Let's Talk about Depression

Did you know that the latest estimate is that one out of every ten adult Americans has depression?¹ That is 10% of the adult population of the United States.  In 2007, suicide was the tenth leading cause of death in the United States; third for people ages 15 to 24.² The National Institute for Mental Health estimates that depression is a major cause for suicide in 90% of cases.³  That means that nearly one in ten people who have depression will commit suicide. That is a noticeable number of preventable deaths. And yet, no one talks about it. We hide it, or sweep it under the rug, or tough it out. Depression is still a taboo subject for most people, which means that when someone we know does commit suicide because of depression, we are usually shocked and surprised.

In the interests of full disclosure, I have depression. I have had at least three major depressive episodes in my life, the first of which means that there are five years of my childhood that I do not remember. During that first major depressive episode, I came up with my suicide plan, so that I would have a way out if things got bad enough. Every morning, I would wake up and think, “Is it bad enough?” Every night, I would review the day and think, “Is it bad enough?” Obviously, the answer was always “no,” or I would not be writing this now, but the point is, it happened. I never told anyone about these thoughts because I did not want to add to the stress of the situation.

My second major depressive episode retreated (I can’t say it ended because I’m not sure it really did) when I changed my circumstances. The third one, though, was worse, and when it got to the point where I was seriously contemplating suicide again, I went to the doctor. She gave me antidepressants, which have literally saved my life.

As a teenager, I never told my family about my depression or suicidal thoughts because I did not want to add to the stress of the situation we were going through at the time. I did not think I was important enough. Given the high rate of suicide among teenagers and young adults, it’s time to bring depression out into the open, look at it in the light of day, and dispel the idea that there is something shameful about being depressed. First, let’s look at what depression is not. Then we’ll look at what depression is, and treatment options.

What Depression is NOT

1. Depression is not just feeling sad. There are eight factors in the official diagnosis of depression, which will be discussed later, but only one of them is feelings of sadness.

2. Depression is not a spiritual problem. There are some religious leaders who claim that depression is a symptom of lack of faith. There is no justification for this claim, and my personal experience is exactly the opposite. My faith is strong. My depression has nothing to do with my faith; in fact, when the depression is bad, suicide seems more tempting because I know where I’m going when I die, and it will be a place of no more sorrow and no more tears.

3. Depression is not shameful. Most professionals believe that depression is caused by a chemical imbalance in the brain or in the endocrine system.⁴ Other health issues, such as diabetes, are also caused by chemical imbalance in the body, but are not treated as shameful.

What Depression Is

1. Depression is complicated.  For major depression, the medical community generally looks for five of the following eight symptoms: little interest or pleasure in doing things, feeling down, depressed, or hopeless, trouble falling or staying asleep or trouble waking up, feeling tired, poor appetite or overeating, feeling like you are a failure or you let yourself or your family down, difficulty concentrating, and either speaking and moving so quickly or slowly that other people notice.⁵ Fewer than five of these symptoms can indicate depression, as well.

2. Depression is treatable. Depending on who you talk to, medication may or may not be the first line of treatment for you. Medication is a common treatment, but it is not the only one. Therapy works for some people, for some types of depression. It may take some time to find the right combination of techniques, but once you do, you’ll realize that even though you thought you were seeing the world in color, you were really seeing it in black and white.

3. Depression is common. You are not alone. See the numbers at the beginning of this article for the statistics. You are not at fault for your depression. You are worth the time and effort to be diagnosed and treated.

What to Do if You Think You May Have Depression

1. Go to the doctor. I cannot emphasize this point enough, so I will say it again. GO TO THE DOCTOR. Your primary care physician can prescribe antidepressants. You do not need to see a psychiatrist. Take the meds. Trust me on this. They have saved my life. Let them save yours.

2. Try self-help. Vitamin D deficiency can cause depression, so add a good Vitamin D supplement to your diet. It should be liquid or a gelcap, and you need to take it with food. If you take a prescription antidepressant, add folic acid to your vitamin regime; it helps make the antidepressant more effective. Do NOT reach for alcohol; alcohol itself is a depressant, and will only make your depression worse. Other things you can try are exercise, sleep, and finding the right diet for you.

3. Find someone to talk to. Sometimes the medications and vitamin supplements, or other self-help remedies, cannot overcome the depression. It doesn’t have to be a therapist. Find someone who can be a friend when you need one.

What to Do if You Have a Friend with Depression

It can be difficult for someone who has never suffered from depression to understand how it really works. Depression, even treated, does not go away completely if it is not caused by circumstance. Keep in mind the Abilify commercials with the dark cloud following a person around. Even under control, the cloud is still there; it just does not direct the person’s behavior. So how can you help your friend who has depression?

1. Listen. Even if you think your friend’s problems are petty or silly, to a person with depression, they are important and overwhelming. Listen to the words, and also to what is not said.

2. Educate yourself. Learn what depression is and is not, so that you know when your friend is speaking from depression and when there may be a different cause.

3. Encourage your friend to get treatment. When a person is depressed, sometimes he cannot see the problem. It may take some education by you for your friend to understand that she is depressed and should seek help.

What NOT to Do if You Have a Friend with Depression

1. Don’t offer an easy answer. “Cheer up,” “have faith,” “it’s not that bad” – none of those are helpful to a person in the throes of depression. If we could cheer up, we would. And what may not seem bad to you may be overwhelming to someone else.

2. Don’t trivialize it. Don’t say “I know how you feel” unless you too have depression, because you don’t know.

3. Don’t turn away. A person with depression needs friends. You never know if a conversation with you is keeping a person from harming himself.

Depression is an insidious condition that can sneak up on a person, developing over time so gradually that the person does not realize how far he has sunk. You can help fight depression and the suicide statistics by education and discussion. Depression should no longer be considered shameful or somehow the fault of the person who has it. Talk about it.

¹CDC, http://www.cdc.gov/features/dsdepression/index.html

² NIMH, http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/index.shtml

³ NIMH, http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/index.shtml

⁴ http://www.allaboutdepression.com/cau_02.html

⁵CDC, http://www.cdc.gov/features/dsdepression/index.html