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Depression Part 4

Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is an illness that causes extreme mood changes from manic episodes of very high energy to the extreme lows of depression. It is also called manic-depressive disorder.

This illness can cause behavior so extreme that you cannot function at work, in family or social situations, or in relationships with others. Some people with bipolar disorder become suicidal.

Having this disorder can make you feel helpless and hopeless. But you are not alone. Talking with others who suffer from it may help you learn that there is hope for a better life. And treatment can help you get back in control.

Family members often feel helpless when a loved one is depressed or manic. If your loved one has bipolar disorder, you may want to get counseling for yourself. Therapy can also help a child who has a bipolar parent.

What causes bipolar disorder?

The cause of bipolar disorder is not completely understood. We know that it runs in families. It may also be affected by your living environment or family situation. One possible cause is an imbalance of chemicals in the brain.

What are the symptoms?

The symptoms depend on your mood swings. In a manic episode, you may feel very happy, energetic, or on edge. You may feel like you need very little sleep. You may feel overly self-confident. Some people spend a lot of money or get involved in dangerous activities when they are manic.

After a manic episode, you may return to normal, or your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness. When you are depressed, you may have trouble thinking and making decisions. You may have memory problems. You may lose interest in things you have enjoyed in the past. You may also have thoughts about killing yourself.

The mood swings of bipolar disorder can be mild or extreme. They may come on slowly over several days or weeks or suddenly over a few minutes or hours. The mood swings may last for a few hours or for several months.

How is bipolar disorder diagnosed?

Bipolar disorder is hard to diagnose. There are no lab tests for it. Instead, your doctor or therapist will ask detailed questions about what kind of symptoms you have and how long they last. To be diagnosed with bipolar I disorder, you must have had a manic episode lasting at least a week (less if you had to be hospitalized). During this time, you must have had three or more symptoms of mania, such as needing less sleep, being more talkative, behaving wildly or irresponsibly in activities that could have serious outcomes, or feeling as if your thoughts are racing. In bipolar II disorder, the manic episode may be less severe and shorter.

Your urine and blood may be tested to rule out other problems that could be causing your symptoms.

How is it treated?

The sooner bipolar disorder is identified and treated, the better your chances of getting it under control. One of the most important parts of dealing with a manic episode is recognizing the early warning signs so that you can start treatment early with medicine that is especially for manic phases.

Many medicines are used to treat bipolar disorder. You may need to try several before you find the right combination that works for you.

  • Most people with bipolar disorder need to take a medicine called a mood stabilizer every day.
  • Medicines called antipsychotics can help get a manic phase under control.
  • Antidepressants are used carefully for episodes of depression, because they cause some people to move into a manic phase.

People often have to try several different medicines before finding what works for them. Regular checkups are important so that your doctor can tell if your treatment is working.

Counseling for you and your family is also an important treatment. It can help you cope with some of the work and relationship issues that your illness may cause.

Charting your mood is one way you can start to see your patterns and symptoms. Keep a notebook of your feelings and what brought them on. If you learn what triggers your mood swings, you may be able to avoid them sometimes.

People often stop taking their medicines during a manic phase because they feel good. But this is a mistake. You must take your medicines regularly, even if you are feeling better.

Who is affected by bipolar disorder?

Over 3 million Americans—about 1% of the population, or 1 out of 100 people—have bipolar disorder, with similar rates in other countries.1 Bipolar disorder occurs equally among males and females. It often begins between the ages of 15 and 24.

 

Other Mood Disorders

Some mental health conditions are related to, or occur with, clinical depression. Here are a few of the most common.

Dysthymia
You may have this common mood disorder if you experience a less severe degree of the symptoms of major depression for more than two years.

Obsessive-compulsive disorder (OCD)
If you have intrusive thoughts or exhibit compulsive behavior, such as excessive hand-washing, read about OCD here.

Post-traumatic stress disorder (PTSD)
If you experience panic, depression, or anxiety after a traumatic event, you may have PTSD. Seek professional help as soon as possible.

