Depression: A Conversation We Need to Have.

Depression: A Conversation We Need to Have.

Ok, so tonight I heard something that just flew me right into a rage that exceeded my level of road rage. Anyone who has been in the car with me, knows how this looks.

This person told my husband that 90% of people that have depression, have it because they “weren’t loved enough as a child.” This person stated that it was a “fact”… are you fucking kidding me? Not being loved as a child?
Let that sink in. If it were only that fucking easy.

As a therapist, I work with people who suffer from depression and it is gut-wrenching to see how depression takes the life out of that person. I have seen how it affects every aspect of their life, every relationship, every minute of the day.

Depression is a serious mental illness and it is different than being sad. There is a whole list of critieria that someone has to meet in order for them to be diagnosed.
For example, to be diagnosed with Major Depressive Disorder you have to present with at least 5 of the following symptoms and those symptoms have to be present during the same two week period… and they have to be present every day or nearly every day.

• Depressed mood
• Diminished loss of interest or pleasure in almost all activities
• Significant weight loss or gain (at least 5% +/- in a month) or appetite
• Sleep disturbance, either too much sleep or insomnia or not being able to sleep
throughout the night
• Speeding up or slowing down of muscle movement
• Loss of energy or fatigue
• Feelings of worthlessness, hopelessness, helplessness (low self-esteem)
• Diminished ability to think, concentrate and make decisions
• Recurrent thoughts of death, dying or suicide
• Longstanding interpersonal rejection ideation (ie. others would be better off
without me)

Now, one of the symptoms has to be either depressed mood or loss of interest. But that is not all that is needed. And these symptoms have to cause clinically significant distress or cause impairment in social, occupation or other important areas of functioning.

It cannot be attributed to the physiological effects of a substance or to a medical condition.

There are several types of depression that are recognized by the DSM 5, that is the Diagnostic and Statistical Manual of Mental Disorders:

• Major Depression
• Persistent Depressive Disorder
• Bipolar Disorder
• Seasonal Affective Disorder (SAD)
• Psychotic Depression
• Peripartum (Postpartum) Depression
• Premenstrual Dysphoric Disorder (PMDD)
• ‘Situational’ Depression
• Atypical Depression

So, as you can see it isn’t just feeling sad it goes way beyond that… and it sure as fuck isn’t 90% of that being caused by “not being loved enough as a child”… whatever dipshit thought of that number needs to get a good, solid punch to the throat.

Depression is extremely complex and why a person goes into any of these types of depression has a plethora of factors.

First of all,
Genetics and Biology may play a part for some people.
Most researchers suspect that having parents or siblings with depression may be a risk factor.

Brain Chemistry Imbalance
Depression is believed to be caused by an imbalance in the neurotransmitters which are involved in mood regulation and they are: serotonin, dopamine, norepinephrine, acetylcholine, glutamate and GABA.

Neurotransmitters are chemical substances which help different areas of the brain communicate with each other. When certain neurotransmitters are in short supply, this may lead to the symptoms we recognize as clinical depression. This is why medications such as Selective Serotonin Reuptake Inhibitor’s (SSRI’s), Antidepressants, and Antipsychotic’s are often prescribed to people with depression because they work by balancing chemicals in your brain’s neurotransmitters that affect mood and emotions. It is a very complicated process in the brain and this is a simple explanation.

Female Sex Hormones
It has been widely documented that women suffer from major depression about twice as often as men. Because the incidence of depressive disorders peaks during women’s reproductive years, it is believed that hormonal risk factors may be to blame. Women are especially prone to depressive disorders during times when their hormones are in flux, such as around the time of their menstrual period, childbirth, and perimenopause. In addition, a woman’s depression risk declines after she goes through menopause.

Circadian Rhythm Disturbance
One type of depression, called seasonal affective disorder (officially known as major depressive disorder with seasonal pattern) is believed to be caused by a disturbance in the normal circadian rhythm of the body. People who reside in colder climates where there are short, dark days may be at the highest risk.

Poor Nutrition
A poor diet can contribute to depression in several ways. A meta-analysis from the The British Journal of Psychiatry found a link between vitamin D deficiency and depression. Another study done by cautioned about sugar. They found that men who consumed 67 grams or more of sugar per day were 23 percent more likely to be diagnosed with depression in a five-year period than men who ate 40 grams or less. Some studies have found that diets either low in omega-3 fatty acids or with an imbalanced ratio of omega-6 to omega-3 are associated with increased rates of depression.

Physical Health Problems
The mind and the body are clearly linked. If you are experiencing a physical health problem you may discover changes in your mental health as well.
Illness is related to depression in two ways. The stress of having a chronic illness may trigger an episode of major depression. For example people who have suffered from a heart attack 40-65 percent have been diagnosed with depression, Parkinson’s disease (40 percent), Multiple sclerosis (40 percent), cancer (25 percent), diabetes (25 percent) and chronic pain (30-54 percent). They found that any history of hospitalization for infection was associated with a 62 percent increased risk of later developing a mood disorder. That has zero percent to do with how much they were loved as a child.

Stressful Life Events
Researchers suspect high levels of the hormone cortisol, which are secreted during periods of stress, may affect the neurotransmitter serotonin and contribute to depression.

Grief and Loss
Following the loss of a loved one, grieving individuals experience many of the same symptoms of depression. Trouble sleeping, poor appetite, and a loss of pleasure or interest in activities are a normal response to loss. The symptoms of grief are expected to subside over time. But when symptoms get worse, grief may turn into depression.

Minority/majority status
Being a minority comes with its package of social pain. They report feeling more guilt, embarrassment, shame and sadness than people with higher status. Not only that but:
• Primary care physicians are less likely to detect mental health problems, including depression, among African American and Hispanic patients than among whites.
• Women who are poor, on welfare, less educated, unemployed and from ethnic/racial minority populations are more likely to experience depression.
• Ethnic/racial minorities were less likely to receive treatment for depression Of adults who received treatment, 16% were African American, 20% Hispanic, and 24% white.
Again, this is a MUCH larger systematic problem in our country that I will get into eventually, but not right now.

My whole point is that if you don’t work with people who suffer and deeply suffer from depression, or you haven’t seen it first hand with someone you love… just shut your fucking mouth! You clearly have no idea what you are talking about.

In light of the recent passing of Anthony Bourdain and Kate Spade, the topic is a sensitive one, but suicides in the United States have increased by 25% since 1999. We have to have discussions without shaming people regarding depression.

In the U.S., suicide rates are highest during the spring. It is the 3rd leading cause of death for 15 to 24-year-olds and 2nd for 24 to 35-year-olds. The highest suicide rate (19.72 per 100,000 people) was among adults between 45 and 54 years of age. The second highest rate (18.98 per 100,000 people) occurred in those 85 years or older. And it is the 10th leading cause of death in the US.
On average, 1 person commits suicide every 16.2 minutes, that is 123 suicides per day.

So, while we may hear about the tragic loss of a celebrity (and my heart goes out to them and their families,) there are a shocking number of suicidal deaths every day, leaving behind people who love them and may never have suspected depression affected the person they lived with, worked with, raised children with and so on.

If you are feeling any of the symptoms I mentioned, especially if you are having thoughts of suicide, even if they are just passive thoughts… please talk to someone. There are actually people out there that understand and want to provide help. As someone who has had suicide happen in my family and by people who I am very close to, I speak from the heart when I say, you are loved, you are needed, you are worthy and we want you here with us.

So, please call a friend, or one of the following numbers if you need to talk.

National Suicide Prevention Hotline: 800-273-8255

Parental Stress Hotline – Help for Parents: 800-632-8188

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