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Erica S. Bargmann
20 May 2009
Mr. Schlueter
Research Paper

Depression

Most people have felt sad or depressed at times. Feeling depressed can be a normal
reaction to loss, life's struggles, or an injured self-esteem. But when feelings of intense
sadness -- including feeling helpless, hopeless, and worthless -- last for days to weeks and
keep you from functioning normally, your depression may be something more than
sadness. It may very well be clinical depression -- a treatable medical condition.

According to the website of the National Institute of Mental Health, depression is the
leading cause of disability among Americans between the ages of 15 and 44. Further
statistics show that 6.7 % of the U.S. populations (14.8 million adults) are affected by
Major Depression in any particular calendar year. And at least in the U.S., more women
are diagnosed with depression than men, with the median age of onset being 32 for both
genders.

Most people when asked what depression is think that it’s when someone is so sad that
they feel worthless and constantly think about taking their own lives. What they don’t
know is that it’s much more than that. The definition of depression is a mental state
characterized by a pessimistic sense of inadequacy and a despondent lack of activity
which reflects a sad and/or irritable mood exceeding normal sadness or grief. The signs
and symptoms are not only characterized by negative thoughts, moods, and behaviors but
also specific changes in bodily functions (for example: crying spells, body aches and
pains, low energy, as well as problems with eating, weight, and sleeping.) In spite of clear
research evidence and clinical guidelines regarding therapy, depression is often
undertreated and misunderstood. Hopefully, this situation can change for the better. If this
illness is not treated correctly, it can cause severe damage towards a person and their
families and friends. This research paper will go in depth on the things that cause
depression, the effects it has on patients, their families, and friends, as well as the solution
to treating this illness.

Family History and Physical Conditions

Depression runs in families for generations but researchers have not yet located a single,
defective gene responsible for the condition. When a family member has depression,
spouses, siblings, or children are inevitably affected emotionally by the illness and while
depressed parents don’t pass on depression per se to children, the way they pass on hair
or eye color, they can pass on a vulnerability to depression. Whether inherited or not,
depression is often associated with changes in brain structure or brain function.
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Serious medical conditions like heart disease, cancer, and HIV/AIDS can contribute
to depression, partly because of the physical weakness and stress they bring on.
Depression can make medical conditions worse, since it weakens the immune system
and can make pain harder to bear. In some cases, depression can be caused by
medication used to treat medical conditions. Depression also can increase the risk for
subsequent physical illness, disability, and premature death. The symptoms of
depression can also be caused by undiagnosed medical conditions, including epilepsy,
multiple sclerosis, Huntington’s disease, Parkinson’s disease, hyperthyroidism, Lyme
disease, and pancreatic cancer.

 Heart Disease- For people with heart disease, depression increases the risk
for an adverse cardiac event such as a heart attack or blood clots. For
people who do not have heart disease, depression increases the risk of
heart attack and coronary disease. During recovery from cardiac surgery,
depression can intensify pain, cause worsened fatigue and sluggishness, or
cause a person to withdraw into social isolation. Patients who have had
coronary artery bypass graft (CABG) surgery and have untreated
depression after surgery also have an increased morbidity and mortality
rate.

 Cancer- People diagnosed with cancer may face an increased risk of

depression that persists for years, according to research published online
Feb. 17 in the Journal of Clinical Oncology and up to 1 in 4 people with
cancer have clinical depression which causes great distress, impaired
functioning, and may even make the person with cancer less able to follow
their cancer treatment plan. When someone is diagnosed with cancer, their
“normal reaction” is depression, which means that it doesn’t require any
special treatment-the prevalence of depression among cancer patients
ranges from 23 percent to 60 percent. While doctors today are better than
ever at fighting the disease, a new study by the Institute of Medicine in
Washington, D.C., finds that the anxiety, fear and depression associated
with cancer often go untreated. Of the country’s top 20 cancer care
centers, eight reported screening for emotional stress in only some of their
patients. "It's becoming a chronic illness, so now we have to take a wider
view and treat the whole patient and take care of all their needs, including
their cancer," said Dr. Lee Schwartzberg, co-author of the study and the
medical director of the West Clinic in Memphis, Tenn.

