Overcoming Depression

What is Depression?
How do you know when you’re depressed? Everyone experiences some unhappiness or “the blues”, often due to a change, in the form of a setback or a loss. The painful feelings that accompany these changes are usually appropriate, necessary, and transitory and can even present an opportunity for personal growth. However, when depression persists and impairs daily life, it may be an indication of a depressive disorder. Severity, duration, and the presence of other symptoms are some of the factors that distinguish normal sadness from a depressive disorder.

Generally in major depression, at least five of the symptoms listed below occur for a period of at least two weeks, and they must represent a change from previous behavior or mood.

1. Depressed mood on most days for most of each day. (Irritability may be prominent in children and adolescents)
2. Total or very noticeable loss of pleasure most of the time.
3. Significant increase or decrease in appetite, weight, or both.
4. Sleep disorders either insomnia or excessive sleepiness nearly every day.
5. Feelings of agitation or a sense of intense slowness.
6. Loss of energy and a daily sense of tiredness.
7. Sense of guilt and worthlessness nearly all the time.
8. Inability to concentrate occurring nearly every day.
9. Recurrent thoughts of death or suicide.

Who Becomes Depressed?
Many wonder if they are at risk for depression. It is an illness that can affect anyone, regardless of age, race, class, or gender. About 17 million Americans are estimated to develop depression each year. In one large survey, 8.6% of adults over the age of 18 reported having a mental health problem for at least two weeks. However, the incidence may be even higher since many people fail to seek help for depression and some physicians are reluctant to diagnose depression. The following list include various factors that can affect depression:

1. GENDER. Women, regardless of nationality or socioeconomic level, have higher rates of depression than men. This may be in part due to hormonal changes often experienced during the days before menstruation, the postpartum period after delivering a baby, and around menopause. Women are also affected by the difference in their social status from men.

2. SOCIAL AND ECONOMIC CONSIDERATIONS. Being in a low socioeconomic group is a major risk factor for depression. However, people of all income levels are likely to be depressed if they have poor health and are socially isolated.

3. SEVERE OR CHRONIC MEDICAL CONDITIONS. Depression follows or is caused by many medications or serious medical problems.

4. EMOTIONAL AND PERSONALITY DISORDERS. Chronic depression is a frequent companion to anxiety disorders. Personality disorders, such as borderline and avoidant personalities, appear to strongly predispose people to depression.

5. SUBSTANCE ABUSE AND ADDICTIONS. It is estimated that 25% of people with substance abuse problems also have major depression. Internet addiction is a recent phenomenon that may a pose risk for depression as well.

6. SLEEP DISORDERS. A study of male medical students found that young men who experience insomnia are twice as likely to suffer from depression at middle age.

7. FAMILY HISTORY. A family history of mental illness, especially mood disorders, appears to predispose a patient to the development of depression. Often a combination of genetic, biologic, and environmental factors are at work. Children of depressed parents are at a higher risk for depression and other emotional disorders.

Treating Depression
It is important to remember that depression can be treated! A very effective way to treat depression is by therapy with a mental health professional. Sometimes the level of dysfunction may be serious enough to warrant hospitalization. In most cases, however, depression can be treated in an office setting by a psychologist.

Dr. Kathy Marshack can help you. She is accepting new clients and has two office locations for your convenience. If you live in the Portland, Oregon or Vancouver, Washington area (or can drive to these locations) please call to set up your first appointment. See Therapy FAQs for more information. Please give us a call at (360) 256-0448 or (503) 222-6678 or email us at

In addition to psychotherapy, antidepressants are another effective way to treat depression. One study reported that up to 90% of patients with major depression will improve with good compliance and adequate doses of the right antidepressant drug. Patients who improve within two weeks of taking medications may not require lengthy treatment. Some patients, however, may require indefinite maintenance therapy. Something to consider is that virtually all antidepressants have side effects and complicated interactions with other drugs can be very serious. It’s important to work closely with a physician.

Often lifestyle changes can help depression. A healthy diet and regular exercise promotes mental and emotional health. A strong network of positive and healthy support from family and friends is important for prevention and recovery from depression. Studies also indicate that people with strong spiritual faiths have a lower risk for depression. Such faith does not necessarily require an organized religion, some might find solace from less structured sources for obtaining spiritual self-fulfillment.