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| Mary-Colleen Millage, NP Chippenham Family Medicine |
Clinical depression, affecting approximately 19 million people in the
United States alone, is a vastly underdiagnosed condition that, with the tragic
passing of Robin Williams last week, has been catapulted back into the national
conversation. When a person has clinical depression, they are not “sad” and
they cannot “snap out of it” as it is not a situational emotional reaction. Depression
is caused by chemical changes in the brain, which, like heart disease or
diabetes, cannot be willed away. There is significant stigma still associated
with mental illness, and seeking help for depression should be noted as a very
courageous act.
People experience clinical depression in various ways, with no two cases
being alike, although many exhibit common symptoms. Some of the most common
signs of depression include a loss of interest in previously enjoyable life
activities, general hopelessness, lethargy, anxiety, and trouble accomplishing
normal daily activities.
Energy-zapping fatigue is one of the most prominent symptoms someone experiencing
depression faces, causing withdrawal from the productive activities crucial to
daily life. Depressed individuals may find themselves feeling like they can’t
get out of bed, or sleeping longer than normal with no clear explanation. Even
in the presence of overwhelming fatigue, depression sufferers can also
experience insomnia. This can be a side effect of certain medications, but also
puts a person at risk for more intense health issues up to and including the
consideration of suicide. Restorative sleep is crucial to the treatment of
depression, and should be reviewed seriously with your healthcare provider.
Anxiety is both a symptom of depression and a condition on its own, and can
make depression relapse much more likely. It requires complex treatment and can
amplify the effects of depression in the afflicted individual. People who
suffer from both depression and anxiety disorders may take longer to respond to
treatments (both through medication and psychotherapy).
Suicidal thoughts are the most dangerous depression symptoms. More than
90% of those who attempt or commit suicide are depressed or suffering from a serious
mental health disorder. Those in the 65 and older age group have the highest
suicide rate, with men being more vulnerable than women. Suicidal thoughts are
not the same as daydreaming about harming oneself – they become obsessive and
inescapable mental images, often against the will of the afflicted. If you find
yourself or a loved one discussing or contemplating suicide, seek immediate
help from a mental health specialist, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
More than 80% of those suffering from depression respond well to a
variety of available treatments. Once a person has worked with their healthcare
provider to diagnose depression, they will collaborate on a course of
treatment, including medication, psychotherapy or a combination thereof.
Many questions abound about antidepressant therapy, but it remains one
of the most successful long-term solutions from those suffering from
depression. Used as a stand-alone treatment or in combination with
psychotherapy, antidepressants work by altering brain chemistry to alleviate
mood disorders. While this can seem scary, it is targeted to modify only the chemicals
in the brain affecting the depressive symptoms, without changing one’s
personality. The intent is to reverse the debilitating effects of depression
while allowing the person to feel normal again.
Antidepressant therapy does have some notable risks. It’s not always
effective on adolescents, and can trigger more severe reactions in that age
group. It should be monitored carefully, but not ruled out as a treatment
option. Also, after a course of antidepressant therapy, one should not quit
cold turkey as it can trigger major withdrawal symptoms, including flu-like
symptoms, dizziness, and worsening depression. Just as it takes several weeks
to build up to therapeutic doses with antidepressant medication, you should
wean off the medication at a mutually agreed upon interval with your provider.
For further inquiries about depression, anxiety, treatment
options, and mental health resources, contact Mary-Colleen Millage, NP, with
Chippenham Family Medicine at 804.560.0490 or visit chippenhamfamilymedicine.com.
If you or someone you know is experiencing thoughts of
suicide or self-harm, call the National Suicide Prevention Lifeline at
1-800-273-TALK (8255).
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