Depression

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 Online Depression Screening Test
Depression Hotline

Depression and Suicide Warning Sigs
What Is Depression?

 DSM 5th Edition
Types of Depression
Major depressive disorder - Clinical Depression
Major depressive disorder with seasonal patterns, previously known as
seasonal affective disorder (SAD)
Postpartum depression
Atypical depression
Dysthymia - Persistent Depressive Disorder
Cyclothymia

What are the symptoms of Depression?
Depression Symptoms and Warning Signs

Men.
Women
Teens
Toddlers & Children
Elders

Depression Testing

Beck Depression Inventory (3 page PDF - self scoring)
Hamilton Depression Rating Scale (2 page PDF - administered by a health professional)
Zung self-rating scale for depression (2 PAGE PDF- self administered)

Depression Diagnosis
Does Social Media Cause Depression?
What to do if you are depressed?
How to Help Someone with Depression
Where can I get more information about Depression?
I Knew I had a Good/Bad Psychiatrist/Therapist When…
Postpartum Depression
A comic that accurately sums up depression and anxiety - and the uphill battle of living with them
Teen Depression
Big Data for Depression
Related topics:
Are you feeling suicidal? Attempts, Crisis Text Line, Crisis Trends, Contagion/Clustering, Depression, Emergency Phone/Chat/Text Numbers, Facebook Live , Guns, How to Help, How to talk with your kids about suicide, Mental Illness, Need to Talk?, Online Depression Screening Test , Oregon Suicides 1990 to date, Postpartum Depression, Prevention, Religion, Safety Plan, Secrets No More, 741741, Semicolon Campaign, Stigma, Suicide, Suicide Internationally, Suicide Notes, Suicide Resources, Suicide 10-14 Year-Olds, Teen Depression, Teen Suicide, 3-Day Rule, 13 Reasons Why', Warning Signs

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Overcoming depression | TED Talk
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Mostly Human: Silicon Valley's secret

 

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It's Gets Better

Need to talk?


Find a therapist that's a good fit for you with this health tool.
Source: therapists.psychologytoday.com/webmd

Depression and Suicide Warning Signs


There are warning signs you can watch for in hose who may be at risk of attempting suicide. Though there is no single type of person who may commit suicide, and the symptoms below are not exhaustive, these are the most common signs observed among people who may be contemplating taking their own life.

  • A change in personality, especially behaviors in social situations.
  • Withdrawal from interaction or communication with others.
  • Mood changes that are drastic, such as being very low mood one day to being in a very high mood the next.
  • Triggers such as life crisis or trauma in a person who is already suffering from depression.
  • Threats of suicide, or expressed negative wishes regarding life, such as wishing they'd "never been born."
  • Giving away of cherished belongings to friends and loved ones.
  • Deep depression (manic) observed that affects their ability to function socially or in the workplace.
  • Aggressive or risky behaviors, such as high-speed driving.

Source: www.verywell.com/suicide-rates-overstated-in-people-with-depression-2330503

What is Depression?


A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression. For more information: National Institute of Mental Health www.nimh.nih.gov/publicat/depression.cfm#ptdep1

Depression is a serious medical illness; it’s not something that you make up in your head. More than a feeling of being “down in the dumps” or “blue” for a few days, the symptoms of Depression are severe and debilitating. Depression is characterized by feeling “down,” “low” and “hopeless” for weeks at a time. Factors that can contribute to the onset of Depression include stress, poor nutrition, physical illness, personal loss, relationship difficulties and the presence of other physical disorders.

Depression isn’t always easy to detect, and people with depressive conditions can experience different symptoms. It may be expressed through lack of appetite or overeating; insomnia or an unnatural desire to sleep; the abuse of drugs and alcohol; sexual promiscuity; or hostile, aggressive, or risk-taking behavior.

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include

  • Persistent sad, anxious or “empty” feelings;
  • Feelings of hopelessness and / or pessimism;
  • Feelings of guilt, worthlessness and/or helplessness
  • Difficulty thinking, concentrating or making decisions
  • Irritability, restlessness;
  • Loss of interest in activities or hobbies once pleasurable, including sex;
  • Loss of energy or increased fatigue
  • Difficulty concentrating, remembering details and making decisions;
  • Trouble sleeping or sleeping too much. Insomnia, early-morning wakefulness, or excessive sleeping;
  • Changes in appetite — weight loss or gain unrelated to dieting. Overeating, or appetite loss.
  • Thoughts of suicide, suicide attempts;
  • Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
  • Thoughts of death or suicide

Symptoms must last at least two weeks for a diagnosis of depression.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime.

Depression Is Different From Sadness or Grief/Bereavement

The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being “depressed.”

But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:

  • In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood and/or interest (pleasure) are decreased for most of two weeks.
  • In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
  • For some people, the death of a loved one can bring on major depression. Losing a job or being a victim of a physical assault or a major disaster can lead to depression for some people. When grief and depression co-exist, the grief is more severe and lasts longer than grief without depression. Despite some overlap between grief and depression, they are different. Distinguishing between them can help people get the help, support or treatment they need.

Risk Factors for Depression

Depression can affect anyone—even a person who appears to live in relatively ideal circumstances.

Several factors can play a role in depression:

  • Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
  • Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
  • Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
  • Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.

How Is Depression Treated?

Depression is among the most treatable of mental disorders. Between 80% and 90% of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.

Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem. The evaluation is to identify specific symptoms, medical and family history, cultural factors and environmental factors to arrive at a diagnosis and plan a course of action.

Medication: Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression.

Antidepressants may produce some improvement within the first week or two of use. Full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant. In some situations other psychotropic medications may be helpful. It is important to let your doctor know if a medication does not work or if you experience side effects.

Psychiatrists usually recommend that patients continue to take medication for six or more months after symptoms have improved. Longer-term maintenance treatment may be suggested to decrease the risk of future episodes for certain people at high risk.

Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used in along with antidepressant medications. Cognitive behavioral therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on the present and problem solving. CBT helps a person to recognize distorted thinking and then change behaviors and thinking.

Psychotherapy may involve only the individual, but it can include others. For example, family or couples therapy can help address issues within these close relationships. Group therapy involves people with similar illnesses.

Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions.

Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments. ECT has been used since the 1940s, and many years of research have led to major improvements. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant.

