Depression
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Descriptions, definitions, synonyms, organizer terms, types of
http://www.about-depression.com/symptoms-of-depression/images/img02-01.jpg
According to Merriam-Webster Online Dictionary, depression is a state of feeling sad, a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies. Depression is a reduction in activity, amount, quality, or force and a lowering of vitality or functional activity.
Depression and the Sense of Self
The sense of self described in terms of self-concept (the cognitive perception and appraisal of the self in the different areas of functioning) and self esteem (the emotional experience and valuing of the self) is viewed as a central construct in the understanding of depression by most theorists. Depression can be a consequence of real or perceived damage to one's sense of self. Feelings of helplessness and hopelessness about one's self, the state of the world, and the future are among the characteristics commonly associated with depression. A common threat to one's self is belittlement or loss. Experiences such as these evoke feelings of sadness and worthlessness that could have a negative impact on a person's sense of self and lead to an onset of depression.
Maintaining a positive sense of self is a key componet for avoiding feelings of depression. In order to keep one's sense of self intact, an individual must have hope. Hope is an overall positive emotional attitude towards one's personal future, and a favorable cognitive appraisal contributes to it. Feelings of hope provide reassurance to a person who is dealing with unfavorable or adverse circumstances that positive changes can occur. A hopeful attitude helps an individual to feel that the future is open and full of opportunities despite the presence of poor circumstances.
In contrast, helplessness (inability to cope) and hopelessness (inability to anticipate positive change) can be debilitating to one's sense of self. Hopelessness is the opposite of hope and reflects an overall negative outlook on the future with a constriction of opportunities. Coupled with poor coping, aggravation of physical illness, and mental illness, hopelessness is a particularly prominent factor in depression. The presence of helplessness and hopelessness distort one's cognitive image of their life and the future, which leads to reduced motor activities, withdrawal from social interactions, and the onset of depression.
It is possible to feel depressed during the winter, but not the summer. This is known as seasonal affective disorder. (SAD) Symptoms include weight gain, lethargy, excessive sleeping, and a craving for sugary/starchy foods.
Depression in the Schools
An individual's sense of self evolves throughout his or her encounters with various physical, intellectual, social, and emotional environments. The environment can influence this process in ways that are positive, empowering, growth promoting, affirming to one's emerging sense of self, and conducive to the development of strengths which can act as buffers to future environmental stress. However, an individual can also be exposed to experiences that are devaluing, humiliating, or disempowering which inhibit or distort the development of the self. Children with a damaged sense of self are vulnerable and have a decreased resistance for meeting future threats to their sense of self and are at a greater risk for depression.
As a child enters school, he or she has a developmental history that has predisposed him or her towards more or less effective coping skills in and stressful situations. Strong coping skills act as buffers to events that threaten the sense of self, and vulnerabilities such as tendencies toward introjection, cognitive distortion, emotional over-sensitivity, and negative attributions tend to maintain self-devaluation and facilitate feelings of depression. The successes and failures in coping with school demands contribute to the formation of the child's sense of self as a worthy or unworthy member of a larger community.
Leaving home and adapting to school life presents a major challenge to most children. Sharing, getting along with others, and forming relationships in a new social setting are major challenges to a young child. For some children, school stress is compounded by a loss of emotional security or support as a result of parental conflict, separation, divorce, unemployment, or substance abuse. The school presents a wide range of academic and behavioral tasks and expectations that maybe realistic, overly demanding, or lacking in stimulation. A child's inability to complete academic tasks and meet behavioral expectations can be threatening and demeaning to his or her sense of self. When children continue to have difficulty in school and deal with negative circumstances outside of school, the self can undergo a great deal of damage and feelings of hopelessness can arise and possibly lead to depression. In these types of cases, the child needs a collaborative and supportive social network which includes the family, school, and community to help him or her with the challenges of the school setting.
Mother's and Depression
An estimated 50-80 percent of all mothers experience postpartum blues in the first 10 days after childbirth. Symptoms may include tearfulness, fatigue, insomnia, and feelings of loss or being overwhelmed.
Approximately 8-15 percent of women experience postpartum depression sometime during the first year after childbirth. Postpartum depression is a major depressive episode, with symptoms – lasting two weeks or more — commonly including low mood, irritability, sleep and appetite disturbance, fatigue, loss of interest or the ability to feel pleasure in daily life, guilt, decreased concentration, indecisiveness, feelings of worthlessness, despair, or thoughts about harming oneself or one’s child. Postpartum depression will not completely go away without treatment; it may last for a period of weeks or for longer than a year.
