Depression and Bipolar Disorders (Your Personal Health) - Softcover

Edwards, Virginia

Softcover

ISBN 10: 1552976378 ISBN 13: 9781552976371

Publisher: Firefly Books Ltd, 2002

Synopsis

Depression is a deceptively common illness. At some point in their lives, one out of every five people will struggle with bouts of depression, and nearly twice as many women will be affected as men.

At the outset, depression can seem quite similar to the sadness or low moods that we all feel from time to time. As the illness progresses, however, work life, social life and intimate relationships all suffer. The affected person loses interest in those around him, feels exhausted and hopeless and often considers "giving up."

In Depression and Bipolar Disorders, Dr. Virginia Edwards explores the causes, symptoms and treatment of depressions. Topics include:

normal versus abnormal depression
unipolar depressive disorders
bipolar depressive disorders
biological and psychosocial therapies
depression in women and the elderly
treatment options, including involuntary hospitalization
suicide.

This comprehensive examination of depression also features case studies and an extensive resource list.

About this title

About the Author

Dr. Virginia Edwards has been in private practice -- focusing on women's health and family issues -- for more than 30 years. She recently retired from her position as the head of Toronto East General Hospital's Child Psychiatry Department.

Excerpt. © Reprinted by permission. All rights reserved.

Chapter One

Depression: Normal and Abnormal

Antonio is forty years old, and has recurrent major depressive episodes. "Why do I have to suffer so much?" he asks. "All the things I can't do, the plans I can't make, because I don't know what shape I'll be in from one week to the next. For the last two days I haven't cared about anything, I haven't even taken a shower. I've just been trying to manage the pain of my own emotions. Tonight at dinner I started to feel sane, and then the despair hit me again, like a ton of bricks. I'm afraid one of these days my boss will fire me. How do I get healthy, and stay that way?"

--

All of us experience feelings and emotions. These are signals that tell us if we are safe or in danger. They also communicate to others that we are upset or pleased. We can cope with changes in the world by tuning into our feelings, the signaling system that sends emotional messages that are universally recognizable, and interprets other people's emotions accurately. Feelings are the subjective awareness of emotions.

In fact, feelings are present throughout mammalian species. Dogs and gorillas can signal happiness by jumping playfully and showing their teeth, much as humans do when they smile. The physical signs of the emotion, such as a smile, a grimace, a red face, clenched fists, or downcast eyes, indicate the state we're in to those around us. Although we are not always conscious of what we communicate, the signals we send, such as a raised voice, a cry, or a hunched posture, tell other people what responses we need from them. Sometimes we don't have time to think what to do in response. A stranger hears the distressed cry of someone drowning and, without thinking, jumps in to save the person. When the stranger is given a medal for heroism, he or she says there was no conscious act of bravery.

The more varied our awareness and expression of our feelings, the healthier we are emotionally. Healthy families accept and encourage the expression and awareness of a full range of feelings in their children. They accept the children's anger, sadness, and joyfulness. They neither deny nor censor these feelings, although this doesn't mean the child is allowed to act in a hurtful way. Healthy families also accept other people's faults, and enjoy being with others. They are sociable and outgoing.

That's the ideal. Most of us manage to approach it rather than achieve it. I can remember self-righteously criticizing someone for being bitter, only to realize the next day that I had been the negative one. Good therapy helps us relax our rigidity so we can experience the full range and richness of feelings. We need to feel angry, sad, happy, joyful, and a whole range of more subtle emotions to feel truly alive.

Moods versus Depression

A mood is a state of emotion sustained for a period of time. When we're in a "good mood" we feel buoyant, self-confident, and happy. We're interested in what's happening around us and want to explore new things. Usually something good has happened to us or we are having fun with people we like. We feel positive about ourselves and optimistic about the state of the world. Too bad we can't feel this way all the time! But if we did, we'd miss out on signs of danger.

"Bad moods" start when we feel anxious, angry, frightened, or sad. Often these feelings are provoked by some external event -- not getting the promotion we wanted, finding out we're overdrawn at the bank, or, worse yet, learning that our company is downsizing or our partner is fed up and thinking of leaving the relationship. If we didn't feel anxious, irritable, sad, or frightened under these circumstances, we wouldn't be able to look out for our needs. We have to be able to take steps to protect ourselves from hurt and humiliation, so we can survive adversities and maintain our self-esteem.

The word "depressed" can describe a feeling, as in "I'm so depressed that John didn't call for a date for Saturday night." It can also convey a more persistent state of low mood, as in "I've felt so depressed since I found out I was passed over for the promotion I'd worked so hard for, and I can't shake it." Usually, when we experience the feeling or mood as appropriate and understandable, we don't rush off to a doctor. We know we will cheer up when things change, or we took for other ways to handle our disappointments.

Feeling blue, sad, defeated, depleted, or helpless is all part of being human. We experience these feelings when things go wrong in our world. Paradoxically, if we don't accept these feelings -- if we;'re rigid and controlled -- we experience even more emotional distress. Our energy gets used up in suppressing the feelings and denying the hurt. We give up but we don't know why. At this point, the illness of depression can result.

How Depressed Is Depressed?

Depression can be distinguished from sadness in a number of ways. The intensity of the sadness is more severe and painful. A sufferer may describe the pain as "worse than any physical pain." The pain is so unbearable that often you feel you would rather be dead. The sadness pervades all aspects of your life and can't be shaken off. The feeling takes on a life of its own; it seems detached from whatever the original painful event was, so that you can't be reasoned out of the horrible feelings. You feel guilty and worthless and reproach yourself for your failings. You are unable to express your feelings or experience pleasure. You have difficulty concentrating, feel unpleasant body sensations, are agitated or slowed down, and appear downcast and unsmiling.

The above paragraph describes clinical depression. Several scales have been developed so that the doctor can assign a number value measuring the severity of the depression; these scales also give you a way to see if the depression is improving with treatment.

The Patient Health Questionnaire
A simple screening test called the Patient Health Questionnaire picks up many cases. If at least five of the following nine descriptions apply to you, and if these symptoms are increasing in frequency and severity over a two-week period, you likely have a depressive illness that should be treated. If your depression needs to be treated, you are unable to function in many areas of your life. You are impaired at home, at work, and with friends. If you have actively thought about suicide, you would be wise to get help as soon as possible.

little interest or pleasure in doing things
feeling down, depressed, or hopeless
trouble falling or staying asleep, or sleeping too much
feeling tired or having little energy
poor appetite or overeating
feeling bad about yourself, or feeling that you are a failure or have let yourself or your family down
trouble concentrating while reading the newspaper or watching television
moving or speaking so slowly that other people would notice, or the opposite -- being so fidgety or restless that you can't stop moving
thinking that you would be better off dead, or thinking of hurting yourself in some way

If you have only two or three of these symptoms, you should view them as a warning. Talking over your feelings and concerns with someone who cares about you may help. You could also lighten up the demands you make on yourself, spending less time working and more time enjoying yourself, although this isn't always possible. Looking after yourself with comfortable sleep, exercise, and nutritious food, and spending time with friends and family, can also help. If the feelings don't let up, you should see a doctor or counselor to talk over your problems.

If you have more than four of these feelings or have suicidal thoughts, it's important to seek help from your doctor or a counselor. Lots of good help is available. You might start by seeing your family doctor. If the doctor feels you are depress

Edition details

• Publisher: Firefly Books Ltd
• Publication date: 2002
• Language: English
• ISBN 10: 1552976378
• ISBN 13: 9781552976371
• Binding: Paperback
• Number of pages: 184