Depression

Murat Engin Akkaya

Professor L. Adams

English 112

22 April 2005

Depression

"Mom is sad all the time. She cries a lot. Sometimes she doesn't get up in the morning. She stays in bed until late in the afternoon with covers pulled up around her ears. At first I didn't worry. She'd stay in bed for a day or two and then get up again, and I'd think she was better. But after a couple of weeks, she didn't eat much any more, and she stayed in her room most of the time"...... "She has something called depression" (DenBoer, Helen 1-2).

Most people today do not think that depression is an illness. In fact most people think that depression is a moral failure. "Some 400,000 patients are treated for depression in the United States annually, most as outpatients and most by non-psychiatric physicians" (Hollister, Leo E 80). In 1989, major depression cost the nation at least $27 billion in medical care, worker absenteeism, and related costs. In 2002, "as many as 14 million people in the United States had symptoms of depression, resulting in a prevalence rate of 3% to 7% of the general population. This led to a loss of approximately $40 billion dollars a year in productivity (Breen, Robert and McCormac, Rupert 1).

Everyone at one time or another has felt depressed, sad, or blue. Being depressed is a normal reaction to loss, life's struggles, or an injured self-esteem. But sometimes the feeling of sadness becomes intense, lasting for long periods of time and preventing a person from leading a normal life. In fact depression is often considered a "female disease," since affected women reportedly outnumber men by four to one. Yet male depression may be more. "Many men try to hide their condition, thinking it unmanly to act moody. And it works: National studies suggest that doctors miss the diagnosis in men a full 70% of the time" (Real, Terrance 1). But male depression also stays hidden because men tend to express depression differently than women do. Depressed women are more likely to talk abut their problems and reach out for help, while depressed men will often turn to some action or substance for relief. Men often attempt to escape pain by overusing alcohol or drugs, working excessively or seeking extramarital affairs. They go into isolation, withdrawing from loved ones, and they may lash out, becoming irritable or violent (Real, Terrance 1).

The American National Institute of National health has defined depression as an illness that involves the body. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years (National Institute of Mental Health). According to the same report nearly 18.8 million Americans over the age of 18 suffer from major depression. Suicide, closely linked to depression, is the third leading cause of death in 10- to 24-year-olds. Unfortunately, most people never seek treatment. "Left undiagnosed and untreated, depression can worsen, lasting for years and causing untold suffering, and possibly even result in suicide" (National Institute of Mental Health).

Depression is far more common than most people realize. "Two out of every 10 people are clinically depressed. Approximately 23 percent of all adult women have had one major depressive episode in their lifetime. Depression has touched the lives of some of the most successful and brilliant men and women of our time. Sylvia Plath, Dick Cavett, Georgia O'Keeffe, Mark Twain, Virginia Woolf, and Abraham Lincoln all wrestled with depression" ((Myrna A. Wallis 1). Douglas Jacobs, a Harvard Medical School psychiatrist who has devised national screening programs for depression, says that the key difference between having sad feelings and a true major depression is that sad feelings eventually pass.

Depression comes in many forms. Some of the most common types of depression are; major depression, dysthymia and bipolar disorder. Major depression has steadily increased in all age groups over the past few decades. It is now the most common chronic condition seen by primary care physicians and is present in five to nine percent of patients. (National Institute of Mental Health). Major depressions has symptoms such as sad mood, low energy, loss of interest in usual activities, difficulty concentrating, changes in eating or sleeping habits, and suicidal thoughts. It affects people of all ages, striking women twice as often as men. In 1989, major depression costed the nation at least $27 billion in medical care, worker absenteeism, and related costs (National Institute of Mental Health).

As for dysthymia it refers to mild to moderate depression and those with it live in a gray state that may be the only condition they have known. To be diagnosed with dysthymia, one has to have had persistent symptoms for at least 2 years. In many cases, patients have lived with dysthymia so long that they have come to accept it as part of their personality. Also, with the right treatment, they may begin to feel better than they ever have. Symptoms of dysthymia are the same as those of major depression and include: "difficulty sleeping, loss of interest or the ability to enjoy oneself, excessive feelings of guilt or worthlessness, loss of energy or fatigue, difficulty concentrating thinking or making decisions, and Changes in appetite (Michalak, Erin E; Lam, Raymond W 1).

Bipolar disorder (manic-depressive disease), major depressive episodes alternate with periods of extreme elation or agitation, known as mania. The manic phase can develop gradually and is preceded by a state called hypo-mania. Erin Michalak and Lam Raymond also state that "Being hypo manic can be extremely seductive because it confers extra verve, productivity, and sociability. Hypo manic's are often the lives of the party and may have charismatic appeal for others" (1). Symptoms of mania can be divided into two - the high and low phase symptoms. Symptoms for the high include: "excessive happiness, hopefulness, and excitement, sudden changes from being joyful to being irritable, angry, and hostile, restlessness, rapid speech and poor concentration, increased energy and less need for sleep, high sex drive, tendency to make grand and unattainable plans and drug and alcohol abuse (Michalak and Raymond 1).

Symptoms of the low phase of Bipolar depression are the same as those of major depression and include: