Thursday, October 27, 2011

Depression Looks Different in Men and Women

Human Experiences, depression/loss of loved oneImage via WikipediaIn working with depression, counselors and clients alike have seen the symptoms of depression to be the same across the board.

Depression has several different criterion - at least the depression that we are familiar with.  Major Depressive Disorder is characterized by one or more Major Depressive Episodes that are not consistent, but a person can be diagnosed with Depression if they have had one or more episodes.  An episode consists of:
  • at least 2 weeks of depressed mood or loss of interest
  • accompanied by at least four additional symptoms of depression as follows:
    • markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
    • significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day
    • insomnia or hypersomnia nearly every day
    • psychomotor agitation or retardation nearly every day
    • fatigue or loss of energy nearly every day
    • feelings of worthlessness or excessive or inappropriate guilt nearly every day
    • diminished ability to think or concentrate, or indecisiveness, nearly every day
    • recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
Other forms of depression are Dysthymic Disorder which is characterized by at least 2 years of depressed mood for more days than not and then the Bipolar 1 and 2 Disorders which cycle between Depressive Episodes and Manic Episodes.  With regard to Bipolar, these diagnosis are more complicated than what I have described, but this post is not about Bipolar, it is about depression so I am  not going to go into these in detail.

Depression is not about just having a down day.  I often describe it as having a dark veil over your life that you can see through, but it colors everything.  It is a state of mind rather than a passing mood and it is not something that should be ignored.  Often depression is characterized as a condition that you can just buck up and get over without any help or support.  That is not true.  Having a down day or a blue mood can be overcome by changing your thoughts, getting more sleep or engaging in social activities.  True depression is more complicated and difficult.  Depression is a condition of the brain, whether it is a shrunken hypothalamus or an imbalance in brain chemistry.  Since we can't live outside our brains, when our chemistry is out of balance it is extremely difficult to overcome this without help.  Telling someone with this condition to just pull themselves up by their bootstraps and get on with life is the worst thing to do.  I would encourage anyone with depression to seek out a doctor or a naturopath for assistance with this condition.  

Often individuals who have gone through abuse in their lives are susceptible to depression in their lives.  Chronic inner conflict can be a major contributor to the body's ability to remain in a balanced state.  Can a person be depressed without going through abuse?  Yes, absolutely.  However there can be others sources of inner conflict such as being in a relationship where you aren't able to be yourself, working and/or living in a very controlled environment, alcohol or drug use, disease and medications to name a few.  Living in our area, we are now going into the winter months and many people are affected by Seasonal Affective Disorder which is a Disorder that comes on when sunlight is limited.  

However, the symptoms of Depression are now being categorized differently for men and women.  Here is the list for you to look at:

                       Female Depression                                                    Male Depression

  1. Blame themselves                                                          Feel others are to blame
  2. Feel sad, apathetic, worthless                                        Feel angry, irritable and ego inflated
  3. Feel anxious and scared                                                 Feel suspicious and guarded
  4. Avoids conflicts at all costs                                            Creates Conflicts
  5. Always tries to be nice                                                   Overtly or covertly hostile
  6. Withdraws when feeling hurt                                          Attacks when feeling hurt
  7. Has trouble with self respect                                          Demands respect from others
  8. Feels they were born to fail                                           Feels the world set them up to fail
  9. Slowed down and nervous                                            Restless and agitated
  10. Chronic procrastinator                                                  Compulsive time keeper
  11. Sleeps too much                                                           Sleeps too little
  12. Trouble setting boundaries                                            Needs control at all costs
  13. Feels guilty for what they do                                         Feels ashamed for who they are
  14. Uncomfortable receiving praise                                     Frustrated if not praised enough
  15. Finds it easy to talk about weaknesses and doubts         Terrified to talk about weaknesses and doubt
  16. Strong fear of success                                                   Strong fear of failure
  17. Needs to "blend in" to feel safe                                      Needs to be "top dog" to feel safe
  18. uses food, friends, and love to self medicate                   Uses alcohol, TV, sports and sex to self-med
  19. Believe their problems could be solved only                    Believe their problems could be solved only
          if they could be a better (spouse, co-worker                  if their (spouse, co-worker, parent, 
          parent, friend)                                                               friend) would treat them better.
   20.  Constantly wonder, "Am I loveable enough?"                 Constantly wonder "Am I being loved 

Comparing this list, the two sides look very different.  Additionally, the symptoms Mr Diamond lists for male depression are symptoms that are often attributed to other disorders, anger problems, personality disorders and trauma disorders.  I believe that there needs to be continued research into this so that depression in both sexes can be diagnosed accurately and treated appropriately.  In domestic violence situations and abusive relationships, men tend to display many of these symptoms as do women.  

If both parties in a relationship are depressed, it stands to reason that the relationship would suffer.  There would be little energy coming from either side as well as few internal resources available to work at the problems that would inevitably appear.      