Self-help and Coping

There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improve mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.

Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. This is a start to addressing mental health needs.

Related Conditions

  • Peripartum depression (previously postpartum depression)
  • Seasonal depression (Also called seasonal affective disorder)
  • Persistent depressive disorder (previously dysthymia)
  • Premenstrual dysphoric disorder
  • Disruptive mood dysregulation disorder
  • Bipolar disorders

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.

National Institute of Mental Health. (Data from 2013 National Survey on Drug Use and Health.)

Kessler, RC, et al. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593602.
Source: projectsemicolon.com/what-is-depression/

DSM


According to the 5 th edition of the DSM, a person must exhibit at least five of the following characteristics to be diagnosed with a depressive disorder:

  • Depressed mood most of the day, almost every day, indicated by your own subjective report or by the report of others (characterized by sadness, emptiness, or hopelessness).
  • Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day.
  • Significant weight loss when not dieting or weight gain.
  • Inability to sleep or oversleeping nearly every day.
  • Psychomotor agitation or retardation nearly every day.
  • Fatigue or loss of energy nearly every day.
  • Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day.
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
  • In addition, the "symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning" and the "episode is not attributable to the physiological effects of a substance or to another medical condition."

The above represent a "major depressive episode". The other two criteria as stated by DSM-5 is that "the occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders" and there has never been "a manic episode or a hypomanic episode."
Source: www.depression.org/

What are the symptoms of Depression?


According to the National Foundation of Depressive Illness, the symptoms of Depressive Illness are highly recognizable, both to those affected and to those closest to them, once they are told what to look for.

• Loss of energy and interest.
• Diminished ability to enjoy oneself.
• Decreased (or increased) sleeping or appetite.
• Difficulty in concentrating, indecisiveness, slowed or fuzzy thinking.
• Exaggerated feelings of sadness, hopelessness, or anxiety.
• Feelings of worthlessness.
• Recurring thoughts about death and suicide.

Think you might be suffering from depression? Try one of these free online quizes: Depression-screening.org and www.psycom.net/depression-test/

Depression Symptoms and Warning Signs


How to Recognize the Symptoms and Get Effective Help?

Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won't go away, you may have depression. Depression makes it tough to function and enjoy life like you once did. Just getting through the day can be overwhelming. But no matter how hopeless you feel, you can get better. Learning about depression—and the many things you can do to help yourself—is the first step to overcoming the problem.

How do you experience depression?

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular may even feel angry and restless. No matter how you experience it, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun.

Some people feel like nothing will ever change. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation. You can do things today to start feeling better.

What are the symptoms of depression?

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.

Symptoms of depression include:
  • Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
  • Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  • Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
  • Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
  • Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  • Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  • Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  • Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • Concentration problems. Trouble focusing, making decisions, or remembering things.
  • Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Is it depression or bipolar disorder?

Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This is a problem, because antidepressants for bipolar depression can make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder. See: Bipolar Disorder Signs and Symptoms.

Depression and suicide risk

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and watch for the warning signs:

  • Talking about killing or harming one’s self
  • Expressing strong feelings of hopelessness or being trapped
  • An unusual preoccupation with death or dying
  • Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
  • Calling or visiting people to say goodbye
  • Getting affairs in order (giving away prized possessions, tying up loose ends)
  • Saying things like “Everyone would be better off without me” or “I want out”
  • A sudden switch from being extremely depressed to acting calm and happy

If you think a friend or family member is considering suicide, express your concern and seek help immediately. Talking openly about suicidal thoughts and feelings can save a life.

The symptoms of depression can vary with gender and age

Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults.

Depression in men. Depressed men are less likely to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. They’re also more likely to experience symptoms such as anger, aggression, reckless behavior, and substance abuse.

Depression in women. Women are more likely to experience symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain. Depression in women is also impacted by hormonal factors during menstruation, pregnancy, and menopause. Up to 1 in 7 women experience depression following childbirth, a condition known as postpartum depression.

Depression in teens. Irritability, anger, and agitation are often the most noticeable symptoms in depressed teens—not sadness. They may also complain of headaches, stomachaches, or other physical pains. Learn more

Depression in Children & Toddlers. Kids can have depression, too, even toddlers. ... Depression is a serious mental health issue that can affect even very young children. Depressed children are generally lacking in energy and enthusiasm. They often become withdrawn and are unable to concentrate or to enjoy life.

Depression in older adults. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression: things like fatigue, unexplained aches and pains, and memory problems. They may also neglect their personal appearance and stop taking critical medications for their health.

Types of depression

Depression comes in many shapes and forms. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment.

Major depression

Major depression is much less common than mild or moderate depression and is characterized by intense, relentless symptoms.

  • Left untreated, major depression typically lasts for about six months.
  • Some people experience just a single depressive episode in their lifetime, but major depression can be a recurring disorder.

Atypical depression

Atypical depression is a common subtype of major depression with a specific symptom pattern. It responds better to some therapies and medications than others, so identifying it can be helpful.

  • People with atypical depression experience a temporary mood lift in response to positive events, such as after receiving good news or while out with friends.
  • Other symptoms of atypical depression include weight gain, increased appetite, sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to rejection.

Dysthymia (recurrent, mild depression)

Dysthymia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood.

  • The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years).
  • Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.”
  • If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.”

Seasonal affective disorder (SAD)

For some people, the reduced daylight hours of winter lead to a form of depression known as seasonal affective disorder (SAD). SAD affects about 1% to 2% of the population, particularly women and young people.

  • SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love.
  • SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring.

Depression causes and risk factors

While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics.

Risk factors that make you more vulnerable to depression include:

  • Loneliness and isolation
  • Lack of social support
  • Recent stressful life experiences
  • Family history of depression
  • Marital or relationship problems
  • Financial strain
  • Early childhood trauma or abuse
  • Alcohol or drug abuse
  • Unemployment or underemployment
  • Health problems or chronic pain

The cause of your depression helps determine the treatment

Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead end job, the best treatment might be finding a more satisfying career, not taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.

What you can do to feel better

When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.

What you can do

Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. He or she just needs to be a good listener—someone who’ll listen attentively without being distracted or judging you.

Get moving. When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there.

Eat a mood boosting diet. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar, and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids.

Find ways to engage again with the world. Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better.

