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Guide to Depression and Bipolar Disorder

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Guide to Depression and Bipolar Disorder Guide to Depression and Bipolar Disorder Depression and Bipolar Support Alliance (DBSA) Previously National Depressive and Manic-Depressive Association We’ve been there. We can help. You are not alone Promoting mental epression and bipolar disorder (also known as “health for all Americans manic-depression) are both highly treatable Dmedical illnesses. So why do so few people get will require scientific know-how but, the treatment they need? There are many reasons, but one of the main ones is the lack of accurate information even more importantly, a societal patients and their families can understand. Many people think that these illnesses will go away by themselves or that getting help is a sign of weakness or moral failure. resolve that we will make the needed These views are incorrect. That’s why DBSA created this guide. investment. The investment does not This booklet will discuss depression and bipolar disor- call for massive budgets; rather, it calls der, their symptoms and their treatments. It will provide general guidance on the best resources and support. It for the willingness of each of us to edu- will also inform you about DBSA, its mission and its nationwide network of patient and family support cate ourselves and others about mental groups. Part of DBSA’s mission is to help you help yourself – health and mental illness, and thus to whether you have one of these illnesses or know some- one who does. Reading this Guide to Depression and confront the attitudes, fear, and misun- Bipolar Disorder is one of the first steps on the road to recovery. derstanding that remain as barriers before us. Depression 2 ” Bipolar Disorder 6 David Satcher, M.D., Ph.D. Treatment 12 United States Surgeon General Support 20 from Mental Health: A Report of the Surgeon General, issued December 1999 Resources 26 DBSA Services 28 DBSA, its advisors and consultants do not endorse or recommend the use of any specific treatments or medications listed If you are thinking about death or in this publication. For advice about spe- suicide, go to a hospital emergency room, cific treatments or medications, or contact a medical professional, clergy individuals should consult their physi- member, loved one or friend immediately! cians and/or mental health professionals. Depression If you or someone you know has thoughts of death or suicide, contact a medical professional, It’s Not Just in clergy member, loved one or friend immediately. Your Head If you experience five or more of these symptoms for Everyone, at various times more than two weeks or if any of these symptoms inter- in life, feels sad or “blue.” fere with work or family activities, contact your doctor It’s normal to feel sad on for a thorough examination. This includes a complete occasion. Sometimes this sadness comes from things physical exam and a review of your family’s history of ill- that happen in your life: you move to a different city ness. Do not try to diagnose yourself. Only a health care and leave behind friends, you lose your job or a loved professional can determine if you have depression. one dies. But what’s the difference between “normal” feelings of sadness and the feelings caused by clinical depression? Types of Depression It is now believed that depression is the sign of an While it’s normal for people to experience ups and imbalance in brain chemicals called neurotransmitters. downs during their lives, those who have clinical Although the direct causes of the illness are unclear, it is depression experience specific symptoms daily for two known that body chemistry can bring on a depressive weeks or more, making it difficult to function at work, disorder, due to the presence of another illness, altered at school and in relationships. health habits, substance abuse or hormonal changes. Clinical depression is a treatable medical illness marked People who have major depressive disorder have by changes in mood, thought and behavior. That’s why had at least one major depressive episode – five or more doctors call it a mood disorder. In this booklet, the term symptoms for at least a two-week period. For some “depression” is used to refer to clinical depression. people, this disorder is recurrent, which means they may experience episodes every so often: once a month, How to Recognize Depression once a year or several times throughout their lives. Each person is different. Depression is not a character flaw or sign of personal weakness. You can’t make yourself well by trying to Dysthymia is a chronic, moderate type of depression. “snap out of it” or “lighten up.” And you can’t catch it People with dysthymia usually suffer from poor appetite from someone else, although it can run in families. To or overeating, insomnia or oversleeping, and low energy understand what depression is, it’s important to recog- or fatigue. People with dysthymia are often largely nize the symptoms: unaware that they have an illness because their