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Rantings Of A Maniac............

Artist: Masked Maiden

Where to begin? I would like to speak to you some more about how depression IS. Or how it is to battle it. And maybe something on my reasons for needing depression to be understood.

Feeling blue or sad is often a normal reaction to a life situation. We all feel this way sometimes, and often talking to a good friend, or changing our environment or schedule, we start to feel more like ourselves again. Clinical depression is very different. Clinical depression is an illness, and it requires specific treatment.

Unlike the blues, clinical depression persists and doesn't go away no matter how hard the individual wants it to or tries to "shake it off". Clinical depression is not a weakness or character flaw. It is an illness of the mind, body and soul and can last for months or years if left untreated. In some cases, it is a lifelong disease just as diabetes that must be treated on a continual bases. The most serious and tragic consequence of clinical depression is suicide.

Research data indicates that people suffering from depression have imbalances of neurotransmitters, natural substances that allow brain cells to communicate with one another. Two transmitters implicated in depression are serotonin and norepinephrine. Scientists think a deficiency in serotonin may cause the sleep problems, irritability, and anxiety associated with depression. Likewise, a decreased amount of norepinephrine, which regulates alertness and arousal, may contribute to the fatigue and depressed mood of the illness.

Other body chemicals also may be altered in depressed people. Among them is cortisol, a hormone that the body produces in response to stress, anger, or fear. In normal people the level of cortisol in the bloodstream peaks in the morning, then decreases as the day progresses. In depressed people, however, cortisol peaks earlier in the morning and does not level off or decrease in the afternoon or evening.

Researchers don't know if these imbalances cause the disease or if the illness gives rise to the imbalances. They do know that cortisol levels will increase in anyone who must live with long-term stress.

This can be counteracted with antidepressant drugs. There are many forms of therapy used in conjunction with an ever growing number of drugs.

According to the classical analytic model of depression, using grief as an example, a distinction is made between grief, a normal response to loss of a love, and melancholia, an intensely ambivalent love-hate relationship resulting from the real or imagined loss of a love. Individuals predisposed toward melancholia may become highly dependent. This dependency creates hostility toward the focus of the dependency, but these negative feelings of anger are repressed and ultimately converted into self-hostility. Depression results from the negative impact of this anger turned inward on the self. This is not done on a conscious level and the depressive can and often is totally unaware that their thinking is obscure in anyway. This lack of knowledge allows the patterns to build and strengthen over time, leaving an emotional path often which a person cannot get off of. It is my findings with my own depression, that I am able to identify the "who" "what" "why" "where" and "when's" of these obscure thoughts, and know that I was incorrect in thinking them, but am still not able to alter my subconcious patterns. This in my case, causing a great deal of inner turmoil. I know what is correct and make every effort to change the patterns in my concious thoughts. When I am unable to do this, my thoughts revert back to the inward attack. When I become aware that this has happened again, it is seen as a failure and feeds the vicious cycle.

~~~~~~~"Similar to the psychodynamic model, behaviorists view depression as a result of significant loss (Kovacs & Beck, 1977; Schwartz & Johnson, 1985). Whether this is through changes in the environment, the loss of a reinforcing interpersonal relationship, or failure to encourage and arrange for positive reinforcement, depression is seen as the consequence of inadequate or insufficient reinforcement (Ferster, 1973; 1974). Depressed individuals tend to attribute negative events to either external causes beyond their control or to internal, unchangeable deficits in the skills that are necessary to create change. They tend to set high standards for positive self-evaluation and at the same time have low standards for negative self-evaluation. Reduced self-esteem and increased feelings of helplessness and depression result from these maladaptive structures of self- evaluation."~~~~~~~~~~~


Psychotherapy involves the verbal interaction between a trained professional and a patient with emotional or behavioral problems. The therapist applies techniques based on established psychological principles to help the patient gain insights about him or herself and thus change his or her maladaptive thoughts, feelings, and behavior. There are several forms of this "talk treatment" that have proven useful in helping the depressed person. Three types of psychotherapy have proven effective in reducing symptoms. Behavioral therapy concentrates on current behaviors; cognitive therapy focuses on thoughts and beliefs, and interpersonal therapy involves current relationships. A good therapist can help you modify the particular patterns contributing to your stress and depression. If your disorder appears not to be a function of habit or personality alone, a therapist should refer you to a psychiatrist for evaluation. Psychotherapists, although highlyeducated professionals, are not medical doctors and therefore cannot prescribe medication. You may find a psychiatrist who is skilled in psychopharmacotherapy, the study of both psychotherapy and medication management. Other psychiatrists may work in partnership with a therapist who may be a psychologist, social worker or nurse.

Interpersonal Psychotherapy --- This therapy is based on the theory that disturbed social and personal relationships can cause or precipitate depression. The illness, in turn, may make these relationships more problematic. The therapist helps the patient understand his or her illness and how depression and interpersonal conflicts are related.

Cognitive/Behavioral Therapy --- This treatment approach is based on the theory that people's emotions are controlled by their views and opinions of the world. Depression results when patients constantly berate themselves, expect to fail, make inaccurate assessments of what others think of them, feel hopeless, and have a negative attitude toward the world and the future. The therapist uses various techniques of talk therapy and behavioral prescriptions to alleviate the negative thought patterns and beliefs.

Psychoanalysis --- This therapy is based on the concept that depression is the result of past conflicts which patients have pushed into their unconscious. The therapist meets 3 to 5 times a week with the patient to identify and resolve the patient's past conflicts that have given rise to depression in later years.

Psychodynamic Psychotherapy --- Based on the principles of psychoanalysis, this therapy is less intense and often is provided once or twice a week over a shorter span of time. It is based on the premise that human behavior is determined by one's past experience, genetic endowment, and current reality. It recognizes the significant effects that emotions and unconscious motivation can have on human behavior.

Electroconvulsive Therapy (ECT) --- Scientists believe ECT works by affecting the same transmitter chemicals in the brain that are affected by medications. As more effective medications have been developed, the use of ECT for the treatment of depression has decreased. However, ECT is very effective for treating patients who cannot take medications due to heart conditions, old age, severe malnourishment, or for patients who do not respond to antidepressant medication. It can be a lifesaving treatment technique that is considered when other therapies have failed or when a person is very likely to commit suicide.

Before ECT is administered, patients receive anesthesia and a muscle relaxant to protect them from physical harm and pain. Electrodes are placed on the head and a small amount of electricity is applied. This procedure is repeated two or three times a week until the patient improves or it becomes evident that further treatment will be ineffective.

Side effects of ECT are largely transitory. Some people may experience mild problems with memory of events that occurred within several months of the therapy.

Light therapy --- Researchers have found that people suffering with seasonal affective disorder can be helped with the symptoms of their illness if they spend a therapeutic session bathed in light from a special full-spectrum light source, called a "light box." In summary, medication or psychotherapy, or a combination of the two treatment methods, usually relieves symptoms of depression in weeks. Even the most severe forms of depression can respond to treatment rapidly.

The battle against depression starts with education. We must erase the myths and stigma that still surround the disease, especially in relation to children. I don't know how to express strongly enough the importance of recognizing depression symptoms in children. I hope that you have read my bio page and atleast have been able to get a feel of it. We all have unpleasant things that happen to us as we grow up, but our perceptions are all different and leave behind a huge variety of unconscious emotional and psychological imprints. In the case of someone who is a depressive, these imprints can be difficult for others to understand or relate too. The non affected person quite often thinks that a simple situation is just that....simple. In the depressives case it can be an overpowering trauma that cannot be shaken off or worked through as easily. Because of the chemical or neurological "makeup" of a depressive, the psychological processes are altered.

