Xpress asked me to open a thread about chronic depression, a condition with which i have lived for many years. It is quite difficult for me to talk about, so i thought i would start by imparting some facts about the illness.


Identifying Depression

Of the many different mood disorders, depression is the most common, and one of the most misunderstood. While modern research indicates that brain chemical imbalances cause depression, many people still believe that chronic depression indicates a weak personality or character flaw. This makes seeking help for depression difficult, as people hesitate before admitting this "weakness" to family, friends or doctors. Imagine the devastation and suffering if people hid a major illness such as cancer from the world. When you know more about what's wrong you can make it right.

Mood disorders—especially depression, are very common. Chances are that someone you know—or you yourself—suffers from depression. And the majority of depressive disorders go untreated. Learning to recognize the symptoms of depression may help those you love get the help they need.


Symptoms of Depression:

-persistent sadness or unhappiness

-lethargy

-loss of interest in previously enjoyable activities

-irritability

-sudden change in appetite

-disruption of normal sleep pattern

-physical discomfort

-difficulty thinking or concentrating

-thoughts of suicide or death.


Chronic Depression

The death of a loved one, health problems, financial stress or other traumatic life events can trigger a variety of depressive mood disorders. In these instances, there is an identifiable trigger associated with the onset of the depression disorder. Some people suffer from what is termed chronic depression, also called recurrent depression. With chronic depression, the individual goes through depressive episodes with periods of time in between when the symptoms of depression seem to disappear. Chronic depression can be a lifelong struggle.

Here is a short poem written by a person with chronic depression. It helps to shed some light on the chaotic nature of this condition. Simple but meaningful...


The uncontrolable state of mind...Chronic Depression!

I'm happy I'm sad, I'm crying I'm glad
Lifes ups and downs and merry-go-rounds
Soaring and free, scared as can be
I wish to be alone no come back I need you here.
Where do I turn, what should I do to rid me of my fear
You laugh...I cry, I am blue dont know why?
The world spinning fast, yet I remain still.
You call me crazy? No I'm ILL


~ written by Celinda M. *C* aka see2ithuney ~
~ Jan, 2001 ~

well organazied raffee ............its intresting thread ........... by the way have u got this disese or ??? ........... :rolleyes:

Unfortunately yes maha, ive had it for years. I also had postnatal depression after my first child, which was quite severe.

Its a condition that is so hard to articulate and express, because to some people, talking about it sounds like self-pity and self-absorption. I resent it myself all the time. I dont want to talk about it. I dont want to feel like this, and I hate that it keeps coming back when I least expect it.

I will keep posting information, for those of you who may be suffering in slience.

I have someone so dear suffering from this.. she's just given birth to a baby girl.. but she's sooooooooo sad.. soooooooooo tired.. looks ssssssssso pale.. she says the doctor told her she'll have to suffer from it for three years :(:sorry:

isn't there any solution? she can't even stay in her house.. and she's absent-minded all the time ..

Floret, here is some information about postnatal depression. Its a debilitating and exhausting condition indeed.

What is it?

Slowly developing postnatal depression (PND) can take two forms. One type occurs when a patch of postnatal 'blues' which started soon after the baby's birth becomes worse and more distressing as time passes. The second type develops more slowly and is not noticeable until several weeks after the birth of the baby.

Top

Symptoms of post-natal depression

DEPRESSION : Many mothers begin to feel depressed, increasingly despondent and hopeless soon after the baby is born. They may feel terribly miserable and sad for no particular reason and may find that they spend a large part of each day in tears. Sometimes the mother may feel rejected by her partner, family, friends, or even by the new baby; these feelings usually have no foundation. The depressed mother may feel permanently tired and lethargic, unable to cope with household chores. She may give up bathing, dressing properly or making-up.

Sometimes, the care of the baby is too much for the mother whilst she is unwell and someone else must be found to 'take over' until she has recovered. It is usually inadvisable to separate the mother from her baby, as this may serve to deepen the depression. If a relation or friend cannot be found to keep the mother company and help look after the baby, an advertisement may be placed in a local newspaper for a lively pensioner who for a small fee will help a convalescent mother with a young baby. This arrangement enables the mother to stay in her own home and keep her baby with her whilst she recovers.