 Huntington’s Disease- a disorder passed down through families in which

nerve cells in the brain waste away, or degenerate. American doctor
George Huntington, who traveled over the bleak countryside five miles to
the larger town of Middleport, Ohio, first described the disorder in 1872 to
the local medical society, composed of physicians of sparsely populated
Meigs and Mason Counties. His brief, uniformly anecdotal and entirely
unreferrenced address, not suffering publication delay, was put eight
weeks later in the Medical and Surgical Reporter of Philadelphia (v 26, no.
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15, April 13, 1872). This has become one of the classical descriptions of
neurological disease. People with Huntington’s disease have progressive
motor problems, cognitive deficits (dementia) and psychiatric symptoms
(the most common is depression) that usually start to appear in mid-life.
There is no cure and death usually results within 10 to 20 years of
symptom onset, or faster in the childhood-onset form of the disease. The
disease is caused by a mutation in a single gene and when this defective
gene is passed from parent to child, 50 percent of the offspring inherit the
disorder, which can be detected by genetic testing.

Trauma and Stress

When dealing with trauma, most people who become depressed can recall a single
traumatic event that happened just prior to their becoming depressed. Painful experiences
such as the death of a loved one, divorce, a medical illness, or losing everything in a
natural disaster may be so impactful as to trigger depression. Events like these take away
a sense of control and cause great emotional upheaval. A person’s recovery from
depression may also be affected by traumatic events. The more trauma and difficulty a
person experiences, the longer a recovery from depression may take. If a person is run
down psychologically, suffers from anxiety or depression or has endured previous
traumatic experiences; it’s more difficult to handle another setback. As a result, additional
grief symptoms can be unbearable. In order to cope, the traumatized individual may
attempt to avoid grieving altogether.

 It is clear that some people develop depression after a stressful

event in their lives such as the death of a loved one, the loss of a
job, or the end of a relationship are often negative and traumatic
and cause great stress for many people. It is not certain why stress
may lead to depression in this way. However, researchers have
theorized an explanation called the "kindling effect," or "kindling-
sensitization hypothesis." This theory surmises that initial
depressive episodes spark changes in the brain's chemistry and
limbic system that make it more prone to developing future
episodes of depression. This may be compared to the use of
kindling wood to spark the flames of a campfire. Since early
episodes of depression make a person more sensitive to developing
depression, even small stressors can lead to later depressive
episodes. It is not certain why stress may lead to depression in this
way. However, researchers have theorized an explanation called
the "kindling effect," or "kindling-sensitization hypothesis." This
theory surmises that initial depressive episodes spark changes in
the brain's chemistry and limbic system that make it more prone to
developing future episodes of depression. This may be compared
to the use of kindling wood to spark the flames of a campfire.
Since early episodes of depression make a person more sensitive to
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developing depression, even small stressors can lead to later

depressive episodes.

Pessimistic Personality

Someone with a pessimistic personality is often not as easy going or fun to be around.
They have a negative view of the current world around them and the future does not look
a lot better. Things can never go right, other people are only nice because they want
something from them and there is no point in having dreams or goals because they will
never happen or be achieved. Pessimistic people tend to feel that they have no real
purpose in life and that there really doesn't seem to be any reason for them to try or even
be around. There are people who are only a little pessimistic at times, but there are also
people out there who are more consistently pessimistic about themselves, their life and
the world around them. It is these people who are more prone to fall into serious
depression, though it can sometimes be depression that can cause a person to develop a
more pessimistic outlook. Oftentimes, depression and emotional health are further
exacerbated by how others react to negativity. Negative people are frequently perceived
as "wet blankets" and may be avoided. For some people a pessimistic attitude serves as a
source of sardonic humor and might even be a coping mechanism. People that fall into
this category might feel they are actually warding off negativity by being prepared for the
worst. "If you continually expect the worse, you are apt to be pleasantly surprised a lot. If
you always expect the best, you may be disappointed frequently." This can be a
reasonable rationale for a pessimist.

