Looking back on gloom, looking for­ward with hope

The Covington News - - Front page -

De­pres­sion has been with us since we evolved into think­ing, feel­ing be­ings. Two thou­sand years ago, Hip­pocrates re­ferred to Dem­ocri­tus who wrote a trea­tise on “me­lan­choly,” (what we call “de­pres­sion”). In 1586 Ti­mothy Bright wrote “a Trea­tise on Me­lan­cholie,” cred­ited as the first psy­chi­atric book in the English lan­guage. In 1621, Robert Bur­ton wrote “The Anatomy of Me­lan­choly,” ar­guable the first self-help book in the English lan­guage.

To­day, de­pres­sion is more preva­lent than ever. The Stud­ies of En­vi­ron­men­tal Catch­ment Area found that among those born be­fore World War I, 1 per­cent suf­fered de­pres­sion, but among those born around 1925 4 per­cent suf­fered de­pres­sion — a four­fold in­crease. To­day’s rate is over 9 per­cent. You might think that the growth in rates of de­pres­sion is re­lated to the two world wars. Not so. Peo­ple born af­ter 1967, 21 years af­ter World War II, are 10 times more likely to suf­fer de­pres­sion than peo­ple born be­fore 1933. The Na­tional In­sti­tute of Men­tal Health con­ducted the Rel­a­tives Study, a study on the in­ci­dence of de­pres­sion in the gen­eral pop­u­la­tion, and found a ten­fold in­crease in de­pres­sion over the course of the cen­tury. Com­pared to our re­cent times of pros­per­ity, fewer were de­pressed dur­ing the Great De­pres­sion. Ours is the era that de­serves the moniker “Great De­pres­sion,” but with a twist — there are far more ef­fec­tive med­i­cal and psy­cho­log­i­cal ways to treat it.

In the past, the words “veg­e­ta­tive de­pres­sion” de­scribed the plight of those with the most se­vere de­pres­sion, those who had no de­sire or en­ergy to move, who didn’t get out of bed for months, who suf­fered enor­mous changes in ap­petite and weight, and for whom lit­tle could be done ex­cept to wait for the de­pres­sion to “lift.” Then came tri­cyclic an­tide­pres­sants that short­ened the du­ra­tion and sever­ity of de­pres­sion, but of­ten with sig­nif­i­cant side ef­fects. To­day, we have SSRI an­tide­pres­sants which have fewer side ef­fects and do not make one drowsy, a bless­ing for those who have to re­main alert and pro­duc­tive.

With de­pres­sion where there is se­vere dis­tur­bance of sleep, gross sup­pres­sion of ap­petite or re­jec­tion of food, dras­tic weight change, or in­abil­ity to per­form sim­ple move­ments due to ex­haus­tion or fa­tigue, psy­cho­log­i­cal ther­a­pies must be com­bined with med­i­ca­tion in or­der to bring that per­son up to a level that al­lows for par­tic­i­pa­tion in ther­apy. It takes strong determination and enor­mous en­ergy to change the de­bil­i­tat­ing pat­terns of thought, feel­ing and be­hav­ior that ini­ti­ate and per­pet­u­ate de­pres­sion. Not only have an­tide­pres­sants be­come more ef­fec­tive, psy­cho­log­i­cal ther­a­pies have be­come sharper and shorter. Ther­a­pists can iden­tity more pre­cisely and fa­cil­i­tate change in the thoughts, feel­ings and be­hav­iors that pro­duce and sup­port de­pres­sion and for mild or moderate de­pres­sion, re­search is clear that psy­cho­log­i­cal ther­a­pies alone are highly ef­fec­tive.

It is im­por­tant to stress that just to de­pend on an­tide­pres­sants without chang­ing the psy­cho­log­i­cal make-up that sup­ports it is like tak­ing med­i­ca­tion for a heart dis­ease without at­tempt­ing to change one’s life­style, e.g. diet, ex­er­cise, al­co­hol con­sump­tion, etc. Thoughts cre­ate feel­ings. Thoughts and feel­ings cre­ate cor­re­spond­ing chem­i­cals in the brain and the body, just as chem­i­cals in the brain and body man­u­fac­ture cor­re­spond­ing thoughts and feel­ings. In some cases, peo­ple just need skills, but in other cases they need pills and skills — ei­ther way, at some point, those who are de­ter­mined to stop the cy­cle of de­pres­sion must ex­am­ine the thoughts, feel­ings, at­ti­tudes and be­lieve that lead to and sus­tain it. In to­day’s world, there is just not need to suf­fer de­pres­sion. Help is avail­able — take it — and thrive.

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