Premenstrual dysphoric disorder (PMDD)
If you’re a woman who has severe mood swings before your period, you might have PMDD. It can be treated.

Seasonal affective disorder (SAD)
If you feel tired, depressed, or anxious during the winter, you may be experiencing SAD.

 
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Posted by on March 15, 2011 in Depression, Health

 

Depression Part 3

Postpartum Depression

What is postpartum depression?

Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth.

Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.

Postpartum depression is not the “baby blues,” which many women have in the first couple of weeks after childbirth. With the blues, you may have trouble sleeping and feel moody, teary, and overwhelmed. You may have these feelings along with being happy about your baby. But the “baby blues” usually go away within a couple of weeks. The symptoms of postpartum depression can last for months.

In rare cases, a woman may have a severe form of depression called postpartum psychosis. She may act strangely, see or hear things that aren’t there, and be a danger to herself and her baby. This is an emergency, because it can quickly get worse and put her or others in danger.

It’s very important to get treatment for depression. The sooner you get treated, the sooner you’ll feel better and enjoy your baby.

What causes postpartum depression?

Postpartum depression seems to be brought on by the changes in hormone levels that occur after pregnancy. Any woman can get postpartum depression in the months after childbirth, miscarriage, or stillbirth.

You have a greater chance of getting postpartum depression if:

  • You’ve had depression or postpartum depression before.
  • You have poor support from your partner, friends, or family.
  • You have a sick or colicky baby.
  • You have a lot of other stress in your life.

You are more likely to get postpartum psychosis if you or someone in your family has bipolar disorder (also known as manic-depression).

What are the symptoms?

A woman who has postpartum depression may:

  • Feel very sad, hopeless, and empty. Some women also may feel anxious.
  • Lose pleasure in everyday things.
  • Not feel hungry and may lose weight. (But some women feel more hungry and gain weight).
  • Have trouble sleeping.
  • Not be able to concentrate.

These symptoms can occur in the first day or two after the birth. Or they can follow the symptoms of the baby blues after a couple of weeks.

If you think you might have postpartum depression, fill out this postpartum depression checklist Click here to view a form. (What is a PDF document?) . Take it with you when you see your doctor.

A woman who has postpartum psychosis may feel cut off from her baby. She may see and hear things that aren’t there. Any woman who has postpartum depression can have fleeting thoughts of suicide or of harming her baby. But a woman with postpartum psychosis may feel like she has to act on these thoughts.

How is postpartum depression diagnosed?

Your doctor will do a physical exam and ask about your symptoms.

Be sure to tell your doctor about any feelings of baby blues at your first checkup after the baby is born. Your doctor will want to follow up with you to see how you are feeling.

How is it treated?

Postpartum depression is treated with counseling and antidepressant medicines. Women with milder depression may be able to get better with counseling alone. But many women need counseling and medicine. Some antidepressants are thought to be safe for women who breast-feed.

To help yourself get better, make sure you eat well, get some exercise every day, and get as much sleep as possible. Seek support from family and friends if you can.

Try not to feel bad about yourself for having this illness. It doesn’t mean you’re a bad mother. Many women have postpartum depression. It may take time, but you can get better with treatment.

 
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Posted by on March 15, 2011 in Depression, Health

 

Depression Part 2

IN CHILDREN & TEENAGERS

What is depression in children and teens?

Depression is a serious mood disorder that can take the joy from a child’s life. It is normal for a child to be moody or sad from time to time. You can expect these feelings after the death of a pet or a move to a new city. But if these feelings last for weeks or months, they may be a sign of depression.

Experts used to think that only adults could get depression. Now we know that even a young child can have depression that needs treatment to improve. As many as 3 in 100 young children and 9 in 100 teens have serious depression.12

Still, many children don’t get the treatment they need. This is partly because it can be hard to tell the difference between depression and normal moodiness. Also, depression may not look the same in a child as in an adult.

