pasts, do so as dominants not submissive. A victim of abuse has an intense desire to be in control of themselves and their surroundings and what happens in those areas. So it makes more logical sense to me that a survivor of abuse would be more likely to become dominant as a direct result of the abuse than submissive. That is, if the past abuse is the reason they entered the lifestyle in the first place. Many dominants, usually dommes, have stated that they became dominant as a result of past abuse. Due to the past abuse, they are more comfortable in a controlling role than in giving up control to another. This is typical an expected for a survivor of abuse.

There does indeed exist a small number of people in the lifestyle who are stuck in victim mode. These are the ones who have not healed past issues of abuse and get into BDSM as a way of finding what it is that they consider to be normal. Now there is nothing wrong with this if the person truly enjoys BDSM. The problem comes in when the person is in the lifestyle to punish themselves for what they consider to be their fault. Or to re-enact the dynamics of their past situations because they feel they deserve nothing better, or have no idea that anything different exists. These are the people most likely to be more masochistic than they are truly comfortable with because they believe they deserve the punishment. They are likely to seek out more and more physical pain than they truly desire to have, this need driven by their belief they deserve to be beaten. This is different than a person who is a masochist because of their nature. A true masochist gains physical pleasure from pain, a victim mindset masochist, does not. They are likely to lack self esteem and become involved with an overly domineering partner. Many times those partners are indeed abusive. To the submissive who is in BDSM for those reasons an abusive dominant is what a dominant should be. They do not look for someone who treats them better, because they feel they don't deserve anything better.

To understand that abuse does not equal submission one first has to understand the mindsets of both and the motivating factors behind each one's actions.

A submissive, gives his/her submission out of a need within themselves. To do so brings them a sense of peace, completeness, and pride (amongst other good results). They strive to please their dominant because it pleases them to do so. The motivating factor is not fear, but is that emotional satisfaction their submission gives them.

A person who is still in victim mindset has a motivating force of fear driving their actions. They gain little to no personal pleasure from their activities. They do them to prevent reprisal (beatings, emotional/psychological abuse).

A submissive trusts, respects and in many cases loves their dominant. A person in victim mindset does not trust, respect or love their abusive partner. They usually fear and hate that person.

The idea that people in this lifestyle are more likely to abuse children and adults is one that I totally disagree with. Those in this lifestyle are vehemently opposed to child abuse. They are more open and receptive to the signs of abuse. For both children and adults, abuse, it's ramifications and signs are often discussed within the lifestyle's communities. Though there do exist some people who use the lifestyle as a front to hide their truly abuse natures under the guise of BDSM, those people are the exception rather then the rule.

Could there be links between past abuse and BDSM? Probably for some people, yes. But there is not enough evidence to support the blanket statement that BDSM is a psychological after affect of past abuse. There does, at first glance, appear to be more survivors in the lifestyle than not. But, if one does a bit of research, they will find, very quickly, that there are just as many survivors, if not more, in non-BDSM relationships. They will also find that there are more currently active abuse relationships outside of BDSM than there are within BDSM. I think that the appearance of higher numbers in BDSM is a direct result of the open communication this lifestyle advocates. The people within BDSM, for the most part, are more open to discussing the topic than vanilla people are. They have fewer inhibitions for forbidden topics due to the seemingly forbidden nature of BDSM itself. A submissive is encouraged to delve deep into his/her own psyche and share this with his/her dominant, this kind of searching and communication opens the pathways to talking about such issues and being comfortable doing so.

For the reasons I state above, and because of my personal experiences with both BDSM and past abuse, I hold the opinion that abuse does not create submissives and BDSM is not a direct result of such past abuse.


Raven Shadowborne © 1998


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4. Depression and the Holidays


BLet's face it - even in an un-depressed state, the holidays are stressful and often disappointing. We run ourselves ragged buying gifts, cooking, decorating and entertaining. Tempers flare as we're thrown together with relatives whom we see infrequently, and don't necessarily enjoy spending time with. Expectations are high that this season will be magical and perfect as we try to recapture the wonderment we felt as children waiting for Santa, or wait for a rush of emotion as we ponder the religious significance of Christmas and Chanukah. When those feelings don't automatically well up, we're disappointed.

I broke down in tears twice while trying to juggle visits to my ex-husband's family and my own. I wasn't even depressed - both those times I was on antidepressants and doing great. The sheer stress of the holidays was just too much for me. One year I even said to my ex-husband, "Do we really have to decorate this year?". Of course the answer was yes, and I'm glad we did. But this illustrates to me how sometimes the ideals of the holidays and the reality can be far apart.


Being Depressed During the Holidays - I'm in Hell, Right?

So that's my view of how holidays can be when you're not depressed. When you are depressed, it's like Dante created your own private circle of hell. The idea of doing all this holiday stuff while you're depressed is beyond overwhelming. Shop for Christmas or Chanukah presents? You're having trouble getting out to shop for food! Decorate the house? You don't even know if you'll get laundry done so you'll have clean underwear tomorrow. Send out Christmas cards to 50 of your closest relatives and friends? What would you say in them - "Doing awful. My new pastime is staring at the ceiling. I hate myself. My clothes are falling off me because I don't eat anymore. I can't wait till the holidays are over. Don't bother to call. By the way, Happy Holidays!".

