“It occurred to me in the morning that no one would probably notice or care if I didn’t get out of bed for the day. From that point, things began to sink lower. I didn’t contemplate suicide, but I wondered what difference it would make if I weren’t alive.” Case History—36-Year-Old Female Diagnosed With Clinical Depression

It’s a medical illness that affects up to 17 million adults each year in the United States, and strangely enough, many people refuse to seek help for depression. The patient quoted above could be any one of five women you know socially or from work. And in men, depression is diagnosed in one of every 10.

Like hypertension, diabetes and other medical illnesses, clinical depression has causal factors, recognizable symptoms, and is treatable. It’s common that people don’t understand or accept the medical nature of depression because it is often viewed as temporary or as an emotional weakness. These beliefs could be why many people allow themselves to remain undiagnosed and untreated. And left unattended, depression can lead to situations where work, relationships and physical health are greatly impaired. Severe depression can lead to a dangerous level of hopelessness where thoughts become self destructive.

“After heart disease, depression is the second greatest cause of disability in the world,” said Michael R. Johnson, M.D., of MUSC’s Institute of Psychiatry. “Despite the severe consequences of this disorder when it is untreated, it is difficult for many of us to give up the idea that ‘I should be able to handle this on my own.’ I have too often worked with people who have come for help only after this illness has devastated their lives, costing them their job, their house, their savings, or even their family. The knowledge that all of this could have been prevented with early treatment intervention does little to heal the pain of these losses.”

Clinical depression can be caused by:

• GENETIC FACTORS—natural genetic composition or temperament can make us more predisposed to feel strongly about events, stress or sadness. Everyone feels blue or sad on occasion, but some just naturally bounce back more easily than others.
• EXTERNAL FACTORS—Events such as a major illness, loss of a job, death in the family or divorce will cause most people to become upset. These feelings of grief are natural and usually subside on their own with time. Feelings of despair that last for extended periods of time can lead to clinical depression.
• BIOLOGICAL OR CHEMICAL IMBALANCE— The chemical messengers of the brain that are responsible for how we think and feel can become disrupted or interrupted. This imbalance can inhibit our ability to handle life’s daily knocks. Medicines used to treat depression correct this imbalance. Once the brain can receive the proper flow of chemicals, we are better able to cope with problems instead of becoming depressed.

Depression is highly treatable. The importance of seeking professional help for depression can’t be over-emphasized. Unexpressed feelings and a sense of isolation can deepen if left untreated. The combination of medicines known as antidepressants, along with psychotherapy, or “talk therapy,” has resulted in the most promising recovery for patients. This medical treatment allows a patient to unravel problems with a more balanced point of view.

SYMPTOMS OF CLINICAL DEPRESSION

• Unyielding feelings of sadness, depression and being down most of the day
• Loss of enjoyment or interest in activities, work, hobbies, friends, sex
• Significant weight loss or gain
• Fatigue or loss of energy
• Trouble sleeping
• Nervousness
• Poor performance or feeling easily overwhelmed at work
• Preferring isolation
• Nagging aches and pain
• Loss of concentration
• Low self-esteem
• Feelings of hopelessness and guilt
• Thoughts of death and suicide

If you are experiencing five or more of the symptoms listed above or if they significantly interfere with your life, seek the advice of your doctor or a mental health professional.

Editor's note: The article is reprinted from Checkup newsletter, produced by MUSC Creative Services.