Depression and Anxiety - Uni-Polar Disorder and Chaos

Introduction To DEPRESSION (Uni-Polar Disorder) &
Anxiety (description, effects - causes)

Depression (suffering from Uni-polar Disorder):

Is a persistent and pervasive mood disorder; a mental
or emotional state; an affective disorder; and often
considered a clinical, psychological or psychiatric
disorder (neurotic or psychotic) lasting two weeks or
more.
Is described differently by people who experience it.
Is a common condition ("normal") - and treatable.
Is not what in everyday language refers to as
“depression” which describes any downturn in mood,
which may be relatively transitory and perhaps due to
something trivial. Depression persists!

Has symptoms that prevent a person from leading a
normal life.
In many ways depression resembles the grief and
mourning that follow bereavement, there are often
feelings of low self esteem, guilt and self-reproach,
withdrawal from interpersonal contact and physical
symptoms such as eating and sleep disturbances (see
below).
Depression ranges from normal feelings of the blues to
major depression (types of depression include: major
depression, bipolar depression, dysthymia, and seasonal
depression (seasonal affective disorder – S.A.D.).

Depression can also be experienced in other disorders,
such as bipolar disorder (manic-depressive disorder).

Depression - Is not just a temporary or situational sadness –
it is persistent and pervasive.

Depression may be the cause of a daily, unrelenting
headache that peaks in the morning and late after- noon.
It is often accompanied by a complications of their
migraines.
People with chronic pain syndromes are often markedly
depressed.

Symptoms, Signs and Characteristics of Clinical
Depression:
Note: Not everyone with depression will have all of these
symptoms or even experience them at the same level.

However, if a person has four or more of these
symptoms, and nothing can make them go away,
or if they last more than two weeks, a doctor, mental
health counsellor, or psychiatrist should be consulted.

Anxiety Disorders affect millions of people age 18 years and
older; it results in fearfulness and uncertainty.
It is different from the relatively mild, brief anxiety caused
by a single stressful event.
Anxiety disorders last at least 6 months and can get worse if
they are not treated.

The Major Dimensions/Characteristics & Symptoms of Behavior
in Depression (Uni-Polar Disorder) are:

Affective (Feelings/Emotions - emotional symptoms):

Depression (dysphoria); sadness and misery; fatigue.
Persistent feelings of "emptiness" or sadness.
Feeling hopeless, helpless, worthless, and/or guilty
- with irritability, increased crying, anxiety and panic attacks.
Substance abuse.
Difficulty concentrating, remembering or making decisions.
altered mood and activities, such as:
a despondent lack of activity, low mood, helplessness, hopelessness and dejection.
difficulties with (or loss of) concentration and thinking.
feelings of apathy and anxiety (more below).
lack of emotional expression, and of motivation.
feelings of guilt (especially inappropriate guilt), and/or self-blame.
recurrent thoughts of death or suicidal ideas & plans - or attempts at suicide.

Depression (Uni-Polar Disorder) : Motivational Symptoms;

Reduced motivation; lack of interest in most activities; lack of pleasure from most activities.
Fatigue or loss of interest in ordinary activities, including sex.
Change in eating and sleeping patterns (too much OR too little).

Depression/Uni-Polar: Cognitive (Mental/Intellectual) Symptoms;

Problems with concentration, memory, and decision-making;
generally negative self-evaluations and guilt;
hopelessness; delusions and hallucinations only in severe cases.
Lack of self-worth (worthlessness), and a pessimistic sense of inadequacy (esteem problems).
Diminished, or loss of, interest or pleasure in nearly all things.

Depression/Uni-Polar: Interpersonal (Social) Symptoms;

General difficulties in interpersonal situations.
Reduced desire for social activities (time with friends etc);
social withdrawal.

Biological/Physical Symptoms: reduction of the functional activity of the body, such as:

Decreased sexual interests - disturbances of sexual function.
Persistent physical symptoms or pains that do not respond to treatment.
poor appetite or weight loss (or gain), anorexia
sleep disturbances, insomnia or hypersomnia (waking early or late)
constipation.
Fatigue and loss of energy (and motivation)
physical symptoms such as slow movement and speech.

