What is Depression?

Everyone experiences sad feelings from time to time. From feeling down and lethargic to not wanting to spend time with family and friends, being down in the dumps happens in life. when these feelings of sadness stick around, it could indicate clinical depression. 

The World Health Organization (WHO) reports that about 5% of adults across the globe suffer from depression. That’s about 280 million adults living with some type of depression. When it comes to those under the age of 18, the Centers for Disease Control and Prevention (CDC), reports about 3.7% of children aged three to 17 years have been diagnosed with depression. That’s nearly 2 million youth in the United States alone living with depression.

Depression can have detrimental impacts on all areas of a person’s life. Not only does the individual live with the feelings of sadness on a daily basis, but this also affects how they function. Depression can impede a person’s work, school, and social life. Often, when someone has depression, they are unable to function well let alone at their full potential. 

At its worst, depression can result in suicide. The WHO reports that each year about 700,000 people across the world die by suicide. In the U.S., the CDC reports that there are nearly 50,000 suicides annually. 

Depression is real. Depression not only robs a person and their loved ones of precious moments in life, but it can also kill. It’s essential to understand more about what depression is, what it looks like in adults, youth, and the elderly, and how to get effective treatment for it. 

October 7 is National Depression Screening Day observed across the United States. This day’s aim is to not only get more people struggling with depression diagnosed and treated but also to raise awareness of the prevalence of depression in our great nation and help more people in need to get help.

 What are the Most Common Types of Depression? 

Depression is a mood disorder. There are several types of depression and depression can be mild, moderate, or severe. The Diagnostics and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-V) lists certain criteria to determine depression. The number of criteria met helps to determine if the depression is mild, moderate, or severe. This also helps to steer the course of treatment. 

As mentioned, there are different types of depression. Let’s explore a few:

Clinical or Major Depression

Clinical depression is one of the most common types of mental health disorders. Clinical depression can begin at any time and under any circumstances. This mood disorder is characterized by a persistent sad or depressed mood. In addition, the loss of interest in activities is also common with major or clinical depression.

Signs of Clinical Depression

• Having feelings of hopelessness
• Having feelings of sadness and emptiness
• Having decreased interest or complete lack of interest in formerly enjoyed activities
• Having feelings of worthlessness, guilt, or being helpless
• Having a lack of energy, feelings of fatigue
• Having feelings of restlessness and irritability
• Experiencing changes in eating habits
• Experiencing changes in sleep patterns
• Experiencing physical problems such as stomach issues, headaches, aches and pains
• Having trouble making decisions, focusing, or remembering
• Having suicidal thoughts or suicide attempts

The DSM-V states that these symptoms need to be present for at least two weeks to be diagnosed with depression. 

Bipolar Disorder

Bipolar disorder or bipolar depression is not the same as clinical depression and is characterized by very low ‘lows’ and very high ‘highs’. The symptoms during the lows are reflective of the same symptoms of clinical or major depression. However, the symptoms during the manic stages are not. These manic or euphoric stages can be extreme (mania) or in some cases a bit less extreme (hypomania). 

Signs of Bipolar Disorder

(Manic episode)

• Having high amounts of energy
• Having a reduced need for sleep
• Being out of touch with reality

(Depressive episode)

• Having low amounts of energy
• Experiencing a lack of motivation
• Having feelings of sadness and hopelessness
• Experiencing a loss of interest in activities

Seasonal Affective Disorder (SAD)

This type of depression most commonly occurs during the winter months in regions where there is much less sun at that time of year. With SAD, once the spring and summer months return, the depression lifts. 

Signs of SAD

• Experiencing social withdrawal
• Engaging in sleeping more
• Experiencing changes in weight particularly weight gain
• Experiencing feelings of sadness and hopelessness
• Experiencing lack of motivation and fatigue

When it comes to SAD and how it is different from clinical depression is that these symptoms generally stop once the increased hours of sunlight return. As awareness of SAD grows, so too do the diagnoses. 

Signs of Depression in Adolescents and the Elderly

Many of the signs of depression from one type to the next are similar. So too, are some of the signs of depression in both adolescents and the elderly. However, depression in both of these groups can present a bit differently so it’s vital to understand these differences. 

