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AAMFT Consumer Update
Depression
 The mental health profession categorizes depression as a mood disorder, but also
recognizes that its symptoms can vary widely from one person to another. It is also
accurate to think of depression as a complex problem that can affect many different
aspects of the sufferer’s life. It can affect the body,
and generate such physical symptoms as insomnia, fatigue, appetite disturbances,
diminished sex drive, and anxiety. It can affect the mind,
interfering with the ability to think clearly, notice and remember details, and make good
decisions. It can affect emotions,
causing feelings of sadness, despair, guilt, worthlessness, and apathy. It can affect behavior, leading to alcohol or drug
abuse, suicide attempts, and other socially or self-destructive behaviors. It can affect interpersonal (social and family) relationships, leading to aggression, withdrawal, or
marital and family distress.
The main forms of
depression are: major depressive disorder,
also called "unipolar" for its affecting only one end of the mood continuum --
depression; and bipolar disorder, formerly called
manic-depressive illness,
("bipolar" for its affecting both ends of the mood continuum --
depression and euphoria, or mania.) Depression can also present itself as dysthymia, a less
intense and more chronic form of depression. Major depression is far more common than
bipolar disorder, and has a much wider range of contributing factors.
What are depression’s effects
on personal and family life?
The symptoms of depression described above make it clear:
To be depressed is to suffer. The hopelessness and helplessness that people experience
when they are depressed is more than just a frame of mind at such times -- it is an entire
way of being. People stop trying, they stop caring, they withdraw from life, and of
course, this makes them feel even worse. Their lives deteriorate, and it affects others as
well. Family members are not immune to the depressive’s negativity -- the
never-ending complaints, the steady stream of criticisms, the lack of emotional closeness,
and the loss of the ability to have fun together. Spouses can feel hurt and alienated, and
children may feel guilty, resentful, and as if they are to blame. In turn, family
relationships can also exacerbate depressive symptoms.
How do you know when to seek help?
As a general answer, you should seek help when depression
is starting to affect your life
(your family, your job, your outlook) in negative ways, and you are not very clear about
what you need to do to prevent things from getting worse. You
should seek help -- for yourself, loved ones, or both -- long before things get really
bad.
To be more specific, take into account the following
factors when deciding to seek professional treatment.
- Suicidal thoughts or
feelings: Suicide is a terrible and irreversible solution to specific
problems. The depressed person and his or her family need to think preventively, and get
help immediately if someone is suicidal.
- Acute depression turning
chronic: Before settling into "life as a depressed person,"
the depressed person, and family if possible, should do all they can to resolve it early
on. Every day spent suffering is too costly.
- Lifestyle disruption:
The depressed person, and his or her family, can prevent bad circumstances from getting
worse by acting quickly. The depressed person does not have to ignore his or her health,
lose a job, or hurt or alienate family and friends.
- Reality testing:
If a family and their depressed member do not have someone good to talk to, someone with
whom they can share their private thoughts, then how will they know whether what they are
thinking makes sense? A good therapist is a valuable partner for "reality
testing."
What kinds of treatments are
commonly used?
Psychotherapy and antidepressant medications are the two
most commonly used treatments for managing depression. Many people use a combination of
the two. People’s responses vary, of course, but these approaches hold good promise
for providing relief.
Most people have already heard of the popular
antidepressant medication, Prozac. It is only one of the many "newer generation"
medications that do, in fact, help the majority of people who take them. Medication is a
valuable tool for reducing symptoms and "raising the floor" on depression.
Speaking to a psychiatrist about the use of medications in your particular case is the
best way to explore whether medications are viable for you. A psychotherapist can also
help you with this decision.
Psychotherapy is an non-drug alternative that is generally
as effective as medication, and in some ways is even superior (though not quite as
fast-acting). For example, people who receive therapy tend to have a lower relapse
(recurrence) rate, and tend to feel better as an active participant in the recovery
process. Psychotherapy can help individuals and families who are dealing with depression.
The most effective psychotherapies are called cognitive
therapy (which teaches how to identify and correct distorted
thinking), behavior therapy (which
teaches how to behave more effectively), and interpersonal
therapy (which teaches relationship skills). All of these are
short-term therapies, and all focus on changing things in the present.
The fact that long-term research shows the effectiveness of
medication and psychotherapy for treating depression can be wonderfully reassuring for
depression sufferers and their families. Depression is highly responsive to good
treatment, and good treatment is available from a variety of sources.
References and Resources
National Institute of Mental Health
5600 Fishers Lane, Room 10-85, Dept. GL
Rockville, MD 20857
(800) 421-4211
Feeling Good Handbook,
by David D. Burns. NAL/Dutton (1990). This book includes techniques that enable readers to
cope with a range of everyday problems such as depression. Presents ideas of cognitive
therapy through exercises, self-tests, and forms.
Mind Over Mood. By
Dennis Greenberger and Christine Padesky. Guilford (1995). This treatment manual draws on
the authors’ extensive experience as clinicians and teachers of cognitive therapy to
help readers successfully understand and improve their moods, alter their behavior, and
enhance their relationships.
The Shelter of Each Other.
By Mary Pipher. Ballantine (1996). Offers thoughtful, practical strategies to reach
families and help them call upon their reserves of mutual nurture and support in the face
of societal, cultural, and economic pressures. Challenges readers to find the courage to
nurture and revive the families they cherish.
Hand-Me-Down Blues: How to Stop
Depression from Spreading in Families. By Michael Yapko.
St.Martins (1999).
Describes the role of the family system in developing depression for both biological and
developmental reasons, and teaches specific strategies for helping families reduce and
even prevent depression in their members.
Breaking the Patterns of
Depression. By Michael Yapko. Random
House/Doubleday (1997). A comprehensive,
"user-friendly" book that recommends an active, skill-building approach to
self-help. Includes nearly 100 structured activities to engage the reader in learning the
skills to overcome depression.
The text for this brochure was written by Michael
D. Yapko, Ph.D. (www.yapko.com)
Click
here to purchase this or other informative materials from AAMFT.
Keywords:
depression, depressed, antidepressant medication, major depressive disorder,
dysthymia, overwhelming sadness, chronic depression, hopelessness.
Item #1040
Marriage and family therapists are mental health professionals who treat a
wide array of disorders, working with individuals, couples, and families.
Marriage and family therapy clients report that they are highly satisfied
with the services they have received, and research shows that marriage and
family therapy is a cost-effective, short-term, and results-oriented form
of treatment.
The American Association for Marriage and Family Therapy (AAMFT), the
professional organization representing marriage and family therapists,
believes that therapists with specific and rigorous training in marriage
and family therapy provide the most effective mental health care to
individuals, couples, and families. This brochure is courtesy of:
the AAMFT.
Visit the AAMFT
TherapistLocator.net, a public service of the
AAMFT. There you will find information about a range of problems facing
today's families, and you can search for a qualified family therapist in
your area.
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