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Posts Tagged ‘
recovery ’
Recovery means something different for every individual with a mental health condition, but every person can achieve some level of recovery in their lives. For some people recovery means they will be able to work; for others that they will be able to live independently; for others that they will be able to have a relationship; and for some it will involve any combination of those or other changes in their lives.
Each person with a mental health condition must define what recovery means for his or her life. A common misperception of what recovery means, however, is that a person no longer has any signs or symptoms of a mental illness. Whereas many individuals in recovery will have no signs or symptoms, this will not be the case for everyone, and regardless of a person's level of functioning, relapses can still happen. Like everyone in the world, most people in recovery from a mental health problem will always have certain challenges that they have to face in life, and some of them may require learning to handle symptoms without allowing the symptoms to control their lives.
The Substance Abuse and Mental Health Services Administration's Center for Mental Health Services assembled an expert panel to develop a consensus definition of recovery. Over 110 panelists, including consumers, family members, providers, researchers, and other stakeholders were involved. The definition was not designed to capture what recovery means for each individual person, but designed to give a broad definition to help people understand what recovery is about.
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential. (Available at: http://mentalhealth.samhsa.gov/publications/allpubs/sma05-4129/)
The time that it takes to recover is different for each person and an important concept here is that each person must take responsibility for his or her own recovery. Family members, peers, providers, and others can help or motivate an individual, but recovery cannot be done to or for a person, it must be achieved by a person. Even developing the motivation to strive towards recovery is often challenging for individuals with mental health conditions, who often must cope with sedating medications, societal stigma, people telling them that they cannot recover, and other barriers. Motivation and hope are some of the best help that family members and other consumers can provide to individuals working on recovery.
There are ways to better orient mental health systems to help consumers in their journeys through the recovery process. A number of recovery-oriented best practices have been identified by experts (including consumers, family members, providers, clinicians, researchers and others) as particularly helpful in improving a mental health system's recovery orientation and operations. Some include:
Consumers can benefit if the mental health staff understand the vision, philosophy, values, and procedures necessary to ensure the full inclusion of consumers in developing their own individual plans of care. This approach looks at a number of aspects of a mental health system that may need to be addressed so that consumers can become full partners in developing their own plans of care.
A state's mental health emergency and acute care service system may not be operating as efficiently and effectively as it could to meet the needs of people in crisis. An evaluation of the system can help suggest ways to improve its accessibility and ability to meet the needs of diverse consumer populations.
People with Co-Occurring Mental Health and Substance Use Disorders have unique needs that cannot effectively be met in a system that is designed to serve people with only one of the two disorders. Use of integrated treatment methods that treat both concerns at the same time can help a service delivery system design an approach that more effectively meets the unique needs of dually diagnosed individuals.
Without having consumers involved in decisions about the service delivery process, it will be difficult for any one else to truly know what is best for them. This approach, which is highly adaptable to a system's individual needs, is designed to help more fully involve consumers in a variety of roles and functions throughout the process of service delivery.
This practice is in the form of a training to help providers, the general public, family members, and others understand the prevalence of past traumatic life experiences in the lives of consumers. The training then helps attendees to understand how trauma can affect peoples' lives well past the event, and how and why service delivery systems must be designed so as to be sensitive to these experiences, if the goal of recovery is to be realized.
There are many different practices that work for different consumers, but there are also many practices that have been identified as consistently beneficial, and they are known as Evidence Based Practices. Mental health systems can be helped to identify and implement one or more of these practices by looking at the state's resources and infrastructure, and assessing what needs to change to make a particular practice widespread.
Consumers must be able to make decisions for themselves about their own care. But providers, based on their clinical experience, have a responsibility to provide education about the possible outcomes that may result from various decisions. The reality is in most systems that consumers, particularly those with more chronic and disabling mental health conditions, are commonly instructed as to what treatments they need, with minimal if any effort to involve them in decisions. A recovery-oriented mental health system acknowledges and encourages consumer involvement and decision-making. Furthermore, a recovery-oriented mental health system is structured in ways that support consumers in their journeys of recovery.
