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Depression and Anxiety: Help and Treatment

A Practical Guide to Feeling Good

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Why diagnosing depression is so important

One of the most difficult aspects of properly treating depression is getting properly diagnosed. Most people suffer for a long time before they even consider getting help.

The negative stigma surrounding mental disorders causes as much harm as the illnesses themselves, resulting in unnecessary guilt, shame, and embarrassment.

Unfortunately, sometimes those close to us are not educated about mental disorders, and they unknowingly make things worse by telling you that what you are going through is somehow your fault, or that you would feel better if you would just_______.

Getting an official diagnosis of depression

In order for a doctor to make an official diagnosis of major depressive disorder, the clinical term for depression, certain conditions need to be met.

Doctors rely on the Diagnostic and Statistical Manual for Mental Disorders version IV, or DSM-IV, to diagnose depression. If you want to take a look at the official version, see the page on DSM-IV criteria for diagnosing a  major depressive episode and major depressive disorder.

If you don’t want to wade through all that technical language, and I certainly don’t blame you for taking a pass, I’ll give you the gist of it in plain English.

The main symptoms of depression

The two major symptoms are depressed mood and loss of interest or pleasure.

Depressed Mood

There are many ways to describe this, such as feeling sad, blue, glum, down, melancholy, under the weather, etc. They all mean the same thing: you feel terrible.

You may or may not have a good reason to feel down. If you’ve been feeling this way for at least two weeks, you might be experiencing a major depressive episode, which means that you should be concerned.

If it goes on for at least two months, you probably have major depressive disorder, and you need to consider seeing a doctor. And when I say “consider seeing a doctor”, that’s just a polite way of saying get your ass to the doctor ASAP.

You don’t have to wait two months just to be sure. If you know that something is wrong, don’t hesitate to get checked out.

Loss of interest or pleasure

Not everyone who is depressed will feel sad. Sometimes depression just makes life seem boring or dull. You might lose interest in going out with your friends, or you might not have the motivation to work.

You just don’t get the same enjoyment you used to from certain activities. Nothing seems interesting anymore.

This is a very serious sign, because living without having interest in things or not gaining pleasure from activities becomes hard to bear.

People are motivated to avoid pain and to seek pleasure. When you can no longer feel pleasure, you are left with trying to avoid pain. That’s no way to live.

What if I have a good reason for feeling depressed?

There are certainly many situations where you might feel depressed for two weeks or longer. Experiencing the loss of a loved one, the breakup of a relationship, or dealing with chronic stress are all good reasons for why you might feel depressed for a period of time.

But if you’ve been feeling down for two months, you are probably not coping with the situation in a healthy way.

Some people are more sensitive to stress, and it isn’t because they are weak. There are biological reasons why Peter might bounce back from a difficult situation in a few weeks, but Paul will end up getting depressed.

That’s why these symptoms need to be accompanied by at least four others, at least according to the DSM-IV.

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Other symptoms of depression

Depression doesn’t only affect your mood and your ability to feel pleasure. It also affects four aspects of your life that are fundamental to health: sleep, appetite, energy, and thinking.

Once you start to experience problems in any of these areas, you know that your depression is becoming an illness, not just a passing mood.

Without proper sleep, appetite, energy, and positive thinking, your physical health and your self-esteem start going downhill fast.

If you start to notice any of these symptoms, go directly to the doctor’s office. Do not pass Go. Do not collect $200.

Sleep

Not getting a good night’s rest affects your energy and your ability to think clearly. You might respond to bad night’s rest by drinking coffee, colas, Red Bull, or by taking other stimulating drugs such as methamphetamine or cocaine.

That might work in the short term, but over time it will deeply exhaust your energy reserves. Even though you are exhausted, you still might have trouble falling asleep and staying asleep. Caffeine has that affect on some people.

As your ability to get a good night’s rest deteriorates, the idea of getting eight hours of sleep becomes a fantasy–wishful thinking at best.

This can set up a vicious cycle of daytime drowsiness and nighttime insomnia that leaves you feeling like a zombie–a cranky, irritable zombie that can’t concentrate too well.

Problems with sleep are serious. Whether you sleep too much or too little, it’ll have a negative impact on your ability to function.

Don’t poo-poo sleep problems. They are a really good sign that you are having a major depressive episode.

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Appetite

Like problems with sleep, changes to your appetite will affect every other aspect of your life. Whether your appetite shrinks or grows, it will seriously mess with your energy levels and undermine your health.

It’s hard to force yourself to eat when you have no appetite, but without enough calories and nutrients you just won’t have any gas in your tank.

Just being alive requires a certain number of calories, not to mention that your brain is an organ that requires a great deal of energy.

Eating too much is obviously not a good choice either, but food cravings are not to be trifled with. Unfortunately, people tend to go for fast-food and snacks when they have strong food cravings. It’s easy to eat too much but remain undernourished.

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Energy

Depression sucks the energy out of your body like a vampire. Everything becomes a huge effort, and you start to worry that you might not have enough time to get everything done.

You might also stop participating in your favorite activities, provided you still get pleasure from doing them, since you don’t have the energy to care or be social.

This will make you feel restless, bored, and frustrated, since you don’t have the opportunity to blow off stream and to express yourself.

This will also add to your feeling of isolation and lonliness, as you gradually become a hermit that only leaves the house for cigarettes, Ramen noodles, and toilet paper. Not good.

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Thinking

Changes in thinking are the most frightening and insidious symptoms of depression.

When you are depressed, negative thoughts dominate your thinking. You find it easier to complain about things, and it’s harder to see the positive side of anything.

This is really dangerous when you start to judge yourself. Your self-esteem will plummet as the depression magnifies all your faults and masks all your good qualities.

You’ll eventually start to lose hope, fearing that the future no longer holds any promise for you.

Depression distorts your thinking and makes it difficult to see things in a fair way. It’s common to think in broad, black-and-white terms, and more often than not, you’ll see black.

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The worse symptom of all

The longer you are depressed, the harder it will become to seek help. One of the symptoms of depression that is not spelled out clearly in the DSM-IV, but in my experience goes hand-in-hand with depression, is that you will not want to seek help.

For whatever reason, depression does everything it can to take control of your life and ruin it. You will do everything and anything except seek help. You will beat yourself up with guilt, and you’ll feel like you’re the only one who has this problem, even though the statistics are clear that mental disorders are more common than you think.

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Depression is difficult to understand, but it doesn’t have to be that way

Recognizing the symptoms of depression is crucial for getting proper treatment. It’s often difficult to recognize depression, because it’s so easy to hide the symptoms from others, or even yourself.

Depression affects everyone differently, and the symptoms can easily be confused with normal expressions of sadness, anger, worry, and other emotions. It’s hard to draw the line between normal emotions and feelings caused by depression.

That’s why it’s necessary for people to have a clear idea of what depression is, how it affects different people, and how to get proper treatment for it. Only then can we start putting an end to needless suffering, and help people to get back to the business of enjoying life.

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