Promoting the Health and Well-Being of Families During Difficult
Times
Understanding Depression Following a Disaster
Marta Stuart
Extension Specialist Yavapai County, Arizona
The purpose of this fact sheet is to help families who are
experiencing stressful times during a disaster develop an
understanding about depression: what it is, what causes it,
what are the symptoms, and how is it treated? According to
the National Institute of Mental Health, an estimated 18.8
million Americans suffer from a depressive illness each year.
Depression does not discriminate; it affects men and women,
young and old, and people of all races, cultures, and incomes.
Depressive illnesses often interfere with normal functioning
and cause pain and suffering not only to the individual, but
also to those who are close to him/her. Depression is a real
illness and carries with it a high cost in terms of relationship
problems, family suffering, and lost work productivity. However,
it is a treatable illness.
What Is Depression?
Depression is not the same as a blue mood, which is a normal
short-term experience of sadness or loss. Depression is an
illness that involves the body, mood, and thoughts. Often
referred to as the invisible disease, it affects the way a
person eats and sleeps, the way one feels about oneself, and
the way one thinks about things. Depression is not a sign
of weakness or a condition that can be willed or wished away.
People who are depressed cannot merely "pull themselves
together" and get better. Without treatment, symptoms
can last for weeks, months, or years. Appropriate treatment,
however, can help most people who suffer from depression.
Causes of Depression
According to the National Institute of Mental Health and
the American Psychiatric Association, depression can affect
anyone, even a person who is considered normal and healthy.
The causes of depression usually relate to several factors.
The following is a summary of factors that may lead to depression.
Environmental Factors
Environmental causes of depression are situations that occur
outside of us. They are directly related to events that happen
in the everyday course of life and may include stress at home,
school, or work. Many people become depressed after they have
experienced a traumatic and painful life event, such as a
medical illness, death of a loved one, or financial crisis.
A natural disaster such as a drought may be traumatic enough
to cause depression. Additionally, continuous exposure to
violence, neglect, abuse, or poverty may make a person more
susceptible to depression.
Personality/Psychological Factors
People with low self-esteem, who consistently view themselves
and the world with pessimism, or who are easily overwhelmed
by stress, are prone to depression. Whether this represents
a psychological predisposition or an early form of the illness
is not clear.
Genetic Factors
Depression can run in families; in some families, major depression
seems to occur from generation to generation. However, genetic
anomalies may also cause depression in people who have no
family history of depression. Whether inherited or not, depression
is often associated with changes in the brain structure or
brain function.
Biochemical Factors
Deficiencies of two chemicals in the brain, serotonin and
norepinephrine, are thought to be responsible for certain
symptoms of depression, including anxiety, irritability, and
fatigue.
Very often, a combination of environmental, psychological,
and genetic factors are involved in the onset of depression.
Types of Depression
There are three main types of depression:
- Major depression is manifested by a combination of symptoms
that interfere with the ability to work, study, sleep, eat,
and enjoy activities that were once pleasurable.
- Dysthymia is a less severe type of depression that involves
long-term chronic symptoms , which do not disable the individual,
but may keep him/her from functioning well or from feeling
good.
- Bipolar disorder, also known as manic-depressive illness,
is a serious brain disorder that causes extreme shifts in
mood, energy, and functioning. The disorder typically emerges
in adolescence or early adulthood, but in some cases appears
in childhood.
Symptoms of Depression
Many people still believe that the emotional symptoms caused
by depression are not real, and that a person should be able
to shake off the symptoms. Individuals with symptoms of depression
need to get professional help. Symptoms include the following:
- a persistent sad mood
- loss of interest or pleasure in activities that were once
enjoyed
- significant change in appetite or body weight
- difficulty sleeping or oversleeping
- physical slowing or agitation
- loss of energy
- feelings of worthlessness or inappropriate guilt
- difficulty thinking or concentrating
- recurrent thoughts of death or suicide
Brain imaging research reveals that in depression, neural
circuits responsible for moods, thinking, sleep, appetite,
and behavior fail to function properly, and that the regulation
of critical neurotransmitters is impaired (Journal of Psychiatric
Research). Additionally, the hormonal system (HPA) that regulates
the body's response to stress is overactive in many people
with depression.