Most individuals will need assistance to figure out what they need to do in order to move forward in the recovery process. The recovery process can take years; it is a journey, with both ups and downs, but it is a journey that is both possible and worthwhile for all consumers.
For more information on recovery or on how your state can obtain assistance with one of these or other recovery models, contact the author at timothy.tunner@nasmhpd.org.
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Tags: Acute Care, Co-Occuring Disorders, Consumer, Evidence-Based Practices, Involvement, mental health, programs, recovery, services, trauma
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In the wake of Hurricane Katrina, many Americans, especially those affected first hand, are trying to cope with the horrendous aftermath and others want to respond in some way to help survivors. This tip sheet offers practical advice for dealing with this high profile natural disaster, whether you are on the frontlines or helplessly watching from your home.
Most of us, at some time or another, have witnessed traumatic events, either in person or vicariously through television, newspapers, and other media outlets.
Here are some general tips on how to begin the healing process:
- Turn Off the Television. Constant repetition of traumatic events and reactions can increase the experience of trauma. Tune in enough to know what is happening in the world, but release yourself from the grip of repetitive traumatic presentations. Make sure children have limited and supervised exposure to the media coverage, as the repetitive pictures and stories can easily overwhelm and traumatize children.
- Talk to Others. Trauma can affect us more deeply when we isolate ourselves. We may do best if we keep share our feelings and thoughts with one another.
- Let Your Feelings Out. There is no shame in having grief, fear, rage, and sorrow. We have reason to feel these feelings. It may be best to let ourselves feel them and to reveal them to people we trust.
- Take Care of Yourself. Be kind to yourself during a traumatic time when rage is the rule of the day. Allow time for rest, for calm, and for comfort to re-enter your life. This may be a challenge at first, but deliberate attention to self-care will help you have the energy to help others.
- Allow Yourself to Find a Peaceful Core Within Yourself. Take time to slow down, rest, and let your emotional reactions settle. Let your attention go within. We each have a place within from which we derive strength and where we know what is true, what is right, and what we need to do. Find that place of strength within yourself.
- Here Is the Challenge: The Atmosphere of Rage and Fear. After traumas occur, many people experience the "fight or flight" instinct. On a collective level, these forces can unleash more trauma if not held in check by compassion, reason, caution, and understanding. Do not unintentionally take out your hurt and rage on others who happen to be in the wrong place at the wrong time.
Here is how we may change the traumatic responses of fear and rage to support our lives:
- Let your fear tell you what you treasure. We fear for ourselves and our loved ones, for all of what we love, and the lives we live everyday. Give support and love to the people and things that matters most to you.
- Let your anger fuel your support of what you care about. Anger is a force that we can use to support action toward what we love.
- Let your anger, pain, and fear bring us together as a world. We may allow our pain and fear and rage to continue to tear us apart, or we may recognize that we are all in pain, in rage, and in fear, and we all want what is precious to us to survive.
- Persistent reexperiencing of the traumatic event - for example, flashbacks, nightmares, or recurring and constant images;
- Persistent avoidance of stimulation associated with the trauma - such as avoiding people or places or images associated with the trauma;
- Numbing of general responsiveness – such as loss of feelings of love, connection, or any feelings at all; and
- Persistent symptoms of increased arousal – such as hyper-alertness, easily startled, and/or irritability.
These symptoms or stress reactions may arise just from exposure to this catastrophe, or they may arise from the triggering of previous public or personal traumas you may have experienced. If the symptoms persist, you may wish to see a mental health professional, especially one trained in treating trauma. The American Red Cross is just one national organization coordinating emergency mental health as well as a national disaster response to Hurricane Katrina. For more information, please log onto www.redcross.org or www.socialworkers.org to find mental health and disaster response services.
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Coping With Addiction Begins With Awareness
Americans consume 60 percent of the world's production of illegal drugs. There are drug users and abusers in every state of the nation and every socio-economic group. Households with incomes of $100,000 a year or more have a higher rate of substance abuse than any other income group.
