Kelly Hill, M.A.  Psychotherapist - 303-834-0394        lifeempowermentcenter1@gmail.com.com
Not all people with depression will show all symptoms or have them to the same degree. These are just a few of the signs to be aware of. If you or someone you love is experiencing multiple indicators, please seek assistance.  Depression is not your fault and you are not alone.
 
 In adults it is common to see:

  • Persistent sad or "empty" mood.
  • Feeling hopeless, helpless, worthless, pessimistic and/or guilty.
  • Substance abuse.
  • Fatigue or loss of interest in ordinary activities, including sex.
  • Disturbances in eating and sleeping patterns.
  • Irritability, increased crying, anxiety or panic attacks.
  • Difficulty concentrating, remembering or making decisions.
  • Thoughts of suicide; suicide plans or attempts.
  • Persistent physical symptoms or pains that do not respond to treatment.
  • Feeling easily overwhelmed
  • Feeling overly sensitive

In adolescents depressive illnesses/anxiety may be disguised as, or presented as, eating disorders, drug/alcohol abuse or addiction, sexual promiscuity, careless or reckless behavior (driving dangerously, having unprotected sex with multiple partners), failure to care about appearance/hygiene, no sense of self or of values/morals, difficulty cultivating relationships, inability to establish/stick with occupational/educational goals.  Other things to look for:

  • Physical symptoms such as dizziness, headaches, stomachaches,  (ruling out other medical causes)
  • Persistent unhappiness, negativity, irritability.
  • Uncontrollable anger or outbursts of rage.
  • Overly self-critical, unwarranted guilt, low self-esteem.
  • Inability to concentrate or make decisions, possibly resulting in refusal to study in school.
  • Slowed or hesitant speech or body movements, or restlessness (anxiety).
  • Loss of interest in once pleasurable activities.
  • Low energy, chronic fatigue, sluggishness.
  • Change in appetite, noticeable weight loss or weight gain, or abnormal eating patterns.
  • Chronic worry, excessive fear.
  • Preoccupation with death themes in literature, music, drawings, speaking of death repeatedly, fascination with guns/knives.
  • Suicidal thoughts, plans, or attempts.

Many people feel that it is "normal" for elderly persons to be depressed. This is a dangerous misconception. Signs and risk factors include:

  • Unusual complaints of aches and pains, extreme fatigue, slowed movements and speech, loss of appetite, inability to sleep, weight increase or    decrease, anxiety, panic attacks, fear of being alone.
  • Inability to concentrate, overall sadness or apathy, withdrawal; inability to find pleasure in anything.
  • Irritability, mood swings or constant complaining; nothing seems to make the person happy.
  • Talk of worthlessness, not being needed anymore, excessive and unwarranted guilt.
  • giving away possessions, talking about and preparing for death
  • Recent loss of a spouse or loved one
  • Frequent doctor visits without relief in symptoms
  • Alcoholism (which can mask an underlying depression).
  • Decreased need for sleep.
  • Restless, agitated, can't sit still.
  • Poor judgment, impulsiveness, spending sprees
  • Embarrassing social behavior.
  • Paranoia, delusions, hallucinations (sometimes mistaken for dementia)

Causes of Depression:
(the remainder of this page is copied from webmed.com)

Have you ever wondered what causes clinical depression? Perhaps you have been diagnosed with major depression, and that's made you question why some people get depressed while others don't.  Depression is an extremely complex disease. It occurs for a variety of reasons. Some people experience depression during a serious medical illness. Others may have depression with life changes such as a move or the death of a loved one. Still others have a family history of depression. Those who do may experience depression and feel overwhelmed with sadness and loneliness for no known reason.

  • Abuse. Past physical, sexual, or emotional abuse can cause depression later in life.
  • Certain medications. For example, some drugs used to treat high blood pressure, such as beta-blockers or reserpine, can increase your risk of depression.
  • Conflict. Depression may result from personal conflicts or disputes with family members or friends.
  • Death or a loss. Sadness or grief from the death or loss of a loved one, though natural, can also increase the risk of depression.
  • Genetics. A family history of depression may increase the risk. It's thought that depression is passed genetically from one generation to the next. The exact way this happens, though, is not known.
  • Major events. Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring.
  • Other personal problems. Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression.
  • Serious illnesses. Sometimes depression co-exists with a major illness or is a reaction to the illness.
  • Substance abuse. Nearly 30% of people with substance abuse problems also have major or clinical depression.