If you are worried about your child, learn more about the symptoms in children. Talk to your child to see how he or she is feeling. If you think your child is depressed, talk to your doctor or a counselor. The sooner a child gets treatment, the sooner he or she will start to feel better.

What are the symptoms?

A child may be depressed if he or she:

  • Is grumpy, sad, or bored most of the time.
  • Does not take pleasure in things he or she used to enjoy.

A child who is depressed may also:

  • Lose or gain weight.
  • Sleep too much or too little.
  • Feel hopeless, worthless, or guilty.
  • Have trouble concentrating, thinking, or making decisions.
  • Think about death or suicide a lot.

The symptoms of depression are often overlooked at first. It can be hard to see that symptoms are all part of the same problem.

Also, the symptoms may be different depending on how old the child is.

  • Very young children may lack energy and become withdrawn. They may show little emotion, seem to feel hopeless, and have trouble sleeping.
  • Grade-school children may have a lot of headaches or stomachaches. They may lose interest in friends and activities that they once liked. Some children with severe depression may see or hear things that aren’t there (hallucinate) or have false beliefs (delusions).
  • Teens may sleep a lot or move or speak more slowly than usual. Teens with severe depression may hallucinate or have delusions.

Depression can range from mild to severe. A child who feels a little “down” most of the time for a year or more may have a mild, ongoing form of depression called dysthymia (say “dis-THY-mee-uh”). In its most severe form, depression can cause a child to lose hope and want to die.

Whether depression is mild or severe, there are treatments that can help.

What causes depression?

Just what causes depression is not well understood. But it is linked to an imbalance of brain chemicals that affect mood. Things that may cause these chemicals to get out of balance include:

  • Stressful events, such as changing schools, going through a divorce, or having a death in the family.
  • Some medicines, such as steroids or narcotics for pain relief.
  • Family history. In some children, depression seems to be inherited.

How is depression diagnosed?

To diagnose depression, a doctor may do a physical exam and ask questions about the child’s past health. You may be asked to fill out a form about your child’s symptoms. The doctor may ask your child questions to learn more about how the child thinks, acts, and feels.

Some diseases can cause symptoms that look like depression. So the child may have tests to help rule out physical problems, such as a low thyroid level or anemia.

It is common for children with depression to have other problems too, such as anxiety, attention deficit hyperactivity disorder (ADHD), or an eating disorder. The doctor may ask questions about these problems to help your child get the right diagnosis and treatment.

How is it treated?

Usually one of the first steps in treating depression is education for the child and his or her family. Teaching both the child and the family about depression can be a big help. It makes them less likely to blame themselves for the problem. Sometimes it can help other family members see that they are also depressed.

Counseling may help the child feel better. The type of counseling will depend on the age of the child. For young children, play therapy may be best. Older children and teens may benefit from cognitive-behavioral therapy. This type of counseling can help them change negative thoughts that make them feel bad.

Medicine may be an option if the child is very depressed. Combining antidepressant medicine with counseling often works best. A child with severe depression may need to be treated in the hospital.

There are some things you can do at home to help your child start to feel better.

  • Urge your child to get regular exercise, eat a healthy diet, and get enough sleep.
  • See that your child takes any medicine as prescribed and goes to all follow-up appointments.
  • Make time to talk and listen to your child. Ask how he or she is feeling. Express your love and support.
  • Remind your child that things will get better in time.

What should you know about antidepressant medicines?

Antidepressant medicines often work well for children who are depressed, but there are some important things you should know about them.

  • Children who take antidepressants should be watched closely. These medicines may increase the risk that a child will think about or try suicide, especially in the first few weeks of use. If your child takes an antidepressant, learn the warning signs of suicide, and get help right away if you see any of them. Common warning signs include:
    • Talking, drawing, or writing about death.
    • Giving away belongings.
    • Withdrawing from family and friends.
    • Having a way to do it, such as a gun or pills.
  • Your child may start to feel better after 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. Make sure your child takes antidepressants as prescribed and keeps taking them so they have time to work.
  • A child may need to try several different antidepressants to find one that works. If you notice any warning signs or have concerns about the medicine, or if you do not notice any improvement by 3 weeks, talk to your child’s doctor.
  • Do not let a child suddenly stop taking antidepressants. This could be dangerous. Your doctor can help you taper off the dose slowly to prevent problems.
 