Treatment of Depression
Informal On-line Screening
The following websites offer a confidential test to help you
identify depressive symptoms and determine whether further
evaluation by a medical professional is necessary:
Professional Diagnostic Evaluation
The first step to getting appropriate treatment is a physical
examination by a doctor. Certain medications and medical conditions
can cause the same symptoms as depression, and the physician
can rule out these possibilities through examination, interview,
and lab tests. A good diagnostic evaluation will include a
complete history of symptoms (i.e., when they started, how
long they have lasted, how severe they are, whether the patient
had them before and, if so, whether the symptoms were treated
and with what treatment). The doctor should ask about alcohol
and drug use, and if the patient has thoughts about death
or suicide. Further, a history should include questions about
whether other family members have had a depressive illness.
Treatment will depend on the outcome of the evaluation. (Source:
National Institute of Mental Health, Publication #02-3561)
Psychotherapy
Certain types of psychotherapy, specifically cognitive-behavior
therapy (CBT) and interpersonal therapy (IPT), have been found
to be helpful for depression. Research indicates that mild
to moderate depression often can be treated with therapy alone.
However, a combination of psychotherapy and medication may
be needed to treat severe depression.
Medications
There are several types of medications used to treat depression.
It is important to keep taking medication until it has a chance
to work. Never stop taking an antidepressant medication without
consulting the doctor for instructions on how to safely discontinue
the medication.
Alternative Medicine / Herbal Therapy / Integrated Medicine
In more recent years, the use of alternative medicine has
been explored and has proven successful in treating depression.
Much interest has risen in the use of herbs, massage therapy,
acupuncture, and other natural healing for the treatment of
depression. However, scientific studies have not been conclusive
in this field. Any alternative medicine, herbal therapy or
integrated medicine should be taken only after consultation
with a doctor or other health care provider.
Internet Resources
National Institute of Mental Health - Depression: Free publications
and other information from the National Institute of Mental
Health on Depression http://www.nimh.nih.gov/healthinformation/depressionmenu.cfm
OR call 1-301-443-4513
How to Locate Mental Health Resources in Your Community:
Provides a list of local resources for depression. http://www.allaboutdepression.com/res_07.html
Understanding Depression: Tips on signs to look for in a
depressed person, information on what causes depression, and
what people can do for victims of depression. http://www.extension.uiuc.edu/ruralroute/depression.pdf
A Checklist and Guide for Making Referrals: A checklist for
assessing ranchers/farmers for stress and depression. http://www.ext.colostate.edu/drought/checklist.html
Resources for Depression: Online resources for depression.
http://www.ext.colostate.edu/drought/depression.html
Clinical Depression in Later Life: Fact sheet on clinical
depression in later life, including causes, treatments, and
how to help older people with depression. http://www.ext.colostate.edu/pubs/consumer/10251.html
Supporting Families Following a Disaster: The University
of Arizona College of Agriculture and Life Sciences Cooperative
Extension has designed this series of fact sheets covering
special needs of families during difficult times. http://ag.arizona.edu/fcs/supporting_families/
References
American Psychiatric Association-Public Information: Depression
http://www.psych.org/public_info/depression.cfm
Chevallier, A. (2000) Natural Health Encyclopedia of Herbal
Medicine. Dorling Kindersley Limited, Great Britain.
Lazarus, J. (2000) Stress Relief & Relaxation Techniques.
Keats Publishing, Los Angeles.
National Institute of Mental Health - Depression, NIH Publication
No. 02-3561
The Invisible Disease: Depression, NIH Publication No. 01-4591
Let's Talk About Depression, NIH Publication No. 01-4162 http://www.nimh.nih.gov/publicat
Niven, D. (2000) The 100 Simple Secrets of Happy People,
What Scientists Have Learned And How You Can Use It. Harper
Collins Publishers, Inc. New York, NY
Soares, J.C., Mann, J.J. (1997) The functional neuroanatomy
of mood disorders. Journal of Psychiatric Research.
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