It's miserable to be depressed during the holidays. One reason is that you know that you really should be enjoying all the wonderful things that come along with them. As down as I sound on the season, I really do enjoy a lot of Christmas-sy things - decorating the tree and the house, giving and receiving presents, watching Rudolph and the Grinch and even sending out Christmas cards. But when I'm depressed, the fact that I can't enjoy these things makes me twice as miserable, and I berate myself for not partaking fully in the joys of the season.

The second thing that makes it so hard to be depressed during the holidays is that doing the holidays right requires planning and organization. If you're depressed, you're so far from having those capabilities that it's pathetic. You can't even plan past the next five minutes, let alone a whole holiday season. And organization? Please! You probably are about to have your electricity cut off because you haven't been able to organize yourself enough to pay your bills.


Have a Holly Jolly Christmas? I Don't Think So

Another horrendous aspect of being depressed during the holidays is spending time with people. Parties, dinners, get-togethers, etc. You're having so much trouble smiling that you're sure you have an absolutely ghastly expression pinned to your face. You feel like bursting into tears when someone asks you to join in singing a Christmas carol. Worst of all, you're overly sensitive in general - to noise, to anything sad, like the other reindeer teasing Rudolph, to really garish decorations that make you really depressed for some unknown reason. So you have to try to act normal while all this turmoil and pain is going on inside you, instead of being able to cry and scream or stare at the ceiling like you can do when you're alone.

I've saved the worst for last - the thing that makes the holidays least bearable in a depressed state. It's that everyone you know (and even strangers and TV commercials) is telling you how much you should be enjoying this time of year. Even if they're at the end of their rope trying to get everything done, they will be telling you what a downer you're being. You know you should be happy and having fun. No one has to tell you. But they do anyway, and you just want to slug them and burst out crying at the same time. Yes, they "mean well." But they're not making things any easier for you.


Ways to Get Through It

Well, that's the bad news. Here's the good news: it doesn't have to be that way. I have some suggestions for the depressive's holiday, drawn from my experience and what I did wrong during my miserable depressed holiday seasons. By the way, these are also good for the non-depressive who's totally stressed out and at the end of his/her rope.

The number one most important rule is: Give yourself permission. Permission to drastically cut back on holiday preparations, permission to feel emotions other than unqualified joy and happiness and permission to gently but firmly tell other people off. Remember that you are ill. Depression is an illness that is affecting your body, mind and personality. You are as fragile as any invalid. Keep this rule in mind during the season, and you should make it through okay. Remember - you are not a loser for scaling back. Other people would probably love to do it too, but there's major peer pressure to "enjoy" holidays to their fullest.


That's the rule; here are the suggestions:

• Instead of making yourself go through the ordeal of sending out paper Christmas cards, send electronic ones instead. Blue Mountain Arts and Amazon have a good selection of free holiday e-cards.
• When it comes to giving gifts, think gift certificates. They're the perfect present. Most mail-order catalogues offer them now, and if you're like me, you receive enough catalogues to cover everyone on your list. This also keeps you out of the stores at a time when you're very vulnerable to excess buying. Yes, everyone will know what you spent - who cares? If you have the energy and the inclination, do an extra-special job of wrapping. If you don't, don't worry about it. Also, consider shopping online, which also keeps you out of the mall. Maybe I'm the only one, but malls at Christmas freak me out when I'm depressed, and I'm ultra-sensitive to the noise and crowds.
• Do not, under any circumstances, have Christmas or Chanukah at your house. No way. If it's your turn, switch with someone else and tell them you'll make it up to them. They'll just have to understand. If you're going to someone else's place and you're expected to bring food, buy it, don't make it. If they want home-made, too bad. Let them make it, then. Just say, "I'm sorry - I'm just not up to it." End of story.
• You'll need excuses. To people who know you're suffering from depression, tell them that you're just not up to doing all the Christmas stuff, or going all the Christmas places, or expressing all the Christmas cheer. To people who don't, perhaps co-workers, tell them, "I'm just so busy, I can't fit it in." Or, "It's just so hard to get into the holiday spirit sometimes, what with all the work that comes with it." If someone calls you a Grinch say, "Well, what would Christmas be without at least one?" and spit in their eggnog when they're not looking.
• If you must send out cards, just sign them instead of racking your brain trying to come up with something cheerful.
• If the usual Christmas music is really grating on your nerves, try different music, like classical or choral renditions of carols.
• Scale back on your decorating. Don't wrap the house and bushes in lights. Put the wreath on the door, and you've taken care of the decorating for the outside of the house. Decorating a Christmas tree is a monumental task, especially if you get a live tree. Consider scrapping it for this year, or just having a mini tree.
• Don't beat yourself up over feeling empty instead of full of the joy of the season. You're feeling empty because that's a part of the illness. It's not your fault, and you're not a bad person or a loser because of it. Even people who are not depressed are often having trouble getting in touch with the real meaning of the season.
• Try to stay away from the alcohol that's flowing freely this time of year. Very simply, alcohol is a depressant. It's the last thing you need. It may relieve the pain for a little while, but you'll probably end up feeling sad and maudlin.
• If you can afford to, arrange to take a vacation during Christmas. Go somewhere tropical or where Christmas isn't celebrated, and just avoid the whole thing. You can use the excuse of getting ready for your vacation as a way to avoid social commitments.
  