Depression/Uni-Polar: Motor Symptoms;

Psychomotor retardation – generally "slow" behavior; psychomotor agitation – generally"hyperactive" behavior.

Depression: Self-Care Symptoms;

reduced self-care; decrease in personal hygiene; decrease in meeting basic responsibilities.

For Anxiety Disorder - see below

ANXIETY DISORDER - details

SPECIFIC PHOBIA: this is an intense fear of something that poses little or no actual danger, such as closed-in places,
heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood. These phobias aren't just
extreme fear; they are irrational fear of a particular thing.

GENERALIZED ANXIETY DISORDER (GAD) - also known as the "free-floating anxiety disorder": these people go
through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They
anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work.
Sometimes just the thought of getting through the day produces anxiety.

Panic disorder is a real illness that can be successfully treated. It is characterized by sudden attacks of terror. It is
usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. When these attacks occur, people
with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest
pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of
losing control.

Obsessive-compulsive disorder (OCD): these people have persistent, upsetting thoughts (obsessions) and use rituals
(compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.
Healthy people also have rituals; the difference is that people with OCD perform their rituals even though doing so
interferes with daily life and they find the repetition distressing.

Post-traumatic stress disorder (PTSD): this disorder develops after a terrifying ordeal that involved physical harm or
the threat of physical harm, including physical assault and rape. The person who develops PTSD may have been the one
who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that
happened to loved ones or strangers.

Social phobia: this is also known as the social anxiety disorder. Its characteristics include: when people become
overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an
intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass
them. They can worry for days or weeks before a dreaded situation.

Agoraphobia (fear of crowds - and going out in public) - any situation involving the feeling that one is in a place it would be
hard to escape from.

For more detail see the article on Anxiety Disorders

Klaas Tuinman MA
Dawn Cove Abbey
Deerfield, (Yarmouth County) Nova Scotia, Canada - 2008

Depression Questionnaire: To assess yourself - - take the quiz - follow instructions carefully - click QUIZ

Causes Of DEPRESSION/Uni-Polar Disorder
PHYSICAL: Genetic/Psychological
Some professionals talk about chemical imbalances in the brain that occur in depression.
This suggests that depression is a medical illness, without psychological causes.

However, all psychological problems have some physical manifestations, and all physical illnesses have psychological
components as well.

In fact, the chemical imbalances that occur during depression usually disappear when you complete therapy for
depression, without taking any medications to correct the imbalance.
This suggests that the imbalance is the body's physical response to psychological depression, rather than the
other way around.
Some types of depression do seem to run in families, suggesting a biological vulnerability. This seems to be the
case with bipolar depression and, to a lesser degree, severe major depression.
Studies of families, in which members of each generation develop bipolar disorder, found that those with bipolar
disorder have a somewhat different genetic makeup than those who are not diagnosed.
However, the reverse is not true. Not everybody with the genetic makeup that causes this vulnerability to
bipolar disorder develops the disorder.
Additional factors, such as stress and other psychological factors, are involved in its onset as well.
Likewise, major depression also seems to occur, generation after generation, in some families, but not with a
frequency that suggests clear biological causes. Additionally, it also occurs in people who have no family history
of depression.

So, while there may be some biological factors that contribute to depression, the indicators are that it is primarily a
psychological disorder.

PSYCHOLOGICAL
A variety of psychological factors appear to play a role in vulnerability to these severe forms of depression.

Most likely, psychological factors are completely responsible for other forms of mild and moderate depression,
especially reactive depression.
During treatment, Reactive depression is usually diagnosed as an adjustment disorder.
People who have low self-esteem, who consistently view themselves and the world with pessimism, or who are
readily overwhelmed by stress are more prone to depression.

SOCIAL ENVIRONMENT (Learned Behaviour)
Psychologists often describe social learning factors as being significant in the development of depression, as well as
other psychological problems.

People learn both adaptive and maladaptive ways of managing stress and responding to life problems within their
family, educational, social and work environments.
These environmental factors influence psychological development, and the way people try to resolve problems
when they occur.
Social learning factors also explain why psychological problems appear to occur more often in family members,
from generation to generation.
If a child grows up in a pessimistic environment, in which discouragement is common and encouragement is rare,
that child will develop a vulnerability to depression as well.
A serious loss, chronic illness, relationship problems, work stress, family crisis, financial setback, or any
unwelcome life change can trigger a depressive episode.