10 tips for reaching out and staying connected

  • Talk to one person about your feelings
  • Help someone else by volunteering
  • Have lunch or coffee with a friend
  • Ask a loved one to check in with you regularly
  • Accompany someone to the movies, a concert, or a small get-together
  • Call or email an old friend
  • Go for a walk with a workout buddy
  • Schedule a weekly dinner date
  • Meet new people by taking a class or joining a club
  • Confide in a clergy member, teacher, or sports coach

For more information, see: Coping with Depression

When to seek professional help

If support from family and friends and positive lifestyle changes aren’t enough, find a therapist who can help you heal.

Therapy can help you understand your depression and motivate you to take the action necessary to prevent it from coming back.

Medication may be imperative if you’re feeling suicidal or violent. But while it can help relieve symptoms of depression in some people, it isn’t a cure and is not usually a long-term solution. It also comes with side effects and other drawbacks so it’s important to learn all the facts to make an informed decision.

Related HelpGuide articles

  • Parent's Guide to Teen Depression: Recognizing the Signs of Depression in Teens and How You Can Help
  • Teenager's Guide to Depression: Tips and Tools for Helping Yourself or a Friend
  • Depression in Men: Signs, Symptoms, and Help for Male Depression

Resources and references

Signs and symptoms of depression

Signs and Symptoms of Mood Disorders – Lists the common signs and symptoms of depression and bipolar disorder. (Depression and Bipolar Support Alliance)

What Does Depression Feel Like? – Provides a list of signs and symptoms and ways you might feel if you're depressed. (Wings of Madness)

When Depression Hurts – Article on the painful physical symptoms of depression, including what causes them and how treatment can help. (Psychology Today)

Male Depression: Don't Ignore the Symptoms – Learn about the distinct symptoms of depression in men and the dangers of leaving them untreated. (Mayo Clinic)

Types of depression

The Different Faces of Depression – Discussion of the different subtypes of depression, including atypical depression, melancholic depression, and psychotic depression. (Psychology Today)

Atypical Depression: What's in a Name? – Article on the symptoms, diagnosis, and treatment of atypical depression. (American Psychiatric Association)

Dysthymia: Psychotherapists and patients confront the high cost of “low-grade” depression – In-depth look at the causes, effects, and treatment of dysthymic disorder. (Harvard Health Publications)

Seasonal Affective Disorder: Winter Depression – Guide to seasonal affective disorder and its symptoms, causes, and treatment. (Northern County Psychiatric Associates)

Depression causes and risk factors

What Causes Depression? Page 1 & Page 2 – Learn about the many potential causes of depression, including genes, temperament, stressful life events, and medical issues. (Harvard Health Publications)

Depression and Other Illnesses – An overview of the mental and physical illnesses that often co-exist with depression, and how this impacts treatment. (Depression and Bipolar Support Alliance)

Co-occurring Disorders and Depression – How medical disorders can affect depression and vice versa. (Mental Health America)

Source: www.helpguide.org/articles/depression/depression-signs-and-symptoms.htm

Depression Diagnosis


To be diagnosed with depression, someone must display five of the following symptoms for at least two weeks:

  • sadness or depressed mood
  • lack of interest or pleasure in almost all activities, especially those that used to be pleasurable
  • trouble sleeping or sleeping all the time
  • fatigue or lack of energy
  • feelings of worthlessness and guilt
  • an inability to concentrate or focus
  • change in appetite
  • agitation or feelings of moving in slow motion
  • recurring thoughts of death

Source: www.healthline.com/health/depression/tests-diagnosis#diagnosis

I Knew I had a Good/Bad Psychiatrist/Therapist When…


I thought it would be helpful and informative to share good/bad psychiatrist or therapist stories.

We’ll start out with my experiences…

My first experience with treatment was at the mental health clinic at the local hospital. I was fairly indifferent toward the first psychiatrist I had there, but I was unpleasantly jarred to find out that he was leaving after six months. Apparently they were on some sort of rotation. When I walked into the new psychiatrist’s office, I immediately got a bad feeling. It looked like he felt this was a temporary situation, as the office was completely bare except for the desk and two chairs. The reason for my visit was to ask him to raise my medication, as I was feeling the familiar signs of depression after being fairly stable for a year. He never even looked at me, and only asked me one question to determine whether I was depressed again or not, “Do you have thoughts of harming yourself or others?” I said, “Well, no, but I never have, so that’s not really an indication for me.” He ignored all the signs of depression I was recounting and refused to raise my medication. I absolutely hated him, and wouldn’t go back until he was gone six months later. This time when I walked into the new psychiatrist’s office I was very wary, but the difference he had made in that cold office was amazing. I’m a little fuzzy on the specifics, but I immediately noticed that the place smelled great. He had air fresheners in the office that made you want to inhale when you walked in. He had prints on the walls and (I’m pretty sure) healthy plants. I may be just remembering the plants because he was such a nurturing person. He also had a photo of himself with a child on his bulletin board, which I took as a good sign. He was very accessible, listened to me, and ordered a blood test to find out the level of meds in my blood, which indeed was too low. He stayed longer than six months before moving on, and I was very sorry to see him go.

I had trouble with severe mood swings for years and my condition was getting worse. Upon finding out that several close relatives were bipolar, I did some research and found that without a doubt I had the symptoms. I took my information and family history to a local psychiatrist. He stated with sarcasm, “If you went out and bought five Corvettes I’d believe you were bipolar, but you’re not.” I believed him, left and did not seek any further treatment as I descended deeper into a horrible depression. Finally I went to a local clinic, and talked to a nurse practitioner who believed me enough to give me a trial of lithium. Literally within days I rounded a corner. The medication literally saved my life. The moral of the story for me is; if at first you don’t get listened to, keep looking until you do. Also, I’d rather talk to a nurse who listens than an MD who doesn’t. – Kate from Idaho

OK, finally…I put off suicide until I could at least get in to see the psychiatrist. The Paxil that my GI put me on isn’t working. I’m slipping down a drain. I had 1 1/2 hours of sleep last night and in another 2 hours I have to go to work. But….I went to the shrink today like I promised. Told him of my plans to end it. Told him how close I came. Told him I was already dead inside. Told him I had 2 hours of sleep and had to work again. I told him I can hardly get through a day anymore. He said “increase the paxil to 1 1/2 tabs and come back in a month”. Oh well. I didn’t deserve the help anyway. – angelica

About six years ago I was suffering from incredible depression. (I have since been diagnosed w/Borderline Personality Disorder, and depression comprises only a part of this). At any rate, because I was cutting myself, wanting to die, and locking myself in my apartment for weeks at a time (where I would sleep for days on end), my employer (who happened to be my church–I was a church secretary) demanded that I see the licensed family therapist they had on staff. I went. He looked like a dish of spumoni–he wore mixed pastels (polyester), and a horrifyingly bad toupee. On top of everything else, he told me (I am quoting here), that I was evil, that God was protecting other people from me, and that he felt sorry for anyone who knew me because I really was a bad person. This, said to a severely depressed person by a supposed professional, is BAD. I quit seeing him, obviously.

