Dear Dr. Garner,
For the past two months I am constantly sad. I have no interest in socializing, getting dressed nicely or going out to dinner. My appetite is terrible. I have difficulty concentrating and making decisions.
My husband thinks I have a case of the blues. He wants to take me to Florida for a vacation.
Do you have any suggestions as to what to do? Do you think I have the blues?
Sincerely Sad in
Sheepshead Bay
Dear Sincerely Sad,
Being sad for a short period of time, or in response to a loss or financial difficulty, is perfectly normal.
“A case of the blues,” as your husband describes it, is very different from a bout of depression. Depression is frequently overlooked by doctors, and many times patients do not get the treatment they need.
Depression is a much more common disease than people believe it to be. It is the second largest cause of disability in the world. There is often embarrassment associated with mental health problems, and patients may not fully disclose their condition with their doctor, which may lead to a misdiagnosis.
From your description, it appears that you may very well have depression. It is more than just a bout of the blues or feeling sad. It is not something you can snap out of on your own. You need to seek professional help. It requires counseling as well as medication. It is no different from having other diseases, such as diabetes or cancer. The good news is that medications are often highly effective in making people feel better.
Identifiable Symptoms
I am frequently asked if there is a test that someone can take to see if he or she is depressed. There is such a test, which anyone can take.
Review the following symptoms. If you have at least five of the symptoms below (one of the five must be either depressed mood, or loss of interest or pleasure), you are depressed:
• Depressed mood most of the day
• Decreased interest or pleasure in activities
• Change in appetite with weight gain or loss
• Change in sleeping patterns
• Loss of energy or feeling very tired
• Restlessness or irritability
• Feelings of anxiety
• Feelings of worthlessness or hopelessness
• Feeling guilty when it doesn’t make sense
• Having difficulty thinking or making decisions
• Thoughts of death or of committing suicide
If you answer affirmatively to five of the above, it is essential that you schedule a visit to the family doctor.
I am often questioned, “Isn’t depression a sign of getting older?” This is absolutely not true. It often goes undiagnosed in older adults, as the symptoms may not be typical. Feeling severe fatigue or loss of appetite, severe tiredness and decreased interest in social activities may be the most common symptoms in older adults. Thoughts of suicide must be questioned, as it is a leading cause of death in older adults.
Causes and Risk Factors
What are the causes of depression? People with depression often have abnormal amounts of chemicals made by their brains. There are chemicals that the brain produces to make someone happy. When these chemicals are not produced properly, depression occurs.
Some factors that put people at high risk for depression include: being a woman (twice as many women are diagnosed with depression than men); having relatives with the disease; being socially inactive, or a loner; having previous episodes of depression; having a serious illness, such as AIDS or heart disease; and abusing drugs, cigarettes or alcohol.
Treatment Options
There are treatments useful in remedying depression. New anti-depressants known as SSRIs (Selective Serotonin Reuptake Inhibitors) are very helpful. Drugs, such as Prozac, Zoloft or Paxil, are examples.
Counseling is also extremely helpful, as are support groups.
A procedure that has long been presented as barbaric, known as ECT (Electrode Convulsive Therapy) may actually be a highly effective treatment. This is more commonly known as shock therapy. While controversial, it is extremely effective for those who do not respond well to medications or are at high risk for suicide. It can also be an option for those who are pregnant, who cannot take medications.
Some patients have to be hospitalized to protect themselves until feeling better.
The key is to take good care of yourself by exercising, eating right and avoiding alcohol and other drugs. It is important to understand depression and realize that you are not alone.
Depression is not caused by something that you did wrong or something that you can will away.
While there is no sure way to prevent depression, taking steps to reduce stress on your body and living a healthy lifestyle are key.
I hope that this helps you. Please let me know of your progress.[hr] Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.