Although most of us would probably not consider alcoholic beverages "drugs," alcohol is a drug, and we all know that drinking is commonplace in our society.
Alcoholics and drug abusers are people we know: family members, friends, or co-workers. By recognizing symptoms of alcohol and drug abuse, experts say you can take the first step to stop the cycle of abuse and addiction.
In their desire to be loving, supporting, or helpful, family members and friends often unwittingly contribute to an addict's drug use. This is called "enabling," and may take the form of denial, taking over responsibilities for the addict, and rescuing the addict when he or she gets into trouble.
Family members may deny the existence or seriousness of the problem. No one wants to believe that drug abuse exists in their home, so they may explain away the drug use or minimize the severity. They may also deny the existence of problems caused by drug abuse, such as financial difficulties.
Sometimes family members take over responsibilities to cover for the addict during a bad time, but it is often the only way to ensure that important things like paying bills or picking children up from school get accomplished.
When addicts can't make it to work or are having financial problems, a family member or friend will often come to the rescue by making excuses for them or lending money. These "rescue missions" only shield the addict from having to face the problems caused by drug abuse, making it that much easier to stay addicted.
Co-dependents are people whose lives have become unmanageable as a result of living in a committed relationship with a substance abuser. Co-dependents become so absorbed in the addict's problems that they forget how to care for themselves.
What should you do if you suspect that your loved one is addicted to drugs or alcohol? Experts offer the following suggestions,
- Don't panic, but do acknowledge the problem.
- Discuss your suspicions with your loved one calmly and objectively.
Never confront someone when they are under the influence of drugs or alcohol. Express your concerns and offer resources for professional help.
Social workers can help counsel addicts. When an active addict seeks help, they are taking a very positive step in their recovery. By asking key questions, the social worker assesses the exact nature and extent of the problem. He or she then facilitates referrals to either an appropriate 12-Step program like AA (Alcoholics Anonymous) or NA (Narcotics Anonymous), or to an inpatient or outpatient rehabilitation program where the client receives individual and group counseling. The social worker provides education about the disease of addiction and the effects of continued drug use on the addict's medical, work, family, social and financial life. Often, the social worker will provide aftercare once the client completes an inpatient or outpatient recovery program.
Remember, family counseling is an important part of any substance abuse treatment program. It provides education and support to help family members understand the cycle of addiction and avoid participating in it. Social workers recommend that loved ones detach emotionally because the addict needs to own the problem and take responsibility for their recovery. Al-Anon, the 12-Step program for families, provides help for anyone who loves or lives with an addict or alcoholic.
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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Introduction
Excessive worries that consume a person's thinking and interfere with their everyday lives are called “obsessions.” They can include uninvited thoughts, urges, or images that appear in the mind over and over again.Often people with obsessions will try to reduce or suppress their obsessions by acting out certain rituals, or specific ways of doing things. For example, a person who is obsessed with dirty hands may believe if he washes his hands and get them clean, he will be able to stop thinking about having dirty hands. Often the obsessive thoughts don’t stop and sometimes these rituals may last for hours.Another example of a common obsession is repeatedly checking to see if the stove is off. When people act on their obsessions, their rituals are called “compulsions.” Thoughts are obsessions and actions compulsions.
When obsessions and compulsions get out of control and begin to interfere with the person's day-to-day functioning, it is called an Obsessive-Compulsive Disorder or OCD. People with OCD usually know that their obsessions are creations of their own minds, but are unable to control or ignore them. Likewise they often know that their compulsions are unwarranted, yet they are similarly unable to refrain from doing them.
Obsessive-Compulsive Disorder is an anxiety disorder that affects about one adult in 40 worldwide and affects men and women at an equal rate. OCD usually begins gradually and most individuals who suffer from the disorder will develop symptoms in adolescence or early adulthood.
