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This sticky has information on depression, types of depression, how to deal with it, helpful resources, etc. If you have something that you think should be added, you can post it in here, or PM me about it. All of the articles are from papers handed out at my college's mental-health wellness day in Oct. of 2005. The resources are places I looked up online.

Thank you for taking the time to read this. heart

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Table of Contents:

- Post 1: Depression article: "Depression and Bi-Polar Disorder" (Edited, since the bi-polar information is in the other sticky)
- Post 2: Depression article: "Depression Co-Occuring with General Medical Disorders"
- Post 3: Depression article: "Men and Depression"
- Post 4: Depression article: "Older Adults: Depression and Suicide Facts"
- Post 5: Article: "Mental Disorders - What Families and Friends Can Do To Help"
- Post 6: Article: "Children, Youth, and Mental Disorders"
- Post 7: Helpful resources for people with depression.

"Depression Co-Occuring with General Medical Disorders"
Awareness and treatment can improve overall health and reduce suffering.


Clinical depression commonly co-occurs with general medical illness, though it often goes undetected and untreated. In fact, while the rate of major depression among persons in the community is estimated to be between 2 and 4%, among primary care patients it is between 5 and 10%, and among medical patients it is between 10 and 14%. And an additional 2 to 3 times as many persons in these groups experience depressive symptoms. Research suggests that recognition and treatment of co-occuring depression may improve the outcome of the medical condition, improve the quality of life, and reduce the degree of pain and disability experienced by the medical patient.


What Is Depression?
Clinical depression is a common and highly treatable illness affecting over 17 million American adults --with or without a co-occuring condition-- each year. Unfortunately, nearly two-thirds of them do not get treatment, in part, because the effects of depression are not understood to be an illness. With proper treatment, however, nearly 80% of those with depressive illness can feel better, and most within a matter of weeks.


Depression: A Whole Body Illness
Depression affects mood, thought, body, and behavior. For some, it occurs in one or more relatively severe episodes, known as major depression. Others have ongoing, less severe but also debilitating symptoms, known as dysthymia. And still others have bi-polar disorder (also known as manic depressive illness), with cycles of terrible "lows" and excessive "highs".

If five or more symptoms last for 2 weeks or longer, or are severe enough to interfere with normal functioning, an evaluation for clinical depression by a qualified health or mental health professional is recommended.


Accurate Diagnosis Is Important
Since some symptoms are common to both depression and certain medical disorders, accurate diagnosis is critical to developing an effective plan for treatment. For example, symptoms of depression such as weight loss, sleep disturbances and low energy may also occur in diabetes, thyroid disorders, some neurologic disorders, heart diease, cancer, and stroke. Other depressive symptoms, such as loss of interest or memory, also occur early in the course of disorders such as Parkinson's and Alzheimer's diseases. In addition, achiness or fatigue may be present in many other conditions. In such cases, careful assessment of an individual's emotional state, and personal and family histories can help determine if one or two illnesses are present.


Other Diagnostic Concerns
The relationship of clinical depression to a medical illness can be varied. Depression can occur as the biological result of a condition such as underactive thyroid, or can be the side-effect of one or a combination of medications, including over-the-counter medications. In such cases, the depression may be relieved by a change in dosage or type of treatment(s). On the other hand, it is not unusual for a traumatic diagnosis, such as cancer, to trigger a period of depressive symptomatology including sadness, poor concentration, anxiety or withdrawal. Careful monitoring of the length and severity of the depressive symptoms can determine if clinical depression is an additional diagnosis.


A Message of Hope: Depression is Treatable!
When depressive illness is a co-occuring condition, it should be treated. With treatment, up to 80% of those with depression can show improvement, usually in a matter of weeks. Common interventions include a range of antidepressant medications,focused short-term psychotherapy, or a combination of the two. In addition, in special circumstances, electroconvulsive therapy (ECT), a safe and effective treatment, may be considered as an option. Which treatment is recommended depends on the severity of the depression, and on the type of co-occuring illess and its treatment. In addtion, maximizing the treatment of the medical disorder may also help to diminish the depressive symptoms.


