While not everyone’s experience is the same, when people have a major depressive episode, generally the world looks, feels, and is understood completely differently than before and after the episode. During a major depressive episode, the world can literally seem like a dark place. What was beautiful may look ugly, flat, or even sinister. The depressed person may believe loved ones, even their own children, are better off without them. Nothing seems comforting, pleasurable, or worth living for. There’s no apparent hope for things ever feeling better, and history is rewritten and experienced as confirmation that everything has always been miserable, and always will be. Depression symptoms can be easily mistaken for bipolar disorder because of similar symptoms like difficulty concentrating, mood disorders, experiencing suicidal thoughts, weight gain, trouble sleeping, having suicide thoughts, medical illnesses, and many other physical symptoms.
When this reality shift happens, it’s difficult to remember or believe what seemed normal before the episode. What the person believes during the episode seems absolutely real, and anything that conflicts with it is as unbelievable as memory or message telling him or her that the sky is purple. For example, if the person is unable to feel love for a spouse, and someone reminds the person that he or she used to feel that love, the person may firmly believe he or she had been pretending to himself/herself and others—though at the time he or she really felt it. The person can’t remember feeling the love, and can’t feel it during the episode, and thus concludes he or she never felt it. The same process happens with happiness and pleasure. Attempts to tell the person that he or she used to be happy, and will feel happy again, can cause the person to feel more misunderstood and isolated because he or she is convinced it’s not true.
What was challenging feels overwhelming; what was sad feels unbearable; what felt joyful feels pleasureless.
Even if nothing was wrong before the episode, everything seems wrong when it descends. Suddenly, no one seems loving or lovable. Everything is irritating. Work is boring and unbearable. Any activity takes many times more effort as if every movement requires displacing quicksand to make it. What was challenging feels overwhelming; what was sad feels unbearable; what felt joyful feels pleasureless—or, at best, a fleeting drop of pleasure in an ocean of pain.
Major depression feels like intense pain that can’t be identified in any particular part of the body. The most (normally) pleasant and comforting touch can feel painful to the point of tears. People seem far away—on the other side of a glass bubble. No one seems to understand or care, and people seem insincere. Depression is utterly isolating.
There is a terrible shame about the actions depression dictates, such as not accomplishing anything or snapping at people. Everything seems meaningless, including previous accomplishments and what had given life meaning. Anything that had given the person a sense of value or self-esteem vanishes. These assets or accomplishments no longer matter, no longer seem genuine, or are overshadowed by negative self-images. Anything that ever caused the person to feel shame, guilt, or regret grows to take up most of his or her psychic space. That and being in this state causes the person to feel irredeemably unlovable, and sure everyone has abandoned or will abandon him or her.
It’s difficult to describe all of this in a way that someone who’s never experienced it can make sense of it. I can’t emphasize enough that when this happens, what I am describing is absolutely the depressed person’s reality. When people try to get the person to look on the bright side, be grateful, change his or her thoughts, or meditate, or they minimize or try to disprove the person’s reality, they are very unlikely to succeed. Instead, they and the depressed person are likely to feel frustrated and alienated from one another. I do believe cognitive therapy has an important place, but generally not in the throes of a major depressive episode.
Support for people with depression
So what does a person whose reality has shifted in this way need? Please keep in mind that I am talking about a major depressive episode—a severe depression that has lasted more than two weeks. I would take a different approach for someone with milder depression, or one that is a response to a terrible loss.
For some people with major depression, psychotropic medication works and is the only thing that works. The same could be said for electroshock treatment, though it’s not for everyone. Many people will emerge from major depression in time, though episodes seem to make more episodes more likely, so if the medication works to end the episode, it’s usually prudent to take it. Nutrition, acupuncture, and other body-based treatments, as well as therapy, can help without the side effects of medication. Any depression treatment is meant to reduce symptoms, there are also support groups that health care providers can suggest to the patients. Brain imaging is one method used to diagnose severely depressed patients on top of the physical exam that is usually done. Patients who experience depression and have severe symptoms of mental disorders are often diagnosed with suicidal thoughts.
National suicide prevention lifeline often looks for people suffering from a severe form of mood disorder and prescribe antidepressant medications to them they also start them with family therapy sessions to help reduce any mental health problem that might trigger depression.
What the family members can do to improve mental health
Loved ones can gently hold and show love and commitment to the depressed person, try not to take on the person’s reality, but also not argue with him or her about it. They can also gently remind the person that depression causes his or her perspective on everything to change, and he or she is unable to think outside of depression mode at the moment. It is a time for the person to avoid making decisions, or avoid doing anything significant that requires a nondepressed perspective. If this is a repeated experience for this person, it can be helpful to discuss all of this between episodes so he or she is more prepared when caught in the quicksand.
