Depression

By on November 13, 2012

Description:

What is the difference between sadness and depression?  Sadness and grief are a part of the normal human experience and not to be mistaken for clinical depression.  When prolonged periods of overwhelming sadness are experienced with very little relief, it becomes distressing to the individual and can affect his/her ability to function normally in daily life.  This situation may be an indication of depression.  It is estimated that 10% of the U.S. population is clinically depressed.  According to the World Health Organization in 2007, approximately 121 million people were affected by depression, resulting in the highest loss of productivity worldwide.  The economic and social costs of depression are astronomically high.

Symptoms & Causes:

Woman are twice as likely as men to experience depression, possibly attributable to changes in hormones before menstruation, following childbirth, through use of oral contraceptives, or possibly due to many stressors that women face.  Women today often play a number of conflicting roles (i.e. parent/employee).  They also typically experience many life phases (i.e. puberty, adulthood, pregnancy, motherhood, menopause and retirement), whereas men typically experience stressful life changes only at puberty, adulthood, parenthood and retirement. Lesbian, gay, and bisexual adults are also at a higher risk for depression.

For a dancer faced with trauma, extreme stress, or an injury, it is not unusual to experience grief and sadness.  However, when these feelings persist for an unusually long time they could be an indication of depression.  Unfortunately, many cases of depression go undiagnosed.  Diagnosis of depression can be extremely difficult.  According to the American Psychiatric Association’s Diagnostic and Statistical Manual, fourth edition, text revised (DSM-IV-TR), depression is marked by significant declines in functioning lasting 2 or more weeks, feelings of worthlessness, inadequacy and self-doubt, diminished interest in virtually all activities, including those formerly found enjoyable, depressed or irritable mood most of the time, lethargy, insomnia or excessive sleep, change in appetite with weight change of +/- 5%, periods of excessive activity or slowness almost every day, feelings of worthlessness or excessive guilt, and/or recurrent thoughts of death or suicide. Individuals must meet five of the DSM criteria for diagnosis of a major depressive episode, however many cases of depression go undiagnosed.  Individuals with depression also experience deficits in memory and executive function.  From a more subjective perspective of depression, clients tend to turn their attentions inward toward themselves.  Depression is a “passive disengagement with the environment in that…attentional focus is on internal concerns rather than environmental events.”

Symptoms of depression can also arise from general medical conditions.  Although these individuals would not meet DSM-IV-TR criteria for diagnosis of a major depressive episode, it is worth noting that injury and illness, both chronic and acute, can contribute to feelings of depression.  This can be due to disorders that cause hormone changes, as in thyroid disease, nutritional deficiencies, or could be the indirect result of pain or disability.

The biological perspective of psychology indicates that depression is a result of imbalanced neurohormones.  Reduced levels of Serotonin and increased levels of Dopamine have been implicated in individuals with depression.

Treatment:

Traditional treatments have sought to alleviate these imbalances and often include antidepressants or mood stabilizers in combination with psychotherapy. Currently the most common pharmaceutical treatment is use of Selective Serotonin Reuptake Inhibitors (SSRIs).   SSRIs work to prevent the reuptake of Serotonin, thus keeping more available at the synapse to bind to receptor sites.  Unfortunate side effects of SSRIs include nausea, diarrhea, tremor, weight fluctuations and headache. SSRI dosage must be carefully monitored by a physician or a psychologist, as there is a high risk of withdrawal symptoms such as dizziness, irritability and anxiety.  In extreme cases of depression in which drug treatment is ineffective or the patient is psychotic, electroconvulsive therapy (ECT) may be used.  For reasons that are still not well understood, inducing seizures in the brain by running an electric current through electrodes on the skin relieves symptoms of depression in these patients.  Although ECT is controversial and seen by many as unethical, it is also extraordinarily effective.

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