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5. Depression Checklist


Infants

• Unresponsive when talked to or touched, never smile or cry, or may cry often being difficult to soothe.
• Failure to gain weight (not due to other medical illness).
• Unmotivated in play.
• Restless, oversensitive to noise or touch.
• Problems with eating or sleeping.
• Digestive disorders (constipation/diarrhea).
  
  
  

Children

• Persistent unhappiness, negativity, complaining, chronic boredom, no initiative.
• Uncontrollable anger with aggressive or destructive behavior, possibly hitting themselves or others, kicking, or self-biting, head banging. Harming animals.
• Continual disobedience.
• Easily frustrated, frequent crying, low self-esteem, overly sensitive.
• Inability to pay attention, remember, or make decisions, easily distracted, mind goes blank.
• Energy fluctuations from lethargic to frenzied activity, with periods of normalcy.
• Eating or sleeping problems.
• Bedwetting, constipation, diarrhea. Impulsiveness, accident-prone.
• Chronic worry & fear, clingy, panic attacks.
• Extreme self-consciousness.
• Slowed speech & body movements.
• Disorganized speech - hard to follow when telling you a story, etc.
• Physical symptoms such as dizziness, headaches, stomachaches, arms or legs ache, nail-biting, pulling out hair or eyelashes. (ruling out other medical causes)
• Suicidal talk or attempts.
  
  
  

In children, depressive illnesses/anxiety may be disguised as, or presented as school phobia or school avoidance, social phobia or social avoidance, excessive separation anxiety, running away, obsessions, compulsions, or everyday rituals, such as having to go to bed at the exact time each night for fear something bad might happen. Chronic illnesses may be present also since depression weakens the immune system.


Adolescents

• Physical symptoms such as dizziness, headaches, stomachaches, neckaches, arms or legs hurt due to muscle tension, digestive disorders. (ruling out other medical causes)
• Persistent unhappiness, negativity, irritability.
• Uncontrollable anger or outbursts of rage.
• Overly self-critical, unwarranted guilt, low self-esteem.
• Inability to concentrate, think straight, remember, or make decisions, possibly resulting in refusal to study in school or an inability (due to depression or attention deficit disorder) to do schoolwork.
• Slowed or hesitant speech or body movements, or restlessness (anxiety).
• Loss of interest in once pleasurable activities.
• Low energy, chronic fatigue, sluggishness.
• Change in appetite, noticeable weight loss or weight gain, abnormal eating patterns.
• Chronic worry, excessive fear.
• Preoccupation with death themes in literature, music, drawings, speaking of death repeatedly, fascination with guns/knives.
• Suicidal thoughts, plans, or attempts.
  
  
  

Depressive illnesses/anxiety may be disguised as, or presented as eating disorders such as anorexia or bulimia, drug/alcohol abuse, sexual promiscuity, risk-taking behavior such as reckless driving, unprotected sex, carelessness when walking across busy streets, or on bridges or cliffs. There may be social isolation, running away, constant disobedience, getting into trouble with the law, physical or sexual assaults against others, obnoxious behavior, failure to care about appearance/hygiene, no sense of self or of values/morals, difficulty cultivating relationships, inability to establish/stick with occupational/educational goals.


Adults

• Persistent sad or empty mood.
• Feelings of hopelessness, helplessness, guilt, pessimism, or worthlessness.
• Drug/alcohol abuse. (Often masks depression/anxiety.)
• Chronic fatigue, or loss of interest in ordinary activities, including sex.
• Disturbances in eating or sleeping patterns.
• Irritability, increased crying; generalized anxiety (may include chronic fear of dying/convinced dying of incurable disease), panic attacks.
• Hypochondria - sufferer actually feels symptoms, they are real and not imagined.
• Difficulty concentrating, remembering, or making decisions.
• Thoughts of suicide; suicide plans or attempts.
• Persistent physical symptoms or pains that do not respond to treatment - headaches, stomach problems, neck/back pain, joint pain, mouth pain.
  
  
  

Note: Many people feel that it is normal for elderly persons to be depressed. This is simply not true and is a very dangerous misconception. If you suspect a older adult is suffering from a depressive illness, he/she should have a thorough medical examination as soon as possible.


Symptoms of Mania:

• Decreased need for sleep.
• Restless, agiated, can't sit still.
• Increased energy, or an inablilty to slow down.
• Racing, disorganized thoughts, easily distracted.
• Rapid, increased talking or laughing.
• Grandiose ideas, increased creativity.
• Overly excited, euphoric, giddy, exhilarated.
• Excessive irritability, on edge.
• Increased sex drive, possibly resulting in affairs, inappropiate sexual behaviors.
• Poor judgment, impulsiveness, spending sprees.
• Embarrassing social behavior.
• Paranoia, delusions, hallucinations.
  
  
  

WHAT ARE THE DANGER SIGNS OF SUICIDE?