How Is Biology Related to Depression?
Researchers have noted differences in the brains of people who are depressed as compared to people who are not. For instance, the hippocampus, a small part of the brain that is vital to the storage of memories, appears to be smaller in people with a history of depression than in those who've never been depressed. A smaller hippocampus has fewer serotonin receptors. Serotonin is a calming brain chemical known as a neurotransmitter that allows communication between nerves in the brain and the body. It's also thought that the neurotransmitter norepinephrine may be involved in depression.

Scientists do not know why the hippocampus is smaller in those with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or poisonous effect on the hippocampus. Some experts theorize that depressed people are simply born with a smaller hippocampus and are therefore inclined to suffer from depression.

One thing is certain -- depression is a complex illness with many contributing factors. The latest scans and studies of brain chemistry that show the effects of antidepressants help broaden our understanding of the biochemical processes involved in depression. As scientists gain a better understanding of the cause(s) of depression, health professionals will be able to make better "tailored" diagnoses and, in turn, prescribe more effective treatment plans.

How Is Genetics Linked to the Risk of Depression?
We know that depression seems to run in families. This suggests that there's a genetic link to depression. Children, siblings, and parents of people with severe depression are much more likely to suffer from depression than are members of the general population. Multiple genes interacting with one another in special ways probably contribute to the various types of depression that run in families. Yet despite all the evidence of a family link to depression, scientists still have not been able to identify a "depression" gene.

Can Certain Drugs Cause Depression
In certain people, drugs may lead to depression. For example, medications such as barbiturates, benzodiazepines, and beta-blockers have been associated with depression, especially in older people. Likewise, medications such as corticosteroids, opioids (codeine, morphine), and anticholinergics taken to relieve stomach cramping have been found to cause mania, which is a highly elated state associated with bipolar disorder. 


What’s the Link Between Depression and Chronic Illness?
In some people, a chronic illness causes depression. A chronic illness is an illness that lasts for a very long time and usually cannot be cured completely. However, chronic illnesses can often be controlled through diet, exercise, lifestyle habits, and certain medications. Some examples of chronic illnesses that may cause depression are diabetes, heart disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis (MS). Hypothyroidism may also lead to depressed feelings.Researchers believe that treating the depression may also help the co-existing illness improve.
 
Is Depression Linked to Chronic Pain?
When pain lingers for weeks to months, it's referred to as being "chronic." Not only does chronic pain hurt, it also disturbs your sleep, your ability to exercise and be active, your relationships, and your productivity at work. Can you see how chronic pain may also leave you feeling sad, isolated, and depressed?

There is help for chronic pain and depression. A multifaceted program of medicine, psychotherapy, support groups, and more can help you manage your pain, ease your depression, and get your life back on track.

Does Depression Often Occur With Grief?
Grief is a common response to loss. Losses that may lead to grief include the death or separation of a loved one, loss of a job, death or loss of a beloved pet, or any number of other changes in life, such as divorce, becoming an "empty nester," or retirement. Anyone can experience grief and loss, but not everyone will experience depression. Each person is unique in how he or she copes with these feelings.

Depression Treatment Options
Once you have a depression diagnosis, your doctor will discuss the different depression treatment options with you. The kind of depression treatment that's best for you depends on the type of depression you have. For example, some patients with clinical depression are treated with psychotherapy, and some are prescribed antidepressants. Others are prescribed antidepressants and psychotherapy. 

Whatever depression treatment your doctor prescribes, it's important to understand that there are no "instant" solutions. You may have to try different antidepressants to find the most effective drug for you. In addition, you'll have to take the antidepressant for several weeks to see if it benefits you at all. Being patient is important. Trust your doctor to know your personal history. With that, he or she can find the best depression treatment options that help improve your mood.

What Are Depression Drugs?
Depression drugs can help lift your mood and ease the sadness and hopelessness you feel. You'll need to work with your doctor to find the depression medicine that is most effective with the fewest side effects.

How Do Antidepressants Work?
It's thought that three chemical messengers are involved with depression. The three are norepinephrine, serotonin, and dopamine, which are neurotransmitters. Neurotransmitters transmit electrical signals between brain cells.

Researchers have found a link between chemical imbalance in these brain chemicals and depression. Antidepressant medications increase the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers. It is believed that modifying these brain chemicals can help improve mood, although the exact ways they work is still unclear.

Take the Beck Depression Inventory: 
 

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