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They are total-body illnesses that affect a person's thoughts, feelings,
behavior, and physical health and appearance.
They affect all areas of a person's life - home, work, school, and social life.
These illnesses are different from ordinary blues - which are normal feelings
that eventually pass.
Depressive illnesses last for months or years with varying patterns.
A person with a depressive illness cannot talk themselves into feeling good.
They cannot snap themselves out of it. Suffering or not suffering
from these illnesses does not have anything to do with a person's
willpower. Many times, society assumes a person suffering from depression
is just lazy, or lacks motivation to get his or her life together. One
might be labeled as simply having a behavior problem. This simply is not
To determine whether a depressive illness is present or not, a thorough medical
examination is essential;
Many drugs used in the treatment of other illnesses, such as cancer, heart
disease, high blood pressure or arthritis, as well as oral contraceptives and
some antibiotics, can trigger depressive illnesses.
Long-term or sudden illnesses can also bring on or exacerbate a depressive
illness. And neurological disorders, hormonal disorders, infections, and
tumors can mimic the symptoms of depressive illnesses or anxiety. If all
medical tests come out negative, or if chronic physical pain does not
respond to treatment, there is a strong possibility a depressive
illness exists.
Depression is the most common, most misdiagnosed illness in America. Over 17
million Americans suffer from depressive illnesses in any given year.

Depressive illnesses are not due to personal weakness or a character flaw, but
are biological illnesses related to imbalanced or disrupted brain
chemistry. The brain is an organ of the body and can get sick just like the
heart, liver, or kidneys.
A combination of genetic, psychological, and environmental factors all play a
role in how and when a depressive illness may manifest itself. And because
these are illnesses, stress doesn't necessarily have to be present,
but can trigger or exacerbate a depression. Depression can appear
out of nowhere, when everything is going fine, at a time when there
would be no reason for a person to feel depressed.
People of all ages, including infants and children (who may be born with a
chemical imbalance), can suffer from depressive illnesses. Since they may be
genetic, a person who is predisposed may be at a higher risk for
developing these illnesses than someone who does not have these illnesses in
their family (as in cancer, heart disease, etc.). We needn't let the
fear of inheritability frighten us. This does not mean everyone will
inherit a depressive illness. Instead, this is good news. By recognizing
the signs of depressive illnesses early on, people can get the
help they need, avoiding needless suffering for months or even years.
Depressive illnesses are nothing to be ashamed of. We aren't ashamed of having
other biological illnesses like heart disease or diabetes. And we
aren't ashamed of going to the doctor for treatment of these illnesses.
Depression and other depressive illnesses are no different. We would never
expect a loved one to treat their high blood pressure on their own. We
shouldn't expect them to treat their depression on their own either.
Yes, all with various symptoms, degrees of severity, and duration.
SAD (Seasonal Affective Disorder) - this illness has to do with a person's
reaction to the amount of light a person receives. Symptoms of depression - low
energy, fatigue, overeating may appear when the days begin to get
shorter and there is less sunlight. People who have Seasonal Affective
Disorder may produce an excess of the hormone melatonin, which is related to
the body's sleep cycle and biological clock.
Unipolar Depression - person has times when he/she feels normal, and other
times when he/she feels depressed, slowed-down, or in a fog. Their ability
to function normally may be significantly impaired. A person may have only
one or two episodes, or may continue to have episodes throughout his
or her lifetime.

Bipolar Illness or Manic Depression - there are two forms of this disease. With
the first type, Bipolar I, a person may have dramatic mood swings,
from severe lows to extreme highs (mania). A person who is experiencing mania
may have excessive energy, he or she may feel restless and unable
slow down, appearing hyper. This state causes grandiose thinking, impaired
judgment, and often times embarrassing social behavior. With the second type,
Bipolar II, the manias are milder (hypomania) and the lows may be of
any severity. A person experiencing hypomania may be very talkative and
social, their thinking may be extraordinarily clear and sharp, with
heightened creativity. They feel in a wonderfully good mood, but eventually
sink into a low period.
Dysthymia - this is chronic mild to moderate depression. A person usually
continues to function, but just doesn't experience the pleasure out of life
like a healthy person does.
Cyclothymia - a form of bipolar illness, this is a mood rollercoaster. A person
may feel up one day and down the next, or up one week and down the
next. Seemingly unpredictable. Periods of normal mood may be few and
far between. Hypomanias occur, along with mild depressions.
Atypical Depression - person can still have fun and experience pleasure if an
opportunity presents itself, such as a party or good news, but the
feeling is short-lived. Heaviness, fatigue, and lack of motivation then recurs
until the next pleasurable occasion comes up. There may be
moodiness, plus at least 2 of these 4 symptoms; oversleeping, overeating,
extreme fatigue and rejection sensitivity.
Premenstrual Syndrome - seems to be related to depression in some people, with
symptoms of irritability, nervousness, sadness, low energy, and physical
symptoms of body aches and bloating presenting themselves prior to
a woman's menstrual period.