OTHER (1): INDECISION

One frequently overlooked cause or factor is related to the psychological one: it is when a person is faced with
having to make a decision, or choice between two or more things/people - and not liking either of the choices. It
is when they avoid the choice or defer it, that the problem arises - for some reason, human emotional-mental
functions do not handle indecision well - especially if on a prolonged basis - and the condition we know as
depression often results.
Hopelessness (having given up, or lost, hope.
Also, certain events & holidays, such as Christmas can bring on a temporary depression. So will bereavement and
loss.

OTHER (2): ANGER
It is widely recognized that some forms of depression are actually anger that is "masked" or suppressed.

CONCLUSION (this section on depression)
Very often, a combination of biological, psychological, and environmental factors are involved in the development of
depressive disorders, as well as other psychological problems.

When you feel "depressed", and don't know where to turn, talk to someone who can help - see your doctor - and get a
referral to a psychologist or coach/counsellor.

DEPRESSION / Uni-Polar Disorder in Children, the Elderly, Women & Men

Depression (Uni-Polar Disorder) in Women
Women experience depression about twice as often as men

Many hormonal factors may contribute to the increased rate of depression in women-particularly such factors as
menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause.
Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and
caring for children and for aging parents.

A recent NIMH study showed that in the case of severe premenstrual syndrome (PMS), women with a
preexisting vulnerability to PMS experienced relief from mood and physical symptoms when their sex hormones
were suppressed. Shortly after the hormones were re-introduced, they again developed symptoms of PMS.
Women without a history of PMS reported no effects of the hormonal manipulation.

Many women are also particularly vulnerable after the birth of a baby. The hormonal and physical changes, as well
as the added responsibility of a new life, can be factors that lead to postpartum depression in some women.
While transient "blues" are common in new mothers, a full-blown depressive episode is not a normal occurrence
and requires active intervention.

Depression / Uni-Polar Disorder in Men
Although men are less likely to suffer from depression than women, millions of men are affected by the illness.

Men are less likely to admit to depression, and doctors are less likely to suspect it.
The rate of suicide in men is four times that of women, though more women attempt it.
In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85.

Depression can also affect the physical health in men differently from women: although depression is associated with
an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.

Men's depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively
long hours.
Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and
discouraged; hence, depression may be difficult to recognize as such in men.
Even if a man realizes that he is depressed, he may be less willing than a woman to seek help.
Encouragement and support from concerned family members can make a difference.
In the workplace, employee assistance professionals or work-site mental health programs can be of assistance in
helping men understand and accept depression as a real illness that needs treatment.

Some people think that it is normal for the elderly to feel depressed. It is not - most older people feel satisfied with
their lives.

Often, when depression develops, it may be dismissed as a normal part of aging.
When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often
reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or
extremely prolonged grief after a loss.
Depressive symptoms in older people are often missed.
Doctors recognize that some symptoms may be side effects of medication the older person is taking for a
physical problem, or they may be caused by a co-occurring illness.

Depression / Uni-Polar Disorder in Children
The depressed child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die.

Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood.
Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child is
just going through a temporary "phase" or is suffering from depression.
Sometimes the parents become worried about how the child's behavior has changed, or a teacher mentions that
"your child doesn't seem to be himself."
In such a case, if a visit to doctor rules out physical symptoms, the doctor will probably suggest that the child be
evaluated by a professional who specializes in the treatment of children.

If you feel you are suffering from depression - or Anxiety - call your doctor, please.

Depression and Anxiety - Uni-Polar Disorder & Chaos

Symptoms of Depression/Uni-Polar Disorder can include (outline only):

Inability to concentrate or make decisions
Irritability, nervousness, anxiety
Decreased energy (on edge, “edgy”), feeling persistently fatigued
Sadness, hopelessness, low self-esteem, feelings of worthlessness
Withdrawal from social and family activities, and frequently episodes of absence from place of employment
Decreased sexual desire and activity
Suicidal thoughts, talk of suicide or planning for suicide attempt
Disturbance in eating or sleep habits, trouble falling asleep or staying asleep (mind and thoughts go into hyper-
speed), or sleeping excessively

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