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Posted by on March 15, 2011 in Depression, Health

 

Depression Part 1

What is depression?

Depression is an illness that causes you to feel sad, to lose interest in activities that you’ve always enjoyed, to withdraw from others, and to have little energy. It’s different from normal feelings of sadness, grief, or low energy. Depression can also cause people to feel hopeless about the future and even to think about suicide.

Many people, and sometimes their families, feel embarrassed or ashamed about having depression. Don’t let these feelings stand in the way of getting treatment. Remember that depression is a common illness. Depression affects the young and old, men and women, all ethnic groups, and all professions.

If you think you may be depressed, tell your doctor. Treatment can help you enjoy life again. The sooner you get treatment, the sooner you will feel better.

What causes depression?

Depression is a disease. It’s not caused by personal weakness and is not a character flaw. When you have depression, chemicals in your brain called neurotransmitters are out of balance.

Most experts believe a combination of family history (your genes) and stressful life events may cause depression. Life events can include:

  • Childbirth, a death in the family, work, or relationships.
  • Finding out you have a long-term health problem, such as arthritis, heart disease, or cancer.
  • Health problems, such as anemia and an underactive thyroid gland (hypothyroidism). Treating the health problem can usually cure the depression.

Just because you have a family member with depression or have stressful life events doesn’t mean you’ll get depression.

You also may get depressed even if there is no reason you can think of.

What are the symptoms?

The symptoms of depression may be hard to notice at first. They vary among people, and you may confuse them with just feeling “off” or with another health problem.

The two most common symptoms of depression are:

  • Feeling sad or hopeless nearly every day for at least 2 weeks.
  • Losing interest in or not getting pleasure from most daily activities nearly every day for at least 2 weeks.

A serious symptom of depression is thinking about death or suicide. If you or someone you care about talks about this or feeling hopeless, get help right away.

You also may:

  • Lose or gain weight. You also may feel like eating more or less than usual almost every day.
  • Sleep too much or not enough almost every day.
  • Feel restless and not be able to sit still, or you may sit quietly and feel that moving takes great effort. Others can easily see this behavior.
  • Feel tired or as if you have no energy almost every day.
  • Feel unworthy or guilty nearly every day. You may have low self-esteem and worry that people don’t like you.
  • Find it hard to focus, remember things, or make decisions nearly every day. You may feel anxious about things.

If you have some of these symptoms for at least 2 weeks, talk to your doctor. Treatment may be right for you.

How is it treated?

Depression can be treated in various ways. Counseling, psychotherapy, and/or antidepressant medicines are all used. Lifestyle changes, such as getting more exercise, also may help. Your doctor or mental health professional will help you find the best treatment.

If you have mild or moderate depression, your family doctor or a mental health professional, such as a counselor or psychologist, may treat you. If you have severe depression or if treatment is not helping, you may need to see a psychiatrist. Some people need to be treated in the hospital, especially if they have thoughts of suicide.

Work with your health care team to find the best treatment for you. It may take a few tries, and it can take several weeks for the medicine to start working. Try to be patient and keep following your treatment plan.

Depression can return (relapse). How likely you are to get depression again increases each time you have a bout of depression. Taking your medicines and continuing some types of therapy after you feel better can help keep that from happening. Some people need to take medicine for the rest of their lives. This does not stop them from living full and happy lives.

Let your doctor know if you think you are depressed. Depression is easy to overlook. The earlier you are treated, the more quickly you will get better.

If someone you care for is depressed, the best thing you can do is help the person get or stay in treatment. Learn about the disease. Talk to the person and gently encourage him or her to do things and see people. Don’t get upset with the person. The behavior you see is the disease, not the person.

 
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Posted by on March 15, 2011 in Depression, Health

 
 
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