How to avoid severe depression
A person who has had a major depressive episode is still more vulnerable to another one, so it’s important not to ignore all the risk factors listed above. On a more personal level, people with a history of depression need to avoid excess alcohol and drugs of any kind, including marijuana. Exercise is vital for everyone—it does more than just help the body; it’s one of the best antidepressants there is. We all need to get regular, good-quality sleep and develop a support system—a few people we can count on who won’t minimize our experience or tell us to just snap out of it. Finally, we need to be patient with ourselves, allow ourselves to experience whatever feelings are present, and take it easy for a while.
The best way to combat depression is to take care of ourselves in all these ways that foster health mentally, emotionally, spiritually, and physically—and recognize when we need support beyond our own coping skills.
What is a major depressive disorder?
A major depressive disorder is a mental illness that causes long-term, low moods and negative thinking. These symptoms can interfere with your ability to work, sleep, eat and enjoy life. A person with a major depressive disorder may feel like they are in a black hole with no way out. What are the risk factors for developing a major depressive disorder?
A major depressive disorder can affect anyone at any age. It is estimated that more than 19 million Americans suffer from a major depressive disorder in a given year (National Institute of Mental Health, 2010). There is no clear cause for a major depressive disorder but there are risk factors: biological factors such as genes and chemical imbalances in the brain; major life events such as losing a job or learning of the loss of a loved one; substance abuse which can lead to depression; and family history. How is a major depressive disorder diagnosed?
People with the major depressive disorder may “mask” their symptoms, meaning they appear normal much of the time because they do not want to talk about their feelings or they feel like there is no one who will understand. This can make it difficult to diagnose. A doctor may ask about a person’s symptoms, personal and family medical history, and any medications he or she is taking. What are the treatment options for major depressive disorder?
There are many treatment options for major depressive disorder, including medication, therapy, stress management techniques, and lifestyle changes. Persistent depressive disorder s mostly common in women taking birth control pills and can lead to serious medical illness.
The American psychiatric association determines the type of antidepressant medication for patients with mental health problems any patient with heart disease. It is important to note that prescribed medications
What is a seasonal affective disorder?
Thus is a medical condition that can cause suicide attempts mostly in young people have common symptoms of the condition include weight loss, reduced physical activity, and some report low self-esteem and irregular sleeping patterns. Other symptoms include mood swings and always being in a state of depressed mood. These depressive symptoms can lead to the victims trying to attempt suicide, research suggests that a person understanding depression can avoid any self-harm. The national institute of mental health has a toll-free number that ensures that the victims are able to find a perfect mental health care professional. The depression affects also the veterans’ crisis line and many reports that symptoms began after deployment.
Electroconvulsive therapy is also used to help with severe cases of major depression, and it is also the last resort for pregnant women who can’t take antidepressants and show symptoms of depression.
What should you do if you think you may have a major depressive disorder?
If you think you may have a major depressive disorder, see your doctor. He or she will ask about your symptoms and conduct a physical exam to make sure there is no underlying medical condition causing your mood swings. He or she may also refer you to a mental health professional for diagnosis and treatment.
A seasonal affective disorder is a type of depression that occurs during a specific season, most often winter. Symptoms include low mood, fatigue, decreased interest in activities, social withdrawal, and problems with concentration and memory. What are the risk factors for developing a seasonal affective disorder?
There is no clear cause for the seasonal affective disorder but there are risk factors, including living at higher latitudes which often correspond with darker winter months; frequent changes of season, such as in the southern United States where fall and spring are shorter than the summer and winter seasons; family history or personal history of major depression or bipolar disorder; and some psychiatric medications. How is a seasonal affective disorder diagnosed?
A seasonally affective disorder is diagnosed after a mental health professional talks with the person about their symptoms, thoughts and feelings. What are the treatment options for seasonal affective disorder?
Some people benefit from light therapy, which involves sitting in front of a special box that emits bright light (which can be provided by an outdoor lamp during winter months) for a certain amount of time each day. A lightbox emits 10,000 lux of light (a typical reading lamp emits 500-1,500 lux) and is used for 30 minutes to an hour per day. Other treatment options for the seasonal affective disorder may include various forms of psychotherapy such as cognitive behavior therapy and interpersonal therapy; medication including antidepressants and antianxiety medications; and lifestyle changes such as exercise, healthy diet, and sleep schedule.
How can I help a friend or family member who is experiencing a major depressive disorder?
Listen to their symptoms without judgment. Let them know you are there to listen and offer support. Let them talk about their feelings without interrupting. Avoid giving advice or telling them what to do. Encourage them to seek professional help. Offer to go with them to their first appointment with the doctor or therapist.
How can I help a friend or family member who is experiencing a seasonal affective disorder?
Listen to their symptoms without judgment. Let them know you are there to listen and offer support. Avoid giving advice or telling them what to do. Encourage them to seek professional help. Offer to go with them to their first appointment with the doctor or therapist.
