I realise this topic has been written already but I don't want mine to get lost in the replies.

How do you know if someone is seriously depressed?

For over a year now I've been thinking that my mother should really get professional help and probably medication. But she doesn't have a doctor who can refer her to a psychiatrist nor the money to pay for one. For various reasons that I won't go into right now she is incredibly down and hit a low point today. She even said that she can't handle the trouble her cat has been giving her she's going to either take him back to the Humane Society or to the vet to put him down. I told her to NOT make any rash decisions while she's so low, to wait a few days for things to clear up and she can think straight.

I don't know what to say or do to help.

Thanks.

This is long, it's from NAMI, which is a wonderful website for information about mental illness. I wasn't sure how old your mother was, so I only printed this information. The website has information on depression for older people.

What is major depression?

Major depression is a serious medical illness affecting 9.9 million American adults, or approximately 5 percent of the adult population in a given year. Unlike normal emotional experiences of sadness, loss, or passing mood states, major depression is persistent and can significantly interfere with an individual’s thoughts, behavior, mood, activity, and physical health. Among all medical illnesses, major depression is the leading cause of disability in the U.S. and many other developed countries.

More than twice as many women (6.7 million) as men (3.2 million) suffer from major depressive disorder each year. Major depression can occur at any age including childhood, the teenage years and adulthood. All ethnic, racial and socioeconomic groups suffer from depression. About three-fourths of those who experience a first episode of depression will have at least one other episode in their lives. Some individuals may have several episodes in the course of a year. If untreated, episodes commonly last anywhere from six months to a year. Left untreated, depression can lead to suicide.

Major depression, also known as clinical depression or unipolar depression, is only one type of depressive disorder. Other depressive disorders include dysthymia (chronic, less severe depression) and bipolar depression (the depressed phase of bipolar disorder or manic depression). People who have bipolar disorder experience both depression and mania. Mania involves abnormally and persistently elevated mood or irritability, elevated self-esteem, and excessive energy, thoughts, and talking.

What are the symptoms of major depression?

The onset of the first episode of major depression may not be obvious if it is gradual or mild. The symptoms of major depression characteristically represent a significant change from how a person functioned before the illness. The symptoms of depression include:

persistently sad or irritable mood
pronounced changes in sleep, appetite, and energy
difficulty thinking, concentrating, and remembering
physical slowing or agitation
lack of interest in or pleasure from activities that were once enjoyed
feelings of guilt, worthlessness, hopelessness, and emptiness
recurrent thoughts of death or suicide
persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
When several of these symptoms of depressive disorder occur at the same time, last longer than two weeks, and interfere with ordinary functioning, professional treatment is needed.

What are the causes of major depression?

There is no single cause of major depression. Psychological, biological, and environmental factors may all contribute to its development. Whatever the specific causes of depression, scientific research has firmly established that major depression is a biological brain disorder.

Norepinephrine, serotonin, and dopamine are three neurotransmitters (chemical messengers that transmit electrical signals between brain cells) thought to be involved with major depression. Scientists believe that if there is a chemical imbalance in these neurotransmitters, then clinical states of depression result. Antidepressant medications work by increasing the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers.

Scientists have also found evidence of a genetic predisposition to major depression. There is an increased risk for developing depression when there is a family history of the illness. Not everyone with a genetic predisposition develops depression, but some people probably have a biological make-up that leaves them particularly vulnerable to developing depression. Life events, such as the death of a loved one, a major loss or change, chronic stress, and alcohol and drug abuse, may trigger episodes of depression. Some illnesses such as heart disease and cancer and some medications may also trigger depressive episodes. It is also important to note that many depressive episodes occur spontaneously and are not triggered by a life crisis, physical illness, or other risks.

How is major depression treated?

Although major depression can be a devastating illness, it is highly treatable. Between 80 and 90 percent of those suffering from serious depression can be effectively treated and return to their normal daily activities and feelings. Many types of treatment are available, and the type chosen depends on the individual and the severity and patterns of his or her illness. There are three basic types of treatment for depression: medications, psychotherapy, and electroconvulsive therapy (ECT). They may be used singly or in combination.

Medication. The first antidepressant medications were introduced in the 1950s. Research has shown that imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine can be corrected with antidepressants. Four groups of antidepressant medications are most often prescribed for depression:
Tricyclic antidepressants (TCAs) – still widely used for severe depression. TCAs elevate mood in depressed individuals, re-establish their normal sleep, appetite and energy level , but it often takes three to four weeks for an individual to respond. These medications include amitriptyline (Amititril, Elavil), desipramine (Norpramine), doxepine (Sinequan), imipramine (Antipress, Imavate, Tofranil), nortriptyline (Aventyl, Pamelor), and protriptyline (Vivactyl).
Monoamine oxidase inhibitors (MAOIs) – are often effective in individuals who do not respond to other medications or who have "atypical" depressions with marked anxiety, excessive sleeping, irritability, hypochondria, or phobic characteristics. These medications include phenelzine (Nardil) and tranylcypromine sulfate (Parnate).
Selective serotonin reuptake inhibitors (SSRIs) – act specifically on the neurotransmitter serotonin. In general SSRIs cause fewer side effects than TCAs and MAOIs. These medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa) and escitalopram (Lexapro).
Serotonin and norepinephrine reuptake inhibitors (SNRIs) – useful as first-line treatments in people taking an antidepressant for the first time and for people who have not responded to other medications. In general SNRIs cause fewer side effects than TCAs and MAOIs. These medications include Venlafaxine (Effexor)
Bupropion (Wellbutrin) – newer antidepressant medication classified as a dopamine reuptake blocking compound. It acts on the neurotransmitters dopamine and norepinephrine. In general bupropion causes fewer side effects than TCAs and MAOIs.
Consumers and their families must be cautious during the early stages of medication treatment because normal energy levels and the ability to take action often return before mood improves. At this time - when decisions are easier to make, but depression is still severe - the risk of suicide may temporarily increase.
Psychotherapy. There are several types of psychotherapy that have been shown to be effective for depression including cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). Research has shown that mild to moderate depression can often be treated successfully with either of these therapies used alone. However, severe depression appears more likely to respond to a combination of psychotherapy and medication.
Cognitive-behavioral therapy (CBT) – helps to change the negative thinking and unsatisfyhing behavior associated with depression, while teaching people how to unlearn the behavioral patterns that contribute to their illness.
Interpersonal therapy (IPT) – focuses on improving troubled personal relationships and on adapting to new life roles that may have been associated with a person’s depression.
Electroconvulsive therapy (ECT). ECT is a highly effective treatment for severe depressive episodes. In situations where medication, psychotherapy, and a combination of the two prove ineffective, or work too slowly to relieve severe symptoms such as psychosis or thoughts of suicide, ECT may be considered. ECT may also be considered for those who for one reason or another cannot take antidepressant medications.
What are the side effects of the medications used to treat depression?

