COLUMN I: DEPRESSION - FINDING OUT MORE ABOUT YOUR DEPRESSED MOOD
Question:
Why did the chicken cross the road? Answer: To prove to the possum that it could
be done. Didn’t laugh? Two options. One, you are a dyed-in-the-feathers
animal lover and find no humor in chickens or possums, nor in any irreverent combination of the two. Two,
you’re depressed.
Now I know this isn’t a scientific method of diagnosing depression, but
it’s a place to start. When you are depressed, life ceases to be funny…or fun, or interesting,
or even worth living. Your life might not have been super to start with, but when you are depressed, you find yourself bumped
down a few notches, even from the mediocre existence to which you’ve become accustomed. Your family
and friends make unwelcome comments. “My, Naomi, you’re looking tired.” “Gee,
Nancy, we don’t see you much any more.”
Low energy and social isolation—two clear indications
that depression may be lurking about on the fringes of your life and aiming for your very soul. Statistics
have rarely made anyone’s life better but they do tell the tale.
- Depression
is a common emotional disorder affecting about 7% (13-14 million people) in any given year.
- Only 20% of those who
experience depression will receive an appropriate treatment plan.
- 16% of all adults will
experience depression.
- 97% of those suffering from depression say their work, home life, and
relationships are negatively affected
Women of all ages suffer from depression in staggering numbers.
- Depression is the leading cause of disability in women.
- Depression
in women usually occurs between the ages of 25 and 44.
- 7 million women in the United States are clinically depressed.
- 1
in 5 women will develop clinical depression over the course of her life.
- Only 1/3 of depressed women will seek professional
help.
- About 10% of women will experience postpartum depression after childbirth.
- Women are twice as
likely as men to develop depression.
So what are women doing about their depression? A few manage
to break down in tears when they see their doctor to have a mole removed. They walk away with a prescription
for Prozac or Paxil and a referral to a mental health provider. A few blaze their own trail to a local
mental health clinic or private counselor.
The rest…and you may be among them…are suffering
in silence. You wake in the morning with a sense of impending doom. You slog through
the day, drop dead tired. Dishes pile up in the sink. Reports stack up on your desk.
You can’t think your way out of a paper bag. Your eyeballs are doing an imitation of Niagara
Falls. Sleep comes and goes—two hours later. You stare at the ceiling from two
to four o’clock in the morning worrying about all the things you don’t have the energy to do.
You’ve
become a cross between a banana slug and a snapping turtle—slow moving but ready to take off the head of the nearest
bystander. The urge to run away has become overwhelming—even worse than when you were sixteen and
wanted to run off and marry Billy Thompson.
Most frightening, thoughts about driving into the nearest
bridge abutment no longer frighten you. You are even having difficulty reading this column.
Your concentration is shot. You can see the words but even on the fifth try; you can’t make
sense of them.
TIP: Get up from the computer RIGHT NOW and go take a ten-minute walk.
Don’t feel up to it?
Of course, you don’t. You’re depressed! But give yourself a fighting
chance to absorb the information you need. TAKE THAT WALK !
…WELCOME BACK.
At this point, you could drag yourself off to your doctor for an official diagnosis—couldn’t hurt.
But you probably don’t have the energy to stay on hold with your HMO’s call center to make the appointment.
So read through the following checklist and see if it all adds up. I know you’ve completed
checklists for depression before—in the newspaper on National Depression Screening Day, in your favorite woman’s
magazine, on the Internet—but I think descriptive behavioral examples might make it easier for you to decide if the
shoe fits.
CHECKLIST FOR DEPRESSION:
Ö
IRRITABILITY
Irritability may seem to you an odd place to start in determining if you are depressed.
But snapping at your husband, yelling at your children, insulting your boss, going off on your best friend—all
of these can be signs of the increased irritability that signals depression. Your frustration tolerance
is at a very low ebb. When your anger emerges, you feel and act like a three-year-old throwing a tantrum.
