Holiday blues or is it major depression?

Published 9:09 pm Friday, December 16, 2016

The holiday season is a time that is supposed to be filled with joy and happiness. Unfortunately, this usually does not translate to everyone. For some in our society, it can be a difficult time especially if they are struggling with major depression. This article hopefully will educate and dispel some of the myths associated with this medical illness.

First of all, having major depression is not just being sad. It is a syndrome consisting of symptoms that usually will impede the daily function of a person. To meet the criteria of major depression a patient must have a minimum of the following symptoms for at least two weeks in duration: a persistent depressed mood and or loss of interest. This is also accompanied by at least some of the following symptoms: poor appetite, which has been described by some patients as their food has no taste, or an intense appetite. A few patients will overeat to comfort their emotional pain. Another coping mechanism is for patients to sleep excessively in an attempt to avoid dealing with their life. Other patients become insomniacs and stay up worrying about how to cope with their current situation.

Hopelessness is also a very significant complaint made by patients who suffer from major depression. When a psychiatrist does a suicide risk assessment, it is usually asked of the patient if they feel hopeless. If they do, then it means the patient’s depression is a more severe form of depression. In fact, research studies have demonstrated if a patient specifically describes their life as hopeless, their risk of suicide increases significantly. The patient’s will to live is gone. Even if a patient has everything going for them, this risk is still present.

Another problem patients have is when a non-depressed person has a difficult time understanding why someone would feel so bad to the point of even considering suicide. Here are a few myths that will shed some light on this illness.

Myth 1: “One must have something seriously happen to you and/or your family to precipitate a depressive episode.” You do not have to have a significant life stressor to cause major depression. This is usually referred to as endogenous depression, meaning it comes from out of the blue, without a life stressor.

Myth 2: “Patients can just snap out of being depressed.” This is probably one of the biggest complaints patients report to me. To someone who has not experienced clinical depression, it can seem foreign to them. A non-depressed person may ask themselves why someone who may have everything would be experiencing a major depressive episode. Trust me — if a patient could just snap out of it, they would have done it a long time ago. For every patient that gets discharged from a psychiatric hospital there are at least four to eight patients trying to get in for treatment.

Myth 3: “Antidepressant medications are really happy pills.” First, antidepressants are not designed to make you happy. They, for most part, do not get you “high.” If this were the case, they would be on the black market. You just do not hear about “Prozac dealers” on the evening news.

What they are designed to do is to improve your mood to a level at which most folks function. Since antidepressants cause the brain chemistry to change, they can take up to a few weeks to really start seeing a full effect on the patient. Also, some patients just do not like taking medications. One-third of patients never get their prescriptions for their psychiatric medications filled.

Myth 4: “Asking about suicide will make someone suicidal. This might implant an idea in a depressed patient.” Nothing can be further from the truth. First, most patients who have suicidal thoughts do not kill themselves. In fact, speaking about it will lessen some of the shame patients may be experiencing. Family members have a hard time speaking about suicide with another family member. I recommend just listening to them so the patient does not suffer in silence.

Hopefully this will shed some light on this debilitating disease. Depression is treatable. There is no shame in getting help for this illness. Just like a diabetic patient who needs insulin to treat their diabetes, a depressed patient is no different. If you or someone you care about has these symptoms, I urge you to get some help. Call Vidant Behavioral Health at 252-946-3666 or for urgent matters call Vidant Behavioral Crisis at 252-975-8852.

Dr. Paul Garcia is chief of psychiatry for Vidant Beaufort Hospital.