Depression

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    AMarsha Lucas, Psychology, answered
    Does the stigma about mental health issues lead to underdiagnosis of depression?

    There's still a stigma surrounding depression, says neuropsychologist Marsha Lucas, PhD. In this WisePatient video, she explains how social taboos prevent many people from seeking treatment for depression.


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    Seek out friends who will stick by you and help you through tough times. Ask them for specific help with daily routines, such as getting to therapy, exercising with you and encouraging you to take good care of yourself. You may need to educate your friends about your depression. They may not understand that depression is an illness and requires treatment. They may expect that you can just pull it together and get better. They may think they can cheer you up.
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    A depressive episode involves symptoms such as depressed mood, loss of interest and enjoyment, and increased fatigability. Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate or severe.
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    ALara Honos-Webb, PhD, Psychology, answered
    We can't deny that giving a child or adult a deficit-disorder label can impair confidence and motivation, which may create a clinical depression. In addition to a diagnosis of depression following attention deficit hyperactivity disorder (ADHD), there are two other common patterns: 1) ADHD and depression are both present and co-occurring, and 2) depression is misdiagnosed as ADHD or ADHD is misdiagnosed as depression.

    One of the diagnostic requirements of ADHD and depression is that the symptoms not be "better accounted for by another mental disorder." The oversight of this simple phrase has resulted in an elevated rate of diagnosing both ADHD and depression when one diagnosis is the correct one. For example, if a person can't pay attention or follow through on projects because they are depressed, then the correct diagnosis is depression and there is no reason to add a diagnosis of ADHD unless an extremely rigorous evaluation has been conducted to determine that both disorders are present. One time I asked a client why she did not finish her projects. She reported that "I look at what I've done and I tell myself it stinks, so I just stop." This is not ADHD, this is low self-esteem.
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    AMehmet Oz, MD, Cardiology, answered
    According to Nassir Ghaemi, a professor of psychiatry at Tufts University School of Medicine and author of A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness, which examines the mental health of famous leaders, the depressive realism hypothesis argues that "[depressed people] are depressed because they see reality more clearly than other people do."

    This may explain why one study showed that persons with a history of depressive symptoms usually score higher on tests for standard measures of empathy than a nondepressed cohort of college students. “This was the case even when patients were not currently depressed but had experienced depression in the past,” Ghaemi writes. “Depression seems to prepare the mind for a long-term habit of appreciating others' point of view.”
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    AMehmet Oz, MD, Cardiology, answered
    In addition to higher levels of empathy and realism, some professionals believe that the effects of treating depression with psychotherapy may also bestow benefits that nondepressed people often don’t access: self-knowledge.

    Dr. Gina Newsome Duncan, associate professor of psychiatry at Georgia Health Sciences University, believes one crucial characteristic of mental health involves knowing oneself and being self-aware. She often tells her depressed or anxious patients that “they are in a position to be some of the most mentally healthy people around because their illness has forced them to grapple with unhealthy patterns and learn new skills to cope with the stresses of everyday life.” This shows the importance of seeking professional help when one is suffering psychologically. It can save a life.

    Though these qualities may give depression an upside, I don't want to misrepresent the suffering and pain that those with depression experience. If left untreated, depression can put a person on a slippery slope. "Suicidal thoughts occur in about half of clinical depressive episodes," writes Ghaemi. Ten percent of people with depression take their own lives. "The benefits of depression come at a painful, if not deadly price."
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    ARealAge answered

    Depression affects 7% of the population, including 10% of the population over the age of 18, during a single year. In the U.S., 19 million people will suffer from mood disorders this year.

    Major depression is a major cause of disability in the U.S. and worldwide. Unipolar major depression is second only to coronary heart disease as the major illness contributing to disability in major market economies, and unipolar major depression accounts for 7% of disability adjusted life years, an international standard measure of disability.

    Each year, 12% of American women and 7% of American men will experience depression. Over their lifetimes, approximately 20% of women and 10% of men will experience major depression. Whether examined for one year or for the entire life span, approximately twice as many women as men will be affected. Women between the ages of 18 and 45 compose the largest proportion of people with major depression.

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    ARealAge answered

    People who are depressed, by definition, do not feel good. They experience low energy, sleep poorly and feel helpless, hopeless and often unwilling to interact with others. As a first line of self-medication, many people turn to drinking alcohol or taking either legal or illegal stimulant drugs. This is actually the worst possible strategy for dealing with depression. Alcohol and some drugs are depressants. Depressed mood can be a direct outcome of substance abuse. Conversely, use of alcohol or of some drugs by people with a depressive disorder may increase the severity of their depressive symptoms.

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    ARealAge answered

    Studies have shown that genetic makeup plays a role in the etiology of depression, but no study has indicated that depression is solely based on a person's genes. Family, twin and adoption studies have indicated that genetic factors are involved in the development of mood disorders (affective disorders). Potential genetic markers (that is, specific traits present on the genes) have been identified on specific chromosomes. Some of these markers are directly linked to neurobiological processes, believed to be related to the occurrence of major depression.

    The neurotransmitters involved in these neurobiological processes are chemical substances that transmit or block impulses among the nerve cells (neurons) in the brain. Norepinephrine and serotonin have been the most widely studied neurotransmitters in depression research. These may be thought of as up, or excitatory, neurotransmitters. Studies of the effects of antidepressant medications used to treat depression suggest that depression is characterized by low levels of both serotonin and norepinephrine. Depletion of up neurotransmitters is associated with feeling down and depressed.

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    ARealAge answered
    Certain medications used in the treatment of medical conditions may induce or contribute to depressive symptoms. Some of the alleged links between certain medications and depression are based on a small number of cases and may not be generalized to the majority of people taking those medications. However, evidence supports a potential link between depressive symptoms and certain types of prescription medications. These are:
    • corticosteroids
    • calcium channel blockers
    • digoxin
    • antihyperlipidemic agents
    • angiotensin converting enzyme inhibitors
    • sedative hypnotics
    • psychostimulants
    • certain hormones

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