Coping With Depression

Depression a common term for a sad or low mood or the loss of pleasure; an emotion that does not affect capacity to perform personal and vocational obligations

Fawn Fitter knew it was not just another bad day at the office. She was doing what she loved–writing about careers for major publications. She didn’t have a horrible boss to answer to; as a freelance, she called the shots. She didn’t even have to show up. Still there came a day when she was barely able to make a phone call. Her depression lasted for months.

With her own capacity for weaving events into words, along with psychotherapy, and “vitamin Z,” she eventually pulled out of it. But Fitter didn’t just recover. She realized her own experience must be multiplied by millions and wrote a guide to coping with depression on the job.

“The workplace doesn’t wait for depression to go away,” say Fitter and coauthor, management consultant-psychotherapist Beth Gulas. The team talk about how to hold on to your job when you know you’re not performing and you’re terrified that getting help will not only get you fired anyway but make you unemployable in the future.

Coping with Depression in Office:

• First determine whether you are in fact depressed. In the office depression manifests as problems with concentration and memory; difficulty processing information in general; irritability or, conversely, apathy; feeling slowed down or, conversely, restless. “You can’t hide depression,” says Fitter. “People notice,” adds Gulas, “but they don’t talk about it, making it even more of an untouchable topic than it already is.”
• If you are depressed, you need to ask yourself whether your job is contributing to your depression and plan how to deal with that. Ask yourself, “Am I having a bad day or am I having a bad job? Are the conditions that bother me temporary or permanent?”
• Every job evolves and changes; you may have outgrown the job or vice versa. Mounting stress culminating in depression could be an indicator that you need to move on.
• You have to ask yourself whether depression is affecting your ability to do your job, and how to deal with that.
• Whatever other steps you take, you must depression-proof your daily work life.
• Interact with coworkers in small ways. Do not give in to the temptation to isolate yourself. The less visible you are, the more you jeopardize your job.
• Do not attempt to carry conversations; ask questions instead. If necessary, write them out before meetings.
• Even if you feel overwhelmed, behave as though you feel fine. You will have an easier time if you play the part of a competent person.
• Pay attention to your appearance. Make a special effort to look good.
• Take care of yourself so you have the strength to cope. Avoid changes in your daily routine; do not consider transfers to another job or city.
• Cut back on your responsibilities as much as you can; at least don’t add on new ones. Can you get a temporary assistant? Can you telecommute two days a week? Seek your supervisor’s cooperation, lest your absence draw attention to changes in your behavior.
• Make room for yourself in your schedule. Take 10 minutes at lunch just to go outside and breathe. Or take a short walk.
• Hold yourself together. A crying jag may make you feel better, but it can disconcert your coworkers. If you burst into tears, go to a private place to compose yourself.

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Depression, a common term for a sad or low mood or the loss of pleasure; an emotion that does not affect capacity to perform personal and vocational obligations

There are 330 million people around the world suffering from depression. According to Dr Christopher Murray from the World Health Organization (WHO), major depression will be the world’s second-most debilitating disease by 2020 – losing a number of years of productive life that is surpassed only by cardiovascular disease. Medical scientists estimate that rates of major depression are between four and ten per cent of the world population and life-time prevalence of the condition – the chance of developing it at some point – runs between ten and twenty per cent.

And WHO says the global total of suicides attributable to depression per year is 800,000. Cashing in on this trend are companies supplying a $7-billion worldwide market for anti-depressants – expected to expand 50 per cent over the next five years. But joining the anti-Prozac backlash are countries like Germany, where the herbal remedy St John’s Wort is seven times more popular than Prozac for treating depression.

Others say poverty may have something to do with depression’s cause and cure – Russia’s rates of depression soared in recent years as the economy drooped and in the West the poor suffer disproportionately from the disease.

Depression is something a bunch of us are going through, or will go through. There are varying degrees of depression, ranging from just a perpetual sadness to severe, debilitating clinical depression. I have also included information on bipolar disorder, or manic depression if you will, since it’s on the same branch of psychology. Whichever it is, you will probably benefit from eating up as much knowledge about it as you can.

Depression pushes you against surfaces, and adds heaviness either atom by atom or all at once until the strain of this motion dominates all else. It is one-pointed, claustrophobic, and circular. It doubts, denies, and questions everything that comes in contact with it.

Already Depressed the Word Economy:

The Great Depression was a time of economic down turn, which started after the stock market crash on October 29, 1929, known as Black Tuesday. It began in the United States and quickly spread to Europe and every part of the world, with devastating effects in both then industrialized countries and those which exported raw materials. International trade declined sharply, as did personal incomes, tax revenues, prices and profits. Cities all around the world were hit hard, especially those dependent on heavy industry. Construction was virtually halted in many countries.