Treatment of Depression Has Added Benefits
Treatment of depression can improve a patient's overall quality of life in several ways. It may enhance the abililty to follow the treatment regimen for the co-occuring medical condition, decreasing complications and improving the eventual outcome. In addition, effective management of depression can lessen the degree to which the patient is irritable, demanding, or experiences overall problems in functioning, any of which may contribute to slower or more difficult recovery, and greater stress and disability from the medical condition. Finally, controlling the depression will often improve the cognitive symptoms that are a part of some illnesses.


The Path to Healing
Whether or not it co-occurs with medical illness, overcoming depression requires recognition of symptoms, and evaluation and treatment by a qualified health or mental health professional. Success involves a partnership with a health care provider so that the individual's concerns can be addressed. Negative thinking is a part of the depression that will fade as symptoms resolve. family and friends can help by encouraging the depressed person to seek or remain in treatmen, and by offering emotional support. In addition, the following may be helpful adjuncts to treatment: support groups, mild exercise or hobbies, reading self-help materials.


Symtpoms of Depression
- Persistent sad, anxious or empty mood
- Loss of interest or pleasure in activities, including sex
- Irritability or excessive crying
- Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
- Sleep disturbances
- Eating disturbances
- Decreased energy and fatigue
- Thoughts of death or suicide
- Difficulty with concentration, memory, or making decisions
- Chronic aches and pains


Symptoms of Mania
- Excessively "high" mood
- Irritability
- Decreased need for sleep
- Increased energy and activity
- Increased talking, moving, and sexual activity
- Racing thoughts
- Poor judgement or decision-making
- Grandiose notions
- Being easily distracted

When 5 or more of these symptoms last for longer than 2 weeks,a re not caused by other illness or medication, or disrupt usual functioning, an evaluation for depression or manic-depressive illness is indicated.

Older Adults: Depression and Suicide Facts

Depression, one of the most common conditions associated with suicide in older adults, is a widely unrecognized and undertreated medical illness. In fact, several studies have found that many older adults who die by suicide -up to 75%- have visited a primary care physician within a month of their suicide. These findings point to the urgency of improving detection and treatment of depression as a means of reducing suicide risk among older persons.

Older Americans are disproportionately likely to die by suicide. Compromising only 13% of the US population, indivudals aged 65 and older accounted for 18% of all suicide deaths in 2000. Among the highest rates (when catagorized by age and race) were white men aged 85 and older: 59 deaths per 100,000 persons in 2000, more than 5 times the national US rate of 10.6 per 100,000.

Of the nearly 35 million American age 65 and older, an estimated 2 million have a depressive illness (major depressive disorder, dysthymic disorder, or bi-polar disorder) and another 5 million may have "subsyndromal depression", or depressive symptoms that fall short of meeting full diagnostic criteria for a disorder. Subsyndromal depression is especially common among older personals and is associated with an increased risk of developing major depression. In any of these forms, however, depressive symptoms are not a normal part ofd aging. In contrast to the normal emotional experiences of sadness, grief, loss, or passing mood states, they tend to be persistent and to interfere significantly with an individual's ability to function.

Depression often co-occurs with other serious illnesses such as heart disease, stroke, diabetes, cancer, and Parkinson's Disease. Because many older adults face these illnesses as well as various social and economic difficulties, halth care professionals may mistakenly conclude that depression is a normal consequence of these problems - an attitude often shared by patients themselves. These factors together contribute to the underdiagnosis and undertreatment of depressive disorders in older people. Depression can and should be treated when it co-occurs with other illnesses, for untreated depression can delay the recovery from or worsen the outcome of these other illnesses. The relationship between depression and the other illness processes in older adults is a focus of ongoing research.

Both doctors and patients may have difficulty identifying the signs of depression. NIHM-funded researchers are currently investigating the effectiveness of a depression education intervention delivered in primary care clinics for improving recognition and treatment of depression and suicidal symptoms in elderly patients.


Research and Treatment
Research has revealed varying patterns of clinical and biological features among older adults with depression. As compared to older persons whose depression began earlier in life, those whose depression first appears in late life are more likely to have a chronic course of illness. In addition, there is growing evidence that depression beginning in later life is associated with vascular changes in the brain.