ANXIETY : A depressed mother may feel extremely anxious about a variety of subjects and situations. She may be worried about her health, possibly having felt unwell since the birth of the baby. She may experience severe pain for which the doctor can find no satisfactory explanation. This pain is often in the head or neck. Other mothers suffer backache and chest pains which they fear are due to heart trouble. The mother may have a number of minor medical complaints which can cause undue distress.

Pain and a general feeling of illness or constant tiredness are very common symptoms of depression and can become worse if the depression remains untreated.

Anxiety may take the form of unjustified worries about the health and wellbeing of other members of the family, especially the baby.

The mother may feel too tense and anxious to go out of her home. She may not be able to bear to meet even her closest friends, and may refuse to answer the door, telephone or letters. In this situation, she will not venture out to consult a doctor so a home visit may be required.

PANIC : A depressed mother is often very confused by everyday situations and may experience feelings of panic. These feelings are unpredictable and often very distressing. She is unable to calm down and every effort should be made to avoid the situations in which she becomes distressed.

TENSION : Feelings of tension are often associated with depression. The mother who experiences these feelings finds them extremely distressing. She is quite unable to relax however much she is encouraged to do so. She may feel as if she is about to explode when the tension is at its worst. This type of tension, when it is a symptom of depression, may not be helped by taking tranquillisers. Women taking these drugs should not despair if they do not work, as there are other drugs; which run no risk of dependency; that can be of more help.

OBSESSIONAL AND INAPPROPRIATE THOUGHTS: A mother suffering from depression commonly has some obsessional thoughts. These may be about a person, a situation or about a certain activity. Some mothers become very frightened and believe that they may harm a member of their family especially the baby. These fears are very common symptoms of depression and may or may not be accompanied by feelings of guilt. Such fears are almost entirely unjustified, but if a mother is afraid that she may hurt the baby then she should tell her family and doctor.

A distressed mother may find the companionship of a suitable relative or friend reassuring. This phase of the illness usually passes quickly once the treatment has started to have its effect. the mother will benefit from the company and moral support of a companion as she recovers.

CONCENTRATION : A depressed mother will probably find that she cannot concentrate on books, television programmes or even conversation. She will find, to her distress, that her memory is very poor and she will often feel very disorganised. She will find that she sits for long periods of time doing nothing, but thinking about how awful she feels.

SLEEPING : Often a depressed mother will have some form of sleeping difficulty. She may be awake until the early hours of the morning, or get no sleep at all. Some find that they sleep very fitfully and waken frequently, others that they wake in the early hours of the mrning with nightmares, and then cannot get back to sleep.

Many depressed mothers dread going to bed as their symptoms trouble them more at night. Indeed some mothers find insomnia one of the most distressing aspects of the illness. Often mothers are prescribed sleeping pills by their G.P. and find them ineffective even taken in large doses. This situation can cause the mother to feel quite desperate. If the depression is treated normal sleep will be restored.

The feeding requirements of a young baby do not help a mother who is having sleeping difficulties. It can be of great benefit if someone else can feed the baby at night.

SEX : A common effect of depression is a complete loss of interest in sex. This may last for some time, and is helpful if partners realise that this is a symptom of the illness and that sexual desire will return as soon as the depression lifts. It should be stressed that a return of sexual desire is often the last sign that a depression has lifted, and great patience is necessary if a relationship is to be kept intact whilst a mother recovers from postnatal depression.

During the illness physical contact in the form of touching, hugging and cuddling can do much to reassure both partners and is very beneficial.

How can PND be treated?

HELP FROM THE FAMILY : Friends and family should make sure that the depressed mother is receiving treatment for her depression from the doctor. If the treatment she is prescribed does not suit her, do encourage her to go back to the doctor and ask him to change it. It can be helpful if someone accompanies the mother when she sees the doctor. This person can then assure the doctor that the mother is ill and not just being 'nervy'.

