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The Blues, The Blahs Or Something Bigger?

The blues have been around since, well, human beings. Everyone experiences an occasional cloudy spell, sometimes for no apparent reason. Those blah days can be even more of a downer during the holidays – the season when good cheer is supposed to be bountiful.

But how do you know when the blues are just a passing phase and when they signal depression?

This article sheds light on mood disorders and how to cope – during the holidays and throughout the year.

The Difference Between Being Blah And Being Depressed
If the problem is garden-variety blues, you’re able to function more or less normally and you’ll feel better in a matter of days.

But bona fide depression won’t go away on its own and requires expert attention.

Symptoms of depression can include:

• Feelings of sadness, emptiness, worthlessness and helplessness
• Fatigue
• Difficulty concentrating
• Overeating or loss of appetite
• Aches and pains, including headaches and digestive troubles
• Lack of interest in normal activities and in sex
• Insomnia, excessive sleeping and difficulty getting up in the morning

Depression comes in many forms, including five primary types listed below. Major depression and dysthymia are the most common. Psychotic depression is rare.

1. Major depression can occur once or several times during a person’s life. The severity of symptoms may make it difficult for a person to work, sleep, study and take part in normal activities.
2. Dysthymia is a chronic form of depression that can last for years, with less severe symptoms than those of major depression. Sufferers aren’t disabled but don’t feel good or function as well as they used to.
3. About 10 percent to 15 percent of new mothers develop postpartum depression – a major depressive episode – shortly after having a baby.
4. A few individuals experience psychotic depression, which is characterized by symptoms such as hallucinations and delusions.
5. Seasonal affective disorder (SAD) occurs during the winter months, when short days reduce exposure to sunlight. Depression caused by SAD usually gets better as the days lengthen and outdoor activities pick up. It can be treated with a special light box that simulates natural light, but patients may also need antidepressant medicine and/or therapy.

You need medical help to treat all of these types of depression.

The Causes Of Depression
Experts can’t point to any single cause of depression. It’s likely that biological, psychological and environmental factors all play a contributing role. Depression often runs in families – as a result of genetics, behavior patterns or both.

Scientists do know that in depressed individuals the part of the brain that regulates mood, sleep, appetite and other functions doesn’t work normally. An imbalance between the brain chemicals serotonin, dopamine and norepinephrine may cause depression, and modern antidepressant drugs work by attempting to correct it.

The National Alliance on Mental Health estimates that about 15 million U.S. adults, or between 5 percent and 8 percent of the population, experience major depression in any given year. More women than men develop depression.

Mood disorders often occur along with health problems such as cardiovascular disease, cancer, diabetes, HIV/AIDS, Parkinson’s disease and other disabling conditions.

Sometimes external factors can bring on depression. Examples include a trauma such as having a serious accident or being the victim of a crime; a relationship that causes great stress; the loss of a loved one; or abuse of alcohol or drugs.

Coping With The Holiday Blues
Along with thoughts of peace on earth and good will to all, the holidays often bring a hefty dose of stress and anxiety. Because of the focus on togetherness during the season, singles and people who have recently lost a loved one through death or a breakup may be especially prone to the blues.

As an antidote, schedule time with the friends and family members you enjoy most.

The American Psychological Association’s advice for coping focuses on honestly assessing your feelings and deciding how you truly want to spend the season.

• Minimize the time you’re with people who make you feel bad – even if they’re relatives.
• Set your own rules on how much money to spend. Don’t overspend out of guilt. You can show your affection for people without going into debt.
• Decide which holiday invitations you would enjoy accepting. Don’t readjust your whole life just to make every party.
• Don’t be pressured into directing the children’s Christmas play or baking cookies for your social circle. It’s always OK to say no.
• Don’t get sucked in by the advertising hype that says every family enjoys perfect happiness during the holidays. Focus on seasonal activities or religious observances that are meaningful to you.
• Maintain a healthy lifestyle. Drinking too much or overeating will only make you feel worse.
• Reach out to the needy. A few hours spent serving lunch at the soup kitchen or packing Thanksgiving baskets for the poor can give your own mood a major boost.