Farming and rural areas suffered as crop prices fell by 40 to 60 percent.[1] Mining and logging areas had perhaps the most striking blow because the demand fell sharply and there were few employment alternatives. The Great Depression ended at different times in different countries; for subsequent history see Home front during World War II. The majority of countries set up relief programs, and most underwent some sort of political upheaval, pushing them to the left or right. Democracy was weakened and on the defensive, as dictators such as Hitler, Stalin and Mussolini made major gains, which helped set the stage for World War II in 1939.

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This new procedure uses brain stimulation to improve symptoms, but long-term effects aren’t yet known. Discover how it works and understand the pros and cons

Depression is usually a very treatable condition. Often, standard treatment with antidepressant medications, psychotherapy or electroconvulsive therapy can help improve even severe cases of depression.

But if standard depression treatment doesn’t work, a relatively new type of treatment involving brain stimulation may be an option. In mid-2005, the Food and Drug Administration (FDA) approved a type of brain stimulation called vagus nerve stimulation for certain types of depression.

How vagus nerve stimulation works

The vagus nerve serves as a primary communication pathway between your brain and such major organs as your heart, lungs and intestines. There’s one vagus nerve on each side of your body. The nerve runs from your brainstem through your neck and down to your chest and abdomen. Information travels through this nerve to and from your central nervous system.

Vagus nerve stimulation uses electrical impulses to affect mood centers in the brain by stimulating the vagus nerve. The treatment is sometimes called vagal nerve stimulation.

With vagus nerve stimulation, a device called a pulse generator is surgically implanted in the upper left side of your chest. The device is about the size of a stopwatch. A lead wire is connected to the pulse generator. The lead wire is guided under your skin from your chest up to your neck, where it’s attached to the left vagus nerve.

Electrical signals travel from the pulse generator, through the lead wire and to the vagus nerve. The vagus nerve delivers those signals to the brain. But precisely how stimulation of the vagus nerve may improve depression remains unknown. Research indicates that vagus nerve stimulation alters the functioning of brain areas involved in mood regulation and depression.

.Who may benefit from vagus nerve stimulation?

Vagus nerve stimulation may not be appropriate for all cases of depression. In fact, the FDA approved use of vagus nerve stimulation in depression only for these specific situations:

For treatment of long-term, chronic depression that lasts two or more years, in conjunction with standard treatments

Recurrent or severe depression

Depression that hasn’t improved after the use of at least four other treatments, such as four different antidepressants

The approval of vagus nerve stimulation for depression didn’t come without controversy, though. In fact, some FDA scientists repeatedly recommended against its approval. Not all scientific studies have shown that vagus nerve stimulation is an effective treatment for depression. In fact, some studies have suggested it’s no more effective than a placebo. Additional research will help determine its long-term effectiveness and safety.

Common side effects and adverse health problems associated with vagus nerve stimulation include:

1. Voice changes
2. Hoarseness
3. Cough
4. Neck pain
5. Breathing problems, especially during exercise
6. Difficulty swallowing
7. Tingling or prickling of the skin
8. Sore throat

There’s also a small risk that the pulse generator may malfunction or move about within your body. You may then require additional surgery to fix or remove the device.

On the other hand, vagus nerve stimulation doesn’t have the side effects that are typical of antidepressants. For instance, it’s not associated with weight gain, sexual problems, memory problems, food or medication interactions, or sleep disturbances.

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Is it safe to take antidepressants during pregnancy? It’s hard to find a straight answer on whether expectant women should continue taking antidepressants during pregnancy and what effect the medication has on newborns. Recent studies have been as contradictory and unclear as news about the benefits or drawbacks to a low-carbohydrate diet.

A May 2005 study found that infants born to women taking antidepressants during the last trimester of pregnancy were more likely to experience irritability, seizures, tremors, and respiratory ailments. The results indicate that infants born to these women go through withdrawal after birth.

In January, a study published in the Journal of the American Medical Association found that women who stopped using antidepressants during pregnancy were more likely to suffer a relapse of depression than women who stayed on their medications. Put simply, pregnancy didn’t offer the protection against depression that some previously believed.

Yet another study published in April found that pregnant women taking selective serotonin reuptake inhibitors (SSRI)—antidepressants that boost serotonin levels—have a higher risk of delivering stillborn babies. Canadian researchers found that women taking SSRIs to deal with aggression were twice as likely to give birth to stillborn babies and deliver underweight infants. Women using these medications also were slightly more likely to deliver a baby prematurely and have seizures during pregnancy.