How should a person deal with someone who is depressed?  First of all, don't tell them to get over it, cheer up or just snap out of it.  They can't and that creates more hopelessness.  Patience is a good start.  Often being bright and cheery around a depressed person can be hurtful to them because they can't reciprocate.  Listening to them, supporting them, helping them with daily activities is a good start.  If the person needs supplementation or medication, a trip to the doctor is in order.  Some individuals are leery of antidepressents, however these medications have their purpose.  If an antidepressant is prescribed, it is always wise to stay in touch with your doctor and never just stop taking them.  Anti-depressants require 6 weeks to reach appropriate levels in the bloodstream and they are started in stages and stopped in stages.  Keep in touch with your doctor about how you feel because they will help you decide whether you are being given the right medicine at the right dose.  

Natural remedies for depression can include exercise.  30 minutes of exercise 3 times a week has shown to be very therapeutic for people who suffer from depression.  Other remedies are St. John's Wort, SAM-e, 5-HTP which is a serotonin enhancer, L-Tyrosine, improving diet by looking for food allergies to wheat or gluten, corn or soy.  Improved sleep habits are important for improving mood as well.  It is always recommended to consult with a professional before taking any supplement.

I encourage all my readers to participate in good self care.  Toxic relationships have a dramatic effect on the psyche as well as health problems.  Don't suffer through another day of depression without taking some steps to move forward.  Life without joy or happiness is a hard place to be and no one should be in that place very long.  


Thursday, October 13, 2011

Looking Beyond Abuse

The social self.Image via WikipediaWhen I started this blog, I thought that it would be enough to discuss all the different ways that domestic violence could be seen and understood.  Although I'm sure I haven't provided an exhaustive source of information, I think I did a good job of getting some relevant information out there for people to use.  One thing that I haven't done is to look into some of the mental health issues that might be sources for abuse and how they can look with regard to relationships and parenting abilities.  With this post, I am going to start doing that.

There are many mental illnesses that have their roots in childhood abuse and neglect....just take a look at the nine personality disorders if you need convincing.  When children are abused, be it sexually, emotionally or tends to change them and often not for the better.  The ACE Study for example, is a study completed by Kaiser Permanente, a large HMO in the US.  It shows a direct correlation between Adverse Childhood Experiences (ACEs) and physical illness in adults who scored above 4 on the test.  In other words, the more abuse, the greater the possibility of illness and physical problems as an adult.

In other studies done by Bessel van der Kolk, he has shown numerous times that there is a direct correlation between abuse/trauma and changes in the brain.  Children who grow up with an angry parent tend to develop anger problems themselves.  As an added benefit, these children often have deficits in self esteem, are depressed or formulate highly developed control issues.  Abuse and neglect produce more abuse and neglect, even if we look at it from the perspective of simple modeling.  If a husband treats his wife without honor, where is his son going to get the understanding that men and women need to treat each other honorably?

When speaking of mental illness, it can be separated into organic and non organic causes.  Beyond that there is a category of illnesses that no one is sure what the cause is.  Personality disorders can fall into that category.  They just know that with each one, there is a common denominator of abuse, neglect and/or trauma.  Modeling and conditioning would then be another common denominator with children coming from families that consistently model inappropriate behavior towards each other and/or conditioning which changes the normal way human beings relate to each other.

Lithography. Drunk father.Image via WikipediaWhen we look at abuse, it is common to see some mental health issues involved.  Besides the personality disorders there are Bi-Polar Disorders, Anxiety Disorders, Depression as well as co-existing addiction issues.  Any kind of drug, alcohol, gambling, or sexual addiction can lend a contributing factor to abusive or neglectful behavior in a family, marriage or parenting relationship.  Abuse, in the majority of cases, does not come out of a vacuum.

The good news is that in the disorders which are organic, meaning they have physical causes, medication has shown to be a very good option in returning the person to an emotional balance. Some common organic disorders are BiPolar, Depression, Anxiety and Schizophrenia.  Others who would rather not use medication have found appropriate supplementation to work effectively in some cases.  When someone has BiPolar Disorder, in most cases when they have found the right supplement or medication in the right dose, they can lead a very normal and balanced life.  It then becomes their responsibility to take the medication as prescribed and stay in good contact with their physician to monitor their progress.  Developing a relationship with a good counselor is always advisable as it has been proven that medication alone or counseling alone in cases of BiPolar, Anxiety and Depression are not as effective as medication/supplementation and counseling together.

With non-organic disorders such as Personality Disorders, Post Traumatic Stress Disorder (PTSD) and other disorders that are based out of trauma, counseling can have a positive effect.  EMDR therapy is a proven and effective therapy which deals with trauma and has shown to be most helpful in cases of PTSD.  Behavioral therapies such as Dialectical Behavioral Therapy (DBT) work well in most situations of Borderline Personality Disorder if the person will commit to the process.  Cognitive Behavioral Therapy and different forms of spiritual counseling have shown to be effective in general when individuals have been traumatized.

Vector image of two human figures with hands i...Image via WikipediaIn these rather chaotic and trying times, it seems that the days of the lone ranger are coming to a close.  As human beings, we tend to function better in relationship with others than as separate and isolated people.  When we face challenges, working with another person or a team of people who have the ability to get you from where you are to where you would like to be is an option we all must consider.  If you are struggling with some issues, please seek out the help of someone you trust.  That may be a friend, a pastor, a counselor, your doctor or your naturopath.  Just make sure the person you seek help from has the skill set to be able to truly help you.  Friends and family can provide support, love and kindness when you truly need it but when that is not enough, please seek further assistance from a professional.