Depression is at epidemic proportions in the United States and around the world. The National Institute of Mental Health estimates that twenty percent of the population of the United States experiences symptoms of depression at any one time. The cost to the country in terms of time lost from work, visits to doctors offices with physical complaints and the abuse of drugs and alcohol in an attempt to self medicate is inestimable. The cost in human suffering cannot be exaggerated. Depression leads to loss of sleep, irritability, the tendency to quarrel, and even divorce and alienated child/parental relationships. The symptoms have been described as despair, despondency, melancholy and hopelessness. There is nothing romantic or appealing about this illness. In addition, no one is immune to the possibility of suffering depression at some time in his or her lives. For some, there may be a single experience of depressive symptoms but for others it can and often does become a chronic problem with no relief in sight.
Unfortunately, medical doctors, employers, and teachers do not recognize the symptoms of this problem and, therefore, fail to refer people to the mental health community. At worst, the cost of depression can be a life itself. Suicide is always a possibility when an individual is in the clutches of a depressive episode. The facts are that many more women than men attempt suicide but many more men are successful at killing themselves than women.
It is very difficult for many people to acknowledge the fact that they are feeling depressed. The stereotyped view is that depression is a sign of weakness that they can change. Consequently, people experience terrible feelings of shame associated with this illness along with a lack of empathy on the part of family and friends. People would rather deny their depression and engage in drinking and drug abuse than to admit experiencing it and seeking help. The old myth continues to persist that depression means craziness.
National statistics show that many more women than men suffer from depression. However, given the fact that men are taught from earliest childhood to hide their deeper feelings and to be tough, it is probable that depression in men is under reported and under diagnosed. Along the same lines it is also true that men avoid medical check-ups and ignore the physical symptoms of illness. American values stress toughness and independence. Acknowledging the need for any kind of help is akin to a lack of masculinity and virility. The human cost in human suffering is enormous in terms of emotional pain, and physical sickness.
The difference between feeling depressed versus occasionally blue is immense. The depressed person suffers from low self-esteem. This individual feels worthless and hopeless. Other people's glances and nuances become proof for the sufferer of how they are disliked and rejected. Successes are dismissed as accidental while errors and mistakes become irrefutable confirmation of being a failure. These feelings and thoughts persist for weeks, days or years. By contrast, occasional blueness is transitory and passes within a few hours to a few days.
Someone who is depressed has little in the way of a reservoir of inner well being and pride. Consequently, the person must look to external sources for validation. This makes it difficult for the individual to make decisions. They fear the wrong decision might win disapproval from others.
In an effort to please others in order to win love and acceptance, the sufferer of depression buries angry and annoyed feelings. Wearing a mask of happiness and amiability, they are unaware of how small angers are building and getting ready to come flooding over the gates into a torrent of rage. When this happens everyone, including the individual, are shocked by the sudden out pouring of anger.
Depression greatly complicates relationships. The individual both withdraws from others and self-isolates or becomes irritable. The irritability is expressed as an endless number of complaints about mundane and minor things. However, the chronic complaining and irritability serves to alienate those closest to the depressed person. The result is further isolation, guilt and self-hate. This sets up a vicious cycle in which isolation feeds depression, then anger and further isolation. The depressed person succeeds in finding evidence for self-contempt by pointing to the ways in which friends and family avoid or minimize contact.
Another scenario that breeds isolation and loneliness is the apathy and exhaustion felt by individuals with this illness. The sense of lethargy experienced in depression robs people of the desire to go out and enjoy social events. The tendency is to want to remain at home. At worst, an acutely depressed individual will not get out of bed for most of the day.
It is said that depression is an illness in which people cannot identify what they feel or why they experience what they do feel. Either, events occur and feelings are pushed out of awareness, or feelings are experienced but the precipitating events are ignored and forgotten. In addition, it is also said that depression is learned helplessness because the person is convinced that problems cannot be solved. Psychotherapy is an effective treatment for depression. It helps individuals identify the reasons for their feelings or what those feelings might be after some precipitating event has occurred. By helping the patient make this connection between thoughts and feelings, people gain a better sense of understanding and control over their lives. Choices of action become available and the person discovers an entire variety of ways to solve problems. When feelings are too overwhelming to be helped by psychotherapy, anti-depressant medication is available. The combination of psychotherapy and medication is extremely effective.
Dr. Schwartz is a clinical social worker with training in psychoanalysis and family therapy. He has more than twenty years of experience working with people seeking help with feelings of depression, anxiety, relationship issues or family problems. Marital life and the experience of raising children have given him a deeper understanding of the joys and difficulties of family and work life. These experiences have deepened his effectiveness as a psychotherapist. He has a private practice in New York, NY and Rochelle, NY.
You may visit Dr. Schwartz's website or contact him via email.
Copyright (c) 2000 Allan N. Schwartz, CSW, Ph.D. - Reprinted by permission of Allan N. Schwartz, CSW, Ph.D.
