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Depression And Its Symptoms

Depression is a devastating illness that affects the total being -- physically, emotionally, and spiritually.
The symptoms of clinical depression falls into five major categories:
sad affect, painful thinking, physical symptoms, anxiety, and delusional thinking.

Sad Affect (Moodiness)

One major symptom of depression is a sad affect or moodiness.
An individual suffering from depression has a sad expression on his face.
He looks depressed.
He either cries often or feels like it.
His eyes are cast down and sad.
The corners of his mouth droop.
His forehead is wrinkled.
He looks tired, discouraged, and dejected.
His features are strained.

As the depression progresses, he gradually loses interest in his personal appearance.
Even if he tries to hide his depression by smiling, it still shows.
In fact, many depressed individuals have what is known as a smiling depression.
Many smile inappropriately to cover up the sad or angry feelings within.

Painful Thinking

A second major symptom of depression is painful thinking.
The thinking of a depressed individual is painful emotionally.
There are those who would say that emotional pain is worse than physical pain.

The depressed individual is very introspective in a self-derogatory way.
He ruminates a great deal over past mistakes.
He often feels guilty, even when innocent.
He may feel responsible when he is not.
He feels at fault when blameless.
He worries excessively over all kinds of wrongs in the past, both real and imagined.
His thoughts are self-debasing.

He has a negative, self-concept.
He has an exaggerated few of these problems and frequently blames himself for all of his problems.
Some depressed individuals go to the opposite extreme, and inappropriately blame others
for all their problems as they wallow in self-pity.

He tends to view himself as being deficient in qualities that he considers important,
such as popularity, intelligence, or spiritual maturity.
He feels blue, said, helpless, worthless, and hopeless.

Some experts in this field would say that seventy five percent of depressives feel they will never recover.
He often feels deprived of emotional support and thus feels empty and lonely.
He craves affection and reassurance from others, but often his deep-seated hostility frustrates
his purposes.

He is filled with remorse from imagined wrongs, both recent and remote.
He is unhappy and pessimistic.
He may become petulant and distressful.
His every experience is combined with his mental pain.
He is preoccupied with himself.
He is self-possessed.
He is absorbed with a few topics of melancholic nature.

He anticipates nonacceptance from others and feels rejected and unloved,
usually significantly out of proportion to reality.
He is so occupied with himself and his ruminations that his attention, concentration,
and memory are impaired.
He feels anxious and perplexed.
To him the future is gloomy.
He experiences a low energy level and a sense of futility.

His painful thinking often centers around guilt.
The guilt may be true guilt, but often for the depressed individual false guilt is also
a significant problem.
He feels guilty when innocent.
He feels guilty for many minor mistakes and wrongs.

Most individuals have suffered from guilt for brief periods of time after doing something wrong.
The only exception is a sociopath or a criminal.

Imagine how painful it would be to live with a constant, haunting guilt
and how miserable the depressed individual feels.
He has guilt which he thinks he cannot escape.

The painful thinking of the depressed individual centers around taking on responsibility
for acts and events which, realistically, are outside of his control.
This may have its origin in man's need to feel important.

The depressed individual has an overwhelming sense of inadequacy
and has feelings of worthlessness.
He feels as though he is a nobody -- a zero.
But he cannot be a zero if he is responsible for great many events and acts
-- so much hinges on him.

Thus, in a warped sort of way, his feelings of overwhelming responsibility protect him
unconsciously from his feelings of worthlessness.
They give him a great sense of power.
In many ways, he becomes omnipotent as a reaction of his true inner feelings
of inadequacy and emotional impotence.

The depressed individual is characterized by motivational disturbances.
That is, he lacks motivation.
He loses interest in the type of activities in which he was previously involved.
He begins to avoid people and wishes to be left alone.
He loses his sense of humor.
He becomes indecisive.
Eventually, he may become suicidal.

Physical Symptoms

A third major category of the symptoms of clinical depression includes physical symptoms,
which are known by medical doctors as the "physiological concomitants of depression."
Actually biochemical changes involving the brain amines takes place
in the human nervous system during clinical depressions.
These biochemical changes have various physical results.
The body movements of the depressed individual usually decrease.

The quality of his sleep is affected.
He may have difficulty falling asleep at night, but more often he suffers from waking up
too early in the morning.
After waking up early, he has difficulty going back to sleep.
This is a frequent occurrence.
Actually, rather than sleeping too little, he may sleep too much.

His appetite is often affected.
He that he eats too much or too little (usually too little).
Therefore, he may have either significant weight loss or weight gain.
He may suffer from diarrhea, but more frequently from constipation.
In women, the menstrual cycle may stop entirely for months, or it may be irregular.