One in 1000 women, at most, may experience postpartum psychosis during the first year after childbirth, with most cases occurring before the baby is three months old. Symptoms include agitation, racing thoughts, rapid speech, hallucinations, paranoia, an inability to care for oneself or the baby, and thoughts about suicide or infanticide.a
The Cognitive-Behavioral Approach to Treating Depression
The cognitive-behavioral approach links symptoms to therapeutic goals to specific interventions. Specific symptoms for depression include low level of behavior, lack of pleasure and interest, withdrawal, self-criticism, and hopelessness. The goals for treating these symptoms are to increase behavioral levels, to increase pleasurable and rewarding behaviors, to increase and enhance social relations, to improve self-esteem and decrease self-criticism, and to assist the patient in developing short-term and long-term positive perspectives. A numer of behavioral and cognitive interventions are utilized to achieve these goals. Activity scheduling and graded task assignments can increase pleasurable and rewarding behaviors. Social skills training, assertivenes, and self-monitoring of complaining are used to enhance social relations. Identifying, challenging, and modifying negative automatic thoughts, assumptions, and self-schemas can improve self-esteem and decrease self-criticism. Identifying long-term and short-term goals, developing problem-solving strategies, and carrying out and revising plans are activities that can assist an individual with developing positive short- and long-term perspectives.
A behavioral assessment allows the clinician to evaluate the behavioral deficits and excesses associated with depression. In addition, with behavioral assessments, clinicians can evaluate interpersonal problems that may contribute to depression, such as frequent arguing, loss of relationships, lack of assertion, and other negative interactions. Finally, cognitive assessments provide an evaluations of typical distorted automatic thoughts, maladaptive assumptions, and negative schemas that may conflict with a strong cognitive sense of self.
DSM-IV-TR Criteria for Depression
Major Depressive Disorder, Single Episode: 1. There must be a presence of a single Major Depressive Episode. 2. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder or Psychotic Disorder Not Otherwise Specified. 3. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.
Major Depressive Disorder, Recurrent: 1. Presence of two or more Major Depressive Episodes 2. The Major Depressive Episodes are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder or Psychotic Disorder Not Otherwise Specified. 3. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.
Dysthymic Disorder: 1. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least two years. 2. Presence, while depressed, of two (or more) of the following: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, or feelings of hopelessness. 3. During the 2-year period of the disturbance, the person has never been without the symptoms in Criteria 1 & 2 for more than 2 months at a time. 4. No Major Depressive Episode has been present during the first 2 years of the disturbance. 5. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. 6. The disturbance does not occur exclusively during the course of a chronic Psychotic Disorder, such as Schizophreniz or Delusional Disorder. 7. The symptoms are not due to the direct physiological effects of a substance or a general medical condition. 8. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
I was wondering about whether or not research has been done with music to treat depression in either children or adults? It seems to be a means to alter one's mood or to help one cope with difficulties which life presents. It seems that music instruction is often limited to just a set period of time in school and it might prove to be beneficial in other ways. Also, what about the notion of relaxing to music? Has this been found to be beneficial in schools? B. Orenic
Interventions for mothers
Empirically validated interventions for postpartum depression would ideally be offered on site at community- based programs, possibly through partnerships with Community Mental Health Centers. Such arrangements would require staff who are trained to work with both very young children and adults. Interventions that have been shown to reduce mothers’ depressive symptoms or improve the mother-child relationship include: · Individual interpersonal psychotherapy (O’Hara, Stuart, Gorman, & Wenzel, 2000); · A mother-infant therapeutic group approach (Clark, Keller, Fedderly, & Paulson, 1993; · Home-based interventions for depressed mothers and infants (Gelfand, Teti, Seiner, & Jameson, 1996; Cooper & Murray, 1997); and · Relaxation and massage, music, and coaching strategies to improve maternal mood and enhance mother- infant interaction (Field, 1997). At the University of Wisconsin’s Postpartum Depression Treatment Program, we are currently conducting an NIMHfunded clinical trial comparing the efficacy of our mother/infant/family relational approach to the treatment of postpartum depression with individual psychotherapy. This study will examine individual differences in who benefits from what type of intervention, as well as following the psychosocial functioning and development of the children, and the quality of mother, child, and family relationships over two years. Staff of community-based programs who are working with mothers who are experiencing major depression should also keep in mind the possibility of consultation concerning the use of medication for women who are feeling suicidal, panicky, hopeless or helpless. Q: Is depression an issue for staff of infant/family
Signed "life experiences", testimonies and stories
Many students within the public school system display various symptoms of depression. I find members of the special education population showing these signs most often, especially those students, who have specific learning disabilities (LD) and/or emotional or behavior disorders (E/BD). Students who have these disabilities seem no different from a regular education student and are sometimes held to the same standards and expectations as the regular education students. Unfortunately the disabilities of these special education students impede the learning process and makes most school-related tasks difficult for them. These students constantly have difficulty in the school setting and typically receive very little support at home. Constant frustration in the school environment and little or no support at home can cause students to experience a great deal of anxiety. This anxiety can lead to feelings of hopelessness and helplessness that can trigger the onset of depression. During my nine years as an educator, I have seen a number of students dealing with various types of depression, and the school system has limited resources for dealing with this issue.