The main symptoms of Obsessive-Compulsive Disorder are recurrent obsessions or compulsions that interfere with a person’s life. The symptoms:
- Take up more than one hour a day or
- Cause marked distress or significant impairment.
At some point, the person is likely to become aware that the obsessions and/or compulsions are excessive or unreasonable, and they may feel ashamed and try to hide them from others.
- Fear of contamination (such as fear of dirt, germs, body fluids or diseases)
- Repeated doubting (such as whether the stove is turned off )
- Focus on exactness and order
- Preoccupation with religious images and thoughts or fear of having blasphemous thoughts
- Fear of harming oneself or others
- Fear of blurting out obscenities in public
- Forbidden or unwanted sexual thoughts, images, or urges.
- Cleaning/washing (washing hands too often, cleaning household
items or other objects)
- Checking (repeatedly checking something, i.e. paperwork, for mistakes)
- Ordering/arranging (repeatedly making sure objects are in a certain order)
- Hoarding (collecting seemingly useless items)
- Mental rituals, such as excessively counting or repeating words.
Obsessive-Compulsive Disorder appears to be caused by a combination of psychological, biological, and genetic factors.
- People may associate certain objects or situations with fear (thus the obsession) and either avoid the things they fear or perform rituals that help reduce the fears (the compulsion).
- Research shows a link between OCD and insufficient levels of the brain chemical serotonin (a neurotransmitter that plays a role in regulation of mood, aggression, impulse control, sleep, appetite, body temperature and pain).
- Researchers have also found that people with OCD appear to have greater than usual activity in areas of the brain that may be involved in controlling feelings and actions.
- Appears to run in families
- Genes involved in regulating serotonin may be passed on through generations
- Counseling (cognitive-behavioral therapy is the most common)
- Medication (usually antidepressant medication; sometimes anti-anxiety medication)
- Group therapy (with people who have similar concerns) can also help.
- Support Groups.
While therapy and medications can help reduce the symptoms of Obsessive-Compulsive Disorder, the process of recovery, like the onset of the illness, is gradual and ongoing. Continuing with treatment, even when symptoms have improved, can help maintain health and prevent relapse.
The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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An Invisible Epidemic
A great deal has been written about alcoholism and drug addiction over the last two decades. However, information regarding prescription drug abuse and addiction only seems to surface when someone famous has a problem, needs treatment, or dies.
Historically, prescription drug addiction has been the most under reported drug abuse problem in the nation according to the National Institute of Drug Abuse. It may also be the least understood. Addiction to and withdrawal from prescription drugs can be more dangerous than other substances because of the insidious nature of these drugs.
Two types of the most commonly abused prescription drugs are opioids and benzodiazepines. Opioids are generally used to control pain. Benzodiazepines, or tranquilizers, are used to manage anxiety. These drugs are prescribed for short-term use such as acute pain and anxiety that is in reaction to a specific event. They may also be prescribed for chronic pain or generalized anxiety.
Prescription drug addiction is no different from alcoholism or an addiction to any other substance. People who suffer from chronic pain are in a very difficult position. Painkillers will relieve their pain. For people who suffer from constant and chronic pain, narcotics may be necessary to allow them to have any quality of life. Unfortunately, they may risk becoming physically and psychologically dependent, and addicted to the medication.
While it is true that the drugs themselves are highly addictive, not everyone who takes painkillers becomes an addict. The statistics of those suffering from chronic pain that become addicted to these drugs are actually pretty low according to the Chronic Pain Advocacy League, a grass roots organization dedicated to helping those who suffer the debilitating effects of chronic pain. However, this is not to say that those who suffer with chronic pain are not at increased risk of prescription drug addiction.
There is a difference between dependence and addiction. Dependence occurs when tolerance builds up and the body needs the drug in order to function. Withdrawal symptoms will begin if the drug is stopped abruptly.
In contrast, when a person turns to the regular use of a drug to satisfy emotional, and psychological needs, they are addicted to that substance. Physical dependence exists as well, but the drug has become a way to cope with (or avoid) all kinds of uncomfortable feelings.