Both antidepressant medications and short-term psycho-therapies are effective treatments for late-life depression. Existing antidepressants are known to influence the functioning of certain neurotransmitters in the brain. The newer medications, chiefly the slective serotonin reputake inhibitors (SSRI's), are generally preferred over the older medications, including tricyclic antidepressants (TCA's) and monoamine oxidase inhibitors (MAOI's), because they have fewer and less severe potential side effects. Both generations of medications are effective in relieving depression, although some people will respond to one type of drug, but not another.

Research has shown that certain types of short-term psychotherapy, particularly cognitive-behavioral therapy and interpersonal therapy, are effective treatments for late-life depression. In addition, psychotherapy alone has been shown to prolong periods of good health free from depression. Combining psychotherapy with antidepressant medication, however, appears to provide maximum benefit. In one study, approximately 80% of older males with depression recovered from combination treatment. The combination treatment was also found to be more effective than either treatment alone in reducing recurrences of depression.

More studies are in progress on the efficacy and longer-term effectiveness of SSRI's and specific psychotherapies for depression in older persons. Findings from these studies will provide important data regarding the clinical course and treatment of late-life depression. Further research will be needed to determine the role of hormonal factors in the development of depression in older adults, and to find out whether hormone replacement therapy with estrogens or androgens is of benefit in the treatment of late-life depression.


(The National Institute of Mental Health in the US was the source of this article.)

Children, Youth and Mental Disorders




Though Canada prides itself on its universal healthcase system, mental health services for children and youth are not keeping pace with the high rates of depression, suicide, eating disorders, schizophrenia, and other mental illnesses in young Canadians.

A 2002 analysis of mental illness prevalence studies concluded that 15%, or around 150,000 children and youth in BC, "experience mental disorders causing significant distress and impairing their functioning at home, at school, with peers, or in the community" - anxiety, conduct, attention-defecit, and depressive disorders being the most common.

Depression and suicide are among the most talked about youth mental health issues. In Statistics Canada's 2000/01 Community Health Survey, 32,000 or about 8% of young people in BC aged 12 - 19 disclosed symptoms consistent with major depression. About 20% of young people admit having considered suicide in the past year, and just under 10% having attempted it. Being bullied at school increases the suicide risk about three-fold. That risks drops the more connected the youth is to their school.

Despite the number of children with depression, eating disorders and other mental disorders, many of these illnesses are left untreated in children, according to mental health advocates. For example, while an estimated 15% of BC's children and youth are needing help and would benefit from treatment, only 1%, or about 11,000 children and youth, were connected to the mental health system in BC in 2002, according to the Ministry of Child and Family Development.

One resaon for the lack of diagnosis and treatment is that people do not expect mental illness to affect someone so young. Another is that identifying mental illness in children can be challenging, particularly because young people change so much as they grow.

Parents may have difficulty distinguishing between normal phases in development and an underlying mental illness. For example, frequent outbursts of anger or tears may result from hormonal changes in puberty, or they may be symptoms of depression, a drug and/or alcohol addiction, or an eating disorder.

The pressures of school and growing up can be difficult for some children to cope with successfully. Parents who look at situations through adult eyes may not even realize the depths of their children's concerns - and even if they do, other factors such as culture and gender moderate whether a young person would even talk to their parents in the first place. In one BC study, Chinese youth, for instance, were twice as reluctant to consider a parent a preferred source of help for depression problems (17%) compared to non-Chinese youth (33%). In both cases, girls were the ones most likely to choose friends over parents.

Proper diagnosis and treatment are critical to recovery since the symptoms of mental disorders can worsen over time. Without help, mental illness can slow a child's mental and emotional development and leads to problems in school, family upheaval, substance use problems and even suicide.

Children with anxiety problems or disorders - at least 5% of whom have significant problems such as panic disorder, generalized anxiety, obsessive-compulsive or post-traumatic stress disorder, social phobia, or other phobias or disabling fears - can have varying reactions and social consequences from upset and worry to anger, uncooperative behavior and even aggression. Left unmanaged, anxiety in young people can worsen and lead to development of other problems such as depression.

