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Mental Health: Depression

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Depression is a dysregulation of the brain function that control emotions (or moods). It is a mood disorder characterized by intense and persistent negative emotions. These emotions negatively impact people’s lives, causing social, educational, personal and family difficulties.

Depression is different than feeling sad or down. It is a medical condition affecting the way mood is controlled by the brain. Someone with Depression can’t just “snap out of it.” Depression affects the way he or she thinks, feels and acts. It becomes a negative lens through which he or she sees and experiences the world. 

When Depression happens, it often lasts for many months and then sometimes gets better. This is called an episode of Depression. Most people who get Depression will experience many episodes during their lifetime. Depression is often called Major Depressive Disorder (MDD).

Sometimes a negative event (such as the loss of a loved one, or severe and prolonged stress) will trigger an episode of Depression but often episodes will occur spontaneously. Depression is not caused by the usual stresses of life. Depression is often accompanied by feelings of anxiety and causes significant problems with family, friends, work or school. 

How can you tell if someone you know might have Depression?*

Depression, and other mental disorders, should only be diagnosed by a medical doctor, clinical psychologist, or a trained health provider who has spent time with the teenager and has conducted a proper mental health assessment. Diagnoses are complicated with many nuances. Please do not attempt to diagnose someone based on the symptoms you read about in magazines or on the internet. If you are concerned, speak to a trained health professional.

It can be confusing when people use the word “depression” to mean different things. We should try to save the word “depression” to mean the mental disorder of Depression, and use other, more exact words to describe the negative emotions that we feel. 

Use the Right Words!
USE RIGHT WORDS
There are 3 types of depressive disorders:
Major Depressive Disorder (MDD)

Someone with MDD will experience episodes of intense depression (lasting weeks to years), separated by periods of relatively stable mood. When people refer to Depression, they usually mean MDD.

Persistent Depressive Disorder (formerly Dysthymia) 

People with Persistent Depressive Disorder will experience depressive episodes that are less intense than in MDD but last much longer. For teenagers, these depressive episodes last at least one year and for adults, they last two years or more

Disruptive Mood Dysregulation Disorder

Children up to 18-years-old can be diagnosed with Disruptive Mood Dysregulation Disorder if they have persistent irritability and frequent episodes of unreasonable verbal and physical aggression.

To determine if someone you care about may be at risk for Depression, consider the following questions:

  • Does the person feel sad or low most of the time?
  • Has the person lost interest in activities he or she usually enjoys?
  • Does he or she have trouble concentrating?
  • Does he or she feel fatigued or tired much of the time?
  • Does he or she feel hopeless or worthless?
  • Does he or she experience much less enjoyment in life?
  • Has this behaviour lasted at least two weeks, and been present every day for most of the day?

There are three areas of symptoms that often present in youth experiencing depressive episodes. Here are some things to watch for:

Mood
  • Feeling persistently depressed, sad, unhappy or something similar
  • Feeling a loss of pleasure, or a noticeable disinterest in all or almost all activities
  • Feelings of worthlessness, hopelessness or excessive and inappropriate guilt
Thinking
  • Diminished ability to think, concentrate or make decisions
  • Suicidal thoughts/plans or preoccupation with death and dying

Body Sensations
  • Excessive fatigue or loss of energy
  • Significant sleep problems (difficulty falling asleep or sleeping excessively)
  • Physical slowness or, in some cases, restlessness
  • Significant decrease or increase in appetite that may lead to noticeable weight change

If someone in your life has five of the above symptoms (with at least one of them being a mood symptom) present every day for most of the day during the same two week period, then he or she may be experiencing Clinical Depression (MDD). Talk to your family doctor about your concerns. This behaviour cannot be due to a substance, medicine or another illness and must be different than the individual’s usual mood state.

