Everyone has their ups and downs in life, but major depression is different than feeling sad for a short while after a negative event. Mood disorders, like depression, are very real illnesses that can have serious and sometimes fatal results. They are one of the most common mental illnesses and can affect the body as well as the mind, with physical symptoms like fatigue, stomach complaints, or muscle/joint pain as well as changes in mood.
There are several depressive mood disorders, including bipolar disorder (or manic-depressive illness), and perinatal depression, but major depression (also called clinical depression) is the most common mood disorder. The 2012 Stats Canada survey found that 4.7% of respondents met the criteria for major depression in the previous 12 months, and almost 1 in 8 (12.6%) met the criteria for a mood disorder at some point in their life. American statistics show that over 17 million adults (7.1% of the population) and 1.9 million children aged 3 to 17 experience depression in the United States each year. Women are twice as likely as men to be diagnosed with depression.
Causes
There is no single cause of mood disorders. Several risk factors interact to increase the chance of developing a mood disorder:
Family or personal history – Having already experienced an episode of depression or having an immediate family member who is affected don’t guarantee a person will develop depression, but they do increase the risk. Over 50% of those who have had an episode of major depression will develop a recurrence.
Traumatic life events – Some are more susceptible to depression when in a difficult or abusive relationship, after a divorce, after a death of a loved one, as a result of low income, poor housing or workplace stress or from other distressing major life events.
Chronic medical conditions – Chronic conditions such as stroke, heart disease, obesity, Parkinson’s disease, epilepsy, arthritis, cancer, AIDS, chronic obstructive pulmonary disease (COPD), and dementias like Alzheimer’s Disease can trigger depression, especially if the person suffers from more than one of these.
Physical changes – Changes in hormones, neurotransmitters (the chemicals that pass signals from one nerve to the next) or the immune system, a disability or poor quality of life itself are thought to be contributing causes. New research suggests that gut bacteria may also have an influence on brain function and mood.
Symptoms
Although each person is unique and will have different symptoms, there are some that are common:
Depressed mood
Feelings of guilt, worthlessness, helplessness, or hopelessness
Loss of interest or pleasure in activities usually enjoyed
Change in weight or appetite
Decreased energy or fatigue, even without physical exertion
Thoughts of death
Poor concentration or difficulty making decisions
Symptoms can be mild or so debilitating the person has difficulty getting out of bed. If these symptoms persist on most days for more than 2 or 3 weeks, it is advised to contact a doctor or mental health professional. It is very important to get medical help right away if a person has recurring thoughts of suicide.
What should you say to someone who has depression?
There are no magic words that will heal a major depression, although talking with a professional over time (“cognitive therapy”) is a form of treatment that can be successful. For family and friends, being comforting and supportive is the best way to help someone manage their symptoms.
Without being forceful or exerting pressure, it helps to ask a person with depression how they are feeling. This gives them space to talk and vocalize thoughts, making them less powerful. Not everyone feels like talking all the time, though, and it’s important to respect that, so ask if they want to talk.
Sometimes just being there can help too. Ask if they’d like some company. Offer to do something fun to distract them from their thoughts, like watching a movie, sharing a meal, or going for a walk or outing. Even being there quietly without speaking can give comfort.
Let the person know you care, even if you don’t understand or know what to do or say. Ask them how you can help or what is best to do or avoid doing. Know that simply saying “I love you” can be supportive.
The best time to talk is when both of you are calm and not distracted or tired. Never bring up depression during an argument or times of high stress. Avoid spending all your time together talking about mood problems and be sure to take care of your own needs, too, if you feel uncomfortable. Often talking about good times or doing activities the person once enjoyed can be helpful.
What NOT to say…
But here are some examples of things you might want to say that are not usually helpful:
“Have you tried eating better/exercising more/ getting outside?” Although lifestyle changes can help improve the effectiveness of depression treatment, it is better to be supportive, leaving treatment to the professionals. Some people may find these suggestions disrespectful, as though you think a minor change in lifestyle could easily cure their major depression.
“It’s not that bad.” Or “But you look fine!” If you appear to doubt or disbelieve what they are saying, you are invalidating their feelings and they may be unlikely to talk about them in the future. Minimizing their feelings can make the person feel ashamed and alone.
“I know how you feel.” Even if you have suffered a major depression yourself, you cannot know what another person is feeling. You also don’t want to shift the discussion to yourself when a person is expressing their deep feelings.
“You’re making me feel bad.” While listening to a person sharing their thoughts and feelings of depression can be overwhelming, don’t blame them or make them feel guilty. However, loving a person who is depressed can be difficult and it’s OK to set boundaries if necessary or get external support for yourself from friends, family or a therapist.
Like everyone else, I’ve had times when life events have made me sad and depressed but, fortunately, not a major depression. My husband has always helped by encouraging me not to focus on the event for long periods of time and to keep it in perspective and balance with the good parts of life. We can all try to be that person for others, whether they are dealing with major depression or a depressing life event, by being loving and supportive and asking what they need.
References:
What to say to someone with depression – Medical News Today
What is Depression? – Government of Canada website
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