My little brother is a high schooler that struggles with both depression and ADD. He isn't a special needs student and is currently medicated for depression. Our whole family is aware of his problem and we all do our best to keep the home and his learning environments positive and full of resources for him to turn to when he needs them. Sometimes, though we have to almost force him to take support from us. I have stayed awake many a night with him to help him through his homework. All the while he is in tears, both frustrated over why he doesn't get it and crying because he feels as though he will never understand it no matter how much he tries. Between his medication and support from the rest of the family he's getting better slowly. He's starting to understand his shortcomings and how to deal with them. Matt Munley
I had my first experiences with a student who has depression. It was so frustrating for me to see her not participating or even bringing her trumpet to band class. I did not know what to do, but I knew something was not right. I would talk to her and try to let her know that she could talk to me if she wanted to or I would let her go to the counselor, but it never seemed to help. I reported this to the principal more than once until finally there was a meeting with the guidance counselor and the girl's parents. The following week she was a completely different person and she told me about going to the doctor and getting anti-depression medication. It was an amazing turn-a-round for about a week until she began toying with her dosages. I hope this upcoming year will be easier for her. -Missy Legutki
I find the debate over depression medication very interesting. Many doctors are not in favor of prescribing medication to patients who are diagnosed with depression. It has been found that there is a large placebo effect in patients who take medication. That raises interesting questions. Should patients not take it because it may only in their mind that it works? And should they just focus on a strong support group and therapy instead? Some patients don't care that they may be feeling better because of a placebo effect, they just care that they feel better, and would argue on sticking with medication and therapy. --S. Peduzzi
I didn't realize that depression was a neurological/chemical/physical conditions until I was in college and made friends with someone who explained what depression really was. I always saw depression as something that you could overcome if you tried hard enough, and that it was a choice. After investigating I found out that there were close relatives of mine who dealt with depression on a daily basis. I wonder if all people have potential for depression and I wonder why only some are hit harder by it than others. I do believe that my friend and family members that have depression were subject to circumstances that if not properly counseled could lead to severe depression. I wonder where the internal and external balance exists in the degree of depression experienced by my friend and family members. I am very skeptical about medications effectiveness in preventing depression as well as other neurological/physical conditions. I believe that intensive counseling efforts and a loving support system should be attempted before any medical treatments are considered. ~C. Hatchett
As someone who is diagnosed with depression and lives with it through counseling and medication I can certainly feel for many of kids that have been identified. It sucks to be depressed. Like C. Hatchett above discovered it can be totally a physical problem as it is for me. I can engaged and happy one minute and then totally crashed with no external intervening situations. For me it came on in adulthood and has made my grad school experience sometimes trying situation. Focusing on reading is very difficult at times and it takes a while to get really simple things. My minds just spins off into self-defeating litanies. I do good work and have solid grades but I really have to push myself. I remember some grad school experience 12 years ago that was really theoretical stuff, (Vygotsky, Foucault, Bordieu, the usual suspects) and I flew right through it. Not anymore.
Thanks to treatment I'm able to do everything in school, albeit a bit slower than I'd like. Thinking back to how I felt four years ago I never thought I'd be back in school. There is hope. -J. Tubbs
References and other links of interest
[(diff) (hist) . . Poverty and Learning; 05:53 . . Jeske28 (Talk | contribs) ]
Becker, R.E., Heimberg, R.G., Bellack, A.S. (1987). Social skills training treatment for depression. New York: Pergamon Press.
Greden, J.F. (Ed.). (2001) Treatment of recurrent depression. Washington, D.C.: American Psychiatric Publishing, Inc.
Have A Heart A depression resource for teens.
Leahy, R.L. and Holland, S.J. (2000). Treatment plans and interventions for depression and anxiety disorders. New York: The Guilford Press.
Miezitis, S. (1992). Creating alternatives to depression in our schools. Seattle: Hogrefe & Huber.
