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Commentary: The many sides of depression

By Tim Trainor

EO Media Group

Published on August 19, 2014 12:36PM

The recent death of comedian and actor Robin Williams shook a lot of people.

His manic energy, his wild enthusiasm and his serious acting chops brought a lot of pleasure to many people.

But there was a dark side, even though he never let it show. For a man who got so high when the lights came on, it was only human to think he would sometimes get just as low when they were off. We know now that Robin Williams long suffered from severe depression, and that he hanged himself.

If any good can come from this tragedy, it’s that more people are openly discussing mental health issues and depression, both online and in their personal lives.

There is a lot that needs to see the light of day when it comes to discussion depression, so let’s do so here in this week’s Two Truths and a Lie.

TRUTH: Depression affects many people all over the world.

According to the National Institute of Mental Health, roughly 7 percent of Americans 18 or older had at least one major depressive episode in the past year.

An estimated 17.5 million Americans are affected by some form of depression, and 9.2 million suffer major or clinical depression. That makes it one of the most common mental illnesses.

Those figures may even be low. Because of the stigma associated with depression, many don’t admit to suffering from it. In fact, the NIMH estimated that only one in three people suffering from the disease seeks treatment for it.

And it’s not just an American problem. By 2020, the World Health Organization estimates that depression will be the No. 2 cause of “lost years of health life” throughout the world. Countries as vastly different as Sweden, Iran, Libya and Croatia are among the highest sufferers of depression.

According to NIMH, women experience depression about twice as often as men. The reasons for that are generally unclear, but may include hormonal changes women go through during menstruation, pregnancy, childbirth and menopause.

TRUTH: Depression is treatable.

According again to the National Institute of Mental Health, 80 percent of people who suffer from clinical depression and seek treatment show improvement.

Many studies have found that cognitive-behavioral therapy is effective at dealing with depression and other mood disorders. The therapy works to identify negative thought patterns and works to replace them with positive ones.

Still, the most common treatment is antidepressant medication. There are also more studies surrounding antidepressant drugs than you can imagine. Studies are more mixed on their effects, with some people showing improvement while others do not.

Overall, the National Alliance for Mental Illness estimates that about 70-80 percent of patients with major depression respond to treatment.

But everyone’s depression reacts to treatment differently, and if initial treatment fails, it’s possible that a different set of medications or therapeutic techniques would perform better. There’s also some evidence that aerobic exercise can be an effective treatment for depression.

In more extreme cases, techniques like vagus nerve stimulation and deep brain stimulation have shown some promise in initial experimenting.

LIE: Depression is about feeling sad.

Persistent feelings of sadness may be one of the symptoms of depression, but the disease is more than that. It also involves physical symptoms such as changes in appetite and quality of sleep, emotional symptoms such as feelings of worthlessness and changes in behavior such as the loss of interest in our usual activities. For people experiencing depression, these symptoms continue for more than two weeks.

Many people interviewed since Robin Williams’ death have noted that they never saw him unhappy, yet he suffered from severe depression.

Persistent, inescapable feelings of sadness is one of the symptoms of depression. But according to the National Institute of Mental Health, many of those suffering from depression don’t feel any emotion at all – more like emptiness and apathy rather than overwhelming sadness.

And according to an article in Forbes: “Since anxiety often accompanies depression, many feel a constant state of tension that persists for no apparent reason.”

The bottom line: Depression is often misunderstood.

If you are in a mental health crisis, you should call 9-1-1. You can also call the nation’s mental health crisis hotline at 800-273-TALK.

Tim Trainor is the editorial page editor of the East Oregonian.


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