Anxiety is feeling excessive fear, nervousness or worrying that something bad
might happen, even though there is no logical or specific reason to be
afraid. Many times depressive illnesses and anxiety go hand in hand.
Various types of anxiety disorders include:
Panic Disorder - panic attacks occur with symptoms of dizziness, rapid heart
beat, feelings of faintness or detachment from body, shortness of breath,
nausea, diarrhea, numbness or tingling in arms/legs, trembling,
flushes or chills, fear of dying, the immediate need to flee the situation
which has triggered the attack.
Phobias - intense fear of an object (animal, insects), activity (flying,
heights, driving), or situation (public speaking, eating or writing in public)
that causes an individual to avoid these things at all costs. Phobias may
result in agoraphobia causing a person to never leave the security of
their home.
Obsessive-Compulsive Disorder - characterized by having continuous thoughts or
doubts (obsessions) that keep playing over and over again in a person's
mind, in an annoying and bothersome way, interfering with everyday
functioning. Obsessions are repetitive, irrational thoughts such as
excessive fears of germs. Also may have a need to do something over and
over again (compulsion), such as checking appliances, cleaning, washing
hands, counting, repeating tasks or performing rituals in order to ease
Post-Traumatic Stress Disorder - this disorder can occur as a result of an
emotional or physical trauma such as a car or plane crash, physical/sexual
assault, war, or natural disaster. Symptoms such as flashbacks or
nightmares may suddenly begin happening years after the event took place,
resulting in social isolation, panic attacks, angry outbursts or substance
abuse, which may be an attempt to forget.
Generalized Anxiety Disorder - people who worry constantly about anything and
everything (money, health, safety of their children taken to extremes)
may have GAD. Possible symptoms include trembling, pain in arms & legs
from muscle tension, chronic fatigue, stomach problems, dizziness, inability to
concentrate, irritability, jittery and nervous appearance. May have
problems with eating and sleeping.
Social Phobia - anxiety about appearing foolish or acting in such a way as to
embarrass oneself. Examples may be speaking in a group of people or to
someone with authority, anxiety in social situations, writing in public, or
eating in public.

A person may have as few as 2 or 3 symptoms or many of the symptoms.
Note: It is important to understand what constitutes
normal development in infants, children and adolescents vs. what may be
signs of a depressive illness. You may not see a drastic change in a
child/adolescent's behavior or mood if they were born with a depressive
illness. It may be part of their make-up having been present from day one.

