Hidden depression

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Karen Smith has battled depression most of her life.

She has tried to manage the condition with drug treatments and speaks regularly with a therapist. Yet Smith — her real name is being withheld to protect her privacy — fights an urge to isolate herself when symptoms are severe, hiding from a society that has little understanding of depression.

Smith is hardly alone. As many as one in 10 Americans suffers from major depression, according to the Centers for Disease Control and Prevention. The mental condition, sometimes called clinical depression, isn’t ethnic- , gender- or age-specific. And it often is well hidden by those who do not seek treatment.

The National Alliance for Mental Illness defines major depression as a “serious emotional and biological disease that affects one’s thoughts, feelings, behavior, mood and physical health. Depression is a life-long condition where periods of wellness alternate with recurrence of illness and require long-term treatment to keep symptoms from returning.”

Left untreated, episodes of major depression can last a few months or many years. Still only half of those with clinical depression seek help.

Dawn Wever, a licensed mental health counselor and president of NAMI Hernando, strives to bring awareness about depression and other mental illnesses to the forefront. NAMI provides workshops, educational tools and support both for people with such conditions and for their caregivers or loved ones.

According to NAMI, as many as one in four adults have some type of mental illness, Wever said. That means it is likely everyone knows someone with such an illness, even if it isn’t obvious or discussed. Depression, like other mental illnesses, is easily hidden because it usually is not physically apparent to observers.

Major depression affects as many as 25 million Americans each year. Wever, a licensed mental health counselor, said it can present itself in a myriad of ways. During a client evaluation she looks for certain elements to achieve an accurate diagnosis and determine a treatment plan.

Has the patient experienced a major change in their daily functioning? Is she or he experiencing shifts in moods, less interest in activities they used to enjoy, or feeling unmotivated or uninspired?

Other leading factors to consider include:

♦ Significant weight loss or weight gain

♦ Excessive sleeping or consistent insomnia

♦ Excessive fatigue

♦ Feelings of worthlessness

♦ Difficulty concentrating or staying focused

♦ Recurrent thoughts of suicide

It also is important to discuss the onset of circumstances that might contribute to a diagnosis. For instance, a client who has experienced a life-altering episode, such as the loss of a loved one or close friend, often will experience symptoms of depression.

To determine if such episodes are linked to situational depression, Wever looks at the timing of possible symptoms. Have they been present for at least two months following a life-altering event? By contrast, major depression not linked to a life event would look at the duration of at least two weeks, she said.

Wever also rules out certain illnesses that might mimic depression. For instance, if a client is suffering from chronic pain or a thyroid imbalance, it is likely they will experience symptoms of depression.

“We ask clients to see their primary physician to rule out any other diseases or illnesses,” Wever said.

Treatments of depression might include various interventions. Medication, counseling using cognitive behavioral therapies and support groups can help manage symptoms.

NAMI Hernando offers various support groups and classes for both the client and their caregiver or family members.

“Mental illness can be an isolating experience,” Wever said. “It is important for society to understand how to approach the topic if they suspect someone is struggling with depression.”

Through mental health first-aid classes (MHFA.org) taught by Wever, the topic of how to approach someone suspected of dealing with depression is discussed. “I teach in my classes that it is OK to bring it up,” she said. “It is as simple as saying, ‘Hey, I’m concerned about you. Is there something I can do for you?’”

By avoiding the topic or the person who might be afflicted, society is isolating that individual and delivering the message that mental illnesses should not be discussed.

If left untreated, NAMI reports, major depression can lead to serious impairment of daily functioning and even suicide. Some researchers maintain more than one half of suicide victims were experiencing depression.

“Devastating as this disease may be,” NAMI states, “it is treatable in most people.” The availability of effective treatments and a better understanding of the biological basis for depression may lessen barriers that can prevent early detection, promote accurate diagnosis and lead to a decision to seek medical treatment, the alliance asserts.

For more information about major depression or other mental illnesses, visit NAMI.org. NAMI Hernando meets at 10554 Spring Hill Drive and offers support, information and educational tools on various mental illnesses. Contact NAMI Hernando at (352) 684-0004.