Being Diagnosed

If you think you have depression, the first step you need to take is to make an appointment with your primary care physician.

Before your appointment, you should get an in-depth family history. You should also include any symptoms and behaviors, whether they seem related or not, as well as personal information including stress, life changes and lifestyle habits (exercise, diet, sleep, alcohol & drug use). The doctor will also ask for all medications, vitamins and supplements, both prescribed and over-the-counter, that you are taking. It is usually best to sit down and write out this information before your appointment, to insure that you remember everything.

During your appointment, your doctor will ask a lot of questions. Many of these questions may seem extremely personal, but you need to answer them as honestly as possible. The doctors won’t judge you, they want to make sure you get the help you need. The doctor may do a physical exam to rule out a physical health problem. They may also do lab test including a blood test to check your thyroid. An overactive or underactive thyroid will also present the same symptoms as depression. You might also have to have a psychological evaluation. Don’t hesitate to ask questions anytime you don’t understand anything.

To be diagnosed with depression, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. As previously discussed, major depression is characterized as having more than 5 of the symptoms discussed in a previous post, for over a 2 week period.

If you see your primary care physician, get referrals for a psychiatrist and/or a psychologist. I will go into more detail on the differences between the two in another post.

If you are diagnosed with depression, seek the help that you need. Be your own advocate & realize you are not alone.

Depression is A Lying Bully

Depression is a lying bully. It reaches into the darkest places of my mind and uses it against me. My depression tells me that I’m worthless, that I’m not worth anyone’s time, that I can’t do anything right and that I’m never going to make something of my life. In a nutshell, my depression tells me that I’m a loser.

And the worst part is that depression reinforces itself. Every time someone blows me off, my depression is right there, whispering that I’m not worth anyone’s time. Every time, I get ignored, my depression tells me that I don’t have any friends. And unless my definition of friendship is off, then I don’t and that is rather unfortunate.

I feel better when I’m around other people, because then I’m not alone. And when I’m not alone, my depression isn’t so all-consuming. Unfortunately, I am alone almost all of the time. I work alone, and when I am off work, I don’t have any friends to hang out with. I’m not sure why I don’t have friends. My depression makes me think that there is something wrong with me and that’s why there isn’t anyone. But maybe it’s because they don’t understand my depression.

I realize that everyone has their own life, but we make time for the people that matter to us and it’s just unfortunate that it seems like no one can make time for me. At the moment, I have one friend I can count on. One person who has been there for me no matter what and I want to thank him. I hope he understands how much I appreciate him and what a difference he has made in my life.

Some people say that I like feeling this way. That I like feeling down all the time. That I like having no friends. That I like thinking negatively about everything. But they are wrong. I can’t help the way I think. I wish I could, but there is something chemically wrong in my brain that affects my thinking and I can’t fix that on my own.

There are days when I wake up, and I don’t want to be alive anymore. It’s not that I want to die; there is no plan or intent, I just don’t want to be alive anymore. My life feels pointless, like I’m just wasting space. Othertimes, I want to die because then, maybe someone would pay attention to me. Maybe all of those people who were too busy when I was alive, would understand what they missed once I was gone. But I don’t actively want to die. There is no plan and I have no intention of creating one, there are just days when I don’t want to live.

So please, if you know of someone with depression, let them know that you care. Let them know that you are there for them; to listen and to hug them. Some people do lose this fight. Some people do have a plan and successfully carry it out, and you never know who that could be.

So I want to know. Do you suffer from depression? How do you cope?

Depression: A Personal Definition

While the clinical definition helps us understand what depression is, it is a totally different experience when you live with it. Depression is not some vague term that other people have to deal with. I used to view those commercials for antidepressants with casual disregard. Now, those commercials apply to me and often describe my very life.

I have my good days and my bad. It is worth noting that I am not on medication at the moment, but I am in therapy and have been since I was first diagnosed. Honestly, I probably should be on medication, but I will get into that more on a later post.

Lately, I have been having mostly bad days. Things in my life have not been going well. I used to have a plan, but unfortunately, my depression derailed that. For those of you without depression, this may be hard for you to understand, but depression seeps into every part of your life and turns it upside down.

It is not a matter of just “getting over it” or “thinking positively”. Telling me that “there are other people worse off than you” or “you don’t look depressed”, is not helpful either. Honestly, I mostly want you to listen and show me that you care.