• Talking or joking about suicide.
• Statements about being reunited with a deceased loved one.
• Statements about hopelessness, helplessness, or worthlessness. Example: "Life is useless." "Everyone would be better off without me." "It doesn't matter. I won't be around much longer anyway." "I wish I could just disappear."
• Preoccupation with death. Example: recurrent death themes in music, literature, or drawings.
• Writing letters or leaving notes referring to death or "the end".
• Suddenly happier, calmer.
• Loss of interest in things one cares about.
• Unusual visiting or calling people one cares about - saying their good-byes.
• Giving possessions away, making arrangements, setting one's affairs in order.
• Self-destructive behavior (alcohol/drug abuse, self-injury or mutilation, promiscuity).
• Risk-taking behavior (reckless driving/excessive speeding, carelessness around bridges, cliffs or balconies, or walking in front of traffic).
• Having several accidents resulting in injury. Close calls or brushes with death. Obsession with guns or knives.
  
  
  

Just because an individual is doing these things does not mean his mind is made up. He can be stopped! He has not chosen death, but is instead focusing only on easing the pain or ending the pain. Pain which is usually the result of an illness - a chemical imbalance in the brain that is, many times, treatable. If a person understood that he could have the life back that he once had, before the depressive illness, he would almost certainly chose life, not death.


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6. Depression

If you're not suffering from depression yourself, chances are that anywhere from 15 to 50 of every hundred people you know are. It is an insidious illness that sucks an individual further and further into a state of "impotence" and at the same time impacts the well-being of everyone who comes in contact with him/her. The numbers offered here are somewhat ambiguous because depression is only recently recognized as a real illness and not a figment of one's imagination.

Diane, who has been suffering from depression for more than eleven years, is one of those who are willing to talk about her illness. She says, "Most people are still very much surprised that I admit and am willing to talk openly about my depression. There is still a stigma associated with the disease. People still don't understand." For this reason, we won't use real names in this article although the people who shared their stories are very real.

Incidences of this illness are staggering. An estimated 10-14 million Americans suffer from depression, according to a recent article in the Alliance for the Mentally Ill publication. Other estimates range as high as 35-40 million.

No one is immune from an attack of depression. Keep in mind that everyone feels "down" or "blue" at times. That's normal. But it's been estimated that 26 out of 100 women and 12 out of every 100 men will have a major depressive episode at least once in their lives. For creative individuals the estimate increases to 38 out of 100.

Statistics can be deceiving and any attempt to quantify this disease could be challenged. Particularly since, according to the Alliance for Mentally Ill, we're talking about those who are only now beginning to and seek help -- 80 % of those suffering >been institutionalized for depression and bi-polar disorder. Another study performed in the 80's showed that more creative people suffered from emotional strife synonymous with certain neurosis. (Time-Life Books, 1992)


THE GOOD NEWS


Although the problem appears to be hopeless, there is good news. If you're going to have an illness, you want it to be depression. It's the most easily treatable.

The afflicted needs to work at getting back in balance. Professional counseling, support groups and the medical profession are learning to work together to speed recovery.

The medication is a critical aspect of treatment. The new drugs are marvelous even with the occasional discomfort of side effects. They work to re-balance the synapses that are responsible for the transmission of brain impulses.

Social workers and psychiatrists, too are much more skilled at identifying symptoms today than ever. Group counseling, support groups and crisis lines are more accessible. There's help and information out there for those who have the courage and determination to find it.

Much of the work, says Barbara Hayes, a licensed clinical social worker who oversees a 12-session group that's been running throughout the summer at Family Service DuPage, focuses on teaching cognitive reasoning techniques. Those who participate in this therapy learn to evaluate the validity of their thought processes and to recognize distorted thinking patterns. Then they learn to restructure their thought processes more positively and realistically. It's a sort of de- programming that allows individuals to discover that there are other ways to look at one's life experiences. Hayes has found this kind of therapy most productive when participants have the appropriate medical support. She assures her patients that "using medication is not wimping out." Trying to pull yourself out of depression without the proper medical attention just doesn't work, she says. It's like a diabetic telling his pancreas to shoot insulin into his system, she says.

Unfortunately current health care programs, both private insurance and public aid, put unrealistic limits on treatment. All too often they cut short coverage long before the patient is able to cope without the medication and psychological support. When this happens they "hamstring the health care providers," said Rose. It's not at all uncommon for these programs to cut off the payment for medication and counseling sessions just about the time a patient starts to show some progress and before the patient is sufficiently recovered. The only recourse in cases like that, short of going "cold turkey", is to get on a waiting list for services that are offered on a sliding scale fee. All too often the patient is not financially able to handle that.

Fortunately it's the patient who does the real work of recovery. Those who discover that they control of their own destiny have the greatest hope of recovery. They can then learn how to maintain balance in their lives and their habits. They practice being less compulsive nurturers. They begin to trust themselves and be a bit more open with others. They learn to maintain a childlike attitude of gratitude and wonderment. And, they learn to be less sensitive to outside turmoil.

One of the key ingredients to healing lies in getting away from introspection and self-centeredness and to reach out to others. Those who have been afflicted and have made the most progress typically have found ways to give of themselves to others less fortunate or to share their unique talents with the community...the challenge being that a person who is severely depressed has great difficulty breaking through his/her feelings of isolation.

One group of women developed a phone network that they said was particularly helpful. One of the women is dealing with a pregnant teenager, another with a financial problems, a third with the death of a mother and a fourth with an overbearing aging mother. These women discovered that being able to pick up the phone and connect with someone who they knew would understand helped to speed recovery. In short order, often a matter of minutes, they managed to break the downward spiral of day-to-day crises. These calls provided the ladies a life-line that they turn to before the crisis could escalate. Most often within a very few minutes, they found they could put the experience into perspective and they'd find themselves laughing. And therein they found a cure, because you simply can't be depressed and laugh at the same time.