Young people with depression are much more likely than other children to have low self-esteem, problems in school, physical ailments and substance use disorders.

Conduct and attention-defecit disorders, which may include hyperactivity, reduce a child's ability to direct and control his or her attention. Left untreated, these illnesses can interfere with the learning process and make it difficult for a child to live in harmony with family and friends.

Psychosis is a serious condition that often strikes young people, and it often goes undetected for months and ever years. It's characterized by symtpms such as hallucinations, delusions, paranoia, social withdrawl and at its most extreme, loss of contact with reality. The symptoms of psychosis may be related to ongoing illnesses such as schizophrenia, schizoaffective disorder, and some forms of unipolar or bi-polar affective disorder (also known as depression and manic depression). Since early detection of psychosis is associated with a better chance of recovery, it's important to intervene as soon as possible.

Like adults, young people develop mental illness for a variety of reasons. Some children develop depression in response to major life changes such as moving to a new city, being bullied, or going through their parents' divorce. Eating disorders such as anorexia or bulimia nervosa may be linked to depression, social pressures, low self-esteem and disordered food behaviors in the home. Children who are neglected, sexually abused, and/or exposed to family violence are much more vulnerable to mental illness. Genetic factors may also play a role. For example, research shows that a child has an increased chance of developing schizophrenia if a parent, both parents or an identical twin is diagnosed with the illness.

Regardless of the case, mental illness can make life difficult for children and youth and others around them. An adolescent with depression may feel worthless and believe that he or she is disliked by everyone. Children with attention-defecit disorders may create havoc in the classroom and at home, because of their impulsivity and difficulty expressing their true needs. And major illnesses, such as schizophrenia, may require extensive, ongoing care from parents which can lead to jealousy and resentment in other family members.

Nevertheless, professional and community support services that do exist throughout BC can help improve the quality of life for the child with a mental disorder, the caregiver, and the rest of the family. Many services offer practical support, education on mental illness, and messages of hope and recovery. The symptoms of mental illness are highly treatable and recovery is possible with the appropriate therapies, medications and support.


Signs of Mental Illness in Children and Youth
- Changes in behavior: ie - an active child becoming quiet and withdrawn, or a good student suddenly starts getting poor grades.
- Changes in feelings: For example, a child may shown signs of feeling unhappy, worried, guilty, angry, fearful, hopeless or rejected.
- Physical symptoms: Frequent headaches, stomach or back aches, problems eating or sleeping, or a general lack of energy.
- Changes in thoughts: For example, a child may begin saying things that indicate low self-esteem, self-blame, or thuoghts about suicide.
- Abuse of alcohol and/or drugs.
- Difficulty coping with regular activities and everyday problems.
- Consistent violation of the rights of others: ie - theft or vandalism.
- Intense fear of becoming fat with no relation to the child's actual body weight.
- Odd or repetative movements beyond regular playing, such as spinning, hand-flapping or head banging.
- Unusual ways of speaking or private language that no one else can understand.


What Parents Can Do To Help
- Encourage your child to discuss his or her concerns, but avoid a confrontational approach; listen carefully to what he or she has to say.
- Check with your family doctor to determine whether there is a physical cause (ie - iron deficiency) for your child's feelings of fatigue and low moods.
- Ask school teachers if they have noticed changes in the child or can suggest reasons for your child's altered behavior.
- Ask if your school board has a staff counsellor who can refer to you individual or group counselling to help children and teens cope with stress.
- Based on referrals from your family doctor, school counsellor or self-referral, book an appointment with a children's mental health team, psychiatrist or psychologist who works with children.
- Consider family counselling or a family support group to ease conflicts and teach family members how to support each other through difficult times.


Resources For Children With Mental Illness
A comprehensive evaluation and treatment team may include:
- Parents and family.
- Child or adolescent psychiatrist.
- Pediatricians and specialized physicians (ie - neurologists).
- Psychologists.
- Clinical social worker.
- Psychiatric nurses.
- Therapists/counsellors.
- Specific learning programs.
- Specific social skill and behavior programs.
- Specific schools or hospitals.
- Respite care services for the caregiver and family.
- Self-help groups and family support groups.