However, some researchers believe that a pessimistic attitude might negatively affect
health. Studies conducted in the Netherlands between 1995 and 2001 suggest a possible
link between pessimism and heart disease. The studies, published in The Archives of
General Psychiatry, followed over 900 Dutch citizens from ages 65 to 85 over the six-
year period. Each participant was ranked on a scale of optimism and pessimism. The
study found that 30.4% of the optimistic participants died during the study period,
compared to 56.5% of the pessimistic participants. While factors like diet and smoking
were accounted for, it should be noted that participants were not screened for depression.
Whether or not a link does exist between pessimism and heart disease, it has become
widely accepted that a positive attitude is certainly helpful in life. If being a pessimist
doesn't shorten life, being an optimist will make it more enjoyable. Virtually anyone who
nurtures a habitually negative temperament can transform from a pessimist to a more
positive person with time and effort. Psychotherapy and cognitive behavior therapy can
help a person to change his or her thinking habits. If the cost of therapy is prohibitive, a
more affordable method might be to seek out self-help books that teach how to recognize
negative thinking patterns and replace them with positive habits of thinking. Local
classes and seminars might also be of assistance. With practice and diligence, positive
thinking can become a habit as easily as pessimism does.

Families and Friends

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Depression can be especially cruel in that it doesn't affect just the depressed person, but
everyone around them, too. Someone who is depressed can be very difficult and draining
to deal with. What makes this so cruel is, that as a depressed person's relationships
become strained--to the point where others actively avoid having anything to do with
them. This further contributes to a worsening self-image and makes the person feel even
more isolated, intensifying the depression. Depressed patients must learn to understand
how their illness affects other people, and expect that their relationships will not be what
they were, for some time. By the same token, those around them must understand that it
is not the person, but the illness, which is an inconvenience. The best way for them to be
relieved of the stress, is to help the patient toward recovery. Friends and family must
remember that the depression patient did not ask for this illness, it is not a character flaw,
and the patient often doesn't have much control over what he or she does. They cannot
afford to take the symptoms of depression in someone else, personally. Most primary
relationships, however strong, go through trying times during the course of normal life
even when everyone is in the best possible state of mind. Therefore, one can only imagine
the difficulties and setbacks experienced by people suffering from depression. It is also
equally challenging and difficult for the other person or people in such relationships,
because, as part of the negative effects of depression, depressed people often fail to see
reason, do not want to believe there is hope, and ultimately give up any and all effort
towards making relationships work.

Individuals

Depressed individuals will tend to avoid friends and social gatherings, and be unable to
derive satisfaction from hobbies and leisure interests. It impairs their ability to sleep, eat,
work, and get along with others. It damages their self-esteem, self-confidence, and the
ability to accomplish everyday tasks. People who are depressed find daily tasks to be a
significant struggle. They tire easily, yet cannot get a good night's sleep. They have no
motivation and lose interest in activities that were once enjoyable. Depression puts a
dark, gloomy cloud over how they see themselves, the world, and their future. This cloud
cannot be willed away, nor can we ignore it and have it magically disappear.

Work and School

Ongoing stress and pressure can cause work depression. It is a reality of the fast paced
work environment of today. More than $43 billion are lost each year as a result of so-
called work depression. It is a rather common illness affecting 1 out of every 20 adults at
any given time. Work depression affects three out of every ten workers at least once a
year. Most people see the workplace as a secure environment where they obtain some
form of stability and structure. When a person struggles with symptoms of work
depression, the very same place of structure can become a cage where he/she feels
trapped without a means to get out. Depressive can affect an employee's productivity,
judgment, ability to work with others, and overall job performance. The inability to
concentrate fully or make decisions may lead to costly mistakes or accidents. Changes in
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performance and on-the-job behaviors that may suggest an employee is suffering from a
depressive illness include:
o Decreased or inconsistent productivity
o Absenteeism, tardiness, frequent absence from work station
o Increased errors, diminished work quality
o Procrastination, missed deadlines
o Withdrawal from co-workers
o Overly sensitive and/or emotional reactions
o Decreased interest in work
o Slowed thoughts
o Difficulty learning and remembering
o Slow movement and actions
o Frequent comments about being tired all the time

