Here's the stunning stat of the day: About 15 percent of us have clinically significant depression at some time in our lives. Depression, particularly as we get older, can be especially confusing to diagnose. For one thing, it shares many symptoms and is often diagnosed in tandem with anxiety. For another, depression is often associated with dementia and other physical illnesses. Depression is associated with increased physician office and emergency room visits, increased drug use, and high costs of health care. Plus, depressed mood may be the first symptom of a number of medical conditions including stroke, diabetes, cancer, hypothyroidism, heart failure, and other heart diseases. Depressing, isn't it? Depression is reported to be more prevalent among women, but that may be because women are more often classified as depressed, while men are classified as alcoholics (that's because men are more likely to self-medicate their blues with the bottle). So, although the prevalence of diagnosed depression is higher in women across all age groups, this may be an artifact of how depression is defined and symptoms are elicited (men are more likely to present with anger, irritability, withdrawal or apathy, and alcohol abuse, and less likely to acknowledge sadness or psychological symptoms). The truth is that depression is a lot like hot saucethere are all different kinds and nuances, but they can be dangerous just the same. There's postpartum depression, which 10 to 15 percent of recent mothers experience. There's seasonal affective disorder, which is brought on by lack of exposure to sunlight--most notably in northern climates during the winter (although some people have the reverse patterna summer depression with improvement in the winter). There's depression brought on by medications, ranging from steroids to narcotics to alcohol to sleeping pills, which suppress dopamine and serotonin, mimicking the chemical reactions that cause depression.
Generally, depression is classified in three categories:
Major depression: This is a major depressive episode longer than two weeks with at least five of the seven following symptoms:
- sleep alteration
- decreased interest in activities
- feelings of guilt
- decreased energy
- difficulty concentrating
- alteration in appetite
- thoughts of suicide
Situational depression: Greater than two months with the above symptoms after suffering a significant life change, such as bereavement or retirement. Significantly, your symptoms improve with time after the major event, so most therapists feel that your long-term functioning is better if you can manage to get through this without drugs.
Vascular depression: Depression that commonly occurs after a brain or blood-vessel disorder, such as a stroke, or after a heart attack or heart surgery. Patients with lesions in the left hemisphere of the brain, especially of the left prefrontal cortex, tend to have increased frequency and severity of depression. The greatest risk period of depression following a stroke appears to be the first two years afterward, peaking within the first three to six months.