There is often a loss of sexual interest.
The depressed individuals may suffer from tension headaches or complain of tightness in his head.
Along with slow body movements, he may have a stooped posture and seem to be in a stupor.
He may have gastrointestinal disturbances.
He may have a slow metabolic rate.
He may suffer from a dry mouth.
A rapid heartbeat and heart palpitations are fairly common.

These physiological changes scare most individuals into hypochondriasis
(an overconcern with physical illnesses).
Many are honestly convinced that they have cancer, or hypoglycemia,
or a nutritional disorder.
Actually, they would prefer to have a physical illness in order to save face.
They hate to admit that they have psychological conflicts, which they view as weakness.

Anxiety Or Agitation

A fourth major symptom of depression is anxiety or agitation.
Anxiety and depression usually occur together.
The depressed individual feels anxious and often is more irritable than usual.
Also, as depression increases, so does agitation.
The depressed individual feels tense and has difficulty sitting still.

Delusional Thinking

A fifth major symptom that can occur in very severe depressions is delusional thinking.
It differs from painful thinking only in degree -- a delusional thinker is clearly out of touch with reality.
His delusions involve either notions of persecution (that is, he thinks people are out to get him)
or grandiose assumptions (that is, he thinks God has given him some special gift or insight).

He may have auditory hallucinations -- he hears voices that are often condemning
and accusing in nature.
The voices, of course, are not really there.

He may also have visual hallucinations -- he sees things that no one else sees.
He may interpret these as visions from God.
If he is treated soon after his break with reality, he is usually restored to normality,
once again thinking clearly and happy with life.

In such cases one or two months of hospitalization may be needed, with daily psychotherapy,
antipsychotic and antidepressant medications, and encouragement.
Unfortunately, some persons become permanently psychotic.

In summary, a true clinical depression is a complex, painful disorder involving our total being
 -- mind, body, and spirit.
There can be a wide range of severity -- from a sad affect and painful thinking all the way
to complete loss of contact with reality (a psychotic break) in order to compensate
for the extreme pain of reality.

Most clinical depression just do not reach the psychotic stage.
However, most clinical depression do include a sad affect, painful thinking,
physical symptoms (the physiological concomitants of depression), an anxiety (or agitation).
If these symptoms disabled the individual biologically and socially, he has a depressive neurosis.

Anyone can be cured of a depressive neurosis if he becomes actively involved
in good-quality professional psychotherapy.
If the depressed individual has considerable anxiety along with his sad affect, painful thinking,
and psychomotor retardation (slow body movements, but with periods of restlessness),
he has agitated depression.
This is also totally curable.

However, if the depressed individual, in addition, has delusional thinking or hallucinations,
he has a psychotic depression.
Psychotic depressions are usually curable if caught fairly early, although they are
much more difficult to treat.
Some psychotic depressions worsen and become lifelong schizophrenic disorders
which are incurable at present.
It is hopeful that medical science may come up with some breakthroughs soon so that even " incurable" schizophrenics may someday be restored to total health.

Here is a self-rating depression scale.

Anyone who answers "true" to a majority of the following statements is almost certainly depressed
and should seek professional assistance before the depression worsens.

1. I feel like crying more often now than I did a year ago.
2. I feel blue and sad.
3. I feel hopeless and helpless a good part of the time.
4. I have lost a lot of my motivation.
5. I have lost interest in things I once enjoyed.
6. I have had thoughts recently that life is just not worth living.
7. My sleep pattern has changed of late. I either sleep too much or too little.
8. I am losing my appetite.
9. I am too irritable.
10. I am anxious of late.
11. I have less energy than usual.
12. Morning is the worst part of the day.
13. How I find myself introspecting a lot.
14. When I look at myself and the mirror, I appear to be sad.
15. My self-concept is not very good.
16. I worry much about the past.
17. I have more physical symptoms (headaches, upset stomach, constipation,
    rapid heartbeat, etc.) than I did a year ago.
18. I believe people have noticed that I do not function as well at my job as I did in the past.

The above has been based on the book, "Happiness Is a Choice," by Frank B. Minirth
and Paul D. Meier.


Definitions of terms used above:

Depression -- a morbid sadness, dejection, or melancholy

Neurosis -- formerly referred to individuals in contact with reality
           but so incapacitated by anxiety and its symptoms as to function
           inadequately over a period of time.
Schizophrenic -- mental disorder characterized by rambling thoughts,
                lack of or inappropriate facial expression, withdrawal, and immobility.

Next on left menu: Overcoming Depression

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