Depression: Signs and Treatment

By Frederick Jerant

“Depression” can mean a lot of different things–a sunken landform, a very severe economic downturn, an area of low atmospheric pressure.

But for as much as 15.7% of patients seeking treatment for any ailment, it’s the name of a mental disorder that can have crippling, even fatal outcomes. (It often leads to suicide, which is the 11th leading cause of death in the United States, according to Texas Medical Association, and the third-leading cause among people ages 15-24.)

“Just about everyone experiences mild depression from time to time,” says Timothy C. DeMott, M. A., a licensed psychologist in private practice in Allentown. “We lose a job, a relationship breaks up, a loved one dies, and we enter a depressed mood for a time.”

But that mood could evolve into full-blown clinical depression.

How can you distinguish depression from a case of the blues? DeMott paraphrases the symptoms listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders:

• A consistently depressed mood
• Diminished interest in pleasure
• Significant (5% or more) weight loss without dieting or other physical problems
• Insomnia, or its reverse, hypersomnia
• A lack of energy or motivation
• Restlessness or lethargy
• Feelings of worthlessness or guilt
• A lack of concentration
• Recurrent thoughts of death, suicide or attempted suicide

At least five of these signposts must be present, together, for at least two weeks before a diagnosis of depression can even be considered.

“Many people don’t recognize it in the early stages,” says Dr. Paul K. Gross, M. D., chair of the psychiatry department at Sacred Heart Health Care System, Allentown. “The changes are often subtle, and can take weeks or months to emerge.”

Depressive episodes in teenagers can be harder to spot, Gross explains, because they are sometimes confused with typical adolescent behavior.

In addition, depression’s symptoms often match those for other conditions; they can also emerge as side effects from certain medications. That’s why it’s important to bring such concerns to your family doctor for examination and evaluation.

There are several options for treatment. Audrey Slough, LCSW, an outpatient psychotherapist with St. Luke’s Behavioral Health, Bethlehem, engages in talk therapy. “We discuss just about anything imaginable,” she says, “like marriage, loss of friendships, workplace problems, and so on.”

Through talk therapy, Slough strives to direct the patient’s way of thinking toward a more rational direction, counteracting negative feelings with positive facts.

Interpersonal therapy can be important, too, Slough adds. “If you can’t get along well with others, you may find yourself very isolated. And a sense of being alone is a common aspect of depression. We work toward improving the skills needed to improve relationships, and get people connected again.”

Talk therapy is often used in conjunction with psychoactive medications or other treatments. “Certain chemicals, such as serotonin and norepinephrine, help the brain cells work better,” Gross says. “When they get out of balance, depression can result.”

For example, anti-depressants such as Prozac® block the reabsorption of serotonin by certain nerve cells in the brain. The additional serotonin in the brain enhances the sending of nerve impulses, and improves mood.

Other treatments include:
Electroconvulsive therapy. Electricity is passed to the brain through the patient’s scalp to induce a seizure. Gross says it’s similar to rebooting a computer; it helps the brain to reregulate itself.

Transcranial magnetic stimulation. A powerful magnetic field is transferred to a patient’s brain; it’s a painless, non-invasive FDA-approved procedure that affects brain functions and chemical activity, often resulting in dramatic improvements.

There are also other means of coping with depression and its effects.

NAMI Lehigh Valley, a non-profit volunteer group, offers various support and educational programs for the mentally ill, and for their families. Janet Bandics, director, says the programs are conducted by trained volunteers at no charge. Groups meet weekly or monthly, and often serve as a stopgap measure between patients’ medical appointments.

The American Foundation for Suicide Prevention-Greater Lehigh Valley Chapter (Dr. Peter Langman, Ph. D., director) strives to increase awareness of suicide as serious issue; supports survivors of suicide; and helps prevent suicide by promoting local resources, reducing the stigma of mental illness and depression, and supporting research efforts on prevention and treatment.

Strength in Hope is a traveling suicide awareness program founded by musician Joe Scorsone, himself a survivor of attempted suicide. Aimed at teens and young adults, SIH shows combine performances by local bands with true-life, first-person accounts. Literature and other resources are available at all performances.

“The good news is that treatment for depression is extremely successful,” Slough concludes. “If depressed people are able to get themselves into some kind of therapy, nearly all will benefit.”

Health Watch offers the latest information on keeping our readers and their families healthy.

Resources for e-zine:
Timothy C. DeMott
2806 Hamilton St.
Allentown, PA 18104

Dr. Paul K. Gross, MD
Allentown Associates in Psychiatry and Psychology
401 N. 17th Street
Suite 304
Allentown, PA 18104

Audrey Slough
St. Luke’s Behavioral Health

NAMI Lehigh Valley
802 West Broad Street
Bethlehem, PA 18018
(610) 882-2102

The American Foundation for Suicide Prevention-Greater Lehigh Valley Chapter
P. O. Box 542
Nazareth, PA 18064

Strength in Hope (Joe Scorsone)

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