Here’s the REALLY juicy part: he then attempted to blackmail me with my patient records, which he said (I’m quoting again) that he would keep for his own protection, in case I said anything unflattering about him. He said he would make those records public if anything bad I said got back to him. I have since found out that in my state, ANYBODY can be a “licensed family therapist”, just by paying a fee for the license. Scary, huh? (NOTE: this loser has since been taken off the church staff, and I have long since gotten some QUALIFIED help. And I had a Government agency confiscate my records from his office–with my permission, because I work for a defense contractor and had to obtain a security clearance. I have no idea how many other people this pig damaged, though.) – Anita from Alabama

After reading your story, I started to think about my psych, he’s from India, he thinks I’m really off my rocker. He tells me to do other things from what my therapist tells me, and I think he uses me for his guinea pig. He’s been trying to start me on some of the strangest meds, and all I want to do was to get my Effexor refilled. Then he gave me a 2-week supply, but this medicine takes effect in about 30 days. When I go back and see him, what does he do, he prescribes me something else. I’m going to find another psych and keep my therapist. She’s more understanding of my problem. – Tom

Even though I had had depression for years and mild mania, I started off with a psychologist who did not refer me to a psychiatrist until it got so bad I had to be hospitalized. Thankfully, the psychiatrist knew what he was doing (actually at that point it had become quite obvious). So he became my doctor for the last 6 years and was great. Except in October he was too close to a tree that got hit by lightning and he had to stop practicing while they evaluated him. The doctor he left as a back-up was “too busy” for any sessions. I had to go out and interview doctors. That was fun. Finally, my doctor’s office called me and told me to call this other doctor, that he would see me. Well, he started off the conversation stating he was a “mood expert” and started diagnosing me over the phone. He tells me I have to increase my medications and I have to be totally reevaluated and maybe hospitalized (a week before the holidays). I told him that I had no problem raising the medication and that he would find that I took my medications as I was told. He actually said “That’s an oxymoron.” After that experience, I did the incredible. I actually called the insurance company and asked them to find me a doctor. They did, he was nice and he took care of me until my old doctor came back. No, I never did make my appointment with the “mood expert”. You should always interview a “doctor” before actually going into their office. In this state, a doctor has the power to hospitalize you if they think you are in danger or a danger to others. – Lourdes from Miami

I knew I had a bad shrink when he called me at home on Saturday morning to ask me my advice for how he should deal with his problems with his girlfriend. — Eee-gads! – Meg

It was my first experience with a psychiatrist, but I knew it was a mess when one of his assistants/office staff/next door neighbors/whatever kept walking into the office. On the second visit, the doctor spent most of his time on the phone with apparently his stock broker as they were talking all about money, selling this, buying that, etc. Needless to say, I did not go back, and shortly after that he was arrested for DWI and essentially run out of town on a rail. (Turns out I was not the only person that he’d “ignored” in favor of his stock broker.) Current primary care doctor wants me to see a psychiatrist again, and after one bad experience, I’m not sure this is a good idea. I called the insurance company just to clarify what the benefits were. Turns out that they really don’t want you to use their “mental health services.” I can’t use any doctor in the plan, nope, it has to be one who is also in their “merit services” program (which probably means money in one way or another). My other doctors (primary care doctor, orthopod, etc.) are located at the biggest hospital in the area — but none of their “merit services” people are, and they could only give me two names of anyone in town that I could *maybe* see! Needless to say, I won’t be seeing a psychiatrist, and I’m not terribly upset about that! – Laurie

When I first met Dr. X I had an almost unwelcome feeling. I felt like I should be paying for his services and only then he would treat me like I worthy of his therapy. Anyway, I told him that I wanted some sort of psychotherapy rather than drugs because of sideffects, etc. Although he listened to me he decided that drugs would be most useful in this case. Well I didn’t take them, but I did continue to see him. Being a psychology student I am sure my beliefs about drugs were emanating from my psyche. With time, however, I gained respect for this person with a British accent and snotty attitude. When he started sharing some of his personal history and I found that we had a bit of history in common I began to trust him. I guess trust was a real issue for me. I began taking the meds and gradually became healthier. We developed a bit of a friendship which was in the end briskly cut off by him. I guess because he didn’t want me to become too dependent on this one and only friendship. Anyway I still hear his voice once in while and find comfort in knowing that he knew me enough to get me to help myself. – Anonymous

I have been having a hell of a time, lately, with psychiatrists (i.e., finding one and keeping one) during this last bout of depression. My heart sinks when I walk into a practitioner’s office and it barely looks as if they write scripts there. We probably just can’t help it, but women are probably more sensitive to this. The past two pdocs I’ve seen (and didn’t go back to when I couldn’t take it anymore) hardly looked at me, either, except to say “these are the rules” type statements and ask me if was suicidal. Funny thing – it made no difference in their reaction if I said I was suicidal or swore I wasn’t. Not really very humorous. The psychiatrist I saw previously was (is!) a real human being, who listened, empathized, and did his damnedest to help me feel that I too, am a human being, defects and all. He had an office with “real” furniture, old worn oriental carpets, real works of art, including that of friends of mine. Offices of both my current individual therapist and someone my husband and I see occasionally are warm, inviting, not fancy, but with pictures of both their kids and “artwork” done by the same. In other words, if they see themselves as human beings, perhaps they can give us the same courtesy. I resolve to walk right out of the “robot” practitioner’s offices as soon as I walk in from now on! Our instincts may be all we have left…. – Robin

I have been to untold numbers of these people over the last 5 years that I have been suffering from depression. One told me that I could blame it all on my parents and that I should let them know. (Thank God that I did not do so). The next one would give me a depression test every week that I saw him. He placed me on different drugs over the years, all with the same results, but at least the data was of use.

