Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It is a mental health condition that requires understanding and care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan many people can and do get better.
Some will only experience one depressive episode in a lifetime, but for many, depressive disorder recurs. Without treatment, episodes may last a few months to several years. People of all ages and all racial, ethnic, and socioeconomic backgrounds experience depression.
Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:
- Changes in sleep
- Changes in appetite
- Lack of concentration
- Loss of energy
- Lack of interest in activities
- Hopelessness or guilty thoughts
- Changes in movement (less activity or agitation)
- Physical aches and pains
- Suicidal thoughts
Treatments
Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment, a client-centered treatment plan can include any or a combination of the following:
- Therapy: includes cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
- Medications: including antidepressants, mood stabilizers and antipsychotic medications.
- Exercise: can help with prevention and mild-to-moderate symptoms.
- Light therapy: uses a light box to expose a person to full spectrum light to regulate the hormone melatonin.
Bipolar Depression
Symptoms
Symptoms and their severity can vary. A person with bipolar disorder may have distinct manic or depressed states but may also have extended periods—sometimes years—without symptoms. A person can also experience both extremes simultaneously or in rapid sequence.
Mania. To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. Hypomania is a milder form of mania that does not include psychotic episodes. People with hypomania can often function well in social situations or at work. Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; others may experience them only rarely.
Although someone with bipolar may find an elevated mood of mania appealing—especially if it occurs after depression—the “high” does not stop at a comfortable or controllable level. Moods can rapidly become more irritable, behavior more unpredictable and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions, and take unusual risks.
Depression. The lows of bipolar depression are often so debilitating that people may be unable to get out of bed. Typically, people experiencing a depressive episode have difficulty falling and staying asleep, while others sleep far more than usual. When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt, or helplessness; this negative thinking can lead to thoughts of suicide.
The depressive symptoms that obstruct a person’s function must be present nearly every day for at least two weeks for a diagnosis. Depression associated with bipolar disorder may be more difficult to treat and require a customized treatment plan.
Treatment – Bipolar disorder is treated and managed in several ways:
- Therapy, such as cognitive behavioral therapy and family-focused therapy.
- Medications, such as mood stabilizers, antipsychotic medications and, to a lesser extent, antidepressants.
- Self-management strategies, like education and recognition of an episode’s early symptoms.
- Complementary health approaches, such as aerobic exercise meditation, faith and prayer can support, but not replace, treatment.
We all experience anxiety. For example, speaking in front of a group can make us anxious, but that anxiety also motivates us to prepare and practice. Driving in heavy traffic is another common source of anxiety, but it helps keep us alert and cautious to avoid accidents. However, when feelings of intense fear and distress become overwhelming and prevent us from doing everyday activities, an anxiety disorder may be the cause.
Anxiety disorders are the most common mental health concern in the United States.
Symptoms
Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People typically experience one or more of the following symptoms:
Emotional symptoms:
- Feelings of apprehension or dread
- Feeling tense or jumpy
- Restlessness or irritability
- Anticipating the worst and being watchful for signs of danger
Physical symptoms:
- Pounding or racing heart and shortness of breath
- Sweating, tremors and twitches
- Headaches, fatigue and insomnia
- Upset stomach, frequent urination or diarrhea
Treatment
Different anxiety disorders have their own distinct sets of symptoms. This means that each type of anxiety disorder also has its own treatment plan. But there are common types of treatment that are used.
- Psychotherapy, including cognitive behavioral therapy
- Medications, including antianxiety medications and antidepressants
- Complementary health approaches, including stress and relaxation techniques
Traumatic events—such as an accident, assault, military combat, or natural disaster—can have lasting effects on a person’s mental health. While many people will have short term responses to life-threatening events, some will develop longer term symptoms that can lead to a diagnosis of Posttraumatic Stress Disorder (PTSD). PTSD symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety. Women are significantly more likely to experience PTSD than men.
Symptoms of PTSD generally fall into these broad categories:
Re-experiencing type symptoms, such as recurring, involuntary and intrusive distressing memories, which can include flashbacks of the trauma, bad dreams and intrusive thoughts.
