Most everyone feels sad from time to time; it’s all part of being human. But if you feel sad, anxious or empty, or experience feelings of hopelessness, guilt, or worthlessness that don’t go away for weeks at a stretch, you may be experiencing depression. Depression is a serious medical illness.
Who is at risk for Depression?
Depression wears many faces. You are at special risk if you have experienced a significant loss — of a loved one, a relationship, your reputation, or your job. People who are unemployed, divorced, young adults who use drugs or alcohol excessively are at significant risk. Your risk also increases if your family has a history of mood disorders.
Symptoms of Depression
Depression diminishes quality of life and interfere with functioning in most areas of our lives: work, relationships, play, pleasure.
People with depression can experience:
- Episodes of crying
- Disrupted sleep (insomnia for portions of the night or excessive sleep)
- Change in appetite
- Impaired concentration
- Low energy and motivation, fatigue
- Feelings of hopelessness, helplessness, worthlessness, excessive guilt
- Loss of interest in formerly pleasurable activities
- Decreased libido
- Irritability
- Problems with decision making
- Feelings that life is not worth living
Types of Depression
There are different types of depression. And even within these types, people experience a range of symptoms that can vary in severity and persistence.
Major depression involves a combination of symptoms that interfere with your ability to carry on with normal living.
A milder type of depression called dysthymia involves long-term symptoms that don’t disable you, but subtly keep you from feeling well.
If you have five or more of the symptoms listed above, and these last at least two weeks, you may be experiencing major depression. If you have several of the above symptoms for a two-year period of time, you may have be experiencing dysthymia.
Other forms include post-partum depression. The media has made us more aware of the risk that illness poses for a mother and her family. Also receiving more publicity is Seasonal Affective Disorder (SAD), a depression that occurs in response to changing light conditions in fall and winter.
Bipolar disorder, also called manic-depressive illness, is another type of depression. Not nearly as prevalent as other types, bipolar is characterized by major mood swings, with dramatic highs and lows.
Therapy for Depression
Depression is treatable. Treatment for depression involves talk therapy and may also require medication. Treatment outcome studies find that a combination of the two works best for major depression.
The type of talk therapy or psychotherapy that is often most helpful is cognitive behavioral therapy (CBT), a form of therapy that teaches skills to help a person learn to use the logical part of their brain to calm the emotional part of their brain. CBT helps to interrupt thinking patterns associated with depression, such as black and white thinking, catastrophic thinking and over-generalization.
Another mode of treatment effective with depression is called interpersonal therapy, which is helpful when significant relationships are challenging or non-existent.
Social Workers Who Can Provide Therapy
Clinical social workers who have a master’s degree in social work (MSW) and years of clinical practice (differs from state to state, but two to five years are standard) are the largest group of mental health professionals providing talk therapy for depression. Clinical social workers who diagnose and treat depression practice in family service agencies, community mental health centers, private practice mental health groups and in outpatient clinics attached to general or psychiatric hospitals.
You can identify a clinical social worker by the credentialing initials, such as LCSW (Licensed Clinical Social Worker), after a name. Social workers who qualify for advanced credentials from the National Association of Social Workers will be certified as follows: ACSW (Academy of Certified Social Workers), QCSW (Qualified Clinical Social Worker), or DCSW (Diplomate in Clinical Social Work).
Medication for Depression
Medication, which can be prescribed by a primary care physician or by a psychiatrist, is often needed to interrupt the progression of a major depression episode. It can be prescribed for dysthymia, atypical depression or an adjustment disorder, especially those that do not respond to talk therapy alone. The kind of antidepressant medication most often prescribed is an SSRI (serotonin reuptake inhibitor) such as Prozac, Zoloft, or Lexapro; other medications may be equally appropriate and helpful.
Successful treatment depends upon close contact with the prescribing doctor until an effective medication and dose has been achieved. Most treatment guidelines specify six months of medication treatment as a minimum. Remaining on the medication until your doctor feels you can stop taking it is also important.
Conclusion
If you think you might be experiencing depression, seek help from a professional. Depression is a serious condition, but it can be successfully treated.
If you are feeling suicidal, get help immediately: Call or text “988” the three-digit, nationwide phone number to connect directly to the 988 Suicide and Crisis Lifeline.
Don’t isolate yourself or disregard your feelings. Reach out to someone trustworthy, whether it is a friend, family member or professional.