I then found a good man who showed me how to use my brain to help control the pain in my left arm. Two years of little depression. Then he had a stroke. Depression back. Back to other psychiatrist, still more drugs.

Then last year a breakdown in public; result pending police charges (a man with one good arm with two assault police charges), depression deeper, placed in a psych hospital; depression even deeper.

Then my good man came to my rescue, got me out of the hospital and he now treats me (at no charge), ring or visit him at any time. – Anonymous

I refer to the first 3 psychiatrists I saw as quacks #1, #2, and #3. I suffer from severe, chronic clinical depression and have tried nearly every psychiatric medicine known with no permanent success. I was referred to the psychiatrists I saw by an EAP. It turns out that the only requirement to get on the EAP’s list was that these providers apply and send in copies of their licenses.

Quack #1 was relatively innocuous. She prescribed a combination of two tricyclics which gave me severe anxiety attacks. Every other doctor I have seen wonders why she combined those two drugs as no one seems to have ever heard of using them together. She left the area before doing any more damage.

Quack #2 apparently did not believe in taking blood levels. I wound up in the hospital (not once, but twice) with toxic blood levels at therapeutic dosages of the antidepressant I was taking. I later found out that that was not unheard of for those particular drugs.

Quack #3 used to fall asleep in therapy sessions and would tell me it was because my monotone voice put him to sleep. When I finally got angry enough to fire him, he told me I was leaving because we were finally getting to the root of my problems and I was afraid to address my issues. When I asked him what those issues were, he said that I needed to discover them myself. – Gal

I think I know she’s a good therapist because, when friends/family ask how my session went or what my therapist thinks of me, I can’t really give them a pat answer. In other words, she isn’t authoritative or didactic. She listens, responds non-verbally, and then when I’m finished with my latest spiel, she asks me questions about how what I’ve just said relates to past sessions, relationships, my experiences growing up, etc. It feels as if she is quite solidly on my side, no matter what, and I trust her. I’ve described our sessions as my weekly anchor to sanity (no advice from well-meaning friends, no belligerent orders to stop my behaviors, no fear or frenzy for one hour a week…).

I used to be very suspicious of therapy, I think, because of the bad press it gets in our culture. I assimilated this and thought of myself as a spoiled white female who couldn’t solve her petty problems and who wanted to run to therapy (even though she wasn’t “bad enough” to deserve treatment) so someone else could run her life. So I raged and screamed to get attention from my parents (alcoholic father, shy and enabling mother), fell into deep depressions at my lack of perfection, and cut my arm repeatedly to put my anger and pain into a place I could focus on.

Now I feel as if my life is my own and I don’t want to spend another second feeling bitter or loathing myself. I just want new tools and perspectives so I can keep searching. I take 50 to 100mg of zoloft daily (I also take short breaks from it as I see fit–my therapist and psychiatrist both accept my need to control my medication and don’t view my treatment as a power play). I still cut my arm occasionally, but we discuss it and don’t treat it as some terrible backslide. I feel very lucky. I look at my chronic depression and realize that, given my life’s circumstances, much of it was a sane response to insane situations. I feel that I’ve been easy to treat, but had I had a series of “nightmare” therapists, I’d be so much worse off. I’m very grateful to susan for her support. – Laura

I think the thing that amazes me the most about some of the doctors I’ve seen for my episodic depression is that they’ve been so cruel. I wouldn’t say some of the things they’ve said to me to my dog. The first time I got depressed, I was terrified. Therapy was urgent, because of my strong anxiety and complete inability to cope. Naturally, I was referred (by my kind, gentle therapist) to a psychiatrist, which was scary. Was I really that sick? I was highly resistant to the idea of meds, but she didn’t try to allay my fears. “What makes you think you don’t need medication?” she barked, “I think you do.” She convinced me, and I’m glad she did although I’ll never forgive her for treating a suicidal but intelligent teenager like an imbecile. Other doctors I saw were nicer, but there was one last year who was pure evil. I’ll always remember the disgust in her eyes when, in response to the question, “Can you tell me something about this drug I’m taking?” she said, “Don’t you want to have children someday? You are going to harm your children, destroy their lives, if you don’t fix your problems.” Ugh. I think the reason antidepressants take so long to work is that it takes you a month to get over your appointments with your psychiatrist. – Wendy from New Jersey

My first therapist was a social worker (MSW) whom my college roommate (also an MSW) recommended to me. I felt very comfortable with her, but after less than a year, I felt my therapy was at an impasse. (she had suggested meds, which petrified me) and I shut down after that.

I thought I could get along without a therapist but after a few months I realized it was not the case. The next therapist was a social worker too, with training in Freudian analysis, which I have since read is not very good for depression. She was not very empathetic. When I was worried about my parents’ finances because my mother has depression, she said don’t worry about it, they have health insurance and then tried to change the subject, despite the fact that I was worried because their insurance wasn’t paying for some very expensive x-rays. And she wanted to know why I was so upset to find out my mother has lung cancer. (Depressives tend to get overly upset at things, but really, she’s my MOTHER!)

After being with her for almost a year, I realized I needed to do something or I would end up dead. I went to my primary care physician for a referral to a psychiatrist. He asked me a few questions, and a few minutes later he wrote a prescription for Paxil and told me to come back in 6 months.

Well, after that, I called my health insurance, got names of some psychologists. Our first session was an interview, I followed some suggestions from one of my books and asked her a lot of questions — how often she treats depression, etc., etc. I began seeing her and saw a psychiatrist that she recommended. It’s been a hard time finding meds for me (PAXIL was a bad choice for me and it’s taking a while to wean me off.) But all in all I am comfortable with both my psychologist and psychiatrist. – Susan from NYC

I recently had a panic attack. I went to the local clinic and was given Paxil. I found a shrink in the yellow pages, it’s a small town and there was only a choice of two. The one just worked on state cases. I choose shrink number two.

I just got his bill for three sessions. Are you ready for this…$890. My first session I asked his charges. He said $125 for a 50 minute hour, and the first session would go longer, getting background etc. My second session lasted over two hours until I finally said, hey doc, I gotta go. I’m thinking, hey it’s a small town, he’s not busy, maybe he’s interested in my case.

