The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being “depressed.”
But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:
In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood and/or interest (pleasure) are decreased for most of two weeks.
In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
In grief, thoughts of death may surface when thinking of or fantasizing about “joining” the deceased loved one. In major depression, thoughts are focused on ending one’s life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression.
Grief and depression can co-exist For some people, the death of a loved one, losing a job or being a victim of a physical assault or a major disaster can lead to depression. When grief and depression co-occur, the grief is more severe and lasts longer than grief without depression.
Distinguishing between grief and depression is important and can assist people in getting the help, support or treatment they need.
RISK OF DEPRESSION
depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions.
Electroconvulsive Therapy (ECT)
ECT is a medical treatment that has been most commonly reserved for patients with severe major depression who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant. ECT has been used since the 1940s, and many years of research have led to major improvements and the recognition of its effectiveness as a mainstream rather than a "last resort" treatment.
Self-help and Coping
There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improves mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.
Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. This is a start to addressing your mental health needs.
Related Conditions
The six tabs below provide brief descriptions of six conditions related to Depression: Peripartum depression (previously postpartum depression), seasonal depression (also called seasonal affective disorder), bipolar disorders, persistent depressive disorder (previously dysthymia), premenstrual dysphoric disorder, and disruptive mood
PERIPARTUM DEPRESSION
For most women, having a baby is a very exciting, joyous, and often anxious time. But for women with peripartum, (formerly postpartum), depression it can become very distressing and difficult. Peripartum depression refers to depression occurring during pregnancy or after childbirth. The use of the term peripartum recognizes that depression associated with having a baby often begins during pregnancy.
Peripartum depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child. An estimated one in seven women experiences peripartum depression.
SEASONAL DEPRESSION
Seasonal affective disorder* is a form of depression also known as SAD, seasonal depression or winter depression. In the Diagnostic Manual of Mental Disorders (DSM-5), this disorder is identified as a type of depression – Major Depressive Disorder with Seasonal Pattern.
People with SAD experience mood changes and symptoms similar to depression. The symptoms usually occur during the fall and winter months when there is less sunlight and usually improve with the arrival of spring. The most difficult months for people with SAD in the United States tend to be January and February. While it is much less common, some people experience SAD in the summer.
SAD is more than just “winter blues.” The symptoms can be distressing and overwhelming and can interfere with daily functioning. However, it can be treated. About 5 percent of adults in the U.S. experience SAD and it typically lasts about 40 percent of the year. It is more common among women than men.
SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and less sunlight in winter. As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule. SAD is more common in people living far from the equator where there are fewer daylight hours in the winter.
BIPOLAR DISORDER
Bipolar disorder is a brain disorders that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.
People without bipolar disorder experience mood fluctuations as well. However, these mood changes typically last hours rather than days. Also, these changes are not usually accompanied by the extreme degree of behavior change or difficulty with daily routines and social interactions that people with bipolar disorder demonstrate during mood episodes. Bipolar disorder can disrupt a person’s relationships with loved ones and cause difficulty in working or going to school.
Bipolar disorder is a category that includes three different diagnoses: bipolar I, bipolar II, and cyclothymic disorder.
PREMENSTRUAL DYSPHORIC DISORDER
PMDD was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A woman with PMDD has severe symptoms of depression, irritability, and tension about a week before menstruation begins.
Common symptoms include mood swings, irritability or anger, depressed mood, and marked anxiety or tension. Other symptoms may include decreased interest in usual activities, difficulty concentrating, lack of energy or easy fatigue, changes in appetite with specific food cravings, trouble sleeping or sleeping too much, or a sense of being overwhelmed or out of control. Physical symptoms may include breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.
These symptoms begin a week to 10 days before the start of menstruation and improve or stop around the onset of menses. The symptoms lead to significant distress and problems with regular functioning or social interactions.
For a diagnosis of PMDD, symptoms must have occurred in most of the menstrual cycles during the past year and must have an adverse effect on work or social functioning. Premenstrual dysphoric disorder is estimated to affect between 1.8% to 5.8% of menstruating women every year.
PMDD can be treated with antidepressants, birth control pills, or nutritional supplements. Diet and lifestyle changes, such as reducing caffeine and alcohol, getting enough sleep and exercise, and practicing relaxations techniques, can help.
Premenstrual syndrome (PMS) is similar to PMDD in that symptoms occur seven to 10 days before a woman’s period begins. However, PMS involves fewer and less severe symptoms than PMDD.
DISRUPTIVE MOOD DYSREGULATION DISORDER
Disruptive mood dysregulation disorder is a condition that occurs in children and youth ages 6 to 18. It involves a chronic and severe irritability resulting in severe and frequent temper outbursts. The temper outbursts can be verbal or can involve behavior such as physical aggression toward people or property. These outbursts are significantly out of proportion to the situation and are not consistent with the child’s developmental age. They must occur frequently (three or more times per week on average) and typically in response to frustration. In between the outbursts, the child’s mood is persistently irritable or angry most of the day, nearly every day. This mood is noticeable by others, such as parents, teachers, and peers.
In order for a diagnosis of disruptive mood dysregulation disorder to be made, symptoms must be present for at least one year in at least two settings (such as at home, at school, with peers) and the condition must begin before age 10. Disruptive mood dysregulation disorder is much more common in males than females. It may occur along with other disorders, including major depressive, attention-deficit/hyperactivity, anxiety, and conduct disorders.
Disruptive mood dysregulation disorder can have a significant impact on the child’s ability to function and a significant impact on the family. Chronic, severe irritability and temper outbursts can disrupt family life, make it difficult for the child/youth to make or keep friendships, and cause difficulties at school.