Signs of Depression in Adolescents and Teens

When it comes to our nation’s youth, many are struggling with mental health disorders including depression. However, these mental health disorders may mask one another making diagnosis and effective treatment delayed. According to the CDC, one out of two children diagnosed with depression also has behavioral problems. 

In addition to the typical signs of depression, the following are also symptoms of depression in teens and adolescents:

• Being grumpy or cranky
• Being more sensitive to being told ‘no’ or perceived rejection
• Crying more often
• Experiencing vocal outbursts such as yelling and tantrums
• Experiencing problems interacting with friends, family, and teachers
• Having a loss of interest in sports and extracurricular activities once enjoyed
• Thinking or talking about suicide

It’s important to understand that not all youth will show all of these signs. In fact, most often some show some signs and they tend to change from one situation to the next as well as during different times. For older youth and teens, there may be a start of alcohol or drug use during this time as well. 

With suicide rates increasing in youth, it’s vital to be aware of depression and the signs of it. Today, suicide is the second leading cause of death for those between the ages of 10 to 24 years old. If you are depressed or feeling suicidal you are not alone. Call the National Suicide Hotline at 800-273-8255 or text to 741741 for any type of teen crisis. 

Depression in the elderly can also manifest in different ways. Some of the signs of depression in the elderly are written off as typical aging issues, however, too often that isn’t the case and depression goes undiagnosed. If an elderly person has experienced depression earlier in life, they are more likely to develop it later in life. 

According to the National Institute on Aging (NIA) there are four types of depression more common amongst the elderly. All of these are treatable. 

1. Major depressive disorder
2. Persistent depressive disorder (dysthymia)
3. Substance/medication-induced depressive disorder
4. Depressive disorder associated with a medical condition

Depression in older adults is linked to higher rates of cardiac issues. In addition, older adults who have medical problems and depression have lower rates of rehabilitation. This is possibly due to depression causing lack of motivation, problems with sleep and eating, and more. 

In addition to the typical signs of depression other signs of depression in older adults can include any of the following:

• Feeling tired often
• Having trouble sleeping
• Feeling confused
• Being grumpy or irritable
• Experiencing trouble focusing or paying attention
• Stopping engaging in activities they used to enjoy
• Enduring aches and pains without seeking help for them
• Moving slowly
• Having changes in appetite or weight

It’s important to realize that depression and suicide are real threats to the elderly. In fact, the NIMH considers depression in those over 65 to be a significant public health problem. Suicide in this age group is an issue too with those in the age range of 80 to 84 years old having twice the risk for suicide as the general population. 

No matter what age, gender, race, socio-economic or educational background someone has, they can have depression. And, no matter what type of depression someone has or how severe it is, treatment for depression works. 

Treatments for depression typically can include psychotherapy or counseling. Cognitive-behavioral therapy and dialectical-behavior therapy are both types of therapies that have been found to be effective in treating several types of depression. In addition, medications may be used to help. Each course of treatment is based on factors specific to the individual in need. 

It’s also important to note that about 20% of those with a mental health disorder such as depression also have an alcohol or substance use disorder. This is called having co-occurring disorders. Often, those with a mental health disorder such as depression or anxiety will ‘self-medicate’ in order to relieve some discomfort. Sadly, this can turn into a problem of its own and often exacerbates the original problem. As time goes on, one problem can make the other worse and vice versa. 

If there is a co-occurring disorder suspected or present it’s essential to find a treatment center that is experienced and successful in treating both disorders. At Futures Recovery Healthcare our compassionate experts treat mental health disorders including depression, alcohol use disorders, substance use disorders, and co-occurring disorders. 

Depression can be paralyzing. It can rob you of the joys of daily life and make it seem impossible to feel better. However, that isn’t the case. Treatment for depression works. It has worked for thousands of others and can work for you or your loved one too. 

If you are in immediate crisis or feeling depressed, call 911 or the National Suicide Hotline at 800-273-8255. You can also visit them online to chat or learn more. These services are free and confidential and available 24/7. 

When you’re ready to get help for depression, another mood disorder, or treatment for addiction or co-occurring disorders, Futures is here for you. Learn more about our co-occurring disorders program, our mental health program, and our substance abuse programs today. Call us at 866-804-2098. You aren’t alone and you don’t have to suffer any longer—we can help!