Irritability feels physical—your skin crawls, your muscles twitch. For
some women, irritability feels like too much caffeine without the lift or being shrink-wrapped too tight. For
others, only feedback from loved ones tells them that they are on the edge or over the brink more frequently.
Ö TIREDNESS
Feeling drop-dead tired regardless
of the amount of sleep you get has a fancy name, anergia, which means the absence of energy. Note that
I said absence of energy, not reduced energy. It’s gone, honey! You feel your
have to force your body to perform every action, to think every thought. The nerve pathways from your brain
to your arms and legs, to your fingers and toes, even to your sex organs are filled with sludge. The couch
and you are on intimate terms—you can’t tear yourself away from its voluptuous cushions. Your
nickname is Slo-mo. Motion, activity, walk, jump—all have been banished from your vocabulary.
Note: Even when tired, you can feel restless or agitated at the same time. When
you have an agitated depression, you can’t sit down, you can’t rest, but you can’t accomplish anything because
the agitation interferes.
Ö SLEEP
INTERRUPTION
You can fall asleep, although there are exceptions to this rule when anxiety is mixed in, but you can’t
stay asleep. You typically wake every hour or two and have difficulty falling back to sleep.
What sleep you do get is restless and agitated. This is called mid-insomnia. Sometimes you
wake early in the morning, at three or four am, and can’t get back to sleep at all. This is called
terminal insomnia. Your total hours of sleep decreases. You try over-the-counter products
to little avail. You’ve turned to a glass of wine or two at bedtime but the sleep disruption has
only become worse. The bags under your eyes are drooping to your chin. Note:
You may experience just the opposite—that you are sleeping constantly, night and day. Over
sleeping or hypersomnia occurs less often than insomnia but is also a sign of depression.
Ö TEARFULNESS
You find that you’re
not only crying about something, you’re crying about nothing. You feel on the verge of tears constantly.
Tears well out of your eyes and drip off your chin with the least provocation. You find yourself
sentimental, crying during the Hallmark commercials. You begin avoiding friends and family, and especially
strangers, for fear of breaking into tears in their presence. Even if the floodgates haven’t opened
yet, you feel as though a tidal wave of tears is rising up behind your eyeballs. Once you start crying,
you find it difficult to stop. Whimpering turns to sobbing, which turns to hysteria until you can’t
get your breath. Note: Crying to this extent is common and normal in the early stages
and often sporadically in the later stages of bereavement. When you’ve suffered a significant loss
have symptoms similar to those presented in this checklist that persist longer than expected, you probably need the help of
a mental health professional to gauge whether you’ve crossed the line into depression.
Ö IMPAIRED CONCENTRATION
Your ability
to think clearly and remember most everything becomes severely impaired when you are suffering from depression.
You find it difficult to make even the simplest decision. You don’t go out because you couldn’t
decide whether to wear the pink underwear or the blue and, therefore, are still in your jammies. You walk
from room to room wondering where you left your brain. Your thought train runs off track mid sentence.
Your spouse is becoming more annoyed, and doesn’t mind telling you about it, because you’ve forgotten to
pick up his blue suit at the cleaners for the third day in a row. Now, don’t get me wrong, if you’re
trying to take better care of yourself by NOT picking up his suit, you go girl. But if the memory slips
are mounting and it’s bothering you, it may be depression.
Ö WORTHLESSNESS
Even if you have never had sterling self-esteem, when depression hits, any kind
thought about yourself evaporates. You feel quite helpless, as if you had never learned a thing about how
to care for yourself or others. The future looks bleak; there is no hope on the horizon. It
feels as if your current mood is permanent. You brush off suggestions for change as easily as a horse flicks
flies off his hindquarters with a sweep of his tail. It’s as though a whale has swallowed you up
and is not about to spew you back on land. You nay-say every compliment. Even with the
kind ministrations of family and friends, you feel unloved and unimportant. What’s worse, you have
no recollection of former accomplishments and the love you’ve given to others. Bright moments seem
to belong to the rest of world, not to you. Note: You can certainly experience low self-esteem
without being depressed. This type of poor self-image may have been with you most of your life.