School depression is the type of depression that occurs in school going children and
research shows this is a more common illness than was previously thought. Numbers of
students are affected by depression every year and due to the age group that can be
affected by depression it is important at the first signs to have the child diagnosed. School
depression is not a strange kind of depression; it is just the same as some of the other
types of depression. Following are the symptoms of school depression:
o The first and the foremost symptom of depression in school going
children is the inability to concentrate while studying.
o Irritation at school without a proper reason.
o Poor appetite.
o School going children may exhibit sleeping problems; these consist of
too little sleep or too much sleep.
o Little interest in extra curricular activities.
o Nervousness or hesitation without any reason.
o Fatigue.
o Negative thoughts and poor self-confidence also are the symptoms of
depression in school going children.

School depression or depression in school age children exhibit the above listed symptoms
commonly, but these symptoms might vary child to child. The prevalence of depression
in school going children is 3 to 4 out of 100 children. School depression occurs equally in
boy and girls. The relationship of students amongst their friends and teachers play a big
role in school depression. Some of the causes that may lead to depression in school age
children are:
o Extra pressure of parents or schoolteachers on students to perform well
in examinations.
o Too many expectations from parents.
o Students that do not join activities may also develop depression.
o Bookworms may also develop depression.
o Low self-confidence can also develop depression in school age
children.
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o The fear of bad performance in activities such as sports or bad

performance in studies could also be the reason of depression in school
age children.
o Students that have no friends are often found stressed, the stress may
also lead to depression.
o Inferiority complex in students is also a reason that they may develop
depression.

School depression is a treatable illness and can be treated if the proper treatment
technique is followed. Parents need to identify the symptoms in their school age children,
as most of the children do not even know that they are suffering from depression. Parents
need to take their child to a specialist and look for proper treatment plan. Talk therapy,
Cognitive behavioral therapy, family therapy or interpersonal therapies are good method
in these cases. The parents can also help the child getting over school depression.

Antidepressants

Antidepressants are medication used for people who have depression. Most
antidepressants are believed to work by slowing down the removal of certain chemicals
from the brain. According to the chemical imbalance theory, low levels of the brain
chemical serotonin lead to depression and depression medication works by bringing
serotonin levels back to normal. Researchers agree that when depression is severe,
medication can be helpful – even life saving. The most widely prescribed antidepressants
come from a class of medications known as selective serotonin reuptake inhibitors
(SSRIs). Selective serotonin reuptake inhibitors are available only with a doctor's
prescription and are sold in tablet, capsule, and liquid forms. Commonly used selective
serotonin reuptake inhibitors are fluoxetine (Prozac), paroxetine (Paxil), sertraline
(Zoloft), and fluvoxamine (Luvox).

− Prozac is the registered trademarked name for fluoxetine hydrochloride and

the world's most widely prescribed antidepressant to-date, the first product in
a major new class of drugs for depression12 called selective serotonin re-
uptake inhibitors. Prozac was first introduced to the US market in January
1988. It took two years for Prozac to gain its 'most prescribed' status and had
become the world’s most widely prescribed antidepressant. The team of
inventors behind Prozac was lead by Ray Fuller. Fuller was posthumously
awarded the Pharmaceutical Discoverer's Award from NARSAD for
discovering fluoxetine or Prozac. Also awarded were Bryan Molloy and David
Wong, both members of the Eli Lilly Company research team.

