Understanding Depression

Pembimbing : Dr. Iwan Sys. SpKJ

What causes Depression?

Family History
Having a family members who has depression may increase a persons risk Imbalances of certain chemicals in the brain may lead to depression

 Major Life Changes

Positive or negative events can trigger depression. Examples include the death of a loved one or a promotion. Major Illnesses such as heart

 Certain medications used alone or in combination can cause side effects much like the symptoms of depression. Use of Alcohol or other Drugs can lead to or worsen depression. Depression can also occur for no apparent reason!

Symptoms of Depression
Vary from person to person 2 key signs are loss of interest in things you like to do and sadness or irritability

Additional Signs include:

Changes in feelings which may include: Feeling empty Inability to enjoy anything Hopelessness Loss of sexual desire Loss of warm feelings for family or friends Feelings of self blame or guilt Loss of self esteem Inexplicable crying spells, sadness or

Changes in behavior and attitude

These may include:
General slowing down Neglect of responsibilities and appearance Poor memory Inability to concentrate Suicidal thoughts, feelings or behaviors Difficulty making decisions

Physical Complaints
These may include:
Sleep disturbances such as early morning waking, sleeping too much or insomnia Lack of energy Loss of appetite Weight loss or gain Unexplained headaches or backaches Stomachaches, indigestion

Common Types of Depression Major Depression Dysthymia Bipolar Disorder Seasonal Affective Disorder (SAD)

Major Depression
This type causes symptoms that may:
Begin suddenly, possibly triggered by a loss, crisis or change Interfere with normal functioning Continue for months or years It is possible for a person to have only one episode of major depression. It is more common for episodes to be long lasting or to occur several times during a persons life

Dysthymia
People with this illness are mildly depressed for years. They function fairly well on a daily basis but their relationships suffer over time.

Bipolar Disorder
People with this type of illness change back and forth between periods of depression and periods of mania (an extreme high). Symptoms of mania may include:
Less need for sleep Overconfidence Racing thoughts Reckless behavior Increased energy Mood changes are usually gradual, but can be sudden

Season Affective Disorder

This is a depression that results from changes in the season. Most cases begin in the fall or winter, or when there is a decrease in sunlight.

Professional treatment is necessary for all these types of depression.

Treatment for Depression

Medication
Antidepressants can help ease the symptoms of depression and return a person to normal functioning. Antidepressants are not habit forming.

Medication
Antidepressants work to normalize naturally occurring brain chemicals called neurotransmitters, notably serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. The newest and most popular types of antidepressant medications :
selective serotonin reuptake inhibitors (SSRIs), Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SSRIs and SNRIs

SSRI s SNRI s
More populer

Fluoxetine (Prozac) Citalopram (Celexa) Sertraline (Zoloft) And several others

Venlafaxine (Effexor) Duloxetine (Cymbalta)

They tend to have fewer side effects

MAOI
People taking MAOIs must adhere to significant food and medicinal restrictions to avoid potentially serious interactions. They must avoid certain foods that contain high levels of the chemical tyramine (which is found in many cheeses, wines and pickles, and some medications including decongestants) MAOIs interact with tyramine increase in blood pressure stroke

Side Effects
SSRIs and SNRIs
Tricyclic antidepressants

FDA WARNING

2004 4400 children and adolescent Headache Nausea Insomnia and nervousnes Sexual problems
Dry mouth

Constipation Bladder problems Sexual problem Blurred vision Drowsiness during the day

4% of those taking antidepressants thought about or attempted suicide Compared to 2% receiving plasebo

Psychotherapy
This can help many depressed people understand themselves and cope with their problems. For example:
Interpersonal therapy works to change relationships that affect depression Cognitive-behavioral therapy helps people change negative thinking and behavior patterns

If you or someone you know has symptoms of depression

Take Action!

 See a doctor for a complete check up.

Go to the counseling center and talk to a counselor. Talk things over with a friend, family member or a residential life staff member.

Dont expect too much of yourself Take a break Get some exercise Avoid extra stress and big changes

Things to do
Reduce or eliminate the use of alcohol or drugs Exercise or engage in some form of physical activity Eat a proper, well-balanced diet

 Obtain an adequate amount of sleep Seek emotional support from family and friends Focus on positive aspects of your life Pace yourself, modify your schedule, and set realistic goals

Things to Avoid
Dont make long-term commitments or important decisions unless necessary Dont assume things are hopeless Dont engage in emotional reasoning (i.e.: because I feel awful, my life is terrible) Dont assume responsibility for events which are outside of your control Dont avoid treatment as a way of coping

Intervening with a depressed friend

Be empathetic and understanding Dont try to cheer up a depressed person Avoid critical or shaming statements Challenge expressions of hopelessness Empathize with feelings of

Helping a depressed friend

Dont argue about how bad things are Dont insist that depression or sadness are the wrong feelings to be experiencing Dont become angry even though your efforts may be resisted or rejected

Helping a depressed friend

Advocate for their recovery from depression Emphasize that depression is treatable Seek consultation Encourage them to seek help, go with them to the counseling center Be supportive of counselor or doctor suggestions