With depression, feelings of worthlessness come on quite suddenly and are at odds with how you’ve felt about
yourself in the past.
Ö APPETITE
AND AROUSAL CHANGES
This is the one time in life when you lose weight without even trying. Unfortunately,
you lose your sex drive or libido at the same time—so it’s hardly worth it. Your robust appetite
has flown the coop. You forget to eat for the entire day. As you stand in front of open
cupboards or the refrigerator, nothing looks appealing. Occasionally a morsel of chocolate finds its way
into your mouth, offering a temporary taste treat. Your favorite meal gets shoved around on your plate
and scraped into the disposal. Along with your physical appetite, your sexual appetite suffers a similar
decline. Arousal becomes a thing of the past. Your husband (who doesn’t understand
depression and has problems of his own) suspects you of having an affair. Note: Compulsive
overeating, especially of sweet or fatty comfort foods, is often paired with lack of appetite and the result is weight gain
instead of loss.
Ö LOSS OF JOY AND MOTIVATION
The
fancy word to describe loss of joy and motivation is anhedonia—the absence of pleasure. Activities
that you absolutely loved have acquired a lackluster hue. The world has become, not blue, but gray.
You don’t FEEL like doing anything. That golf game you loved, the antiquing that had become
an obsession, sitting down with a good mystery—all have fallen by the wayside. Not even your closest
friend can talk you into high tea at that darling new English tearoom. Weeds are strangling the roses,
green slime is creeping out of the vegetable bins in the refrigerator, and Fred’s suit is still at the cleaners.
You want to care, but you don’t.
Ö DEPRESSED MOOD
You may find it odd that depressed
mood itself is near the end of the list. Frequently, the above symptoms are so severe that you don’t
even recognize that you are in a blue mood. Depression often feels more physical than psychological.
That is why a majority of cases of depression are diagnosed and treated by family doctors, not by mental health professionals.
Ö SUICIDAL THOUGHTS AND PLANS
You
are not alone if at some point in your life, you’ve had the thought that things would be better if you weren’t
here anymore. It was probably a fleeting thought—hoping you wouldn’t wake up in the morning,
thinking it would be okay if God took you now, wondering if getting accidentally hit by a truck wouldn’t be so bad.
These are passive suicidal thoughts with no specific plan or current intention to harm yourself. You
can talk yourself down. You know you couldn’t do this to your children or spouse or other family
members. You have a strong spiritual conviction that suicide is not an option. Or, you
simply know that you’re too chicken to do anything to harm yourself. Suicidal thoughts are almost a sure sign that you
are suffering from depression. When your depression is treated properly, these thoughts will subside or
disappear.
CAUTION: When suicidal thoughts become persistent, especially when they become
tied to a plan and you begin acting on the plan by:
- Collecting pills to take later
- Holding
handfuls of pills
- Taking the razor blade out of the razor
- Making a noose
- Checking out bridges
- Trying
to veer your car off the road
- Purchasing a weapon
- Loading a weapon already in your possession
- Rummaging
through your cleaning supply closet in search for poisons
- OR…When you tell yourself:
- The children will survive
without me
- God will understand if I take my life
- My family is better off without me
- I can’t bear
the pain another second
YOU NEED TO SEEK IMMEDIATE HELP
GO DIRECTLY to a family member,
a friend, your physician, your pastor, or the nearest hospital emergency room and TELL THEM YOU NEED HELP.
Don’t
have the energy to do even that? Call 911 or one of these numbers:
1-800-SUICIDE or 1-800-784-2433
1-800-273-TALK
or 1-800-273-8255
For a Suicide Hotline in your state: www.suicidehotlines.com
Suicide
is a permanent and tragic solution to a temporary problem. GET HELP.
NEXT IN THE SERIES: Name
that tune: Types of depressive and mood disorders.