Dr. Russo's findings confirm that depression is indeed a multi- factorial disease that encompasses genetic, biological and environmental factors. He voices the concerns of many when he says, "The reason that depression is so pervasive is that society is losing its sense of security and moral fiber in both the family and in the community. As it's losing its fiber we're losing our sense of purpose and personal value. At the same time we need to look at the spiritual component that gives us a sense of wholeness and peace when looking for solutions."

Those who understand depression agree, with Heddi, "I need people, but I need people that I can be myself with. And, I need to find a way to make sense out of the madness I face every day I walk out my front door. When things get off balance, I need to make some changes. Alone I can't do it."

NOTE: Although most of the quotes here are those of women, the situation is far from a woman's problem. Women are simply more susceptible to depression. "Role strain is a factor, according to Barbara Hayes. "We are more aware of depression than we were in the past, but there are more stresses in society today for women to fulfill multiple roles. They make very heavy demands upon themselves. Women traditionally are the nurturers and very often in the process of nurturing others they forget to nurture themselves....as a result, at some point, people just start caving in."

The experts tell us that women today suffer twice as much depression as men. While one in four women can expect to develop depression during their lifetime, one in eight men can, too.

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by Joan-Marie Moss


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7. Difference Types of Depression

ARE THERE DIFFERENT TYPES OF DEPRESSIVE ILLNESSES?


Yes, all with various symptoms, degrees of severity, and duration.

SAD (Seasonal Affective Disorder) - this illness has to do with a person's reaction to the amount of light a person receives. Symptoms of depression - low energy, fatigue, overeating may appear when the days begin to get shorter and there is less sunlight. People who have Seasonal Affective Disorder may produce an excess of the hormone melatonin, which is related to the body's sleep cycle and biological clock.


Unipolar Depression
Person has times when he/she feels normal, and other times when he/she feels depressed, slowed-down, or in a fog. Their ability to function normally may be significantly impaired. A person may have only one or two episodes, or may continue to have episodes throughout his or her lifetime.


Bipolar Illness or Manic Depression
There are two forms of this disease. With the first type, Bipolar I, a person may have dramatic mood swings, from severe lows to extreme highs (mania). A person who is experiencing mania may have excessive energy, he or she may feel restless and unable slow down, appearing hyper. This state causes grandiose thinking, impaired judgment, and often times embarrassing social behavior. With the second type, Bipolar II, the manias are milder (hypomania) and the lows may be of any severity. A person experiencing hypomania may be very talkative and social, their thinking may be extraordinarily clear and sharp, with heightened creativity. They feel in a wonderfully good mood, but eventually sink into a low period.


Dysthymia
This is chronic mild to moderate depression. A person usually continues to function, but just doesn't experience the pleasure out of life like a healthy person does.


Cyclothymia
A form of bipolar illness, this is a mood rollercoaster. A person may feel up one day and down the next, or up one week and down the next. Seemingly unpredictable. Periods of normal mood may be few and far between. Hypomanias occur, along with mild depressions.


Atypical Depression
Person can still have fun and experience pleasure if an opportunity presents itself, such as a party or good news, but the feeling is short-lived. Heaviness, fatigue, and lack of motivation then recurs until the next pleasurable occasion comes up. There may be moodiness, plus at least 2 of these 4 symptoms; oversleeping, overeating, extreme fatigue and rejection sensitivity.


Premenstrual Syndrome
Seems to be related to depression in some people, with symptoms of irritability, nervousness, sadness, low energy, and physical symptoms of body aches and bloating presenting themselves prior to a woman's menstrual period.


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8. If Someone is Suicidal


WHAT SHOULD A PERSON DO IF THEY SUSPECT SOMEONE THEY KNOW MIGHT BE SUICIDAL?


Ask him or her! That may sound absurd and very scary, but you must ask him if he ever feels so bad that he thinks of suicide. Don't worry about planting the idea in someone's head. Suicidal thoughts are common with depressive illnesses, although not all people have them. If a person has been thinking of suicide, he or she will be relieved and grateful that you were willing to be so open and nonjudgemental. It shows a person you truly care and take him/her seriously.

If you get a yes to your question, question the individual further. Ask if he has a plan, or a method, or if he has decided when he will do it. This will give you an idea if he is in immediate danger. If you feel he is, do not leave him alone! The person must see a doctor or psychiatrist immediately. You may have to take him to the nearest hospital emergency room.


Always take a suicide threat seriously and never keep it a secret!


You must never call a person's bluff, or try to minimize his problems by telling him he has everything to live for or how hurt his family would be. This will only increase his guilt and feelings of hopelessness. He needs to be reassured that there is help, that what he is feeling is treatable, and that his suicidal feelings are temporary.

If you feel the person isn't in immediate danger, you can say things like, "I can tell you're really hurting", and "I care about you and will do my best to help you." And follow through - help him find a doctor or a mental health professional. Be by his side when he makes that first phone call, or go along with him to his first appointment. A supportive person can mean so much to someone who's in pain. This is an opportunity to interrupt the long process that for many, leads to suicide. You may save a life!