Many prescription drug addicts are initially prescribed the drug for medical reasons. Somewhere along the line, however, the drug begins to take over their lives and becomes more important than anything else. Nothing will stop them from getting their drug of choice.
It may be difficult to understand how someone could let this happen. How could someone who is reasonably intelligent and sophisticated in regards to drug addiction become an addict?
Addiction has nothing to do with intelligence. And addiction to prescription drugs is no different than any other substance abuse problem. Some 12-step recovery program members have described addiction as a disease of the emotions.
Detoxification is a treatment devoted to purging toxins from the body in a medically and psychologically supervised environment. There are many treatment facilities located throughout the country. Many insurance plans cover inpatient detoxification. Some insurance companies will pay for a week, or maybe two. Some health insurance plans may pay for rehabilitation as well. It's important to get help and not to try to get off pills on your own.
Unfortunately, some people may feel that they can't afford to take a week or two out of their lives to spend in a treatment facility to undergo detoxification. The demands of children, a job, school, or other responsibilities may make inpatient treatment seem like a luxury. It is not. It is unquestionably better to leave the routine responsibilities of your life for a week than it is to suffer the inevitable outcome of prolonged drug addiction.
Social workers are involved in quite a few areas regarding treatment. Hospital social workers can help refer an individual to find the right treatment program. Many social workers advocate for their patients. Inpatient detoxification programs tend to have long waiting lists. Therefore, having the help of a social worker intervene on a patient's behalf can make the difference between getting into a program or not.
Many recovering prescription drug addicts become involved in 12-step help programs. Groups like Pills Anonymous can be very helpful and supportive. The meetings can help alleviate some of the guilt and shame through hearing and sharing the similarities of yours and others' experiences. Unfortunately, there are very few Pills Anonymous meetings around the country in comparison to the numbers of Alcoholics Anonymous or Narcotics Anonymous. So many pill addicts go to those meetings in addition to or instead of Pills Anonymous meetings.
Some people struggling with pill addiction will enter therapy at this point in their lives. Therapy can help you find out what emotional need the pills served and what will fill that need now.
Social workers who are licensed in clinical social work, can offer the patient both the insight-oriented perspective as well as the cognitive and behavioral perspective. It is important for the therapist to be aware of the unique stressors each recovering addict must face when going back to the environment that they were active in.
Social workers are uniquely capable of working with these issues since they work with both the internal and external stresses and support systems. Social workers are trained to look at the person in their environment and focus on the psychological, social, economic, and familial aspects of the individual. Social workers are often part of the interdisciplinary treatment teams providing a range of services including individual, family, and group counseling, case management, education, advocacy, and resources referrals.
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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My Partner Is Alcoholic. What Can I Do?
Many problem drinkers are unable to admit to this problem. The cry for help may therefore come from someone close who suffers as a result. The cry often comes at a time when he or she is unable to cope any longer with the drinker. As such, the drinker may self-righteously feel they do not have a problem as they had been drinking like this for years. They may resist treatment and often blame others for their problems. Many marriages fail at this point. One spouse can no longer tolerate the alcohol and the alcoholic refuses to take responsibility. This makes treatment of alcoholics extremely difficult.
It is important for people to understand the stages of recovery and that each stage carries challenges that some alcoholics will struggle for a long time to overcome. Five stages of recovery are discussed: precontemplation, contemplation, preparation, action and maintenance.1
In the precontemplation stage, the alcohol problem has not yet been identified let alone accepted by the alcoholic. During this stage, their defences, most notably denial, are strong. They actively reject any notion of alcohol problems and show anger towards anyone suggesting a problem. They reject treatment and may rely on the support of their drinking buddies to affirm that they do not have a problem.
In the contemplation stage, the alcoholic toys with and finally accepts that they have a problem with alcohol. This acceptance can be overwhelming, at times leading to depression and/or anxiety. These intense feelings must be expected and planned for as part of a treatment process.