The family should understand that the illness is a temporary one, and that with their help and support the mother will recover. They should realise that it may take a considerable period of time before she is completely better.

Please do forget all ideas of 'chivvying' her out of it and accept that she is unwell. Try to treat her as you would if she had a simple physical illness.

When she is feeling unwell, take on as much of the runnning of the household as she wants to give up. However when she feels better let her do as much as she wants to. You may find that she has patches of good and bad days, this is very common with the illness.

Do remind her constantly that she will get better. Remember that depression is not a sign of weakness. Often a depressed mother will hate being left alone. If this is so, then try to organise a rota so that there is always someone who is close to her, and whom she trusts in attendance. This is a passing phase of the illness but it is most important that help be given until the mother is happy to be left on her own.

Ultimately anything you can do to help the mother throught the distressing stages of this illness will help her towards recovery.

MEDICAL TREATMENT : Any mother who thinks that she may be suffering from postnatal depression should see her doctor as soon as possible. If she cannot bear to visit the surgery a home visit should be requested.

Try to tell the doctor all the symptoms which are troubling you, as this will help him to correctly diagnose the illness. If he prescribes some treatment, find out whether you are being given tranquillisers or anti-depressants. Many women feel that tranquillisers do not help them and need to return to the doctor for the treatment to be changed.

Though forms of drug treatment vary, they usually involve the use of anti-depressant drugs. You cannot become addicted to these. You may find that if you are taking a tricyclic drug, your mouth becomes dry and you feel rather drowsy but these feelings wear off as you continue to take the drug.

If the drug you have been given unfortunately makes you feel worse then you must tell your doctor and ask him to change it. If you have taken your medication for several weeks and it has not made you feel any better then consult your doctor as you may need a stronger dose or an alternative drug. These drugs do work gently and improvement is gradual so try not to be impatient.

Many women find that their depression becomes much worse just before, or during, a period. If this is so, you can ask your doctor to consider progesterone therapy to help prevent this severe form of pre-menstrual tension.

It is important to maintain a good diet, sometimes Vitamin B6 or a general vitamin supplement may be given.

It is very beneficial for a woman who has postnatal depression to talk about her illness and its symptoms. Close relations and friends should try to be sympathetic even if they feel bored with these conversations. Often just talking to the doctor (if he is sympathetic) can be a great relief.

When you find a drug that helps you, do not try and persuade your medical advisor to cut the length of the treatment short. You may find when you take drugs that you improve quickly but remember that depression is an illness and give yourself plenty of time to make a full recovery.

If your symptoms should return after you have stopped taking your medication, do not despair, do tell your doctor of your relapse. He will probably put you back onto your previous medication. When you feel better again, ask your doctor if you can cut down the pills down over a period of time, as this often helps prevent a recurrence of symptoms.

COUNSELLING : Professional counselling can be very beneficial if you are depressed. Some health visitors offer counselling on a weekly basis, otherwise you may need to ask your G.P. to arrange for you to see a counsellor. If your depression is mild, counselling alone may help to lift it. If you are given drug treatment for depression you can still ask for counselling as well as the drugs. Whilst counselling is a very valuable treatment for depressed mothers regrettably in some places counsellors are not available.

Cognitive therapy is a very helpful form of therapy to hasten a recovery from depression. It has the added advantage that it teaches the mother coping skills which may be of use after she has recovered. Cognitive therapy helps mothers change many of the negative feelings that they may have towards themselves and others.

SELF HELP : The most important thing you can do for yourself is believe that you will get better. You must have a great deal of patience and realise that recovery will take time.

Try to remember that the aches and pains which affect so many mothers during postnatal depression are not the signs of a serious or fatal illness. Many mothers think their headaches signify brain tumours or the pain and tightness in their chest is due to a heart condition. These pains are very common symptoms of depression and worrying about them makes the depression worse, so do try to relax and forget about the pain and you will find that as the depression lifts the pain quickly will fade away.

