Dealing with Depression - Day by Day
Wertz, Marjorie, Tribune-Review/Pittsburgh Tribune-Review
Kelly's family believes she's in a slump, a phase of feeling bad about herself and life in general.
"I was very tearful and had lots of social anxiety," said the 32- year-old Westmoreland County resident. "I got into a string of bad relationships, drugs and alcohol, and I couldn't get myself straightened out."
Kelly asked that her name not be used to protect her privacy. She spoke of years of abuse as a youngster, and the death of her boyfriend by suicide when they both were 19. After that, Kelly said, she couldn't cope. She, too, tried to take her own life.
In 2000, a friend encouraged her to seek counseling for depression. A doctor at Western Psychiatric Hospital and Clinic, in Pittsburgh, prescribed antidepressant medication, and Kelly joined Alcoholics Anonymous. Today, she's taking college classes and continuing to deal with her illness "day by day."
"My family really gave me a hard time about being on antidepressants," she said. "They believe in pulling yourself up by your bootstraps."
But people who are suffering from mood disorders, such as depression and bipolar disorder, don't just snap out of it, said registered nurse Gary Schadle, an outpatient case manager for Excela Health Westmoreland Hospital's behavioral health unit. Medication, counseling or other health care may be needed.
"Depression is a potentially fatal illness," he said. "So it's not a good idea to turn away from seeking treatment."
Yet many people delay getting help, often for years. A landmark study published last year in the Archives of General Psychiatry found that Americans with mood disorders typically waited six to eight years before telling a doctor about their symptoms.
Many people failed to recognize their illness, the study said. Instead, they attributed the symptoms to "feelings" and tried to wait them out or deal with them alone.
"It takes people a long time to realize they have a problem," said Ronald Kessler, a Harvard Medical School professor and co- author of the study. "Many people simply don't think anything is wrong."
Yet the signs are there, Schadle said.
"People will report that they feel unhappy most days," he said. "In children, depression can be displayed as irritability. You'll also see children and adults lose interest in the things they like to do, things they used to derive pleasure from."
A change in eating habits, a "who cares?" attitude or a change in sleep patterns also can point to depression.
The illness may cause someone to sleep all day, or to remain sleepless at night. "Sometimes the person with depression will suffer from early-morning awakening. They can go to bed and fall asleep, but they can't stay asleep," Schadle said.
People with depression may be agitated and restless, or they may have no energy. They often express feelings of worthlessness or guilt.
"Some people complain that they can't concentrate, can't make up their minds and can't reason things through," Schadle said. "They may be suicidal and express a wish that they weren't alive. To be diagnosed with depression, you have to have five of the symptoms, and one of the symptoms has to be a depressed mood or loss of interest."
Psychiatrist Ellen Frank and nurse Joan Buttenfield, of UPMC Health System's School of Medicine, are conducting a clinical study that focuses on depression. They are exploring the features of a depressed person's mood, personality and genetic makeup and whether those features affect a patient's response to either medication or therapy.
"Often people don't know they have clinical depression," Frank said. "When we started working in this field, only about 25 percent of people with depression ever got treatment for it.
"Now about 50 percent of those with depression have not been treated. They don't recognize that they have depression. …