Today I want to share some information about depression with you. I’ll actually be discussing 2 disorders today: Major Depressive Disorder (abbreviated MDD), and Persistent Depressive Disorder (previously dysthymia).

MDD Symptoms

People typically think of depression as extreme sadness. While sadness is one symptom of depression, it’s just the tip of the iceberg. There are a lot of symptoms that often get overlooked, like:

• changes in appetite (eating everything or eating nothing)
• changes in sleep (sleeping a lot more or less)
• irritability
• lack of motivation
• getting easily tired (fatigue)
• loss of interest or pleasure
• guilt
• feeling worthlessness
• tearfulness
• poor concentration
• difficulty thinking clearly
• slowed reactions
• shaking or trembling
• lack of emotion
• thoughts of death or suicide

If you or someone you know is experiencing thoughts of suicide, please contact your local emergency service providers, 911, or call a national hotline such as the National Suicide Prevention Hotline at (800) 273-8255.

Most people I’ve worked with who have depression describe it as feeling empty, chronically bored, or just “blah.”

Cause

Another thing to know about depression is that it comes on without reason. You could have these symptoms for a variety of reasons, like the death of a family member or friend, and still not be diagnosed with MDD.But if you get about half of these symptoms and can’t really figure out why, you might have MDD. Please consult a medical and/or psychiatric professional if you think that you may have MDD.

Time

People with MDD aren’t depressed 100% of the time. A period of depression (depressive episode) is typically 2 weeks or more, but eventually goes away. It’s not very predictable. And it isn’t a matter of willpower. I can promise you that if they could, just about everyone with depression would stop being depressed immediately.

Medication

Medication isn’t the only way to manage symptoms.It is typically a really important component of the treatment and recovery process, but it isn’t the only thing you can do. Therapy can be really helpful for some people struggling with depression. A nutritious diet and regular exercise can also help a great deal with depressive symptoms. Having a strong support system is also really important to recovery. Using all of these together can be really beneficial to your recovery.

Fun Fact: Research shows having three close friends makes a giant difference in mental health recovery. Having more friends doesn’t really change the impact, but having fewer than three close friends shows a negative impact on your recovery.

The best description I’ve found for the depressed experience is in two of Allie’s posts. You can read them here and here (or click the pictures).

 

Persistent Depressive Disorder

On top of MDD, there’s also Persistent Depressive Disorder (abbreviated PDD), previously called Dysthymia. Not a lot of people I have talked to have heard of PDD. If you think about depression as feeling really crappy for a while, PDD is feeling kind of crappy for a really long time (at least 2 years).

With PDD, you have symptoms more often than you don’t have symptoms. And you’ve never not had symptoms for more than two months. The symptoms for PDD are almost exactly the same as MDD, except thoughts of death or suicide are not included. Crummy, right?

So now that I’ve thrown a bunch of symptoms, big words, and counseling jargon at you, here’s a list of what you need to know about depression:

1. 25% of young adults (ages 18-24) will have a depressive episode.
2. Women are 2 times more likely to be diagnosed with MDD than men.
3. ~8% of adolescents have depressive episodes at any given time.
4. ~7% of the adult U.S. population has had a depressive episode in the last year.
5. ~1.5% (4.8 million) of the adult U.S. population struggles with PDD.
6. In 2013, over 41,000 people committed suicide.
7. In 2013, 1.3 million adults attempted suicide.
8. Untreated mental health disorders can result in substance abuse.
9. Depression is complex and has no one single cause that has been pinpointed.
10. Continued exposure to violence, neglect, abuse, poverty, discrimination, or negative social pressures can make you more vulnerable to depression.

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Suicide

Suicide is an often taboo subject in our current culture. It is rare someone openly discusses this epidemic and I believe this leads to a reduction in people recognizing signs and seeking help. Most all of the clients I work with have a history of at least suicidal thoughts, if not suicide attempts. The reality is that talking about suicide is important.

Suicide Statistics

These current statistics were collected from the Mental Health America, NIMH, Chapterland, and The Trevor Project.

