1. DEPRESSION: Understanding it and getting help * General Information * How to recognize Depression * Treatment Options * Special Populations

2. Who suffers from Depression? Depression can effect anyone but there is a significantly higher rate of depression among women than men. 17 million Americans develop depression each year. 8.6% of adults over 18 have a mental health problem for at least 2 weeks a year.

3. Who suffers from depression? 2% of Children get depressed 6-8% of Teenagers –1999 survey- reported that1 of every 10 American high school students reported making a suicide attempt the year before. –Teenage boys are more likely than girls to kill themselves. –Look for a change in behavior or performance in school

4. What is Depression? Depression is an illness that involves the body, mood and thoughts It impacts the way a person functions socially, at work, and in relationships. It is more than feeling blue, down in the dumps or sad about a particular issue or situation. It is a medical condition that requires diagnosis and treatment

5. What Depression is NOT: It is not something to be ashamed of. It is NOT a character flaw or sign of weakness. No one with depression can just “Snap Out of It”. You can’t “Pull yourself up by your bootstraps”.

6. What Depression IS: TREATABLE No matter what the cause of a persons depression, there is treatment and it is widely available!!

7. Causes of Depression Depression can be caused by one or more of the following: –Imbalance of certain chemicals in the brain –Triggered by stress, medication or other medical problems –Certain personality factors or genetic traits

8. Symptoms of Depression FIVE OR MORE OF THE FOLLOWING FOR AT LEAST TWO WEEKS: Feelings of sadness, depressed mood and/or irritability Loss of interest or pleasure in activities Changes in weight or appetite Changes in sleep pattern-not enough or too much

9. Symptoms of Depression Feelings of guilt, hopelessness or worthlessness Inability to concentrate, remember things or make decisions Constant fatigue or loss of energy Restlessness or decreased activity Recurrent thoughts of suicide or death

10. Treatment for Depression: Approximately 80% of people who receive treatment for Depression improve. There are three types of treatment: –Psychotherapy –Medication –Electroconvulsive Therapy (ECT)

11. Psychotherapy: What is it? Psychotherapy is a form of “talking therapy” that works by helping a person gain an understanding or insight into their problems and work on solving them. Behavioral psychotherapy is a type of therapy that looks at patterns of behavior that may contribute to depression.

12. Medication for Depression: Antidepressant Medication helps by affecting the brain chemistry. Often take 3-5 weeks to become fully effective, but improvement is often experienced within the first week. Work well and are safe They are Non-habit forming!

13. Electroconvulsive Therapy (ECT) ECT is safer than medications for many Faster acting than most medications Can be done on an Out Patient basis Can be used in combination with medication Is used in life threatening situations to achieve fast relief Can be a one time course or can be used as maintenance therapy for those who remain medication resistant

14. ECT: How is it done? ECT is a painless procedure A person is put to sleep with general anesthesia Muscle relaxers are used to prevent any injury from the procedure Oxygen is given by mask during ECT The whole treatment takes 5 minutes You are awake, up walking and eating breakfast with one hour. Home within two!

15. Depression in women Women are at a much greater increased risk of Depression: –At times of hormone swings-premenstrual 3%-8% of women have Premenstrual Dysphoric Disorder during reproductive years –Postpartum period 15-20% of women have depression after delivery –Menopause –Going into puberty –Following a miscarriage (within one month)

16. Postpartum Depression 15% of women report depression within three months of delivery Women with a prior history of depression are at greater risk Postpartum “blues” or “baby blues” is normal –mild feeling of being down, tearful –lasts for only a day or so

17. Postpartum Psychosis A complication of either a Postpartum Depression or Bipolar disorder that has a sudden onset and is a psychiatric emergency Characterized by hallucinations or delusional beliefs about the infant. The infant and mother must be protected and treated immediately! Increased risk in subsequent pregnancies

18. Treatment for Postpartum Depression Psychotherapy is very important Medication Breastfeeding is not contraindicated!

19. What should SHE do: Rest, rest and more rest! Tiredness can lead to exhaustion which in turn can cause worsening depression Resist the temptation for rush around and catch up with housework while the baby is asleep….take a nap yourself! Eat regularly…..gentle exercise…talk about your worries Avoid major stresses at this time Don’t be too hard on yourself

20. What should She do Cont.: GET TREATMENT!!!!!!! –Medications and psychotherapy Do not be discouraged…every woman who suffers from postnatal illness DOES RECOVER IN TIME!!

21. What can HE do? BE PATIENT! Don’t try to reason…depression defies logic. Let her express her true feelings and treat them with sympathy Don’t force her to do anything she isn’t ready for Try to go out as a couple without the children. Don’t ignore your own feelings- Ask for help too!

22. What can a loved one do for someone who is depressed? Listen and provide support –Be patient, understanding and encouraging –Don’t dismiss the symptoms but you can offer hope –Try to understand the negative feelings the person may be feeling –Remember that depression is a medical condition

23. What you can do Continued: Take care of the “little things” Remind your loved one to keep doctor’s appointments and to take their medication! Help to support healthy habits: good sleeping habits, eating well, trying to get exercise Urge your loved one to postpone major life decisions such as changing jobs, divorce, marriage or moving until his or her depression is better

24. What you can do Continued: Suicide threats are to be taken seriously! Take care of your self Remember: –Depression is a very treatable illness, and you or your loved one can get better with appropriate medical treatment and support!

25. Other special populations: Elderly- Our Senior Citizens! –Increased feelings of isolation & support Medically Ill- Depression is often either a symptom or as a result of a serious or chronic medical problem –treatment improves quality of life! Those persons with Addictions- –If the depression is treated, the addiction can be treated also.

26. Where to get help? If it is an EMERGENCY….go to your nearest Emergency Room If it is Urgent… –Psych Urgent Care at UMMS 328-1219 If it can be a regularly scheduled appointment: –Call 410-328-6231- Community Mental Health Programs