Psychotherapy

The most common treatment for depression includes the combination of antidepressant
medicine and psychotherapy (called "therapy" for short, or "counseling"). Psychotherapy
is a general term for a process of treating mental and emotional disorders by talking about
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your condition and related issues with a mental health provider. During psychotherapy,
you learn about your condition and your mood, feelings, thoughts and behavior. A
licensed mental health professional helps people with depression focus on behaviors,
emotions, and ideas that contribute to depression, and understand and identify life
problems that are contributing to their illness to enable them to regain a sense of control.
Psychotherapy can be done on an individual or group basis and can include family
members and spouses.Using the insights and knowledge you gain in psychotherapy, you
pick up healthy coping skills and stress management. Psychotherapy often can be
successfully completed in just a few months, but in the case of a severe mental illness,
long-term treatment may be helpful. There are many specific types of psychotherapy,
each with its own approach to improving your mental well-being. The type of
psychotherapy that's right for you depends on your individual situation. Psychotherapy is
also known as talk therapy, counseling, psychosocial therapy or, simply, therapy.

Alternative Methods of Treatment

Another way of treating depression is through alternative methods of treatment such as

acupuncture, guided imagery, chiropractic treatments, yoga, hypnosis, biofeedback,
aromatherapy, relaxation, herbal remedies, massages, and many more. Of all of these
treatments, the one that seems to help the most is Aromatherapy. Aromatherapy is
particularly effective in dealing with stress, depression and stress related disorders.
'Depression' is a term which encompasses a wide spectrum of psychic problems and
symptoms which, in turn, can lead to more serious illnesses. Aromatherapy, in helping to
relax the patient and by reducing stress, may actually help to prevent such conditions.
Depression related disorders, such as digestive problems, stress and other mental
problems, can be treated by Aromatherapy. As depression is reduced, there is a
corresponding improvement in sleep patterns and energy levels. Aromatherapy is an
alternative treatment that uses the highly concentrated essential oils that are extracted
from plants to treat symptoms and assist in the healing process. Aromatherapy is aimed at
revitalizing the body and mind while lifting your spirits. Aromatherapy will aid in
promoting a sense of well being. Aromatherapy is also known for easing mental fatigue
and insomnia. When you use these wonderful essential oils in the correct blend for
massages, baths, diffusers and even personal perfumes you will begin to benefit from the
use of aromatherapy. Using aromatherapy for depression will give you the peace of mind
and the well being that you need. You will enjoy the uplifting feeling that will rid your
life of depression.

Conclusion-

Most people have felt sad or depressed at times and have wondered if the world would be
a better place if they weren’t in it but by researching this topic, I’ve learned that even
though 6.7 % of the United States population is affected by depression, there are options
and treatments available for those unfortunate ones who feel like they have nothing left to
live for. Depression is a mental state characterized by a pessimistic sense of inadequacy
and a desponent lack of activity which reflects a sad and/or irritable mood exceeding
normal sadness or grief.
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The causes of depression can vary between patients but for the majority depression is
caused mainly by grief due to the death of a loved one, an illness, a traumatic event and
sometimes stress that occurs during work and/or school. Depression can also run in
families for generations and can be caused by someone who has a pessimistic attitude
towards life as well. Depression can take its toll on both the individual and his or her
families, friends, classmates and co-workers. When the patient has finally admitted to
being depressed, the next step is to get help from their doctor who can perscribe an
antidepressant such as Prozac, Zoloft, Paxil, or Symbolta. Other options besides
antidepressants could be psychotherapy which helps the patient learn about their
condition and how to treat it, or Aromatherapy which helps relax the patient by reducing
stress, allowing the body to recouperate and prevent such a condition from happening
again.

About 7 out of 100 men and 1 out of 100 women who have been diagnosed with
depression at sometime in lifetime will go on the complete suicide. In 2005, suicide was
the 11th leading cause of death in the U.S., claiming 32,637 lives. Many suicides are
preventable. Most suicidal people desperately want to live but they are just are unable to
see an alternative solution to their problem. Suicidal individuals will show numerous
symptoms of depression and if these symptoms are discovered early on, then the first step
to recovery has been put into motion. Admitting that you have a problem and are dealing
with depression is getting you one step closer to a complete and total recovery.
Depression is preventable and if people are willing to seek help, then many lives will be
saved each year because if people get treatment for their depression, then no one will
have to say goodbye to a loved one ever again.