Monday, April 2, 2012


     There are three basic types of clinical depression, according to the mental health community: major or severe depression, chronic or dysthymic depression, and bipolar disorder or manic depression.  
     Major Depression---This depressed state will last for two weeks or more, bringing on sadness, frustration, plus intense pessimistic feelings.  The person is so down that they feel that things are hopeless and this feeling will last forever.
     Chronic Depression---With chronic depression the down feeling will come and go.  If your patient is depressed more than half the time, it is considered chronic depression.  If your patient is severely depressed and that depression goes untreated, it can become chronic depression.
     Manic Depression---In this type of depression the patient’s mood swings from one extreme to the other.  They will have periods of high energy and excitability, then swing to periods of depression and low energy.
     Sometimes depression follows a loss of a loved one or some crisis in your life.  It is a normal reaction to be depressed when a crisis befalls you.  It will pass.  Usually, it will last a couple of weeks or even a month, but not much longer.  It might incapacitate you for a while, but you will snap out of it.  This depression is called reactive depression.  You are reacting to a personal crisis or loss, even the loss of a job.  This type of depression is common with older people as they lose their health, their spouse, or their home when they have to move.  But this type of depression is not likely to cause a person to lose weight, concentration, memory, or attention.
     Depression can also well up from within. Again the person will lose his appetite, have problems concentrating or remembering, may have heart palpitations, and may have trouble making decisions.  Personal grooming will suffer and the person may feel guilt and be full of self-doubt about everything.  Mood swings are common.  The person may feel worse in the morning and then as the day goes on, feel a little better.  It is hard to distinguish between this depression (endogenous) and the other type of depression (reactive).  Both make the patient feel terrible.
     It is hard to say what causes depression.  If there is a family history of depression, chances are greater that it will continue with other family members.  Some families keep this a deep, dark secret because they feel ashamed.  Therefore, it can be difficult to gather this information.
     With the many changes that occur as we get older, including the loss of loved ones, moving from the old neighborhood, and retirement, many older people feel unneeded, unwanted, and useless.  This can certainly make them depressed.  Sometimes they wonder if this is all there is to life or if their being on Earth has really made a difference in the world.  These questions are asked by many elderly people.
     Depression can be triggered by medications as well.  One side effect of many medications is depression.  That is why it is so important to know the side effects of all the medications that your patient is taking.
     As we get older our bodies change, we get illnesses that are related to age, we slow down and the simplest task seems to be a chore.  Our bodies are changing, and the brain chemicals are also changing.  There is a delicate balance of chemicals in the brain that can be thrown off by certain illnesses.  These changes can cause depression.

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