Depression and Other Mood Disorders

General Information:

Mood Disorders of some type, including true Depression, are common within the general population and serve as a leading cause for visits to Physicians. These conditions are very treatable. A person's mood is strongly connected to every aspect of their social functioning, thinking and physical state and is influenced, and can influence, each of these parts. What is difficult for many people is determining how severe the mood problems might be, apart from what it feels like, and how to know when to ask for help. As with other mental and emotional conditions good criteria to consider are:

• Does the condition cause you problems with normal sleep?
• Does the condition cause you to have a loss of normal energy and ability to do things?
• Is there a significant change to your appetite and other body functions?
• How much has the condition reduced your ability to function in your normal daily roles?
• Have others close to you noticed and commented on changes in you?

Clinical Symptoms:

As with other mental and emotional conditions a self-diagnosis is not very reliable, although your self-report is essential to properly diagnose and treat the condition. If the mood condition is severe enough that you are not functioning normally after a short while then you should be arranging for professional health assistance.

Mood disturbances are very interconnected with the body-mind-emotion-social spheres and a problem with mood can show itself in each of these areas. Often people with a mood disturbance are not able to concentrate properly, may become very pessimistic, have changes to body functioning including poor appetites, have reduced energy and may withdraw socially.

• Feeling a very depressed mood most of the day, nearly every day for the past two weeks and this being a significant change from normal functioning.
  
• Reduced interest or pleasure in all, or almost all activities of the day, nearly every day.
  
• Significant changes to body weight and appetite
  
• Insomnia or hypersomnia (sleeping too much) nearly every day.
  
• Agitation or very slowed down nearly every day
  
• Fatigue or loss of energy nearly every day.
  
• Feelings of worthlessness, or excessive or inappropriate guilt nearly every day.
  
• Reduced ability to think or concentrate, or make decisions.
  

• Feeling a depressed mood for most of the day, for more days than not in the last two years
  
• While depressed, two or more of the following:
  
  -  Poor appetite or over-eating
  
  -  Insomnia or hypersomnia
  
  -  Low energy or fatigue
  
  -  Poorer concentration or difficulty in making decisions
  
  -  Feelings of hopelessness
  

Other Mood Disorders:

There are many other forms of mood disorder that include those that are caused by short or longer term drug and alcohol use - consistent use of marijuana is an example of one of these for some people. This is usually thought of as a Substance-Induced Depressive Disorder and it may not be enough just to quit using the alcohol or drugs. Seeking a professional mental health opinion and guidance can be important with this condition.

Other mood disorders may occur from hormonal changes through the menstrual cycle or after childbirth. The clinical symptoms of such mood disorders are the same as those described for Depression and Dysthymia and can be serious forms of the mood disorder. These conditions are known as Premenstrual Dysphoric Disorder and Post-partum Depression. Both conditions, especially depression following childbirth, require a consultation with a Physician, Mental Health Clinician or with the Public Health Nurse.

Another form of mood disorder is that which comes about because of the presence of one or more major stressful conditions in the person's life. This is generally known as an Adjustment Disorder and information about this condition is listed under the Stress Reactions heading.

What Helps:

• Because depressive illnesses are quite complex and can be caused by a variety of sources, it is always a good decision to discuss your condition with your Physician. A very important first step in dealing with depression is to properly diagnose the type, cause and severity of the condition. From this starting point, most other issues such as medication use, coping, counselling and so on will be determined.

• Although the term "depression" is used quite loosely to describe everything from general upset, to feeling down, to feeling true major depression; the fact, that someone is using the term to describe their emotional state certainly indicates that something is not right for them. Whether they will benefit from outside professional help is a matter of personal choice and should be based on the degree to which normal functioning has been impaired. As referred to in the section under General Information, good guidelines for considering this are to think of whether sleep is changed, changes to energy, changes to appetite and other body functions, your ability to work, parent and carry out normal daily tasks, and whether others who know you have commented on changes they have seen in you.

• When depressed, most people benefit from use of antidepressant medications. In the worst stages of the illness, the acute phase, people tend not to have all the tools that they need to help themselves and need to have their coping strengths supplemented by medication. Modern antidepressant medications, when managed and taken well, are extremely helpful and have a high rate of success for improving mood and treating other symptoms associated with being depressed. Alternative herbal remedies, such as St. John's Wort, have been shown to have some effectiveness for some people but only with limited forms of a mood disorder. As with self-diagnosis, it is unreliable to treat yourself without the benefit of a careful consultation with a professional health practitioner.

• However, many people have come to believe that medication use alone is not enough and that a certain form of personal counselling together with medication use if the most effective form of treating depression and preventing reoccurrence in the future. It is often said that stressful events themselves do not cause us to be depressed or distressed, but it is our beliefs and attitudes about these events that lead us to experience difficulties. Counselling for depression helps to identify both stressful conditions in your life and attitudes that you may want to change to in order to improve a depressive condition.

• Therefore, what generally helps the most for people with depressive conditions that do not resolve by themselves is a well-managed course of medication used together with specific changes in life circumstances and changes to beliefs and attitudes.

What Doesn't Help:

• Is to suffer in silence and let the course of a depression worsen over time. Symptoms will usually become more severe and normal functioning will deteriorate. This will create its own set of secondary problems in the form of relationship problems with family and friends, employment difficulties and physical health. When a state of feeling depressed just doesn't go away and it interferes with how you normally function, it's probably time to ask for help.

 Additional Internet Resources:

• The Mood Disorders Association of Manitoba
• The National Institute of Mental Health (For the Public)