Often, it is a struggle just to get out of bed and many days, I feel like I am fighting just to survive. One of the biggest issues I find with suffering from depression, is not the the disease itself, although that is a struggle. But the biggest issue from my point of view, is the lack of understand that the general public has towards mental illness. The stigmas attached to mental illness, are oftentimes more difficult to live with, than the illness itself.

I want everyone to understand that depression can get the better of us. It can be fatal, but it does not have to be. With more understanding, and tolerance towards mental health, we can ensure that more people survive. I want you to understand mental illness, and if you have any questions, please do not hesitate to ask. Depression is not the same for everyone, but with a general understanding we can make the world a better place.

Forms of Depression

There are many types of depression.

Major Depression interferes with everyday life. It is characterized as having more than 5 of the symptoms discussed in a previous post, for over a 2 week period. Major depression can occur only once, but there are often several episodes.

Seasonal Affective Disorder or SAD, is the onset of depression during winter months. It is generally attributed to the lessening of sunlight and it is usually effectively treated with light therapy.

Postpartum Depression occurs after the birth a newborn. It is attributed to hormonal and physical changes, as well as the new, overwhelming responsibility of a newborn. If not treated, it could lead to trouble caring and bonding with the baby.

Bipolar Disorder, also known as manic-depressive disorder is characterized by major mood swings. The moods swings from manic to depressive are often gradual, although they can occasionally occur abruptly. There are multiple types of bipolar disorder, depending on the severity of the mood swings.

Persistent Depression Disorder, or PDD, also formerly known as dysthymia is a form of depression where the symptoms last for at least 2 years. It is usually less severe, but more chronic. It is not disabling but persistent as described in the title. People with PDD usually look at life with a “glass half empty” mentality.

Psychotic Depression is major depression with psychosis. This is characterized by hallucinations, delusions and paranoia.

Premenstrual Dysphoric Disorder or PMDD, is depression that occurs with the hormonal changes a week before a woman’s period and improve with the onset her period.

Atypical depression, which is actually more common than the name suggests, is depression where mood is temporarily improved by a  positive event. This depression is characterized by a heaviness in the arms and legs.

Adjustment Disorder is a severe reaction to a difficult event. It is triggered by a stressful, life-changing event and is a type of stress-related mental illness that may affect feelings, thoughts and behavior.

 

  1. National Institute of Mental Health
  2. Anxiety and Depression Association of America
  3. Mayo Clinic 

Thoughts for the Day 1/19

Today has been an interesting day. This year hasn’t started off well, and there are days when I wonder if things are ever going to get better. Honestly, my year started off with my boss cutting my hours from 40 hours a week to less than 20. The plus side, is that it has given me the push I’ve needed to find a new job. The negative, is that I’m not very optimistic about this job search. I’m worried that I’m not going to get called for interviews, that I’m not going to find a new job and that I’m going to burn through my savings trying to stay independent. All of which leads to today.

I’m only working three days this week, which gives me plenty of time to fill out applications on my job search. The downside is that I’m left with a lot of time at home, alone. I got off work today at noon, having an early shift and my first thought when I was getting off was that I didn’t want to go home. The problem is that I don’t have anywhere else to go. I’m sure it would be very different, if I had someone or even a pet, waiting for me at home; if I was not alone all of the time.

I’m so scared that I’m going to spend my life alone. I’m scared that I’m never going to find that person to be with, to marry. I want a family and I’m scared that’s never going to happen. At this point, I feel like I’m facing an entire lifetime alone, and that’s not something I want to face.

I guess, in a lot of ways, I’m a high functioning depressive. I get up and go to work. I try to get things done in my life. Most of the time, it’s because I have to. I want to be independent. I don’t want to need to rely on anyone, and I’m so scared of losing that independence, that freedom. I’m scared that I’m never going to get my feet back under me after being so severely knocked off them when my depression hit.

I was on track to graduate college with a double major and a minor, a semester early. All of that derailed my junior year. Maybe that is all for the best. I was studying a major I did not want. I had no idea what I wanted to do with my life. I may not be any better off than I was three years ago, but at least I have a better view of what I would like to do with my life.