Unfortunately, there isn’t a one-size-fits-all approach for depressed women. The wisest counsel is that each pregnant woman should consult her health-care provider. Together, they should make the decision about whether a woman should continue or discontinue taking antidepressants while pregnant, considering all the risks involved with both choices.

Providers will generally consider the severity of the woman’s depression, what medication she takes, and whether she can switch to a different drug. The problem is that most medications don’t have dosing guidelines for pregnant women. Guidelines for many drugs—including those commonly used in pregnancy—typically are based on studies conducted on men. The drug studies that involve women use only women who aren’t pregnant.

A 2005 study at the University of Minnesota found adjustments to medication in pregnant women depend on the stage of pregnancy and the medication given. Studies like this will help pregnant women get the right dose of medication to successfully manage chronic conditions such as diabetes, HIV, or depression.

Your health care provider needs to know every medication–including over-the-counter, prescription, and herbal supplements–you take at all times. This is never more important than during pregnancy. When women are pregnant, their dosages might need to be adjusted, or they might need to switch to a different drug that doesn’t affect their developing baby.

Before you head to your next appointment, take five minutes and make a list of all the medications you’ve taken in the past 12 months. And don’t stop taking any medication without checking with your health-care provider–regardless of whether you are pregnant.

The answers aren’t black and white. And that’s why you need to talk to your doctor.

The effects of untreated depression during pregnancy can be profound,” says DeFulvio’s colleague, psychiatrist Rory Marraccini, M.D. “It raises the risk for spontaneous abortion, low birth weight and pre-eclampsia (a potentially fatal disorder of late pregnancy).”

These complications may stem partly from elevated levels of the stress hormone cortical as well as from poor self-care. Depressed women are more likely to be careless about their diet and prenatal visits, and may even turn to alcohol or other substances harmful to the developing baby.

If possible, talk with your psychiatrist and obstetrician or family doctor before conception about your therapy and prescription options. Get your depression under control before trying to conceive.

Here is an article on pregnancy depression as well.

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Underweight babies : There has been a significant increase in the number of underweight babies being born in the UK, a report from a think tank has concluded.

According to the study carried out by the Fabian Society, 2006 saw 78 out of every 1,000 babies born weighing less than 5lb 8oz.

This was significantly higher than the figure for 1989, when 67 babies out of every 1,000 were born seriously underweight.

Calling the findings “a scar on the national conscience”, the Fabian Society said that women at risk of giving birth to underweight babies should be given more attention in order to improve the chances of the low birth weight babies.

“The facts should shock us all. Britain has the worst rate of every country in western Europe, except Greece,” commented Louise Bamfield, who led the research.

“And being born very small creates health risks throughout life – and will affect the health of babies they will themselves have years later.”

Low birth weight has been linked with a range of long-term health problems, including diabetes and heart disease, as well as an increased risk of death or disability.

Girls who had been born underweight were more prone to depression at the age of 13 to 16 than those born at normal weight, a study said.

The average weight for a baby at birth is about 3.4 kg. The Duke University study found that girls who had been born weighing less than 2.5 kg were more prone to depression, reported online edition of the BBC News.

Previous research has linked low birth weight to an increased risk of attention deficit disorder, as well as physical conditions such as cardiovascular disease, and diabetes.

Elizabeth Jane Costello and other researchers at Duke University examined data on more than 1,400 children, aged nine to 16. They found that among girls, 5.7 percent were born weighing less than 2.5 kg, and of these 38 percent experienced depression at least once between 13 and 16 years.

This compared with 8.4 percent of those born at a normal weight. On average, 23.5 percent of teenage girls with a low birth weight were depressed each year, compared with 3.4 percent of those born at a normal weight.

Writing in the journal, the researchers said: “For the present, the findings suggest that pediatricians and parents of girls who were of low birth weight should pay close attention to their mental health as they enter puberty.”

The researchers, however, said further investigation was needed to pin down possible reasons of the depression.

Underweight Babies and Babies of Teen Mothers:

Babies with a birth rate of 4.4 pounds or lower and babies of teen mothers are twice as likely to die by suicide later in life than other babies, according to a study at the Karolinska Institute in Stochkholm, Sweden.

Children from large families or whose mothers had little education also had a raised risk of suicide.

Additional risk factors included: stress during pregnancy, poor maternal health, poor parenting, and low income.

Researchers studied 700,000 young adults in Sweden who were born between 1973 and 1980 and monitored them until 1999.

Out of the 700,000 individuals, 4,700 women and 2,000 men attempted suicide, and 166 women and 397 men died by suicide.

“Prevention needs to start before a child is born,” said Dr. Danuta Wasserman, one of the researchers. “We need to monitor and support young mothers during pregnancy and to follow-up their newborn children to help them with emotional and practical support when needed.”

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