In the preparation stage, the alcoholic learns what treatment is necessary in order to recover. Depending on the severity, this can include detoxification, inpatient or outpatient counseling and marital and/or family therapy and possibly even prescription medications.
The next stage, action, is when the treatment plan is implemented and activities are undertaken to address the alcoholism. The support of family and sober friends is crucial here as alcoholics learn to defend themselves, not from admitting alcoholism, but from being pulled back towards drinking by former drinking buddies. Also crucial at this stage is developing an understanding of one's own family history that may have contributed to their drinking problems.
The final stage involves relapse prevention and is referred to as maintenance. This stage is life-long. One of the best-known maintenance programs is Alcoholics Anonymous (AA). This program is based upon self-help, group model. Members meet regularly to manage the challenges of sobriety.
Recovery from alcohol starts with clear, blunt information from friends and family, and by trained professionals such as physicians, social workers or psychologists. Some family and even some professionals beat around the bush when confronting an alcoholic. This is music to the alcoholic's ears. Fuzzy messages allow them to maintain their denial. Thus, one must clearly and fully confront the alcoholic. Clear messages leave no wiggle room.
If you think your spouse has a problem with alcohol:
1. Confront him or her forthrightly. If you are concerned for your safety, then do so in the company of a friend or professional.
2. Get help for yourself too. Learn about alcoholism, your role in the recovery process and of the impact on your family's well-being.
3. Recognize that it may take some time if your spouse is in the first stage of recovery. He or she has yet to even acknowledge a problem. This can be an insurmountable challenge for some people.
4. Recognize that alcoholism can pose a risk not only to the alcoholic but also to those around him or her. At all times, make sure children are appropriately supervised and cared for. Alcohol related problems are a major cause for referrals to child protective services.
Lastly, can a therapist help? Yes, but unfortunately, not in all cases. Much will depend on the stage of recovery, the willingness of the alcoholic to change, the social supports available and a good treatment plan.
1. DiClemente, C.C., Bellino, L.E. and Neavins, T.M. Motivation for Change and Alcoholism Treatment. National Institute on Alcohol Abuse and Alcoholism. Alcohol Research and Health .23:2. 1999.
To read more articles by Gary Direnfeld, MSW, RSW, go to www.yoursocialworker.com
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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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Introduction
Eating disorders have the highest mortality rate of any mental illness—20 percent of affected individuals without treatment. The mortality rate drops to 2 to 3 percent with treatment. One percent of females between the ages of 10 and 20 have anorexia nervosa and 2 to 3 percent have bulimia. Males account for only 1 percent of those with eating disorders.
- Incidence of eating disorders has doubled since the 1960s
- Increasing numbers of children as young as age six suffer from the illness
- 10 percent report onset of illness at age 10 or younger
- Incidences of eating disorders are increasing among diverse ethnic groups
- 42 percent of 1st-3rd grade girls want to be thinner
- 9 percent of nine-year-olds have vomited to lose weight
- 13 percent of high school girls purge
- Osteoporosis
- Muscle atrophy
- Heart muscle shrinkage and irregular heart beats
- In adolescence, growth retardation and peak bone mass reduction
- Frequently co-occurs with depression, substance abuse, or anxiety disorders
- Common causes of death are cardiac arrest or electrolyte imbalance, or suicide
- Dehydration
- Heart and gastrointestinal problems
- Teeth erosion
- Electrolyte disturbances, irregular heart beats, and heart failure
- Laxative dependence
- Use among bulimics is 40 to 75 percent
- 15 percent abuse laxatives several times each day
- Abuse among high school students range from 3.5 to 7 percent
- Abuse can cause failure to absorb nutrients, electrolyte imbalances, loss of colon function, and development of renal stones
- With treatment, 60 percent of people with eating disorders recover
- 20 percent make only partial recoveries and often relapse
- Remaining 20 percent do not recover and suffer chronic deterioration
- Treatment should include nutritional, medical, and psychiatric services, and psychotherapy with the patient and family
- Cognitive behavioral therapy has shown to be effective in reducing symptoms and increasing self-esteem
- Early detection and treatment result in improved outcomes
Sources:
- National Institute of Mental Health (NIMH)
- Eating Disorders Coalition for Research, Policy & Action (EDC)
- Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED)
- National Association of Anorexia Nervosa and Associated Disorders (ANAD)
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Depression is much more than simple unhappiness. Clinical depression, sometimes called major depression, is a “mood disorder” that is a significant mental health problem.