1-800-784-2433
Toll-Free Nationwide USA
24 hours / 7 days a week


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9. Mood Disorders due to Medical Conditions


Clinical depression commonly co-occurs with general medical illnesses, though it frequently goes undetected and untreated. While the rate of major depression in the community is estimated to be between 2-4 percent, among primary care patients it is between 5-10 percent. For inpatients, the rate increases to between 10-14 percent.

Treating the co-occurring depressive symptoms can improve the outcome of the medical illness while reducing the emotional and physical pain and disability suffered by the patient. Here are some medical conditions that have been implicated as triggering depressive symptoms:

• endocrine conditions (hypothyroidism, etc.).
• neurological disorders such as brain tumors.
• encephalitis.
• epilepsy.
• diseases that cause structural damage to the brain.
• viral and bacterial infections.
• inflammatory conditions such as rheumatoid arthritis and lupus.
• vitamin deficiencies (especially vitamin B12, vitamin C, folic acid and niacin).
• heart disease.
• stroke.
• diabetes.
• kidney disease.
• multiple sclerosis.
• cancer.
  
  
  

Anyone who suffers from one of these disorders should treat the underlying illness medically and pursue psychotherapy or counseling if depression accompanies the physical illness.

Medication-Induced Depression


Many people do not realize that a number of common prescription drugs have side effects that can induce depression. Thirty years ago, my mother went into a long-term depression as a result of a reaction to the drug Resperine, a high blood pressure medication. Similarly, my own depression was accelerated by my reaction to large doses of antibiotics given for a leg infection. Prescription drugs with depressive side effects include:

• cardiac drugs and hypertensives.
• sedatives, steroids.
• stimulants.
• antibiotics.
• antifungal drugs.
• analgesics.
  
  
  

It may be worthwhile to consult the Physician's Desk Reference (PDR) or books such as Worst Pills, Best Pills (by Wolfe, Sasich, and Hope) to learn if depression is a potential side effect of a medication you are taking. In addition, taking recreational drugs or being exposed to toxic chemicals in the environment may also have an adverse effect on mood.

Usually, stopping the intake of the offending substance will eliminate the symptoms (as happened in my mother's episode). If depressive symptoms caused by the substance linger, then psychological treatment may be necessary.


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10. Reasons Not To Kill Yourself

1. Because you deserve to live.
2. Because your life has value, whether or not you can see it.
3. Because if was not your fault.
4. Because you didn't choose to be battered, abused and used.
5. Because life itself is precious, because they were and are wrong.
6. Because you are connected to each and every other abuse survivor, and so your daily battle automatically gives others hope and strength.
7. Because you will feel better, eventually.
8. Because each time you confront despair you get stronger....you can't know now what you will ultimately be able to do with this new morsel of strength, what future battles you will be able to win.
9. Because if you die today you will never again feel love for another human being, or trust, or gratitude.
10. Because you will never again see kindness and compassion in another's eyes.
11. Because if you die today you will never again see sunlight pouring through the leaves of a tree, or a bird take flight, or feel the quality of light in winter.
12. Because the seconds do not cease their passing, because even if it feels like time has become an unbearably heave stone, it has not, and you only have to endure.
13. Because you have already won...you have known the cleverness and resiliency and courage and stubborn will to make it this far, and no one can take that away.
14. Because the will to live is not a cruel punishment, even if it feels like that at times: it is a priceless gift.
15. Because your inner children need you, they have no one else and their need is so great, and because they deserve more than anyone to be healed and comforted, they are true heroes against impossible odds.
16. Because you owe your inner children, they are the reason you are here. If you die today you will erase the meaning of their suffering and incredible endurance, and that is too great of a loss.
17. Because you already have the skills to find your healing path, you have proven this over and over again.
18. Because we need more warriors against this evil.
19. Because we need survivors to offer testament against this horror and despair.
20. Because no one knows better than you the meaning of suffering, and the agony deepens the heart.
21. Because you deserve the peace that will come after the battle is won, and it will be won, but only minute by minute - we must learn to let go of the unconquerable.
22. Because we can all come together in later years to laugh in their faces.
23. Because we will be able to show them that even though they had all the power and strength and ruthless cunning, even though we were only helpless, innocent dependent children, we will have beaten them at the game they so smugly thought they had mastered.
24. Because I am furious that we have to suffer the pain of another's evil and filth.
25. Because you too will one day feel fury.
26. Because it is critical that you survive.
    
    
    

By Mari Collings


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11. Surviving Life


I have struggled with the desire to take my own life for close to twenty years. I have been on antidepressants, in therapy, and had religious experiences. And I still want to die.

I do not know how to explain these feeling to someone who has never experienced them. Perhaps it is like explaining snow to someone who lives in the rain forest. Or, more accurately, perhaps it is like describing frostbite to an individual who has never been cold.

For me, the struggle began in an abusive marriage. Although I had a very difficult childhood, it was only after being emotionally, physically, and sexually tortured by a seriously disturbed husband, that life became intolerable. I survived because I had children who needed me, not because I wanted to do so.

It seems to me at times that in some real way, the hell I endured for over six years invaded my soul. I often view the world as dank concrete room, with a bare swinging light bulb, where I lie waiting, cold and naked, for the next blow. It is not that I never experience joy. It is more that it begins to seem a cruel hoax, designed only to leave me less prepared for the next assault.