Avoidance, which can include staying away from certain places or objects that are reminders of the traumatic event. A person might actively avoid a place or person that might activate overwhelming symptoms.
Cognitive and mood symptoms, which can include trouble recalling the event, negative thoughts about one’s self. A person may also feel numb, guilty, worried or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can include out-of-body experiences or feeling that the world is “not real” (derealization).
Arousal symptoms, such as hypervigilance. Examples might include being intensely startled by stimuli that resembles the traumatic event, trouble sleeping or outbursts of anger.
Young children can also develop PTSD, and the symptoms are different from those of adults. (This recent recognition by the field is a major step forward and research is ongoing.) Young children lack the ability to convey some aspects of their experience. Behavior (e.g. clinging to parents) is often a better clue than words, and developmental achievements in an impacted child might slip back (e.g. reversion to not being toilet trained in a 4-year-old).
A child must be assessed by a professional skilled in the developmental responses to stressful events. A pediatrician or child mental health clinician can be a good start.
Treatment
Though PTSD cannot be cured, it can be treated and managed in several ways.
- Psychotherapy, such as cognitive processing therapy or group therapy
- Medications
- Self-management strategies, such as self-soothing and mindfulness, are helpful to ground a person and bring her back to reality after a flashback
- Service animals, especially dogs, can help soothe some of the symptoms of PTSD
Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don’t make sense, they are often unable to stop them.
Symptoms typically begin during childhood, the teenage years or young adulthood, although males often develop them at a younger age than females.
Symptoms
Most people have occasional obsessive thoughts or compulsive behaviors. In an obsessive-compulsive disorder, however, these symptoms generally last more than an hour each day and interfere with daily life.
Obsessions are intrusive, irrational thoughts or impulses that repeatedly occur. People with these disorders know these thoughts are irrational but are afraid that somehow they might be true. These thoughts and impulses are upsetting, and people may try to ignore or suppress them.
Examples of obsessions include:
- Thoughts about harming or having harmed someone
- Doubts about having done something right, like turning off the stove or locking a door
- Unpleasant sexual images
- Fears of saying or shouting inappropriate things in public
Compulsions are repetitive acts that temporarily relieve the stress brought on by an obsession. People with these disorders know that these rituals don’t make sense but feel they must perform them to relieve the anxiety and, in some cases, to prevent something bad from happening. Like obsessions, people may try not to perform compulsive acts but feel forced to do so to relieve anxiety.
Examples of compulsions include:
- Hand washing due to a fear of germs
- Counting and recounting money because a person can’t be sure they added correctly
- Checking to see if a door is locked or the stove is off
- “Mental checking” that goes with intrusive thoughts is also a form of compulsion
Treatment
A typical treatment plan will often include both psychotherapy and medications, and combined treatment is usually optimal.
Psychotherapy is also helpful in relieving obsessions and compulsions. In particular, cognitive behavior therapy (CBT) and exposure and response therapy (ERT) are effective for many people. Exposure response prevention therapy helps a person tolerate the anxiety associated with obsessive thoughts while not acting out a compulsion to reduce that anxiety. Over time, this leads to less anxiety and more self-mastery.
OCD can be treated effectively. Let us help with therapy and support.
Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.
Symptoms
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the “prodromal” period.
With any condition, it is essential to get a comprehensive medical evaluation to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:
- Hallucinations. These include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.
- Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
- Negative symptoms are ones that diminish a person’s abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.
- Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosia or “lack of insight.”
To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized or catatonic behavior
- Negative symptoms
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Treatment
Schizophrenia can be treated and managed in several ways.
- Antipsychotic medications
- Psychotherapy, such as cognitive behavioral therapy and assertive community treatment and supportive therapy
- Self-management strategies and education
Are you feeling stressed, sad, or overwhelmed? We’re here to help. There is hope. From initial contact to intensive ASL therapy sessions, our team is here to center mental health care in every part of the human experience by offering full-service support. We are here to partner with you on your healing journey. We take care of the hassles, so you can focus on yourself.
Anixter Center offers therapy and counseling in American Sign Language (ASL) for Deaf, DeafBlind, and Hard of Hearing communities. We offer help with stress, grief, trauma, and other things that may be troubling you. We serve people of all ages, from children to seniors.