Session number three was going into two hours and I just excused myself, never thinking he has got the clock running.

To sum up, I’ve written the state board of medicine and spoken to their ombudsman, whose first comment was “Jesus”. I’ve flushed the dope down the toilet, and I feel much better thank you very much. – Rodger
Source: www.wingofmadness.com/i-knew-i-had-a-goodbad-psychiatrist-when/

How to Help Someone with Depression


What You Can Do to Support a Friend or Loved One’s Recovery

When a family member or friend suffers from depression, your support and encouragement can play an important role in his or her recovery. However, depression can also wear you down if you neglect your own needs. These guidelines can help you support a depressed person while maintaining your own emotional equilibrium.

Helping a depressed friend or family member

Depression is a serious but treatable disorder that affects millions of people, from young to old and from all walks of life. It gets in the way of everyday life, causing tremendous pain, hurting not just those suffering from it, but also impacting everyone around them.

If someone you love is depressed, you may be experiencing any number of difficult emotions, including helplessness, frustration, anger, fear, guilt, and sadness. These feelings are all normal. It’s not easy dealing with a friend or family member’s depression. And if you don’t take care of yourself, it can become overwhelming.

That said, there are steps you can take to help your loved one. Start by learning about depression and how to talk about it with your friend or family member. But as you reach out, don’t forget to look after your own emotional health. Thinking about your own needs is not an act of selfishness—it’s a necessity. Your emotional strength will allow you to provide the ongoing support your depressed friend or family member needs.

Understanding depression in a friend or family member

Depression is a serious condition. Don’t underestimate the seriousness of depression. Depression drains a person’s energy, optimism, and motivation. Your depressed loved one can’t just “snap out of it” by sheer force of will.

The symptoms of depression aren’t personal. Depression makes it difficult for a person to connect on a deep emotional level with anyone, even the people he or she loves most. In addition, depressed people often say hurtful things and lash out in anger. Remember that this is the depression talking, not your loved one, so try not to take it personally.

Hiding the problem won’t make it go away. Don’t be an enabler. It doesn’t help anyone involved if you are making excuses, covering up the problem, or lying for a friend or family member who is depressed. In fact, this may keep the depressed person from seeking treatment.

You can’t “fix” someone else’s depression. Don’t try to rescue your loved one from depression. It’s not up to you to fix the problem, nor can you. You’re not to blame for your loved one’s depression or responsible for his or her happiness (or lack thereof). Ultimately, recovery is in the hands of the depressed person.

Is my friend or loved one depressed?

Family and friends are often the first line of defense in the fight against depression. That’s why it’s important to understand the signs and symptoms of depression. You may notice the problem in a depressed loved one before he or she does, and your influence and concern can motivate that person to seek help.

Be concerned if your loved one...

Doesn’t seem to care about anything anymore. Has lost interest in work, sex, hobbies, and other pleasurable activities. Has withdrawn from friends, family, and other social activities.

Expresses a bleak or negative outlook on life. Is uncharacteristically sad, irritable, short-tempered, critical, or moody; talks about feeling “helpless” or “hopeless.”

Frequently complains of aches and pains such as headaches, stomach problems, and back pain. Or complains of feeling tired and drained all the time.

Sleeps less than usual or oversleeps. Has become indecisive, forgetful, disorganized, and “out of it.”

Eats more or less than usual, and has recently gained or lost weight.

Drinks more or abuses drugs, including prescription sleeping pills and painkillers.

How to talk to a loved one about depression

Sometimes it is hard to know what to say when speaking to a loved one about depression. You might fear that if you bring up your worries he or she will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive.

If you don’t know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. You don’t have to try to “fix” the person; you just have to be a good listener. Often, the simple act of talking to someone face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about his or her feelings, and be willing to listen without judgment.

Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.

Ways to start the conversation:

"I have been feeling concerned about you lately."

"Recently, I have noticed some differences in you and wondered how you are doing."

"I wanted to check in with you because you have seemed pretty down lately."

Questions you can ask:

"When did you begin feeling like this?"

"Did something happen that made you start feeling this way?"

"How can I best support you right now?"

"Have you thought about getting help?"

Remember, being supportive involves offering encouragement and hope. Very often, this is a matter of talking to the person in language that he or she will understand and respond to while in a depressed mind frame.

What you CAN say that helps:

  • You are not alone in this. I’m here for you.
  • You may not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • When you want to give up, tell yourself you will hold on for just one more day, hour, minute—whatever you can manage.
  • You are important to me. Your life is important to me.
  • Tell me what I can do now to help you.
  • What you should AVOID saying:
  • It’s all in your head.
  • We all go through times like this.
  • Look on the bright side.
  • You have so much to live for why do you want to die?
  • I can’t do anything about your situation.
  • Just snap out of it.
  • What’s wrong with you?
  • Shouldn’t you be better by now?

Source: The Depression and Bipolar Support Alliance

Taking care of yourself

There’s a natural impulse to want to fix the problems of people we love, but you can’t control a loved one’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority.

Remember the advice of airline flight attendants: put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand.

Tips for taking care of yourself

Think of this challenging time like a marathon; you need extra sustenance to keep yourself going. The following ideas will help you keep your strength up as you support your loved one through depression treatment and recovery.

Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, honest communication will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse. Gently talk about how you’re feeling before pent-up emotions make it too hard to communicate with sensitivity.

Set boundaries. Of course you want to help, but you can only do so much. Your own health will suffer if you let your life be controlled by your loved one’s depression. You can’t be a caretaker round the clock without paying a psychological price. To avoid burnout and resentment, set clear limits on what you are willing and able to do. You are not your loved one’s therapist, so don’t take on that responsibility.

Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for your friend or relative, do your best to keep appointments and plans with friends. If your depressed loved one is unable to go on an outing or trip you had planned, ask a friend to join you instead.

Seek support. You are NOT betraying your depressed relative or friend by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time. You don’t need to go into detail about your loved one’s depression or betray confidences; instead focus on your emotions and what you are feeling. Make sure you can be totally honest with the person you turn to—no judging your emotions!