Understanding Major Depressive Disorders [Clinical Depression]

Feeling sad or anxious from time to time is normal, however, when these feelings persist or are so intense that daily functioning becomes impaired it may indicate a depressive disorder. Depression is a type of mood disorder that could negatively impact your quality of life. Without the effective management of depression, individuals will struggle with their day-to-day functioning. As a result, it’s important to seek help from mental health professionals.

If you believe that you or someone you love is living with some type of depression, there is help and hope. Depression, no matter which type you may have, is a treatable disorder. Many who have spent weeks, months, and years living in the grips of depression have found the help they need to manage this often difficult mood disorder.

The term ‘depression’ is used to define a number of conditions. And, when it comes to depression, there are different types. A simple Google search for ‘what is depression’ reveals results that say, ‘nine types of depression’, ‘ten types of depression’, and ‘six types of depression’. This article will briefly discuss some of the most common types of depression but focus on what’s referred to as ‘clinical depression.’ Clinical depression, also known as major depression or major depressive disorder, is a more severe form of depression. People with this form of depression experience more symptoms at a higher level of intensity than those with minor depressive disorder, which is also known as “everyday depression.”

No matter what type of depression and depressive symptoms you or a loved one may be experiencing, the persistent feelings of sadness can affect how you think, feel, and act. Left untreated, any type of depression can be serious.

Five Main Types of Clinical Depression

The National Institutes on Mental Health (NIMH), state that there are five main types of clinical depression or major depressive disorder. These are as follows:

1. Persistent depressive disorder
   For individuals with persistent depressive disorder (also referred to as dysthymia), depressive symptoms must be present for at least two years. Symptoms may include periods of long and severe depression as well as times with less severe depression. The key to this diagnosis is the duration of the depressed mood.
2. Postpartum depression
   This type of severe depression lasts beyond the typical few weeks after childbirth. While it is normal to have a week or two of anxiety and the ‘blues’ after having a baby, postpartum depression lasts far beyond those weeks and can impair a new mother’s ability to engage in daily activities and family life.
3. Psychotic depression
   Psychotic depression is a subtype of major depression that involves symptoms of psychosis such as hallucinations, delusions, and other breaks with reality. The usual symptoms of depression plus psychotic symptoms characterize this type.
4. Seasonal affective disorder
   Seasonal affective disorder or SAD coincides with the onset of the winter. During this time of year there is less natural light and those who have SAD become sad and withdrawn this time of year. With this type of depressive disorder, the sadness lifts in the spring and summer but returns each fall and winter season.
5. Bipolar disorder
   Bipolar disorder is a lifelong mood disorder and mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depressed mood). While major depression is characterized by a persistent low mood and a loss of interest in social activities, bipolar disorder is characterized by extreme mood swings that include emotional highs and lows.

Whether you fall into one of these groups or have the traditional clinical depression or major depression, it’s important to know you aren’t alone. Depression can be one of the most isolating disorders. However, if you or a loved one is living in the grips of depression, remember there is help and you too can live a happy, content life once again.

Futures Recovery Healthcare is devoted to helping the community find the help and treatment they need for not only substance use disorders but also mental health disorders, including clinical depression.

Depression is the most prevalent mental health condition in the U.S. It impacts millions of adults, adolescents, and children across our nation. According to NIMH, in 2017 17.3 million American adults had a major depressive disorder. This mood disorder which impacts more women than men also was reported in 1.9 million children aged 3 to 17 years of age in the United States.

The good news is depression can be treated. With so many in our nation suffering, finding the right treatment to combat this mental health condition is needed now more than ever. As Futures continues to look for new ways to meet the needs of those in our nation who are suffering, we have proudly added a unit solely devoted to mental health treatment including depression.

While many who don’t have depression or have never experienced clinical depression may tell those suffering to ‘snap out of it’ or to ‘feel better’ or to ‘smile more’, clinical depression simply doesn’t work that way. However with effective treatment such as psychotherapy and sometimes medication, most people do recover from depression—of all types.

Often when someone is first experiencing clinical depression, they wonder when they’ll begin to feel better and whether or not they actually have a type of depressive disorder. Knowing the symptoms is an important place to start.