• Suicide is currently the second leading cause of death among people ages 15-24
• 44,000 people committed suicide in the United States each year
• That is the same as someone committing suicide every 9 minutes
• More than 1.4 million people attempted suicide in 2019
• The ratio of attempts to completed suicides is 25 to 1
• 30-70% of people that commit suicide are diagnosed with depression or bipolar disorder
• People with substance abuse disorders are 6 times more likely to complete suicide

One group that is particularly affected by suicide is the LGBT community. As an ally, I struggle with the immense difference between these groups. In comparison with heterosexuals, the difference for LGBT youth is staggering:

• Adolescents that are lesbian, gay, or bisexual are 3 times as likely to contemplate suicide & almost 5 times more likely to attempt suicide.
• Adolescents from both aforementioned groups are 5 times more likely to require serious medical intervention following a suicide attempt.
• Almost half of transgendered adults have attempted suicide. 92% of people reported attempting suicide before the age of 25.
• LGB youth from unsupportive/rejecting families are 8.4 times more likely to have attempted suicide in comparison to LGB youth with supportive families.
• 16.7% of high school students (grades 9-12) have seriously considered suicide within the previous year.
• Each occurrence of LGBT victimization (harassment, bullying, assault, etc.) increases the chance of self-harm by an average of 2.5 times.

Risk Factors

There are several things that make a person more likely to commit suicide and this list is in no way all-inclusive. This is a collection of common risk factors that increase a person’s likelihood of attempting or committing suicide.

• Substance abuse
• Mental health diagnosis
• Social isolation/rejection
• Lack of access to (effective) behavioral health
• Knowing someone who has committed suicide
• Access to lethal means (medication to overdose, firearms, knives, etc.)
• Previous suicide attempts
• Trauma history
• Sexual orientation or identity

Warning Signs

When I was in high school, I read the book Thirteen Reasons Why by Jay Asher and I have forever committed many warning signs of suicide to memory. This story is a fictional story about a girl that committed suicide that left cassette tapes for 13 people to explain her reasons for committing suicide. Netflix has also made it into a series. In this story, she details many of the warning signs of suicide and even says she exhibited them:

• Verbal threats or statements of suicide, such as “you would all be better off without me” or “maybe I just won’t be around anymore”
• Expressions or helplessness or hopelessness
• Previous suicide attempts
• Taking part in risk-taking behaviors
• Personality changes (such as a sudden change from depressed to joyful)
• Depression
• Giving away prized possessions
• Lack of interest in future plans or events

Other warning signs include:

• Talking about:
  • being a burden
  • feelings of hopelessness
  • having no reason to live
  • feeling trapped
  • unbearable pain
• Increased substance abuse
• Aggression
• Fatigue
• Withdrawing or isolating from others
• Looking for ways to end their life (online searches, etc.)
• Calling or visiting people to say goodbye
• Mood signs:
  • anxiety
  • loss of interest
  • irritability
  • anger
  • agitation
  • relief/sudden improvement
  • depression
  • humiliation
  • shame

How To Help

Most importantly, educate yourself and be aware of warning signs.

Many people who are considering suicide do not want to die. Often they are are seeking a means to end their hurt, not necessarily their lives.

Know what resources are available and how to help the person get treatment, even if they are opposed. Most states have emergency custody laws to help keep people safe. If you have questions about this, contact your local police department’s non-emergency number.

 

Know what’s out there

There are several national suicide prevention hotlines that are available:
Hopeline: 1-800-784-2433
IMAlive Online Chat
National Suicide Prevention Lifeline: 1-800-273-8255
National Suicide Prevention Online Chat
Trevor Lifeline (LGBT): 1-866-488-7386
The Trevor Project Alternative Options
Suicide.org’s State Guide

If you are concerned someone you know may be considering suicide:

• Don’t be dismissive. Trust your instincts because that person may be in trouble.
• Be open with the person about your concerns. Be sure to listen to what they say in response.
• Do not be judgmental or act shocked.
• Be direct with your questions but do not be judgmental. Find out if the person has a plan to commit suicide. The more detailed the plan is, the more likely they are to follow through.
• Get professional help, even if the person opposes. Be supportive, and do not counsel the person yourself.
• Do not leave the person alone.
• Do not swear to secrecy.

 

Be aware & care.