Thursday, November 16, 2006

About Depression and Other Mental Health Disorders

Who are we? We are your neighbors, your fellow church members, your co-workers, maybe even a family member. We are persons with a mental illness. We have been called lazy, selfish, weak-minded, crazies, and even subhuman among other things by individuals around us. There are those who are still frightened of us and/or walk on egg shells around us. Although there is progress being made in awareness and education, there are still many stereotypes and misconceptions about our illness. This entry is about education and awarness, about fighting the misconceptions and stigmas surrounding mental illness.

What is Mental Illness?
Mental illness is defined by SAMHSA's National Mental Health Information Center as "Mental illness is any diagnosable mental, behavioral, or emotional disorder that interferes with or limits a person's ability to live, work, learn, and participate fully in his or her community. Mental illness includes disorders such as depression, bipolar disorder, schizophrenia, panic disorder, obsessive compulsive disorder, posttraumatic stress disorder, attention deficit hyperactivity disorder, autism, and Alzheimer's disease. Mental illness involves the body, mood, and thoughts. It affects the way a person thinks, eats, sleeps, and feels about him/herself. Mental illness is not a sign of personal weakness or lack of willpower. People with a mental illness cannot simply overcome it and get better on their own."
According to National Alliance on Mental Illness (NAMI)
  • Mental illnesses include such disorders as schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, panic and other severe anxiety disorders, autism and pervasive developmental disorders, attention deficit/hyperactivity disorder, borderline personality disorder, and other severe and persistent mental illnesses that affect the brain.
  • Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing.
  • Mental illnesses are biologically based brain disorders. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.
  • Mental disorders fall along a continuum of severity. The most serious and disabling conditions affect five to ten million adults (2.6 – 5.4%) and three to five million children ages five to seventeen (5 – 9%) in the United States.
How is It Treated?
Also, according to National Alliance on Mental Illness (NAMI)
"Mental illnesses are treatable. Most people with serious mental illness need medication to help control symptoms, but also rely on supportive counseling, self-help groups, assistance with housing, vocational rehabilitation, income assistance and other community services in order to achieve their highest level of recovery. The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports. Early identification and treatment is of vital importance; By getting people the treatment they need early, recovery is accelerated and the brain is protected from further harm related to the course of illness. Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives; The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States. "
Now I will be narrowing my focus here to depressive disorders and suicide.

What is a Depressive Disorder?
The National Institute for Mental Healthdefines a depressive disorder as, "an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness 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."
And according to the Depression and Bipolar Alliance, "Depression is a treatable illness involving an imbalance of brain chemicals called neurotransmitters. It is not a character flaw or a sign of personal weakness. You can’t make yourself well by trying to "snap out of it." Although it can run in families, you can’t catch it from someone else. The direct causes of the illness are unclear, however it is known that body chemistry can bring on a depressive disorder, due to experiencing a traumatic event, hormonal changes, altered health habits, the presence of another illness or substance abuse."
Some Statistics:
According to the National Institute of Mental Health...
  • Approximately 20.9 million adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder. (1)
  • The median age of onset for mood disorder is 30 years (5).
  • Depressive disorders often co-occur with anxiety disorders and substance abuse (5).
        Major Depressive Disorder
  • Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44(3).
  • Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year (1)
  • While major depressive disorder can develop at any age, the median age at onset is 32(5).
  • Major depressive disorder is more prevalent in women than in men (6).
        Dysthymic Disorder
  • Symptoms of dysthymic disorder (chronic, mild depression) must persist for at least two years in adults (one year in children) to meet criteria for the diagnosis.
  • Dysthymic disorder affects approximately 1.5 percent of the U.S. population age 18 and older in a given year(1). This figure translates to about 3.3 million American adults(2).
  • The median age of onset of dysthymic disorder is 31(1).
        Bipolar Disorder
  • Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year(1).
  • The median age of onset for bipolar disorders is 25 years(5).
What are the Symptoms of a Depressive Disorder?
Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.


  • Persistent sad, anxious, or "empty" mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain


  • Abnormal or excessive elation
  • Unusual irritability
  • Decreased need for sleep
  • Grandiose notions
  • Increased talking
  • Racing thoughts
  • Increased sexual desire
  • Markedly increased energy
  • Poor judgment
  • Inappropriate social behavior
What Does It Feel Like?
Unless you've studied pyschology at a college level or experienced it first hand, the average person probably doesn't know what it's like to experience depression. The following article relates the feelings and perspectives of one person who's experienced depression, with hundreds of others also contributing their experiences in the comment section:

How is it Treated?

What Causes a Person to Attempt Suicide?
According to this website:  Start by considering this statement, “Suicide is not chosen; it happens when pain exceeds resources for coping with pain.”  Well, let's take what we already know, persons with a depressive disorder or substance addiction are experiencing some degree of emotional pain or turmoil. And every person has a different amount of coping resources. Now back to what the website says: "When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources."

Some Statistics:
According to the National Institute of Mental Health...
  • In 2002, 31,655 (approximately11 per 100,000) people died by suicide in the U.S. (7, 8).
  • More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or substance abuse disorder(9).
  • The highest suicide rates in the U.S. are found in white men over age 85(8).
  • Four times as many men as women die by suicide(8); however, women attempt suicide two to three times as often as men(10).
What Can be Done About This?
Indiana's state suicide prevention plan is a good example of a state-wide plan, based on a multi-pronged approach of 1.)Awareness, 2.)Intervention, and 3.)Methodology
On an individual level, there are things you can do as well:
According to the Indiana Suicide Prevention Coalition:
Step 1: Learn to recognize the warning signs of suicide.

Step 2: If you suspect someone you know is depressed and suicidal or could be suicidal, approach that person. Talk openly about depression and suicide and ask directly about whether the person in distress is thinking about suicide. Listen and affirm their feelings. Do not judge or debate whether feelings are right or wrong and don't tell them or imply that they are wrong but do help them explore positive ways to solve their problems.

Step 3: Be available and show interest and support for their situation.

Step 4: Remove any means of suicide such as guns, ropes, knives and pills from their home. Assist them to get help from mental health or crisis intervention experts by calling or taking them to their family physician, your local mental health center, the behavioral health / psychiatric units or emergency departments of their local community hospital or call a national suicide hotline such as 1-800-273-TALK for further information.

1) National Institute of Mental Health
Fact Sheet (reviewed 2006)
The Numbers Count: Mental Disorders in America

2(National Alliance on Mental Illness
About Mental Illness

Suggestions for Support People:
DBSA Educational Materials
Free online brochures with information on a number of mood disorder-related topics. Note: Some come in PDF format and requireAdobe Acrobat Reader

What to Do When Someone You Know is Depressed

Is Someone You Love Depressed?

If You Know Someone Who's Depressed

What to Do When a Friend is Depressed
A helpful guide for teenagers

The 23 Best Things to Say to Someone Who is Depressed

The 99 Worst Things to Say to Someone Who is Depressed

Worst Things to Say to Someone Who is Depressed

Additional Mental Health Resources

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