Symptoms of Depression

While physical symptoms can look somewhat different from one person to the next, overall, clinical depression can be characterized by its ability to impede day-to-day activities. Here are some of the most common depression symptoms seen in clinical depression. Keep in mind, these symptoms need to be present most days for at least two weeks to be considered a type of clinical depression.

• Feelings of sadness, loneliness, or emptiness
• Losing interest in activities and hobbies
• Changes in sleep patterns such as sleeping too much or having insomnia
• Decreased appetite leading to weight loss at times
• Increased appetite leading to weight gain at times
• Getting angry, irritable, and restless with situations that normally wouldn’t upset you
• Experiencing anxiety
• Having problems or difficulty thinking or concentrating
• Moving or thinking slowly
• Losing energy or experiencing fatigue
• Feelings of worthlessness, shame, guilt, or self-loathing
• Thinking about death or suicide

If you or a loved one are experiencing any of these depression symptoms and it has been longer than two weeks, you may be suffering from a type of clinical depression or major depressive disorder. For some, this may only occur once in a lifetime, for others, there are recurrent bouts of depression.

It’s important to note that both children and the elderly with depression may exhibit somewhat different symptoms and signs. For children, signs are similar but may also include, clinginess, aches and pains, refusal to attend school, and overall sadness

For the older adults depression can be harder to identify and they may be very reluctant to talk about it or seek help. Signs of depression in older adults may include memory issues, loss of interest in activities and staying home more often, aches and pains, loss of appetite and weight loss as well as suicidal ideations, particularly in older men.

No matter which situation is true for you, there is help and you can live a happy life again. Although it may not seem like that now. In fact, according to the National Institute of Health, 80% of those treated for depression show significant improvement within just four to six weeks of beginning treatment.

TREATMENT FOR CLINICAL DEPRESSION

Treatment for depression will be somewhat different for each individual. Depending on several factors including the type of depression, possible causes, any medical problems, and associated issues, such as substance or alcohol use disorder, the course of treatment and timeline for symptom relief will vary.

However, for most, treatment will involve psychotherapy, medication, or a combination of both. Some people are leary of taking medication for depression. It’s important to understand that in many instances the medication is not a long term solution or plan. This too depends on each person’s unique situation.

Even the most severe cases of depression can be effectively treated. The sooner help is received the better. The first step in the process is to obtain a comprehensive evaluation by a mental health professional. During this assessment, any physical ailments like thyroid disease should be ruled out. Following this, an individualized treatment plan should be created.

Psychotherapy Treatments

One of the major components in the treatment of depression is therapy or counseling. Usually a type of ‘talk therapy’, psychotherapy can include cognitive behavioral therapy (CBT), interpersonal therapy, dialectical behavioral therapy (DBT), family-focused therapy, and problem-solving therapy. During these sessions, individuals meet with their therapist to discuss trouble-some events, thoughts, or patterns. Together with their trusted therapist new skills are learned and more healthy ways of handling stress and depression are created.

Medications for Depression

Today, there are a number of antidepressant medications that can be useful in treating depression. These medications are not habit forming and work to help balance brain chemicals possibly contributing to, or in some cases, causing the depression. Medications impact people differently so it’s vital that any medication be monitored by a licensed professional such as a prescribing psychiatrist.

When it comes to medications for depression, it generally takes two to four weeks to begin to see some relief from the symptoms of depression. However, some individuals may find relief in the first week while others may not experience relief until a month or two after beginning the medications. It is not uncommon to start on one antidepressant and after finding it isn’t working as hoped to switch to another medication. This is one of the reasons it is so vital to have a licensed, experienced, and caring professional overseeing the medications and also be in some type of psychotherapy.

One of the associated risk factors for having depression is family history. Another approach used by prescribing physicians or psychiatrists is to prescribe an antidepressant medication that a family member found to be helpful.

Risk Factors for Developing Depression

Family history of depression is just one of the factors contributing to an increased chance of developing some type of depression. Research has found that a combination of the following contribute to depression:

• Genetics
• Biology
• Environment
• Psychological factors

A medical diagnosis of an accompanying disease or problem also play a role in an individual developing depression. Diagnosis of serious medical conditions such as diabetes, cancer, Parkinson’s disease, etc. can worsen already present depression or be the catalyst that begins a person’s depression. Life traumas also play a role in the development of depression.