Unresponsive when talked to or touched, never smile or cry, or may cry often
being difficult to soothe.
Failure to gain weight (not due to other medical illness).
Unmotivated in play.
Restless, oversensitive to noise or touch.
Problems with eating or sleeping.
Digestive disorders (constipation/diarrhea).
Persistent unhappiness, negativity, complaining, chronic boredom, no
Uncontrollable anger with aggressive or destructive behavior, possibly hitting
themselves or others, kicking, or self-biting, head banging. Harming
Continual disobedience.
Easily frustrated, frequent crying, low self-esteem, overly sensitive.
Inability to pay attention, remember, or make decisions, easily distracted,
mind goes blank.
Energy fluctuations from lethargic to frenzied activity, with periods of
Eating or sleeping problems.
Bedwetting, constipation, diarrhea. Impulsiveness, accident-prone.
Chronic worry & fear, clingy, panic attacks.
Extreme self-consciousness.
Slowed speech & body movements.
Disorganized speech - hard to follow when telling you a story, etc.
Physical symptoms such as dizziness, headaches, stomachaches, arms or legs
ache, nail-biting, pulling out hair or eyelashes. (ruling out other medical
Suicidal talk or attempts.
In children, depressive illnesses/anxiety may be disguised as, or presented as
school phobia or school avoidance, social phobia or social avoidance,
excessive separation anxiety, running away, obsessions, compulsions, or
everyday rituals, such as having to go to bed at the exact time each night
for fear something bad might happen. Chronic illnesses may be present
also since depression weakens the immune system.
Physical symptoms such as dizziness, headaches, stomachaches, neckaches, arms
or legs hurt due to muscle tension, digestive disorders. (ruling out
other medical causes)
Persistent unhappiness, negativity, irritability.
Uncontrollable anger or outbursts of rage.
Overly self-critical, unwarranted guilt, low self-esteem.
Inability to concentrate, think straight, remember, or make decisions, possibly
resulting in refusal to study in school or an inability (due to
depression or attention deficit disorder) to do schoolwork.
Slowed or hesitant speech or body movements, or restlessness (anxiety).
Loss of interest in once pleasurable activities.
Low energy, chronic fatigue, sluggishness.
Change in appetite, noticeable weight loss or weight gain, abnormal eating
Chronic worry, excessive fear.
Preoccupation with death themes in literature, music, drawings, speaking of
death repeatedly, fascination with guns/knives.
Suicidal thoughts, plans, or attempts.
Depressive illnesses/anxiety may be disguised as, or presented as eating
disorders such as anorexia or bulimia, drug/alcohol abuse, sexual
promiscuity, risk-taking behavior such as reckless driving, unprotected
sex, carelessness when walking across busy streets, or on bridges or
cliffs. There may be social isolation, running away, constant disobedience,
getting into trouble with the law, physical or sexual
assaults against others, obnoxious behavior, failure to care about
appearance/hygiene, no sense of self or of values/morals, difficulty
cultivating relationships, inability to establish/stick with
occupational/educational goals.
Persistent sad or empty mood.
Feelings of hopelessness, helplessness, guilt, pessimism, or worthlessness.
Drug/alcohol abuse. (Often masks depression/anxiety.)
Chronic fatigue, or loss of interest in ordinary activities, including sex.
Disturbances in eating or sleeping patterns.
Irritability, increased crying; generalized anxiety (may include chronic fear
of dying/convinced dying of incurable disease), panic attacks.
Hypochondria - sufferer actually feels symptoms, they are real and not
Difficulty concentrating, remembering, or making decisions.
Thoughts of suicide; suicide plans or attempts.
Persistent physical symptoms or pains that do not respond to treatment -
headaches, stomach problems, neck/back pain, joint pain, mouth pain.
Note: Many people feel that it is normal for elderly persons to be depressed.
This is simply not true and is a very dangerous misconception.
If you suspect a older adult is suffering from a depressive
illness, he/she should have a thorough medical examination as soon as
Symptoms of Mania:
Decreased need for sleep.
Restless, agiated, can't sit still.
Increased energy, or an inablilty to slow down.
Racing, disorganized thoughts, easily distracted.
Rapid, increased talking or laughing
Grandiose ideas, increased creativity.
Overly excited, euphoric, giddy, exhilarated.
Excessive irritability, on edge.
Increased sex drive, possibly resulting in affairs, inappropiate sexual
Poor judgment, impulsiveness, spending sprees
Embarrassing social behavior
Paranoia, delusions, hallucinations.

Yes. There are various ways of treating depressive illnesses depending on the
type of illness, the severity, and the age of the person being treated.
Much of the research has shown that a combination of
antidepressant medication along with psychotherapy is the quickest, most
effective treatment. Many times, antidepressant medication is first needed
to clear the foggy head, thereby allowing a person to concentrate
better and think more clearly in their therapy sessions. The brain has to
be in good working order before problem-solving can begin.
Antidepressant medications correct the chemical imbalance or the chemical
disruption in a person's brain. They are not addictive like common street
drugs, because they aren't pep pills or uppers. If a person took
antidepressant medication who didn't have depression, the medication
wouldn't have any effect on them. It wouldn't make them happier or give
them any more energy. That's why they've never been bought or sold on the
street, because they aren't mood-altering in the sense that street drugs
are. If a person took an aspirin, but didn't have a fever, the aspirin
wouldn't do anything to his/her normal body temperature. Antidepressant
medication can't treat something that doesn't exist in the first place.
Some people take antidepressant medication for a year or so, others may take it
for the rest of their life. Diabetes is treated with insulin, heart
disease is treated with heart medication, and depressive illnesses are
treated, many times, but not always, with antidepressant medication.
Psychotherapy is talking therapy. There are several types of psychotherapy, but
two have been proven to be very beneficial in the treatment of
depressive illnesses.
Cognitive therapy focuses on trying to change a person's negative thinking and
the inaccurate perceptions they have of themselves and their
environment. People are taught to think logically. Example: "If I can't do this
project perfectly, I can't do it at all." (illogical)
Interpersonal therapy teaches a person how to successfully interact with
others. Depressive illnesses interfere with how a person treats his or her
family, friends, and co-workers, which consequently affects how he or she
is treated in return. Interpersonal therapy focuses on social skills.