Encouraging your loved one to get help

Beating depression, one day at a time

You can’t beat depression through sheer willpower, but you do have some control—even if your depression is severe and stubbornly persistent. The key to depression recovery is to start with a few small goals and slowly build from there. Feeling better takes time, but you can get there if you make positive choices for yourself each day and draw on the support of others. Read: Coping with Depression

While you can't control someone else’s recovery from depression, you can start by encouraging the depressed person to seek help. Getting a depressed person into treatment can be difficult. Depression saps energy and motivation, so even the act of making an appointment or finding a doctor can seem daunting. Depression also involves negative ways of thinking. The depressed person may believe that the situation is hopeless and treatment pointless.

Because of these obstacles, getting your loved one to admit to the problem—and helping him or her see that it can be solved—is an essential step in depression recovery.

If your loved one resists getting help:

Suggest a general check-up with a physician. Your loved one may be less anxious about seeing a family doctor than a mental health professional. A regular doctor’s visit is actually a great option, since the doctor can rule out medical causes of depression. If the doctor diagnoses depression, he or she can refer your loved one to a psychiatrist or psychologist. Sometimes, this “professional” opinion makes all the difference.

Offer to help your depressed loved one find a doctor or therapist and go with them on the first visit. Finding the right treatment provider can be difficult, and is often a trial-and-error process. For a depressed person already low on energy, it is a huge help to have assistance making calls and looking into the options.

Encourage the person to make a thorough list of symptoms and ailments to discuss with the doctor. You can even bring up things that you have noticed as an outside observer, such as, “You seem to feel much worse in the mornings,” or “You always get stomach pains before work.”

Supporting your loved one's treatment

One of the most important things you can do to help a friend or relative with depression is to give your unconditional love and support throughout the treatment process. This involves being compassionate and patient, which is not always easy when dealing with the negativity, hostility, and moodiness that go hand in hand with depression.

Provide whatever assistance the person needs (and is willing to accept). Help your loved one make and keep appointments, research treatment options, and stay on schedule with any treatment prescribed.

Have realistic expectations. It can be frustrating to watch a depressed friend or family member struggle, especially if progress is slow or stalled. Having patience is important. Even with optimal treatment, recovery from depression doesn’t happen overnight.

Lead by example. Encourage your friend or family member to lead a healthier, mood-boosting lifestyle by doing it yourself: maintain a positive outlook, eat better, avoid alcohol and drugs, exercise, and lean on others for support.

Encourage activity. Invite your loved one to join you in uplifting activities, like going to a funny movie or having dinner at a favorite restaurant. Exercise is especially helpful, so try to get your depressed loved one moving. Going on walks together is one of the easiest options. Be gently and lovingly persistent—don’t get discouraged or stop asking.

Pitch in when possible. Seemingly small tasks can be hard for a depressed person to manage. Offer to help out with household responsibilities or chores, but only do what you can without getting burned out yourself!

The risk of suicide is real

What to do in a crisis situation

If you believe your loved one is at an immediate risk for suicide, do NOT leave the person alone.

In the U.S., dial 911 or call the National Suicide Prevention Lifeline at 1-800-273-TALK of the Crisis Text Line at 741741 text SOS.

In other countries, call your country’s emergency services number or visit IASP to find a suicide prevention helpline.

It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain he or she is feeling.

When someone is depressed, suicide is a very real danger. It’s important to know the warning signs:

  • Talking about suicide, dying, or harming oneself; a preoccupation with death
  • Expressing feelings of hopelessness or self-hate
  • Acting in dangerous or self-destructive ways
  • Getting affairs in order and saying goodbye
  • Seeking out pills, weapons, or other lethal objects
  • Sudden sense of calm after a depression

If you think a friend or family member might be considering suicide, talk to him or her about your concerns as soon as possible. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you're concerned and seek professional help immediately!

Related HelpGuide articles

Resources and references

Helping a depressed person

Helping Someone with a Mood Disorder – Covers how to support a loved one through depression treatment and recovery. (Depression and Bipolar Support Alliance)

Helping Someone Receive Treatment – What to do (and not to do) when trying to help a loved one get help for depression. (Families for Depression Awareness)

Helping a Friend or Family Member with Depression or Bipolar Disorder – How to help your loved one while also taking care of yourself. (Depression and Bipolar Support Alliance)

What is the role of the family caregiver? – Tips on how families can work together to manage depression treatment. (Families for Depression Awareness)

Helping a suicidal person

How to Help Someone in Crisis – Advice on how to deal with a depression crisis, including situations where hospitalization is necessary. (Depression and Bipolar Support Alliance)

Suicidal helplines

National Suicide Prevention Lifeline – Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).

Crisis Text Line - US 24/7 confidential line for any crisis. 741741 text SOS

Samaritans UK – 24-hour suicide support for people in the UK and Ireland call 116 123. (Samaritans)

Lifeline Australia – 24-hour suicide crisis support service at 13 11 14. (Lifeline Australia)

Crisis Centers Across Canada – Locate suicide crisis centers in Canada by province. (Canadian Association for Suicide Prevention)

IASP – Find crisis centers and helplines around the world. (International Association for Suicide Prevention).

International Suicide Hotlines – Find a helpline in different countries around the world.

Source: www.helpguide.org/articles/depression/helping-a-depressed-person.htm

What to do if you are depressed?


Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:

  • Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
  • Break large tasks into small ones, set some priorities, and do what you can as you can.
  • Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
  • Participate in activities that may make you feel better.
  • Mild exercise, going to a movie, a ball game, or participating in religious, social, or other activities may help.
  • Expect your mood to improve gradually, not immediately. Feeling better takes time.
  • It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition-change jobs, get married or divorced-discuss it with others who know you well and have a more objective view of your situation.
  • People rarely "snap out of" a depression. But they can feel a little better day-by-day.
  • Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.
  • Let your family and friends help you.

For more information: National Institute of Mental Health www.nimh.nih.gov/publicat/depression.cfm#ptdep5

Where can I get more information about Depression?


National Institute of Mental Health Information Resources and Inquiries Branch, 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663, 301.443.4513, FAX: 301.443.4279, TTY: 301.443.8431, FAX4U: 301.443.5158 or www.nimh.nih.gov or nimhinfo@nih.gov

National Alliance for the Mentally Ill (NAMI), Colonial Place Three , 2107 Wilson Blvd., Suite 300 , Arlington, VA 22201, 800.950NAMI (6264) or 703.524.7600 or www.nami.org

A support and advocacy organization of consumers, families, and friends of people with severe mental illness-over 1,200 state and local affiliates. Local affiliates often give guidance to finding treatment.