What’s more, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2018, 21% of people with a substance use disorder also had a major depressive episode within that same year.

No matter the severity of depression, the cause, how long you or a loved one has been suffering, or what you’ve tried to ‘feel better’, there is help for anyone living with depression. As mentioned, the sooner you seek treatments for depression, the better. Depression, according to a White House report, is the cause of more than two thirds of the 30,000 suicides in the United States each year.

If you or someone you love is living with any type of depression, help is just a call away. Futures Recovery Healthcare is here to help you or your loved one begin your journey of healing from depression and improve your quality of life. Call us at 866-804-2098 today.

Assessing the Risk of Mental Health Disorders for California Wildfire First Responders

Many of us take the stress of our jobs home with us. But, when your work involves dangerous, hazardous, and draining conditions and traumatic situations in which people’s livelihood, lives, and families are destroyed all around you, the effects of that stress may not simply melt away in time. For first responders, routinely facing these types of strenuous scenarios puts them at a higher risk of mental health concerns and behavioral health disorders such as depression, substance use disorder, and post-traumatic stress disorder (PTSD).

And, when it comes to time to process their trauma and deal with stressful situations, many emergency responders simply don’t have the luxury. According to a study reported by the Substance Abuse and Mental Health Services Administration (SAMHSA), 69% of emergency medical services (EMS) professionals never have enough time to recover between traumatic events.

Unfortunately, human-caused and natural disasters and emergency situations do not respect the healing times deserving of first responders. Currently, this very concept is being played out all over the world, as first responders reel from crisis after crisis since the COVID-19 pandemic while balancing other local needs within their communities.

One of the most current and topical examples is with California’s wildfires. With 560 wildfires burning throughout the state and at least 100,000 people under evacuation orders, an already stressed population of first responders (from needs required for the pandemic), are working around the clock—and then some. What will be the long-term behavioral health impacts they face?

Going back to the research, it’s important to understand that while symptoms of depression, severe stress and anxiety, PTSD, and suicidal thoughts are real and likely outcomes for some first responders—help is not only available, but it also can lead to a fulfilling, enjoyable, and productive daily life.

At Futures Recovery Healthcare we understand the unique challenges first responders face in and out of recovery. We have the comprehensive support systems in place to help them navigate the specific mental health treatment needed to move forward, and heal from non-stop exposure to trauma. Thereby improving the overall quality of life for emergency workers across the country.

A Closer Look at the Long-Term Effects of Continuous Exposure to Trauma

With the California wildfires as an example, it’s important to remember, that in addition to COVID-19 pandemic and various community-level events, many first responders—firefighters in particular—have had several straight years of non-stop fires to manage.

Reaching as far back as 2017, California’s wildfires have expanded from Napa and Sonoma Counties’ Atlas, Tubbs, Nuns, and Redwood Valley Complex fires, to 2018’s Ventura, Los Angeles, Shasta, and Trinity Counties’ Woosley and Carr fires. Then, 2019’s Sonoma County’s Kincade fire.

Mid-August of this year, first responders, including firefighters and aircraft from 10 different states banded together to fight the July Complex, Blue Jay, Red Salmo Complex, and Apple fires (among others) reaching from one end of the state to the other. At the time this was written, the Shady and Glass fires continue to rage in Northern California, evacuating upwards of 17,000 people.

On top of four straight years of aggressive fires, many of the first responders handling 2020’s barrage of wildfires lacked the full resources needed to do their jobs effectively. This, according to SAMHSA, is a significant contributing factor to triggering behavioral health conditions in first responders. Research demonstrates that not having enough resources, job-related information, and being required to supervise too many people put first responders at an elevated risk for depression and PTSD.

But, there are additional behavioral health risk factors to consider as well, which include:

• Staying at a scene of disaster for long periods of time
• Being one of the first emergency personnel on the scene
• Having assignments that are long-lasting
• Enduring long periods of traumatic and hazardous sights and sounds
• Working with victims of trauma (especially children) in which morbid details are navigated and discussed
• Lacking appropriate and supportive leadership

In addition to resulting mental health conditions or behavioral health disorders such as depression and PTSD, the U.S. Fire Administration also suggests the impact of RET “repeated exposure trauma.” RET, according to research, is a more common outcome of firefighters’ exposure to a series of traumatic events—the California wildfires as a prime example—opposed to one single event. These events often cause severe emotional distress and contribute to an increase in depression for firefighters.