*In accordance with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

Remember, you cannot diagnose someone with Depression without a proper mental health assessment conducted by a properly trained health provider.

http://teenmentalhealth.org/learn/mental-disorders/depression/

Mental Health: Bipolar Disorder

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Bipolar Disorder is a type of mood disorder. However, unlike in Depression, the problem in Bipolar Disorder is in the brain’s regulation of the usual ups and downs of normal mood. In Bipolar Disorder, people cycle between periods of Mania (i.e., feeling really elevated or irritable) and periods of either normal mood or Depression (i.e., feeling really sad and low). These cycles (sometimes called episodes) of Depression and Mania may be frequent (daily) or infrequent (years apart). Although adults in a manic episode can act euphoric and grandiose, young people in a manic episode can sometimes appear more irritable and grandiose.

Someone with Bipolar Disorder will usually experience a depressive episode before experiencing a manic episode, and may even have several depressive episodes prior to a manic episode. This is why some people with Bipolar Disorder are originally diagnosed with Depression.

How can you tell if someone you know might have Bipolar Disorder?*

Bipolar Disorder, and other mental disorders, should only be diagnosed by a medical doctor, clinical psychologist, or other trained health provider who has spent time with the teenager and has conducted a proper mental health assessment. Diagnoses are complicated with many nuances. Please do not attempt to diagnose someone based on the symptoms you read in magazines or on the internet. If you are concerned, speak to a trained health professional.

There are two types of Bipolar Disorder: 

  1. Bipolar I Disorder: The teenager must experience at least one manic episode, although he or she will likely also experience depressive episodes.
  2. Bipolar II Disorder: The teenager must experience at least one depressive episode and one hypomanic episode. A hypomanic episode is a less-severe version of a manic episode. See below for further details.
Depressive Episodes

These look similar to the depressive episodes experienced when someone has Depression. They occur nearly every day for at least two weeks and can include:

  • Feeling sad and low most of the day
  • Losing interest and pleasure in most activities
  • Losing or gaining a considerable amount of weight
  • Eating a lot more or a lot less than usual
  • Difficulty sleeping or sleeping all the time
  • Restlessness or a sense of moving in slow motion that is noticeable to others
  • Fatigue or lack of energy
  • Feeling worthless or guilty for no reason
  • Difficulty thinking or concentrating
  • Recurrent thoughts of death or suicide
Manic Episodes

These occur most of the day, nearly every day for at least one week. They can include:

  • Inflated self-esteem or grandiosity (e.g., acting like he or she is superior to others)
  • Little need for sleep (e.g., feeling rested after only 3 hours of sleep)
  • Need to continue talking – rapid and sometimes confused speech
  • Having too many thoughts at once, feeling a pressure of thoughts in his or her head
  • Acting distracted or unable to focus
  • Increase in goal-directed activity (e.g. either socially, at school or work) or restlessness, although the goal he or she is working toward may not make sense or be logical
  • Excessive involvement in risky activities with painful consequences (e.g., expensive shopping sprees, foolish business investments, drug use, sexual promiscuity)
  • In severe cases, people can experience hallucinations (i.e., hearing or seeing something that isn’t actually there) or delusions (i.e., believing something that isn’t true even when confronted with proof)
Hypomanic Episodes

These are similar to manic episodes and last for four consecutive days or longer, but don’t significantly interfere with the person’s ability to live his or her life. Because hypomanic symptoms are less severe, they don’t always seem problematic to the person, even though they’re an obvious departure from his or her usual behaviour. Although a person may be very productive and accomplish many tasks when experiencing Hypomania, he or she also may become involved in risky behaviour or activities that result in painful consequences.

These symptoms are much more severe and last longer than the regular ups and downs of life. Although most people’s moods change when they experience positive or negative events, the moods swings of someone with Bipolar Disorder occur without any external provocation and are not easily controlled by the person. Some individuals will experience a ‘mixed state’, which is Mania and Depression at the same time.

For many people with Bipolar Disorder, there may be periods of time (lasting from days to years) where the mood is under better control and more likely to stay within “usual” limits. This is especially true if the person is being successfully treated for the illness.

* Statistics are sourced from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

Remember, you cannot diagnose someone with Bipolar Disorder without a proper mental health assessment conducted by a properly trained health provider.

http://teenmentalhealth.org/learn/mental-disorders/bipolar-disorder/