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Anyone can suffer a brief bout of depression.  For example, it’s normal to feel down after experiencing the loss of a loved one or a job.  This type of depression passes in time as a person begins to heal from the loss.  Often, though, depression can result from a biochemical imbalance that can be chronic or recurrent.  This is called clinical depression.   It is not simply a case of “the blues.”  

Nearly 40 million Americans will be affected by a biologically based depression some time during their lives and more than 70% of these people will not recognize it as an illness and will not seek treatment.  

A significant percentage of those who do not receive treatment may be at risk for suicide, alcohol or other drug abuse or other negative coping strategies.  

Some people learn to live with clinical depression.  They can get up, go to work and live their lives.  They don’t realize there is a better way to feel, so they’re not motivated to get treatment.  

Without treatment, though, someone can spend a lifetime feeling miserable and making those around them feel almost as bad.

Signs of clinical depression  

You may not know when a person is clinically depressed, or you may have been living with a clinically depressed person for so long that it may feel more like a normal routine than an illness.  But there are some signs you can look for:

• A persistent sad, anxious or “empty” mood
• Loss of satisfaction with life
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness or helplessness
• Diminished capacity to give or receive affection
• Loss of interest or pleasure in ordinary activities (including sex)
• Sleep disturbances (including early-morning waking, insomnia or oversleeping)
• Eating disturbances (including weight gain or loss and changes in appetite)
• Physical aches and pains (including headaches and lower back pain)
• Excessive crying
• Restlessness, irritability or hyperactivity
• Decreased energy, fatigue or slowed thinking
• Difficulty in concentrating, remembering or making decisions
• Thought of death or suicide; suicide attempts

When four or more of these symptoms persist for extended periods of time, they may be outward indications of clinical depression.  

The person who is clinically depressed needs professional treatment to relieve the depression.  The most important thing anyone can do for a depressed person is to help him or her find appropriate diagnosis and treatment.  

This may involve encouraging the individual to stay with treatment until symptoms begin to abate, which might take several weeks, or to seek other treatment if no improvement occurs. It may require making an appointment and accompanying the depressed person to the doctor.

It may also mean monitoring whether the depressed person is taking prescribed medication.

Helping your spouse

Living with a depressed person is difficult under any circumstances. When the person is your wife or husband, the problems escalate.   The role of spouse carries with it the expectations of love, companionship, parental partnership, economic support and all-around help.

But depression reduces sexual desire, energy levels, sociability and productivity.

It can destroy a relationship.  Even if the depressed spouse is getting treatment, the situation can be stressful. Depression can cause people to become withdrawn, rejecting and irritable.

If the not-depressed spouse realizes that illness causes these behaviors, s/he may find it easier not to feel hurt and to respond in a no rejecting and reality-orienting manner.

For instance, if the depressed person says something like, “You never loved me,” or “I don’t love you anymore,” the no depressed person might respond, “That’s your depression talking. Your illness is hurting both of us, but when you get better, you’ll see things in a different light.”  

An important part of coping with someone else’s depression is finding ways to go on with a satisfying and productive life you.

Counseling for no depressed partners can help achieve these goals.   Until symptoms are alleviated, depressed people need patience, understanding, encouragement and assistance.  They should not, however, be made to feel totally helpless or inadequate.

If a person refuses to get help for his or her depression, consult with a mental health professional on how to deal with the situation. Counseling is often useful to help the no depressed person learn about alternatives and solutions.  

Depression and substance abuse

The relationship between depression and substance abuse is complex. Somewhere between 25 percent and 37 percent of alcoholics entering treatment have symptoms of depression.

For some of these individuals, the depression is strong enough to require treatment after the substance abuse is treated.

It is often difficult to distinguish between the substance abuse and the depression.

The first step is to get the person sober, drug-free and physically well so that a professional can make a proper diagnosis. This may require treatment in an inpatient substance abuse program. Consult with a mental health professional on how to intervene.

Children and depression

Childhood depression is often misunderstood or overlooked by parents and professionals, yet an estimated 10 percent of all children will duffer from depression before the age of 12.

Children and teenagers may show their depression in different ways than adults.

Depressed children may appear to be hyperactive, aggressive or possibly physically ill.

Though these behaviors may be signs of other illnesses, in cases of depression, the child may sometimes feel sad and express depressing thoughts.   Depressed children may show a decline in schoolwork or seem persistently bored.

Another sign may be a change in behavior (for example, a child who used to play often with friends may start spending a lot of time alone).

The child may eat or sleep too much or too little.

Things that were once fun may bring little joy to the depressed child, who may withdraw from previous activities.

Because a depressed child is hurting, he or she usually wants help and responds favorably to treatment.

For more information and guidance, contact your physician or the nearest mental health facility, or look under “Family counselors” or “Mental Health Services” in the Yellow Pages.   In many areas, help is available through your school district’s student assistance program or the employee assistance program where you work

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