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“Skyland
Trail is a model of care for people with mental illness …its services are
simply state of the art.”
Rosalynn Carter
Former First Lady
October 2003
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Depression
Georgia's Premier
Depression Treatment Facility
Depression
covers an extremely wide spectrum of experience, from the almost universal
experiences such as grief and bereavement to apparently inexplicable despondence
and melancholy. Every year more than 18 million Americans suffer from some
type of depressive illness. This includes major depression; bipolar
disorder (often called manic depression); and dysthymia, a form of
depression that is milder, but long lasting. Often overlooked, chronic
irritability may also be a sign of depression.
Untreated major
depression can seriously disrupt social relationships and work. The
hopelessness and emotional pain that can accompany severe depression can
seriously compromise a person’s ability to care for themselves and increase
the risk of suicide.
However, depression is
one of the most treatable of all medical illnesses, and treatment for
depression really works. More than 80 percent of people with depression
realize successful results with medication, psychosocial therapies, or
both. The earlier treatment begins, the more effective it can be. Early
treatment decreases the likelihood of recurrences, and the sooner treatment
begins, the greater its probable effectiveness. Generally, treatment for
major depression is sought about six months after symptoms are first
experienced.
Symptoms
Depression
affects people in different ways. Not everyone has the same symptoms.
However, professional help should be sought if: any five of the following
indications are present for more than two weeks; suicide is a serious
concern; or symptoms interfere with daily activities.
- Insomnia; sleeping too
much; awakening in early morning; interrupted sleep
- Fatigue or loss of energy
- Irritability and
restlessness
- Reduced appetite and weight
loss; or increased appetite and weight gain
- Indifference to very
important situations
- Loss of interest or lack of
pleasure in activities, including sex
- Difficulty concentrating,
remembering, or making decisions
- Feelings of guilt and
hopelessness; a sense of being worthless
- Thoughts of death or
suicide
- Persistent physical
symptoms that don't respond to treatment (such as chronic pain or
digestive disorders)
Causes
- Diathesis-stress Every disorder is best
explained by a "diathesis-stress" model: genetic
predisposition interacting with stress. Stress varies from biological
processes (such as exposure to viruses) to psychosocial processes
(such as loss of employment).
- Chemical
imbalances In
people with depression, certain brain chemicals, called
neurotransmitters, are typically present in incorrect amounts. Changes
in these chemicals may cause or contribute to clinical depression.
- Cognition People with negative
thinking patterns are more likely to develop clinical depression.
Typically, these are pessimistic individuals. They may have low
self-esteem, worry to excess, or feel they have little control over
their lives.
- Medications Some medications, such as
anti-hypertension medications can cause depression.
- Genetics A family history of
clinical depression increases the risk for developing the disease,
although it can occur in people with no family history of the illness.
- Situational
factors Events
ranging from divorce to the death of a loved one can contribute to
clinical depression. Life situations and transitions, such as
financial problems or moving to a new location, can also be
contributing factors. It's normal to feel sad because of such events;
however, sadness that continues over a long period of time may require
professional help.
Epidemiological
characteristics
While not
actually causing depression, the following factors point to causes of the
illness:
- Gender Women are twice as likely
as men to experience major depression, although it is still unclear
why this is the case. The higher incidence among women may be related
to hormonal changes and/or stress. Women suffering from abuse or
poverty may also have an increased risk of major depression.
- Co-occurrence Major depression is more
likely to occur along with certain illnesses such as Alzheimer's
disease, diabetes, cancer, heart disease, hormonal disorders,
Parkinson's disease, and stroke. Depression can also co-occur with
mental illnesses such as eating disorders and anxiety disorders.
Depression can also co-occur with alcohol and/or substance abuse.
Treatment
Treatment for
clinical depression varies with individuals, and may include antidepressant
medication, psychotherapy, behavior modification, or a combination of these
options. Support groups can also be helpful in overcoming the illness. As
with any disorder, treatment success is enhanced by exercise, stress
reduction, balanced nutrition, and proper sleep.
Medication
Severe
instances of depression should be treated with medication that acts on the
brain chemistry, affecting the chemical pathways associated with mood.
Monoamine oxidase inhibitors (MAOIs) have been prescribed for some time.
Newer types of antidepressants include selective serotonin reuptake
inhibitors (SSRIs) and tricyclic antidepressants (TCAs), as well as
aminoketones.
Non-pharmacological
Therapies
A variety of
non-pharmacological therapies have been found to be effective in treating
milder depressions and are used as important supplements to medication in
major depressive disorder. These include the following:
- Psychotherapy
Less severe forms of depression can be treated effectively with
psychotherapy. In some instances, the course of therapy can be as
short as 10 to 20 weeks.
- Cognitive/behavioral
therapy
Some individuals respond well to therapy that helps change negative
thought patterns and behavior that may contribute to depression.
- Interpersonal
therapy
Problematic personal relationships can cause or deepen depression.
Interpersonal therapy can help a person relate more effectively with
others and bring about a positive change in relationships.
- Electroconvulsive
therapy
When medication is not a viable option, when medications are not
effective, or in cases of debilitation or high risk of suicide,
electroconvulsive therapy may be used to relieve symptoms of
depression. This treatment is a safe and painless procedure that
stimulates the brain with a brief, controlled series of electrical
pulses.
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