Take as much rest as you can. This is very important as tiredness seems to make the depression worse. If you can, try and get a rest on your bed, every day, and sleep if possible. Avoid late nights if you can, and try to get someone else to feed the baby at night. Some doctors believe that rest, peace and quiet, after the birth can help to prevent postnatal depression, so rest must play an important part in your convalescence.

Do not go on a strict diet or go for long periods without food. Hypoglycaemia - low blood sugar - can make things worse for a depressed mother. If you need to diet, cut down on sweet and starchy foods and eat plenty of fruit and raw vegetables when you are hungry.

Most mothers benefit from taking a multi mineral supplement tablet once a day.

Do not force yourself to do things which you do not really want to do or which upset you. Treat yourself with a little kindness, and be occupied doing things which do not cause you anxiety.

Now back to chronic depression... more detailed perspective.

Chronic Depression
What is it?
Depression is a strong feeling of sadness. Many people experience depression in response to a loss or sad event. In these cases, an episode of depression usually lasts for six to nine months. However, when depression lasts longer, and the depressive symptoms go away for a short time only to return again, it is termed chronic depression. While everyone experiences sadness at one time or another, these feelings are generally temporary. Chronic depression is long-lasting, interferes with daily activities, and causes a loss of interest in things that were normally pleasurable to the patient.

Who gets it?
People who have a family history of anxiety, depression, or bipolar disorder; are always anxious; or have an alcohol or drug abuse problem are more likely to develop depression. Women are twice as likely as men to experience depression.

What causes it?
While depression is frequently a response to a sad or traumatic event, the cause of chronic depression is often not known. Factors that are known to contribute to depression are heredity, a chemical imbalance in the brain, and significant levels of stress. Heredity refers to the fact that people who have family members with any type of depressive disorder are more likely to also experience depression. Studies of brain functioning have revealed a complex system of neurotransmitters that produce chemicals that transfer signals from nerve cell to nerve cell. Some of these neurotransmitters, such as serotonin, are responsible for feelings of well-being. Drugs that correct neurotransmitter imbalances are very effective in treating depression, which supports the theory that there is some type of chemical imbalance that triggers depression. Chronic depression can occur when stresses in a person's environment become overwhelming, such as years of childhood abuse and neglect. It can also be caused by chronic illness, such as AIDS, Parkinson's disease, chronic fatigue syndrome, certain chronic cardiac conditions, and hormonal disorders.

What are the symptoms?
The symptoms of chronic depression may come and go, with periods of depression alternating with periods of no symptoms at all. Chronic depression usually begins gradually, with vague feelings of sadness that gradually build in intensity. The individual may begin to have difficulty sleeping, or want to sleep more than usual. He or she may experience changes in eating habits, feelings of hopelessness, low self-esteem, low energy levels, restlessness, loss of interest in normal activities, decreased sex drive, feelings of guilt for no reason, difficulty maintaining relationships, and difficulty concentrating. In severe cases, the individual may have thoughts of death, or may attempt suicide. People with chronic depression have at least two of these symptoms for a period of two years or more. People with chronic depression are generally gloomy and extremely critical of themselves and others. They are usually seen as extremely negative people, who seem to expect failure and take no pleasure in anything.

How is it diagnosed?
Doctors diagnose chronic depression by common signs and symptoms. If you are seeing your family doctor, he or she will refer you to a psychiatrist or psychologist, who specializes in mental health. This doctor will ask you questions about your physical health, home and work environments, and any experiences that would affect how you feel about yourself and others. The doctor might use a special questionnaire that helps diagnose depression. The doctor will also ask about any drug or alcohol abuse, or physical illness that could cause depression. If you are a woman and your doctor suspects a hormonal disorder, he or she may order blood tests to make a diagnosis.