Signs and Symptoms of Behavioral Health Disorders in First Responders

If you or someone you care for has been involved in the California wildfires or exposed to a similar type of repeat trauma, it’s helpful to recognize the signs and symptoms of possible resulting mental health issues or behavioral health disorders.

Symptoms of RET include:

• Desensitization
• Irritability
• Cynicism
• Flashbacks

Symptoms of PTSD include:

• Re-experiencing Traumatic Situations

Flashbacks in which a person feels like they are “reliving” a traumatic event can occur, combined with nightmares and being triggered and startled by certain smells, sounds, and sights. Physical symptoms such as rapid breathing and sweating are also typical.

• Avoiding Situations and People

Feelings of guilt, depression, or detachment can lead to avoidance and isolation of crowds and situations that feel similar to a specific traumatic event. A person may even stop engaging in hobbies and activities they used to enjoy and pull away from people they care about. Additionally, they may also experience emotional numbing, which increases their risk for depression or other mental health issues.

• Demonstrating Hyper Arousal

This can manifest as problems sleeping and concentrating. A person may feel as if they need to keep their back to the wall when in public or unfamiliar spaces. Loud or specific noises may easily startle them and create a feeling of “being on edge” or even cause intense, angry outbursts.

Depression

• Feeling hopelessness
• Ongoing feelings of loss and guilt
• Experiencing insomnia
• Abandoning hygiene, not caring about personal appearance

If any of the signs and symptoms above are accompanied by poor performance at work or school, aggressive and risky behaviors, giving away personal and sentimental items, or thoughts and expressions of “not wanting to live anymore,” or “feeling like dying,” these can be indications of suicidal ideation, and should be taken very seriously.

If you or someone you love is exhibiting these behaviors, it’s important to seek professional help immediately.

Barriers to First Responders Seeking Mental Health Support

Despite the fact that first responders and firefighters, like those battling the current California wildfire, likely experience “secondary trauma” or “compassion fatigue,” combined with RET, PTSD, and depression, they face several barriers when it comes to mental health treatment.

First, there is a strong stigma among first responders that to seek help for mental health conditions and behavioral health issues is to be a failure, or not strong enough.

In fact, the 2018 SAMHSA periodical, The Dialogue Volume 14 Issue 1, states this:

“The first responder is not going to ask you for help. The behavioral health professional has to go to them and overcome a strong resistance and stigma attached to seeking psychological help. Strength and the ability to endure physical and mental extremes are highly valued, and anything less is viewed as weakness. Behavioral health professionals with particular training in the peer counseling model of providing stress awareness and resiliency-building practices would be of great value to the first responder community.”

Additionally, finding access to the type of specialty care needed may be difficult to find or obtain. Having a direct line to mental health resources through their leadership, may not only be problematic for first responders because of stigma-related concerns or unresponsiveness, but it can also lead to added and increased stress. This only exacerbates depression, PTSD, RET, and additional disorders for which first responders are more susceptible to developing.

Overcoming Barriers and Seeking Help

If you or someone you love is ready to get help, it’s important to seek out mental health professionals and resources that provide evidence-based therapies, comprehensive and compassionate care, and licensed professionals who are highly-trained and skilled in helping first responders.

Futures Recovery Healthcare Hero’s Ascent First Responder’s program offers a safe and non-judgmental environment for males and females 18 and over struggling with mental health disorders. Here, we address Depressive Disorders, Anxiety Disorders, Personality Disorders, Bipolar and Related Disorders by using clinical, medical and psychiatric interventions and support. Our interdisciplinary team approach allows patients to receive holistic services and care. Our goal is to help develop and establish a journey of healing and a life worth living.

Whether you have been on the frontlines of the California wildfires, or are a first responder who is experiencing the dual effects of COVID-19 pandemic and local disasters, you are not alone. Many have walked before you, and many have prevailed with much-needed support.

With help, you can successfully overcome trauma in whatever forms it takes. You can have a life that is fulfilling and happy.

If you are ready to get help and begin a life in peace and joy, Futures is here for you. Contact us confidentially online or by phone at 866-804-2098.