function- ing is usually not greatly impaired. They go to work and ■ Prolonged sadness or unex- ■ Feelings of guilt, worthlessness manage their lives, but are frequently irritable, always plained crying spells and/or hopelessness complaining about stress or not getting enough sleep. ■ Significant changes in appetite ■ Inability to concentrate, and sleep patterns indecisiveness Who Gets Depression? ■ Irritability, anger, worry, ■ Inability to take pleasure in for- People of all ages, races, ethnic groups, and social class- agitation, anxiety mer interests, social withdrawal es have the illness. Although it can occur at any age, depression frequently develops between the ages of 25 ■ ■ Pessimism, indifference Excessive consumption of alcohol and 44. More women experience depression than men. or use of chemical substances ■ Loss of energy, persistent lethargy ■ Recurring thoughts of death or suicide ■ Unexplained aches and pains 2 3 Children and Depression Postpartum Depression As many as one in 33 children and one in eight adoles- Many women feel especially guilty about having depres- cents has depression. If your child has five or more sive feelings at a time when they should be or are symptoms for at least two weeks and it interferes with expected to be happy. It’s extremely important to talk his or her daily activities (e.g., going to school, playing about postpartum feelings, as untreated postpartum with friends), then your child may be clinically depression can affect the mother-child relationship and, depressed. Other warning signs of childhood depression in severe cases, may put the infant’s and/or mother’s life include headaches, frequent absences from school, at risk. social isolation and reckless behavior. One in ten mothers meets the criteria for depression in Childhood depression is not caused by poor parenting. the postpartum period. Although most of these women It may have many origins – genetics, biochemistry and have only depression, a rare few develop postpartum a variety of other factors. Fortunately, treatment for psychosis – symptoms of depression and mania appear- childhood depression is highly effective. ing in the postpartum period. Both require immediate treatment when symptoms appear. Depression and the Elderly Depression and Other Illnesses Depression is not a normal part of aging. However, of Depression often co-exists with other mental or physical the 32 million Americans over the age of 65, nearly five illnesses. Substance abuse, anxiety disorders and eating million experience serious symptoms of depression and disorders are particularly common mental conditions one million suffer from a major depressive disorder. which may be worsened by depression, and vice versa. Elderly people with untreated depression are more like- Research is currently being done into the relationship ly to have worse outcomes from co-existing medical between depression and physical illnesses. Several recent illnesses. Untreated depression is the most common studies have noted that when co-existing depression is psychiatric disorder and the leading cause of suicide treated, prognoses are substantially improved for condi- among the elderly. tions such as heart disease, AIDS, cancer, Parkinson’s disease and diabetes. It is important to tell your doctor Women and Depression about all of the symptoms you are experiencing and all other illnesses for which you are receiving treatment. If you are a woman, you are almost twice as likely as a man to experience depression. In fact, one in four women will experience clinical depression in her life- The Good News time. The hormonal and life changes associated with Of all psychiatric illnesses, depression is one of the menstruation, pregnancy, miscarriage, the postpartum most responsive to treatment. With proper care, approx- period and menopause may contribute to or trigger imately 80 percent of people with major depression depression. The lifetime prevalence of major depression demonstrate significant improvement and lead produc- is 24 percent for women; for men, it’s 15 percent. tive lives – even those with severe depression can be helped. That’s why it’s crucial to learn about the symp- toms of depression and act promptly. 4 5 Bipolar Symptoms of Mania Disorder ■ Increased physical and mental ■ Racing speech, racing thoughts, activity and energy flight of ideas More Than A Mood Swing ■ Heightened mood, exaggerated ■ Impulsiveness, poor judgment, optimism and self-confidence distractability Bipolar disorder, also known as manic-depression, is a treatable medical ill- ■ Excessive irritability, aggressive ■ Reckless behavior such as spend- ness marked by extreme changes in mood, thought, behavior ing sprees, rash business decisions, erratic driving and energy and behavior. A person’s mood can alternate ■ Decreased need for sleep with- sexual indiscretions between the “poles” of mania and depression. This out experiencing fatigue change in mood or “mood swing” can last for hours, ■ In the most severe cases, ■ Grandiose delusions, inflated days, weeks or even months.
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