I might never succeed in my dream, but this blog is the start to it, so at least I’m taking a step in the right direction. I don’t know if things will work out for me, but if I stay scared, if I don’t try, I’ll never succeed. So here is my first step. This blog, no matter how scary it can be to share your innermost thoughts with the world, is my first step to my dream and hopefully, it will lead me to where I want to be. Hopefully, this blog is providing insight, help and hope to those suffering from depression. And hopefully, it’s providing progress, tolerance and awareness to those who have family or friends suffering from depression.

Adapt – Advocates for Depression Awareness, Progress and Tolerance

Become an advocate. Speak out.

The Causes of Depression

Depression is caused by a variety of genetic, biological, environmental and psychological factors. It can also go hand in hand with various other diseases or illnesses. Despite the recent increased research into mental illnesses and depression, it is still not known what exactly can trigger depression.

Genetic

It is theorized that depression can run in the family. Those who have family members diagnosed with depression are more prone to this condition. Scientists are now researching various genes that may factor into depression. “Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors”.₁ However, depression is not exclusive those families who are diagnosed with depression. It can occur in anyone, which is what makes it so hard to research.

Biological

One of the primary theories regarding depression is biological differences, brain chemistry and hormones. According to research, chemicals in the brain may be out of balance, causing depression. According to NIMH, “brain imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression”.₁ These parts of the brain include those regulating mood, sleep, thinking, behavior and appetite. However, there are many biological issues that can cause depression from neurotransmitters to cell connections so it is hard to pinpoint the exact issue.

Environmental

Environmental issues are also considered to impact depression. These issues can range from traumatic events to the abuse of drugs or alcohol to certain medications or chronic illnesses. While some of these examples may lead to temporary depression, or a single episode, others can continue to impact a person for life. While a person’s environment is considered to impact depression, depressive episodes may occur without an obvious trigger.

Psychological

The final factor that affects depression can be psychological. This includes certain personality traits, such as low self-esteem, pessimism and dependence. Psychological factors are the thoughts going on in the brain, or the thinking pattern. It is not clear, however, if this represents an early form of depression or a psychological predisposition. People with a history of PTSD, anxiety, or other mental illnesses are also at a higher risk.

Despite these factors being recognized, researchers are still unsure of how depression works. Because these factors differentiate between people, it is harder to understand how depression occurs. With more research, hopefully the medical world will have a better understanding of this mental illness.

In the meantime, I find that a more personal view can give the public a better understanding of life as a depressive. It is not all good, but it is not all bad. What I’m trying to say, is though it may seem like it to outsiders, depression is NOT a simple disease.  There are so many factors, triggers and types that experts can’t just figure out a way to turn a depressed person into a happy person.  Research and experimentation have been unable to pinpoint a common factor of the human psyche that causes depression and thus haven’t been able to develop a surefire way of treating it.

  1. NIMH – National Institute of Mental Health

The Beginning

To understand how depression affected me, you need to know who I was before I was diagnosed.

During high school, I was the go-getter. I was very involved in choir, musicals and my studies. I had no problem getting good grades with minimal effort. I wasn’t popular and sometimes I felt like I didn’t fit in, but I had my friends to hang out with.

I was always told that I would thrive in college, that it would be the perfect place for me. That couldn’t have been further from the truth. I struggled, not with my courses, but with me classmates. A series of issues with various roommates left me feeling lonely and forgotten. The feelings that I didn’t fit in and wasn’t wanted became extremely prevalent.

My sophomore year, I was introduced to a guy by a group of friends from home. My first relationship, albeit a long-distance one, began. He was the one I could talk to when things weren’t going well. I fell in love, but like first loves, it wasn’t meant to be.

After another string of roommate failures, I had gotten special permission to live off-campus my junior year. A work opportunity kept me at college the summer before, 6 hours away from my boyfriend. The distance took its toll and 10 months after we started dating, we called it quits.

I was devastated. It had been my first real relationship, the first guy I had fallen in love with, and the guy who had taken my virginity. For weeks, my health deteriorated; loss of appetite, nausea, loss of motivation, tiredness, I wasn’t attending my classes and I could barely get out of bed. At first, I thought I was pregnant, but a pregnancy test quickly negated that. Finally I went to the health clinic on campus. Finding nothing physically wrong with me, I was diagnosed with depression and was put on my first antidepressant.

And so began my battle; a fight that has lasted over three years, thus far.

I would like for you to follow along my journey, as I recount it.  I feel as though sharing my thoughts and feelings through major moments of my illness would help those unfamiliar with depression gain an understanding, albeit small, of what it’s like to live with depression.