Read an Excerpt
How Do I Know if I Suffer from
Depression and/or Obsessive-
Christy is a twenty-eight year-old mother of one. Her child is well behaved and her husband is a dentist with a very successful practice. She knows her husband loves her, but he spends a lot of time taking care of his patients. For about the last month, Christy has not felt upto speed. She has lost interest in almost all the activities that used to provide her with so much pleasure, including aerobics, poetry, and ceramics. She used to enjoy romantic evenings with her husband that culminated in passionate lovermaking. Now, she can't remember the last time she even thought about sex with her husband. When he wants to have sex, she always makes some excuse. Christy has also noticed that she never feels like she gets a good night's sleep anymore. Many nights shetosses and turns for two hours before falling asleep. She always seems to be tired. Her appetite has also decreased substantially over the last month or so. Everything in Christy's life seems to be going well; she doesn't know why she's having these feelings or problems. Christy is most likely suffering from major depression.
People have been suffering from depression since the beginning of recorded time. Ancient civilizations wrote about depression as much as three thousand years ago. The ancient Greeks believed that depression was caused by excessive bile produced by the gallbladder. During the Middle Ages, scholars believed that depression was caused by God as an act of punishment and was nottruly an illness. At that time, society felt depression was a result of the being weak-minded or full of sin. Even today, many misinformed individuals feel that depression synonymous with "having a nervous breakdown. In fact, many great people have suffered from depression, including Abraham Lincoln, Ernest Hemingway, and Ludwig van Beethoven.
Many times the patient misdiagnoses depression. Everyone experiences days of feeling "down in the dumps." This is not the true definition of depression or of someone who is clinically depressed. The diagnosis, classification, and cause of depression are very complex. In fact, some physicians misdiagnose short-term or "down in the dumps" depression as clinical depression and use prescription drugs where they are not needed.
I've had patients come to my pharmacy and ask me if I think they are suffering from depression. They tell me they are feeling really "low." I ask them about their symptoms and I dig a little deeper into their problems. Many times things just seem to be going the wrong way for them or the patient is under a lot of stress at home or work. I explain to them that many people experience very similar feelings at some point during their lifetime. I also tell them that if their feelings persist for at least two weeks, they should see their doctor.
Data on exactly how many people suffer from depression are incomplete. It is believed that approximately 6 to 20 percent of the U.S. population may suffer from depression. Depression also seems to be more common in women than in men. In fact, depression in women occurs twice as often as in men. Even though depression can occur at any age, the highest rates of depression occur between the ages of twenty-five and forty-four.
Depression is also quite common in the elderly. It is believed that as many as 20 to 35 percent of the elderly who suffer from another chronic illness also suffer from depression. Genetics have been found to play a role in depression as well; depressive illnesses tend to occur within families. In fact, relatives of family members who suffer from depression are two to three times more likely to suffer from depression than others. The following discussion provides a brief overview of what causes clinical depression and how a patient can determine if he or she has it.
The cause of depression is too complex to be explained by only one factor or one theory. Life is filled with events that cause mental pain, including divorce, the death of a loved one, loss of a job, major illness, and more. Most people who face these challenges and/or changes and experience mild depression recover on their own and move on. However, some of these individuals may become stuck in a prolonged depressed mood.
The biogenic amine theory is one of the most widely accepted explanations of the cause of depression. This theory is that depression is caused by a reduction (decrease) of neurotransmitter chemicals in the brain. The decrease of these chemicals results in the faulty transmission of impulses within the central nervous system (CNS). In depression, this chemical deficiency is believed to be located within the limbic system. The limbic system is believed to control a number of important functions within the body, including sleep, appetite, energy, and motor functions. The decrease of neurotransmitters within this system creates a disruption of these functions and thus produces some of the symptoms of depression. This theory, however, doesn't totally explain the cause of depression. Other factors such as social and developmental factors may also contribute to causing depression.
The diagnosis of true depression versus normal grief caused by a situation such as the death of a loved one can be difficult because the symptoms may be the same. Grief is defined as a self-limiting reaction to a loss that requires no medical treatment. Grief can, however, become depression if the symptoms are severe and/or continue for several weeks. Suicidal thoughts, motorfunction problems, and feelings of worthlessness are not common to a grief reaction. Such symptoms may indicate that you are depressed.
In my practice as a pharmacist, I've seen many patients taking antidepressants that should not have been. Some patients tell me they told their doctor they were feeling a little "blue" or "down in the dumps" and received a prescription for Prozac. The blues are not depression..All too often physicians use prescription drugs as a "magic bullet." There is no true magic bullet for treating temporary melancholy feelings. These patients most likely do not need drug therapy. Patients who think they are suffering from depression should discuss this thoroughly with their doctor before taking any antidepressant.Zoloft, Paxil, Luvox and Prozac. Copyright © by Donald Sullivan. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.