Caregiving can be a lonely task. Day after day spent caring for another person can lead to feelings of isolation and exclusion. With no one else to talk to, no one to appreciate the small sacrifices you make on a daily basis, it’s no wonder that depression is very common among caregivers. If you are experiencing feelings of extreme sadness, relentless waves of self-criticism, apathy and hopelessness, changes in eating or sleeping habits, trouble concentrating you may be suffering from depression – a serious physical illness.

Everyone feels sad or melancholy at times It is perfectly normal for some days to be better than others. Brought on by stress, fatigue or boredom, mild depressive symptoms linger for short periods and generally cause no harm. However, ordinary depressed feelings are very different from clinical depression, which is much more serious.

Can depression in women be triggered by the hormonal changes that accompany menopause? Researchers are investigating this possibility We do know that many women experience troubling emotional symptoms such as increased irritability during perimenopause, but those feelings may be caused by a lack of sleep rather than hormonal changes.

Treatment

The first step in dealing with depression is to recognize your own symptoms and seek treatment. Talk with your primary care clinician or obstetrician/gynecologist. He or she can assess the symptoms of depression, initiate your treatment, and refer you to a qualified psychiatrist or psychologist for additional treatment, as necessary. Most women are successfully treated for depression on an outpatient basis using psychotherapy, medication or some combination of the two.

Alternative therapies, shown to be effective in properly selected cases, include an over-the-counter herbal remedy called St John’s Wort and exercise The best therapy for you should be discussed with your clinician.

As with many types of diseases, depressive disorders come in many forms. These are the most prevalent types:

Major or Clinical Depression

The most common form of depressive illness is characterized by a combination of symptoms that interfere with the activities of daily living (working, sleeping, eating and pleasurable activities) Symptoms generally persist for at least two weeks, and episodes can occur once or recur multiple times at various stages of a woman’s life.

Usually four or more of the following symptoms must be present:

  • Persistent sad, anxious or “empty” mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies or activities you once enjoyed, including sex
  • Insomnia, early morning waking, or oversleeping
  • Loss of weight, loss of appetite, or overeating and weight gain
  • Decreased energy, fatigue, feeling “slowed down”
  • Thoughts of death or suicide, suicide attempts
  • Restlessness, irritability
  • Difficulty concentrating, remembering, making decisions
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Dysthymia

A less severe type of depression, dysthymia involves long-term, chronic symptoms that do not disable, but keep you from feeling good, or functioning at your best

Manic-Depressive Illness

Also called bipolar disorder, this condition is not nearly as prevalent as other forms of depressive illnesses. Manic-depressive illness involves cycles of depression and elation, during which a sufferer will alternate between extreme periods of debilitating depression and hyperactive creativity and energy. There is most likely a genetic influence in the development of this disease.

Subclinical Depression

Also called “subsyndromal symptomatic depression,” this condition is defined by two or more symptoms of depression, most or all of the time, for at least two weeks in duration It is also associated with evidence of social dysfunction

Seasonal Affective Disorder (SAD)

A mood disorder that is four times more common in women than men and characterized by depression related to a certain season of the year, especially winter. The
decreased amount of sunlight during the winter is believed to be a cause of this disorder, which is often treated with light therapy.

Helping Someone Who Is Depressed

Depressed people can be very difficult to be around, and yet they need more than the usual understanding and support from their friends and family. The anger and lack of trust that a depressed person may have for people close to him or her is very disturbing to someone who is trying to help. At such times, the sincerity of a friend is questioned when the depressed person doesn’t feel worthy of someone’s friendship. Withdrawal from others, even when very lonely, can make it nearly impossible to encourage a depressed person to enter into activities that may help pull him or her out of the depression.

It is frequently difficult for a depressed person to carry on a conversation. Attempts to help may be met with defensiveness and verbal attacks. Frequently questioning him or her about the condition may be met with crying and frustration, simply because the person may not know what is wrong. Reassurance is important, although it can become a drain on the encouragers.

While being supportive and understanding, the friend must be careful not to do things that fulfill any unreasonable or unrealistic needs on the part of the depressed person There is a very thin line between being supportive and being overly protective. Too much concern can feed an unrealistic demand for attention. Performing too many tasks for someone who “just can’t seem to get things done” can bring about great dependency and also guilt over being indebted to someone else.

You can best help a friend or relative who is depressed by considering the following points:

  • Do not moralize. Do not pressure him or her to “Put a smile on your face,” or to “Snap out of it.” Often the person will feel even worse after hearing such statements. Do not expect a “quick fix.”
  • Be available When you are alone with your depressed friend, you might say something like, “I have noticed lately that you seem down. I care about you. I’m willing to listen.” Then be a good listener. Don’t say, “I know exactly how you feel.” You probably don’t. But if you’ve had similar experiences, sharing those may help. Say things like, “This is what helped me It might help you,” or “I know some of what you must be feeling “
  • Urge him/her to get professional help if necessary. Offer to accompany your friend to the first visit if it will be easier for the person.
  • Listen and watch for signs or threats of suicide. Sometimes people who are thinking about killing themselves give away cherished belongings or say something like, “After I’m gone ,” “Are the insurance policies up-to-date?” “Would you take care of my pet if ?” If you think suicide is an immediate possibility, do not leave your friend. Contact a mental health professional for help as quickly as you can.

To Find Help

  • Ask people you know (your physician, clergy, etc) to recommend a good social worker or therapist
  • Try local mental health centers (usually listed under mental health in the telephone directory)
  • Try family service, home health, hospice, or human service agencies
  • Try outpatient clinics at general or psychiatric hospitals
  • Try university psychology departments
  • Try your family physician
  • Look in the yellow pages of your phone book for counselors, marriage and family therapists, or mental health professionals

Adapted from ALS Association