Medical Therapies For Depression
If you suffer from more than the holiday blues, there is help available.

The National Alliance on Mental Illness emphasizes that the vast majority of people with depression can be successfully treated, typically with prescription medications and/or talk therapy.

The most commonly prescribed antidepressant drugs – including Prozac, Zoloft, Paxil, Celexa, Effexor and Cymbalta – increase the available amount of the neurotransmitter serotonin. This brain chemical helps regulate mood, calm anxiety and promote healthy sleep.

Another popular antidepressant, Wellbutrin, influences two other neurotransmitters that affect mood: dopamine and norepinephrine. The medication Remeron targets serotonin and norepinephrine receptors in the brain.

Other drugs may also be prescribed but are less commonly used.

It may take eight weeks for you and your doctor to judge the effectiveness of an antidepressant. You might notice better concentration, sleep, appetite and energy levels before an improvement in mood. It’s also possible that your doctor may need to try several different medications before finding the most effective one for you.

Self-Care To Ease Depression
Depression is highly treatable with medication and therapy. But there are other steps you can take to help yourself.

The National Institute of Mental Health recommends:

• Taking part in mild exercise, such as walking
• Attending church or temple
• Going to a movie or a ballgame
• Participating in activities you’ve enjoyed in the past

Spend time with people who are supportive. Take them up on lunch or dinner invitations, or call just to chat. When others offer to help, let them.

Don’t expect recovery to happen overnight. Depression improves gradually, not suddenly.

Be patient with yourself and set realistic goals for accomplishing necessary tasks. Break up big projects into a series of small steps that aren’t so overwhelming.

Try not to make significant life decisions while depressed. This isn’t the time to get married, ask for divorce or buy a new house.

How Mood Disorders Affect Families
Depression touches everyone who cares about the affected person.

When you’re depressed, family members may feel wounded by your withdrawal, moodiness or irritability. And if you aren’t coping well with life’s responsibilities, relatives may end up with additional stresses.

But the family can also be a force for cure.

The National Institute of Mental Health recommends that family members and friends:

• Listen well
• Avoid criticizing the patient’s feelings and comments
• Offer hope that the depression can be treated
• Continue inviting the patient to take part in favorite activities, even if he or she sometimes says no

If you’re the patient, keep your family in the loop by discussing your treatment plan. Knowing more about depression and the steps you’re taking to combat it can reassure your loved ones and help them be more supportive.

Depression In The Workplace
Experts say depression is a leading cause of absenteeism and lost productivity.

A 2003 review published in the Journal of the American Medical Association estimated the annual cost of depression to the workforce as $44 billion. Workers who are depressed lose an average of 5.6 hours of productivity every week. And absenteeism alone costs nearly $8.3 billion a year.

Although depression is highly treatable with medication and therapy, the National Alliance on Mental Illness reported in 2006 that fewer than 15 percent of depressed Americans actually receive both treatments. Clearly it’s in an employer’s best interests to facilitate medical intervention.

If an employee seems to be depressed or is having difficulty arriving at work on time or getting motivated, ask whether there is anything you can do to help. Note that medical privacy laws don’t permit employers to ask whether workers have received a diagnosis.

But you can offer emotional support and encouragement if an employee discloses that he or she is depressed and seeking treatment. Keep work hours flexible to accommodate therapy or doctor appointments.

If a colleague mentions thoughts of suicide, take it seriously. Urge him or her to see a doctor right away.

For More Information
For more information about depression and mood disorders, visit these Web sites:

The National Alliance on Mental Illness
www.nami.org

The National Institute of Mental Health
www.nimh.nih.gov

Depression Is Real Coalition
www.depressionisreal.org