What is the treatment?
Chronic depression is commonly treated with a combination of drug and psychotherapy. Drugs are used to treat the symptoms of sadness and to correct any chemical imbalances in the brain that contribute to depression. Therapy helps to resolve any personal issues that may have caused the depression. There are many different types of antidepressants and it is helpful to have a basic understanding of each type. One group of antidepressants is called selective serotonin reuptake inhibitors (SSRIs). Drugs classified as SSRIs include fluoxetine and sertraline. These drugs are very effective in treating chronic depression because they increase serotonin levels, which contributes to a feeling of well-being. Any side effects, such as headache, anxiety, diarrhea, sweating, difficulty concentrating, nausea, reduced sex drive, and difficulty sleeping, are generally milder than with other types of antidepressants.

Another type of drug sometimes used to treat chronic depression is a tricyclic antidepressant (TCA), such as amitriptyline, imipramine, and nortriptyline. However, these are not used quite as often because they have the possibility of more severe side effects, including persistent dry mouth, sedation, dizziness, and irregular heart rhythms. You may also have heard of a class of antidepressants called monoamine oxidase inhibitors (MAOIs). These include anylcypromine and phenelzine. MAOIs are so named because they block, or inhibit, the action of the enzyme monoamine oxidase in the central nervous system. However, they can cause severe and life-threatening side effects if combined with certain other drugs or foods. These include foods that are high in tyramine (such as soy sauce, beer on tap, red wines, and aged cheeses and meats), some over-the-counter cough and cold medicines, and both trycyclic and SSRI antidepressants. The combination of an MAOI and any of these causes a sudden and severe rise in blood pressure. People taking MAOIs must be aware of any food or drug interactions. One final category of antidepressant is the heterocyclics. These include bupropion and trazodone. However, bupropion is not given to patients with a seizure disorder. Tazodone can cause sedation, so it is often effective in treating patients with insomnia.

You and your doctor can decide which medication is best for you by reviewing your medical history and evaluating the risks of negative side effects. It may take anywhere from two to six weeks for you to feel the effects of an antidepressant. Antidepressants are not addictive. And, unless you are severely depressed, at risk for suicide, or unable to take care of yourself, hospitalization is generally not needed during treatment.

Just like there are different types of antidepressants, there are also different types of psychotherapy. Your doctor will help decide which is best for you, but all types focus on exploring what life experiences may have contributed to your current feelings. The therapist will help you develop special skills to cope with your problems. Electroconvulsive therapy (ECT, or shock therapy) is only used in cases of severe or chronic depression where medication and psychotherapy have not worked, the patient is dangerously suicidal, or refusing to eat. While the patient is under general anesthesia, electrodes are placed on the head and an electric current is applied, through the electrodes, to create a small, controlled seizure in the brain. The seizure appears to "interrupt" the electrochemical processes in the brain that can cause depression and provides immediate relief. This procedure can cause temporary memory loss, headaches, muscle soreness, and confusion right after the treatment.

Self-care tips
Many people with chronic depression do not seek treatment because they don't want people to know they have a mental illness. However, with proper treatment, people with chronic depression can lead full, productive lives. If you suffer from chronic depression, see a doctor. He or she can help create a treatment plan that will help you feel the way you want to. If your doctor recommends an antidepressant, take the recommended dose at around the same time each day. Even if you are feeling great, do not stop taking your medication or skip a dose without your doctor's permission. Antidepressants need to be reduced gradually to prevent side effects. It is also important to work with a therapist or support group to get help with any problems that are contributing to your depression. They can help you develop a positive attitude and a new way of looking at life and your problems. Recognizing your symptoms and taking control of them is an important step in becoming healthy again. And, never forget that what you eat, the amount of sleep you get, and how much you exercise all contribute to how good you feel. If you or someone you know has thoughts of suicide, call your doctor or therapist immediately. Also call your doctor if you have any negative side effects from an antidepressant.

Raffee.. thaaaaaaaanx so very much.. very very beneficial :)

Very interesting raff, keep them coming dear...
I really admire you for being so strong...
Depressed people don't usually admit that they have a problem, and so once you get through this huge stone in front of you, which is admitting that you have a problem then the rest should be ok, and the chances of getting over this is higher...