All medications have side effects. Different medications produce different side effects, and people differ in the amount and severity of side effects they experience. About 50 percent of people who take antidepressant medications have some side effects during the first weeks of treatment, but these problems are usually temporary and mild. Side effects that are particularly bothersome can often be treated by changing the dose of the medication, switching to a different medication, or treating the side effect directly with an additional medication.

Tricyclic antidepressants (TCAs) cause side effects that include dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness, drowsiness, skin rash, and weight gain or loss.
Monoamine oxidase inhibitors (MAOIs). Individuals taking MAOIs may have to be careful about eating certain smoked, fermented, or pickled foods, drinking certain beverages, or taking some medications because they can cause severe high blood pressure in combination with the medication. A range of other, less serious side effects occur including weight gain, constipation, dry mouth, dizziness, headache, drowsiness, insomnia, and sexual side effects (problems with arousal or satisfaction).
SSRIs, and SNRIs tend to have fewer and different side effects, such as nausea, nervousness, insomnia, diarrhea, rash, agitation, or sexual side effects (problems with arousal or orgasm).
Bupropion generally causes fewer common side effects than TCAs and MAOIs. Its side effects include restlessness, insomnia, headache or a worsening of preexisting migraine conditions, tremor, dry mouth, agitation, confusion, rapid heartbeat, dizziness, nausea, constipation, menstrual complaints, and rash. Bupropion (Wellbutrin) was temporarily removed from the market after its initial release because of the occurrence of seizures in some patients. However, further investigation showed that seizures were primarily associated with high doses (above the current maximum recommended dose of 450 mg/day), a history of seizures or brain trauma, an eating disorder, excessive alcohol use, or taking other drugs that can also increase the risk for seizures. With new warnings and lower recommended doses, the chance of having seizures has been greatly reduced.

LB




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When we feel love and kindness toward others, it not only makes others feel loved and cared for, but it helps us also to develop inner happiness and peace.

I would not waste time on medication. Some claim to take up to 6 weeks to start working and some do not even work and you've wasted time feeling so horrible. I do not suggest medication at all. Please don't do it. But what I recommend highly (if you do not have money to see a highly trained therapist), then check out as much info from a library (it is all free) and try to help your mom and then get your mom to help herself. And work with her and try to support and empathize. Get your mom to start going to church sermons and try to pray with her and for her. Just try your hardest to read up on psychology and ect, and learn more about what is bothering your mom.

She's had all but one of those symptoms for 2 or 3 years, maybe more. I know exactly what's bothering her, but I don't know how to discuss things with her without making things worse. And I think I know exactly what would make things better but I don't know how to suggest them without reminding her why she's so down to begin with.


Thanks for such thourough responses.

Depression and it's symptoms can be similar to every mood dissorder that any person may encounter through his/her life.
I think generally depression is the most common word that comes out of anyones lips when he/she has such symptoms....
Your mom needs a good and experienced psychiatrist that can recognise if she suffers from depression or not.
If She trully suffers from depression MY OPINION is that she has to be informed of all the possible ways that she can be cured ..leaving as her final options drugs and medication...
Good luck to her and to you too


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That which does not kill us makes us stronger.

The trouble is she doesn't have a doctor who can recommend a therapist or the money to see one if she could find one. I mentioned it and she said that all her troubles would sound trivial anyway to why bother. I said that obviously her problems aren't trivial to her.

RMG2003,
Does your mother qualify for any government assitance? This might be your only option to getting her the assistance she needs. If you say that you know what it is that has been bothering her for the past couple of years, the obviously there is a problem. Perhaps you two could do counseling together, it might be helpful to your mother to have you there. Try talking to her about it.

Good luck
LB



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When we feel love and kindness toward others, it not only makes others feel loved and cared for, but it helps us also to develop inner happiness and peace.

Your mother's statement really struck me. I am hearing that she does NOT want to change combined with unworthy feelings, fear and shame. This is a real tough combination. Do you see anything wrong in helping your mother yourself? If you talk with her you are not making things worse. That is a myth. Be there for her please, and give a several hugs and day and remind her that you love her and that she is loved. I was severally depressed when I was younger for many years and none of my parents where there to hug, and say they love me. That is almost a sure and quick drug to elevate the mood. I promise when my mom started to understand what I was going through she started to listen and talk with me and hug me more and express more love and care.

Do that for your mom and for yourself. Love yourself all the time.