I have longed for the comfort of a companion, for the joys of a love relationship, for the hope of a future. I have at times actively sought these things, at others, turned into my hurt as though in itself it could offer solace. I have, over and over, despaired of life.

There comes a point in misery when it becomes monotonous. When the expectation of pain becomes the only constant in your personal universe. Scientists call this learned helplessness. I call it boredom.

Sadly, I doubt that I am alone. I know too many "survivors," who, no matter how many Oprah experts they quote, are fighting just to hang on. Somehow, when someone treats another human being like they are worthless, that poison can seep into the victim's soul. We are not confused. It is not a matter of perspective. Our wounds are real.

The obvious question then becomes, "What do we do? How do we heal?" I will give you my honest answer. I do not know.

What I do know is this. Until we acknowledge the truth, no change is possible.

So there it is. I will say it. I have struggled with the desire to take my own life for close to twenty years. I have been on antidepressants, in therapy, and had religious experiences. And I still want to die.

This one hope I can offer. If you feel this way, you are not alone. I have fought the impulse for close to two decades. You can fight it, too.

Suicidal impulses are a serious life threatening problem and professional evaluation is strongly suggested. The above thoughts DO NOT TAKE THE PLACE OF PROFESSIONAL HELP. IF YOU ARE SUICIDAL, SEEK HELP IMMEDIATELY. Don't wait, don't hesitate. Call someone now.

Suicide Prevention 1-800-SUICIDE
(1-800-784-2433)


by Ethereal Longings


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12. Thoughts on Depression


1. Depression is the most common mental health problem treated by modern psychologists and psychiatrists. In most cases, hospitalization is not required unless you have waited until you have active suicidal thoughts.

2. If you are depressed, expect your brain to be filled with mental garbage - get ready for it! During this time, do not take action on those garbage thoughts and make no major changes in your life. It's best to wait until the garbage truck leaves before making decisions that will or may change our life.

3. Depression has been researched by physicians, psychologists, psychiatrists, scientists, and others. Listen to the advice of your professionals who study depression - not your neighbors or your aunt Gladys. If placed on medication, you may be told "Don't take that Dope!". Remember, the people giving you advice don't have a 200 mile-per-hour garbage truck following them! Stick with professional opinion. Depression is a chemical problem, not caused by demons, devils, poor eating habits, a new moon, or other old-wives tales.

4. You may have other symptoms with your depression, such as severe anxiety or agitation (pacing, no sleep at all, "hyper", etc.). That only means another neurochemical has kicked in. In these cases, a psychiatrist can best select the medication for the combination of anxiety and depression.

5. When you are depressed, those who love you will become a pain-in-the-butt. They will "bug" you constantly, trying to cheer you up, giving you advice ("snap out of it" is most common), and trying to be by your side. Children will become shadows when their mother is depressed, almost protecting Mom. Be prepared for this.

6. During depression, remember that your brain goes on a bad-memory hunt, looking for old memories to torture you. Be prepared to relive or re-feel old hurts, old doubts, old guilt, and old sorrows. Be curious about what memory files the brain selects rather than focus on those memories. You can expect your brain to constantly replay the video tape (your "worst hits" tape) of your life. You'll feel guilty for things you did as a child, mistakes you made ten years ago, etc. You'll live in the past as long as the depression remains. It may interest you to know that as the serotonin level increases, the "past" returns to the past as a memory - not a torture.

7. As your brain tortures you, it may "lock on" horrible thoughts. You may feel you have a terminal disease. You may become preoccupied with guns, evil thoughts, etc. Often, individuals feel they are somehow contaminated by a killer disease, fearing they will pass it to their family. One husband brought his wife in for treatment when she began fixing breakfast in a surgical mask and rubber gloves! One man sought treatment at the office after nailing his closet door shut with 148 nails - his brain became preoccupied with the shotgun in that closet, telling him to kill his family and then himself.

In other depressed situations, people become obsessed with other issues, almost always "the road not taken". Often viewed as mid-life crisis, a straight-laced businessman now wants a Harley and a tattoo while another individual begins suddenly thinking about a past sweetheart. In almost all of these situations, the individual acts totally out of character.

8. All depressed folks look for escapes. Common methods of trying to escape depression are excessive alcohol use, drugs, sexual relationships, changing jobs, etc. A lot of good marriages are lost during these times as the spouse of the depressed partner hears "I've got to have space" or "I've got to get away and find myself!" You'll find these escapes don't work. These methods only complicate your depression and your recovery. Best bet - don't make changes, just get to a professional.

9. Most people classify all medications that act on emotions as "nerve pills". This is far from the truth. Psychiatrists actually have medications for anxiety/nervousness (Valium, Ativan, Xanax, etc.) and those for depression (Elavil, Prozac, Zoloft, Sinequan, etc.). Different brain chemicals are involved in each condition and many people make the serious mistake of taking an antianxiety medication for their "nerves", thinking they are treating their depression - Wrong! While you will be calmer, you will stay depressed. It's like drinking six beers for a broken arm - you might feel the pain less but your arm is still broken. A psychiatrist is most qualified to select the proper medication for your condition.

