Depression is more common than you may think. An estimated one in 10 Canadians will have depression at some time in their lives. And there is another big number too. Two-thirds of Canadians who suffer depression will receive no therapy, either medication or non-drug.
The reasons for this lack of treatment range from cultural habits to the assumption that depression is a common part of another condition such as older age. Of course, many Canadians also don’t want to be diagnosed because of the stigma associated with depression.
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Thankfully, more of us are now realizing that there is more to depression than just not being happy. Depression has clinical symptoms, including changes in your body, your mood and your thoughts.
Even so, more of us need to become more aware of depression, both as it could affect ourselves and as it may affect those we love.
Yes, depression involves having a depressed mood or feeling “down,” especially in the morning, but there is also often a feeling of fatigue. More specifically, you may experience a feeling of worthlessness or guilt and you may exhibit an inability to concentrate, together with a reduced ability to feel pleasure, a general restlessness, and sometimes thoughts of death.
You may also experience changes in weight — either a gain or loss — and in sleep habits — either too much or too little.
And yes, before you ask, everyone does have these symptoms, but in depression they are present every day for at least two weeks. And they occur for no definable reason, such as low thyroid levels or certain drug side effects.
The impacts of depression can be serious. At home there is an increased risk for substance abuse and family problems. Depression is also the number one reason for work absenteeism, loss of work productivity, and work place accidents.
If you have depression, you are twice as likely to develop heart disease, diabetes, high blood pressure, and dementia. Obviously, if you think you may have depression, get your symptoms checked!
Both drug and non-drug therapy are used for depression, and the best results are when the two are combined. The theory behind drug treatment arises from an observed alteration in neurotransmitter levels in the nervous system. Antidepressant drugs work in the nervous system on these levels, but unfortunately there is no test to measure neurotransmitter levels. Thus, there are different types of antidepressant drugs and you may need to try several before you find the one that works best in your nervous system.
Selective serotonin re-uptake inhibitors or SSRIs like fluoxetine, sertraline, paroxetine, and citalopram increase these serotonin levels. Serotonin norepinephrine re-uptake inhibitors or SNRIs like venlafaxine affect both serotonin and norepinephrine. Other antidepressant drugs include bupropion, mirtazapine, tricyclic antidepressants, and monoamine oxidase inhibitors.
Unfortunately, all these drugs take one to two weeks to work, and maximum effectiveness takes four to six weeks, so it takes time for you to know if a drug is working.
If it isn’t working, you may need to switch to another drug and wait to see if it works better.
Non-drug treatment includes counseling, cognitive behavioural therapy, problem solving therapy, mindfulness, and exercise. Most of these treatments require seeing a specialist in the specific area and you may not feel comfortable, you may need to wait for an appointment, or you may not have the funds to pay for the service.
However exercise does not have these drawbacks, and even a walking program may give you benefits.
If you think you may have depression, you are among good company because it is reported that Johnny Carson, John Lennon, Winston Churchill, and Michelangelo all had depression.
A good place to start is the Canadian Mental Health Association at www.cmha.ca or the University of Michigan’s Depression Center at www.depressiontoolkit.org. The latter website has various log books and diaries that you can print and use. Remember, everyone is depressed from time to time, but if you have ongoing symptoms, now is the time to get help.