~~~~~~~~~~"Alert parents can play a vital role in helping their children overcome depression by identifying its basic signs and symptoms. Parents should be concerned if their child seems hopeless, helpless or enveloped in a sadness much greater than children normally feel from time to time. It's also important for parents to note if the symptoms become intense, overwhelming or enduring to the point where they interfere with the child's ability to play with friends or take part in daily activities at home or in school. Lack of energy, dramatic weight loss and sleep frequently disrupted by bad dreams are other signs the child may be suffering from depression. If these symptoms persist over several months, the child needs to be evaluated by a doctor or other qualified mental health professional. Any child who has even passing thoughts about suicide should be seen immediately." by David G. Fassler, MD~~~~~~~~

More than 17 million Americans each year develop depression. Recent research indicates the number may be even higher, closer to 20 million. One thing on which researchers agree is that less than half of the people suffering from depression actually receive treatment. One out of every five adults may experience a depression at some point in their lives. Twice as many women as men suffer from depression, although everybody, including children, can develop the illness.

General Information
Burns, D. Feeling Good: The New Mood Therapy. New York: Morrow, 1980.

Greist, J. and Jefferson, J. Depression and Its Treatment. Washington, DC:
American Psychiatric Press, Inc., rev. ed. 1992.

Morrison, J.M. Your Brother's Keeper. Chicago: Nelson-Hall, 1981.

Sargent, M. Depressive Illnesses: Treatments Bring New Hope. U.S. Dept. of
Health & Human Services (ADM 89-1491), 1989.

Winokur, G. Depression: The Facts. New York: Oxford University Press, 1981.
Technical Books

Deakin, J.F.W. (Ed.): The Biology of Depression. Washington, DC: American
Psychiatric Press, Inc., 1986.

Klein, D. and Wender, P. Understanding Depression: A Complete Guide to Its
Diagnosis and Treatment. New York: Oxford University Press, 1993.

Klerman, G. (Ed.): Suicide and Depression Among Adolescents and Young Adults.
Washington, DC: American Psychiatric Press, Inc., 1986.

Other Resources

National Alliance for the Mentally Ill
2101 Wilson Boulevard, Suite 302
Arlington, Virginia 22201
(703) 524-7600
National Depressive and Manic Depressive Association
Merchandise Mart, Box 3395
Chicago, Illinois 60654
(312) 939-2442
National Foundation for Depressive Illness
P.O. Box 2257
New York, NY 10016
(800) 248-4344
National Institute of Mental Health
Public Information Branch
5600 Fishers Lane
Rockville, Maryland 20857
(301) 443-4536
National Mental Health Association
1021 Prince Street
Alexandria, Virginia 22314
(703) 684-7722
Sources: National Institute of Mental Health, Office of Scientific Inquiry and Information; American Psychiatric Glossary, American Psychiatric Press; ManicDepressive Illness, A Guidefor Patients and Families, Clarke Institute of Psychiatry, Toronto; Electroconvulsive Therapy: A Guide, Center for Affective Disorders and Lithium Information Center, University of Wisconsin, Madison.
Depression. American Psychiatric Press, Inc., 1988.
Depression: What you need to know. D/ART Program, National Institute of Mental Health. Rockville, MD.
Greenberg, Paul. The Economic Burden of Depression in 1990. Journal of Clinical Psych, 54, 1993.
Jacobs, Douglas. National Depression Screening Day Educational Lecture, 1998. Excerpts from Youth at Risk: A Prevention Resource for Counselors, Teachers, and Parents, Second Edition ~~~~~~~~~~~

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