10. If you are placed on medication, don't expect an immediate recovery. With antidepressants, it's similar to refilling the oil in the car, only at 1/8th of a quart a day. As you continue to take the medication, your mood will slowly improve as the serotonin level increases in the brain. When depressed, every day is bad and full of mental garbage. As medication continues, you'll have a bad, then good day. As serotonin gets higher, you'll have a bad morning, then three good days. In short, it's bad-and-good at first, then finally good days with routine hassles. No one is happy all the time. People that are happy all the time are institutionalized - it's not normal. "Normal" is a good mood with normal reactions to the stress of everyday life.

11. In selecting a therapist/counselor, each one is different. All have different personalities, styles, and attitudes. Select one that has your style and most important - somebody that makes sense. If you meet one that says "I don't believe in medications" - get out of there! That therapist is about thirty years behind modern treatment. Often, your family physician is in a position to recommend the best therapist in your area. You can also look for signs of acceptance in the professional community, such as hospital privileges. You may have to shop around to find a therapist right for you.

As a word of caution, many inexperienced therapists or those with limited training may miss the fact that you are depressed. You may arrive at the therapist office preoccupied about something in your childhood that actually happened 20 years ago. You may also fool your family physician with multiple physical complaints as when Serotonin is low, all body systems seem to go haywire. A properly trained therapist will not only asked about your life and upbringing, but about the physical aspects of your situation; your sleep, sexual interest, concentration, and other indicators of low-serotonin depression or stress. The inexperienced therapist might focus on the "garbage truck" thoughts and miss the big picture, the presence of depression. If you are clinically depressed, weekly discussions of your past as told by the garbage truck will only prolong your depression and possibly intensify it. If in doubt, consult your family physician to obtain a medical/physical view of the situation as most physicians are usually trained to recognize the indications of low-serotonin depression. If you think depression is part of the problem, ask your family physician to refer you to a psychiatrist or psychologist in your area.

12. Depression affects more than the individual with the depression - it's a family-and-friends problem as well. If your spouse is depressed, he or she may be constantly talking about the history of the marriage and relationship. Remember, the "garbage truck" is running in their brain, thinking of every bad thing that has been done, said, or not done. The spouse that isn't depressed is frequently "dumped on" with hundreds of accusations and thoughts that are long after-the-fact and totally beyond correction at this point. The nondepressed spouse may suddenly learn that their partner never did like their hairstyle, their mother, their choice of automobile, or the price of the house. The nondepressed spouse will hear many "thoughts" that were present at the time of marital decisions, often years ago, but were never mentioned. The nondepressed spouse may be awakened at night with accusations and complaints that may last for hours. The nondepressed spouse will be made to feel responsible for these unspoken wishes and will be helpless as the depressed spouse lists mistakes and misunderstandings that have taken place during the entire marriage/relationship. Even though they might have been discussed at the time, the nondepressed spouse will receive much blame for past events.

If your son or daughter is depressed, they may suddenly withdraw from the family or become hostile. Due to their youth, most of their life experience is associated with the family, remembering that family experiences makes up 70 percent of their mental video tape. For this reason, the "garbage truck" will be reviewing every mistake or issue in their upbringing. In such cases, the parents are "dumped on" with what they did wrong, bad decisions they've made in raising the son/daughter, or feelings that were never discussed related to their brothers or sisters. With the low self-esteem created by the depression and stress, the son/daughter may be intensely rejecting, as though feeling they must reject the parents before the parents have a chance to reject them. The anger and hostility is often so strong that parents miss the fact that their son/daughter is depressed - they're too busy dealing with accusations or hostility to see the depressed mood.

Older sons and daughters may start apologizing for their behavior in their childhood, seeking forgiveness - despite the fact that they are now parents themselves. Parents may be shocked to find that their depressed married son/daughter is suddenly thinking of divorce in a circumstance that is "out of the blue" and totally unexpected.

If a friend is depressed, they will suddenly have no interest in maintaining your friendship. They'll stop calling, visiting, or writing. If your depressed best friend suddenly gives you their most prized possession or asks you to be included in their will to take care of their children - be on the alert! Such behaviors are often part of a suicide plan in which the depressed friend wants to "take care of business" before they leave this earth. At that point, a heart-to-heart talk is needed, perhaps offering to accompany them to a professional's office for help. Many depressed individuals are brought to the office by their parents, friends, ministers, union stewards, or work supervisors.


Conclusions:

Depression, at some level, will hit every adult eventually. While most depressions are brief, with our serotonin gradually returning as stress decreases, when depression comes and stays you may need professional treatment to recover. If you think you may have depression, obtain an opinion from a mental health or medical professional. That professional can then guide you in the direction of additional treatment and/or possible medication. Depression is no longer a mystery and is easily treated by modern methods. Treatment is usually short-term, there's no lying on a couch, and your insurance covers most of the charges in Ohio and other states. Your community mental health professionals are your clinical psychologists, psychiatrists, social workers, and those at your community health-care facilities.

Credit: This handout was written by Joseph M. Carver, Ph.D., a psychologist in private practice at Joseph M. Carver, Ph.D., Inc. in Portsmouth, Ohio. Dr. Carver is a psychologist consultant at the Adena Regional Medical Center 1-A Inpatient Psychiatric Unit, River Valley Health Systems, and is affiliated with three regional hospitals. The handout is provided as a public service to the community.


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