If depressive illnesses are left untreated, they can be fatal. 30,000 people
kill themselves in the U.S. every year. It is estimated that the actual
figure may be 3 times that number due to inaccurate reporting, i.e.
suicides recorded as accidental instead. The Journal of the American Medical
Association has reported that 95% of all suicides occur at the peak
of a depressive episode. Healthy people do not kill themselves.
Depressive illnesses can distort a person's thinking, so they don't think
clearly or rationally. They may not know they have a treatable illness, or
they may think that they can't be helped. Their illness can cause
thoughts of hopelessness and helplessness, which may then lead to suicidal
thoughts. In order to save lives, it's critical that society recognize the
warning signs of these biological diseases that cause suicide. But there is
still stigma associated with these illnesses which prevents public education
and early treatment for sufferers. The topic of suicide has
always been taboo. It is a subject that is so misunderstood by people, thereby
allowing myths to be perpetuated. Education is the key to
understanding this incredible tragedy that, in many cases, might be prevented.

Talking or joking about suicide.
Statements about being reunited with a deceased loved one.
Statements about hopelessness, helplessness, or worthlessness. Example: "Life
is useless." "Everyone would be better off without me." "It doesn't
matter. I won't be around much longer anyway." "I wish I could just
Preoccupation with death. Example: recurrent death themes in music, literature,
or drawings.
Writing letters or leaving notes referring to death or "the end".
Suddenly happier, calmer.
Loss of interest in things one cares about.
Unusual visiting or calling people one cares about - saying their good-byes.
Giving possessions away, making arrangements, setting one's affairs in order.
Self-destructive behavior (alcohol/drug abuse, self-injury or mutilation,
Risk-taking behavior (reckless driving/excessive speeding, carelessness around
bridges, cliffs or balconies, or walking in front of traffic).
Having several accidents resulting in injury. Close calls or brushes with
death. Obsession with guns or knives.
Just because an individual is doing these things does not mean his mind is made
He can be stopped! He has not chosen death, but is instead focusing only on
easing the pain or ending the pain. Pain which is usually the result of an
illness - a chemical imbalance in the brain that is, many times, treatable.
If a person understood that he could have the life back that he
once had, before the depressive illness, he would almost certainly chose
life, not death.

Ask him or her! That may sound absurd and very scary, but you must ask him if
he ever feels so bad that he thinks of suicide. Don't worry about
planting the idea in someone's head. Suicidal thoughts are common with
depressive illnesses, although not all people have them. If a person has been
thinking of suicide, he or she will be relieved and grateful that you
were willing to be so open and nonjudgemental. It shows a person you
truly care and take him/her seriously.
If you get a yes to your question, question the individual further. Ask if he
has a plan, or a method, or if he has decided when he will do it. This
will give you an idea if he is in immediate danger. If you feel he is,
do not leave him alone! The person must see a doctor or psychiatrist
immediately. You may have to take him to the nearest hospital
emergency room.
Always take a suicide threat seriously and never keep it a secret!!!!
You must never call a person's bluff, or try to minimize his problems by
telling him he has everything to live for or how hurt his family would be. This
will only increase his guilt and feelings of hopelessness. He needs to
be reassured that there is help, that what he is feeling is treatable,
and that his suicidal feelings are temporary.
If you feel the person isn't in immediate danger, you can say things like, "I
can tell you're really hurting", and "I care about you and will do my best
to help you." And follow through - help him find a doctor or a mental
health professional. Be by his side when he makes that first phone
call, or go along with him to his first appointment. A supportive
person can mean so much to someone who's in pain. This is an opportunity to
interrupt the long process that for many, leads to suicide. You may save a life!

The aforementioned information was compiled by
Tracy Pierson
from numerous books, articles, pamphlets and other medical publications
authored by trained physicians and mental health professionals on the subjects
SA\VE - Suicide Awareness\Voices of Education
P. O. Box 24507, Minneapolis, MN 55424-0507
Phone: (612) 946-7998
Internet Address: - E-mail:

Suicide Awareness \ Voices of Education (SA\VE) is an organization dedicated to
educating the public about suicide prevention.

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