Dear Friends (Ali, Kittygal, and others),
DSM-IV is the abbreviated name of the Diagnostic and Statistical Manual of Mental Disorders (currently in its fourth edition). This manual is published by the American Psychiatric Association and is revised from time-to-time. The DSM-IV is the official set of diagnostic criteria for mental disorders in the United States, and the categories generally correspond to the international categories used in the International Classification of Disease published by the World Health Organization.
Depression can be caused by almost anything. Each person's depressive event will be different from any one else's, and even unique from others they themselves may have experienced. Nearly all people will experience a certain amount of depression during their lifetime brought on by everything from the death of a loved one (including pets) to the birth of a baby. Triggers for depression don't have to be life changing events. I experienced a sudden slap of depression this past weekend when all of our extended family was over at our house, everyone was in a good mood, my life was going well, but the cacophony of sound produced by 18 people just suddenly overwhelmed me. Others must face it annual as an internal response to less exposure to the sun during the winter at higher latitudes.
As depression is probably more common than the common cold, one has to be careful not to attach stigma to it. Most people will weather it for a few days to a few weeks, and then move on just fine, with hardly even the memory of the event. But as the common cold if not taken care of can hang on or, worse, become deadly pneumonia in some patients, so to one must take care to not make light of depressive episodes in people's lives telling them to simply get over it. For even a simple "fit of depression" can have serious and long lasting effects if not handled well.
One of the most common forms of depression is what is known as Generalized Anxiety Disorder. A disorder characterized by generalized and persistent free-floating anxiety (anxiety not restricted to any particular event or circumstance). The symptoms are variable, and can include muscule tension, continuous feelings of nervousness, trembling, sweating, lightheadedness, dizziness, palpitations, and gastro-instetinal discomfort. A variety of worries are often expressed, including the worry that the sufferer or a relative will have an accident or become ill. Sleep disturbance is common. Generalized Anxiety Disorder is more common in women than men. One factor in its development appears to be chronic stress. Its course varies, but tends to be fluctuating and chronic.
Another common form of depression is simply called Major Depression. Major depressive disorder consists of one or more major depressive episodes each of which lasts at least 2 weeks. The most prominent symptoms of major depressive disorder are depressed mood and loss of interest or pleasure. Patients also tend to have other symptoms, but these vary from person-to-person. Insomnia and weight loss often accompany major depression, but depressed patients may also gain weight and sleep excessively.
Major depression encompasses disorders that were once conceptualized separately. A form sometimes called melancholia, is most common among older adults people, as are depressions characterized by psychotic features such as delusions and hallucinations. Anxiety symptoms such as panic attacks, phobias, and obsessions also often found mixed with depressive symptoms, making diagnosis an inexact art at times. Untreated major depressive episodes often last about 9 months. Approximately 85% of persons with major depression will get better within 2 years of the first episode, but at least 50 percent of depressions will recur, and after three or more episodes the odds of recurrence within 3 years increases to around 75% if the patient has not had preventive treatment. The risk of suicide makes it important to treat major depression.
Either of these above type of depression can present themselves in severe or low-grade forms. As a pastor I deal with people on a regular basis who are combatting depression. Most are able to find help simply by talking it out. For some it is resolved just that simply. Others need to identify the source of their depression and do some digging to resolve issues they may have buried or be unconscioulsy cling to in their lives. Many have religious issues and attitudes toward God, or concerns with regard to how well/poorly they are living their lives, certain levels of expectations they have for themselves or significant others in their lives, worries with regard to the influence of the devil (Shaytaan) or their ability/inability to please God that are among the issues they have to deal with.
As I already expressed, each person is unique. And finding out what is going on is often quite involved. The good news, is that most people don't need professional therapy. They just need to learn to be a bit more senstive to the events transpiring in their lives, to treat themselves well (the way they eat, the sleep they get, and the pressure they put on themselves to perform). Exercise is perhaps the best therapy, even better than talking to a friend. Though many who get depressed find that if they have a number of healthy relationships (have to emphasize that word healthy) and people that they regularly interact with that this serves as a good preventative tool. But, if you realized that you are depressed. If you find yourself not functioning well. And if going for a run or out to dinner with a friend does not resolve the issue, and especially if this has lasted longer than a couple of week, please see someone. Start with a pastor, iman, or other religious person if you prefer, but remember that we are not generally trained to help people with true clinical depression. For that, you probably need to see a proessional therapist. Your religious leader or your medical doctor should both be able to provide you with direction in that regard. But you do need to get help. Most people can be "cured" by just talking to a friend. But for those for whom it is more serious in nature, it sometimes takes a considerable amount of therapy. Find someone who is trained and skilled in this, be sure it is someone you can be comfortable with, and then go.
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A journal is also a good way to get rid of confusion...if you're confused about life in general; putting your thoughts onto paper can ease the mind a little and unscramble your thoughts.
