Dealing With Depression – Part 1
“Doctor, I feel tired all the time. I don’t want to get out of bed. I feel like I’m making stupid mistakes all the time… I don’t want to hurt myself, but sometimes I think it wouldn’t be a bad thing if I had never been born. I feel worthless, which makes me hungry – I feel good when I eat, but then I feel bad about eating… I don’t like where I am and this is not me.”
Depression can be a subtle feeling that influences some aspects of our lives, or it can be a dramatic feeling that prevents us from enjoying any aspect of our life at all. I am amazed at how many people don’t realize they are depressed when they come in complaining of “just feeling off.” I will ask “Do you have any stressors in your life right now?” “Just the usual.” “What’s the usual?” And then they reply with something like “Well, things are really tight financially and that’s causing a lot of friction between my spouse and I. We have bills to pay and I don’t know if I’ll still have a job tomorrow because they’ve had to downsize a lot of the staff. I hate my job but can’t afford to leave it.”
The numbers are also astounding – 9% of the population will struggle with severe depression at some point in their lives. People who are facing stressors, chronically ill, in an unstable environment, or who have a family history of depression are at the highest risk for developing severe depression. As physicians, when we discuss it in the office with patients, we usually describe it as being on a spectrum, with the genetic element on one end, and the situational element on the other end. We are all somewhere in the middle, some with a larger genetic component and so needing only a smaller trigger, and others with a smaller genetic component and so needing a larger trigger to become depressed. Whatever genes we have, we play the hand we’ve been dealt.
Some people present differently than the norm. In patients above the age of sixty we often see anger or irritability as the main presenting symptom. As their bodies stop behaving the way their minds feel, sometimes an edge develops that wasn’t there before. In adolescents it can be challenging to distinguish between normal teenage angst and depression. Many parents get concerned, but calm themselves down with “it’s just a phase, he’ll grow out of it.” But the feelings persist, and the teenager is suffering. Frequently the person feels something is off, but doesn’t know how to put it into words. Sometimes the person knows they are depressed, but feel they need to power through it. If these feelings last more than two weeks, or they keep coming back over time, there is assistance that can make a powerful change in the person’s quality of life – and in the quality of life of their loved ones.
If you feel this describes you, and it’s been affecting you for more than two weeks, let us know – we are here to help!
Next Week: Part 2 – Discussing Depression with Your Doctor.