Symptoms
The main symptom of depression is a sad, despairing mood that:
- Is present most days and lasts most of the day
- Lasts for more than two weeks
- Impairs the person’s performance at work, at school or in social relationships.
Other symptoms may include:
- Changes in appetite and weight
- Sleep problems
- Loss of interest in work, hobbies, people or sex
- Withdrawal from family members and friends
- Feeling useless, hopeless, excessively guilty, pessimistic or low self-esteem
- Agitation or feeling slowed down
- Irritability
- Fatigue
- Trouble concentrating, remembering and making decisions
- Crying easily, or feeling like crying but being not able to
- Thoughts of suicide (which should always be taken seriously)
- Loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions).
Major depression can occur in 10 to 25 per cent of women — almost twice as many as men. Many hormonal factors may contribute to the increased rate of depression in women — particularly during times such as menstrual cycle changes, pregnancy and postpartum, miscarriage, pre-menopause, and menopause.
Men with depression typically have a higher rate of feeling irritable, angry, and discouraged. This can make it harder to recognize depression in men. The rate of completed suicide in men is four times that of women, though more women attempt it.
Some people have the mistaken idea that it is normal for older adults to feel depressed. Older adults often don’t want to discuss feeling hopeless, sad, a loss of interest in normally pleasurable activities, or prolonged grief after a loss.
A child who is depressed may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may sulk, get into trouble at school, be negative or grouchy, and feel misunderstood. Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child is just going through a temporary “phase” or has depression.
Different types of depression have different symptoms. These include:
- Seasonal Affective Disorder: Usually affected by the weather and time of the year.
- Postpartum Depression: About 13% of women will experience this type of depression following the birth of a child.
- Depression with Psychosis: Depression so severe that a person loses touch with reality and experiences hallucinations (hearing voices or seeing people or objects that are not really there) or delusions (beliefs that have no basis in reality).
- Dysthymia: Low mood with moderate symptoms of depression.
- Genetic or family history of depression, psychological or emotional vulnerability to depression.
- Biological factors such as imbalances in brain chemistry and in the endocrine/immune systems, or a major stress in the person’s life.
- Result of another illness that shares the same symptoms, such as lupus or hypothyroidism.
- A reaction to another illness, such as cancer or a heart attack.
- May be caused by an illness itself, such as a stroke, where neurological changes have occurred.
- People should just get on with their lives.
- Clinical depression is not just unhappiness — it is a complex mood disorder caused by a variety of factors. Depression is not something that people can “get over” by their own effort.
- My life will never be normal again.Most people can and do return to function at the level they did before they became depressed.
The most commonly used treatments, used individually or in combination, are
- Pharmacotherapy (medications)
- Psychoeducation
- Psychotherapy
- Group therapy
- Self-help organizations, run by clients of the mental health system and their families
Clinical depression needs to be managed over a person’s lifetime. Depression, like disorders such as diabetes, can be effectively managed and controlled by combining a healthy lifestyle and treatments.
One should always seek out a mental health professional, such as a clinical social worker, to assist in the diagnosis and treatment of depression. A clinical social worker is one who is licensed by the state to diagnose and treat various types of mental illness. Social workers not only provide support, but also psychotherapy, group therapy, and will interface with psychiatrists to ensure a quality continuum of care. A social worker treats not only the client, but often provides support for the entire family. Such support is vital when working with a family member with depression or some other form of mental illness. Only with continued support from professionals, can depression be truly managed.
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