Depression & Bipolar Support Alliance (DBSA), 730 N. Franklin St., Suite #501, Chicago, IL 60610-7204, 312.988.1150, Fax: .312.642.7243 or www.DBSAlliance.org

Purpose is to educate patients, families, and the public concerning the nature of depressive illnesses. Maintains an extensive catalog of helpful books.

National Foundation for Depressive Illness, P.O. Box 2257, New York, NY 10116, 212.268.4260; 800.239.1265 or www.depression.org

A foundation that informs the public about depressive illness and its treatability and promotes programs of research, education, and treatment.

National Mental Health Association (NMHA), 2001 N. Beauregard Street, 12th Floor, Alexandria, VA 22311, 800.969.6942 or 703.684.7722, TTY 800.443.5959, www.nmha.org

An association that works with 340 affiliates to promote mental health through advocacy, education, research, and services.

Source: www.facetheissue.com/depression.html  

Depression Hotline


Depressed man hugging pillow looking down considering calling hotlineThe World Health Organization estimates that as many as 300 million people suffer from depression worldwide.1 In the United States alone, more than 15 million people (or 6.7% of the population over the age of 18) suffer from major depressive disorder.2

Many people who have depression turn to drugs and alcohol to make them feel better or to numb themselves from their feelings—estimates state that approximately 10.2 million adults live with a co-occurring mental health and addiction disorder.3 This relationship between mental health and addiction is dangerous, particularly because substance abuse can worsen depressive symptoms.

But there are many ways to find help, including calling a depression hotline for information about treatment centers and 12-step programs.

The connection between depression and substance abuse can place you at a higher risk for self-harm, injury, and suicide, so having a 24-hour depression hotline crucial for many people who are in crisis. You can be assured that all calls are private and confidential and that you will speak to a person with experience in helping people with similar issues.

Depression is a significantly debilitating mental health condition that can prevent you from living life to your fullest potential because you feel hopeless, sad, and tired. Additionally:1

There are effective ways to manage depression; calling a hotline can help you or a loved one begin your search for treatment.

What Questions Should I Ask?

When you call a 24-hour depression hotline, it is important that you share as much information as possible with the person on the other end of the line so they can better gauge your situation and provide relevant treatment information.

Before you call a depression helpline, you may want to write down questions you have, which might include:

  • What forms of treatment are available?
  • What happens when you go to treatment?
  • What are the next steps in getting help?
  • How can I find 12-step groups in my community?
  • What programs are available for depression and substance abuse?

If you are concerned about a family member, significant other, friend, classmate, or colleague, it can take an emotional toll on you. When calling a depression helpline, you can ask:

  • Where should I start if I think my loved one needs help?
  • How do I talk to them about their depression?
  • What resources are available for friends and family of depressed people?

When you call, you may be asked your first name as well as your age, which helps the counselors figure out what types of programs you are eligible for. You may also be asked any of the following questions when you call:

  • Are you safe?
  • How can I help?
  • How are you feeling?
  • What is going on?
  • Are you in immediate danger?
  • Who do you go to for support?
  • Are you using any drugs or abusing alcohol?

Should I Call a Hotline?

Most people experience periods of sadness in their lives after major events, such as a job loss, a divorce, or the death of a loved one. However, clinical depression is different than regular sadness or a period of grief. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), depression is diagnosed when you have 5 or more of the following symptoms in a 2-week period:4

  • Depressed mood most of the day
  • Loss of interest in almost all activities
  • Significant weight loss or decrease in appetite
  • Insomnia or hypersomnia (excessive sleepiness)
  • Feelings of restlessness
  • Fatigue or loss of energy
  • Feeling worthless or guilty (sometimes for no reason)
  • Trouble thinking or concentrating
  • Recurring thoughts of death or of committing suicide (without a specific plan)

Mental Health Information

If you have depression and a substance abuse disorder, it can be very difficult to pick up the phone and ask for help. If you feel nervous and aren’t sure you can talk to someone on the phone, you can always try another time. Because all calls are confidential, you can feel safe about being open and honest—the person you speak to has experience and training and understands what you need.

If you want information about mental health in general, these resources can help:

Other Depression Hotlines

For many people, depression is an extremely lonely experience. Calling a hotline gives you the opportunity to talk to a caring person who can help you work through whatever negative thoughts or feelings you have.

If this is an emergency and you need immediate assistance, please call 911.

  • National Suicide Prevention Lifeline, (800) 273-TALK (8255), Live Online Chat: This 24-hour suicide prevention helpline specializes in handling all situations related to suicide and emotional distress.
  • Crisis Text Line, Text SOS to 741741: This 24/7 crisis text line for anyone in crisis connects you with a trained counselor via text.
  • Disaster Distress Helpline, 1-800-985-5990: If you are experiencing depression, anxiety, or stress as the result of a disaster, call this number to speak to someone.
  • National Child Abuse Hotline, 1-800-422-4453: Depression often exists in situations where child abuse is present, and this 24/7 national hotline exists to prevent child abuse. You can reach professional crisis counselors at any time in more than 170 languages, using an interpreter.
  • Rape, Abuse and Incest National Network (RAINN), 1-800-656-4673: This free, confidential, and national sexual assault hotline is operated 24/7 by RAINN, which partners with local sexual assault service providers all over the U.S.
  • The Trevor Project, (866) 488-7386: A 24-hour depression hotline for suicidal LGBTQ youth.
  • Veterans Crisis Line, 1-800-273-8255, Text a message to 838255: Many vets struggle with depression and other debilitating mental health issues. Veterans and their families can call, text, or chat online 24/7 for support.
  • National Hopeline Network, 1-800-442-4673: This 24-hour depression hotline is for people who are depressed and thinking about suicide. When you call, you will be connected with a crisis hotline volunteer.

Sources

1. World Health Organization. (2017). Depression.
2. Anxiety and Depression Association of America. (2016). Facts & Statistics.
3. National Alliance on Mental Illness. (n.d.). Mental Health By The Numbers.
4. DSM-5 Diagnostic Criteria. (2013). Major Depressive Disorder.
Source: www.psychguides.com/guides/depression-hotline/

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