Caring for depression in children with chronic disease
Depression is a common yet complex mental health condition affecting more than 16 million adults and 3 million adolescents in the US each year. People with depression feel sad, empty, or caring for depression in children with chronic disease much of the time. It saps the joy of being with friends and family.
Some cases of depression have a genetic component, but lots of factors beyond an inherited tendency can spur and aggravate depression symptoms, including various environmental factors. Sometimes people don’t acknowledge or recognize depression in themselves or others, so they fail to seek help from a health care professional. Depression can wreck lives, friendships, and marriages and pose problems at school or work. Some people may turn to alcohol or drugs to ease their pain or consider some form of self-harm or suicide as an escape. If you’re feeling depressed or suspect a loved one is struggling with depression, it’s important to reach out for help as soon as possible. Most cases, even severe depression, can be successfully treated.
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Types of depression Major depressive disorder or major depression is another name for classic depression, the type that thrusts people into a dark mood. To be diagnosed with major depression, you must have symptoms that interfere with daily life nearly every day for at least two weeks. Persistent depressive disorder is a common, long-lasting form of depression characterized by low mood. People have symptoms for two years or more, but they aren’t as disruptive as in major depression.
Medication- or alcohol-induced depression is a mood change caused by the use or abuse or alcohol, certain medications, and illicit drugs. Also called substance-induced depression, symptoms may occur when someone stops taking certain medicines or drugs too. It’s normal for these diagnoses to be emotional, but if mood changes linger for more than a couple of weeks, you might have depression. Kids with DMDD are at risk for developing anxiety disorders and depression in adulthood. Bipolar depression, also known as manic-depressive illness, is characterized by unusually wide swings in mood and energy, including periods of depression. Women may experience extreme sadness and have difficulty caring for themselves or their new babies.
Men can have postpartum depression too. Seasonal affective disorder or SAD is also known as seasonal depression. This type of recurring depression commonly strikes in a seasonal pattern, usually during the fall or winter, and disappears in the spring or summer. The exact causes of depression are unclear. Experts think there may be multiple factors involved. Many times, it’s the intermingling of two or more of these factors that bring on depression or make it worse.
Certain gene mutations may impede the ability of nerve cells in the brain to communicate effectively. Depression is often described as a chemical imbalance in the brain, but it’s not quite as simple as being too low or too high in one chemical or another. There are many ways brain chemistry is linked to depression. For example, women are more likely than men to develop depression, perhaps due to fluctuating hormone levels.
Overproduction of the stress hormone cortisol has also been linked to depression. A person’s temperament and upbringing are among the psychological and social factors that may influence how he or she reacts to stressful situations and views the world. As a result, some people may be more vulnerable to depression. Stressful life events, such as a childhood trauma, relationship conflicts, and loss, may alter brain function in ways that make a person susceptible to depression. Depression often goes hand-in-hand with certain chronic conditions, such as diabetes, cancer, heart disease, Parkinson’s disease and Alzheimer’s disease. Certain medicines are tied to depression. Depression symptoms People think of depression as a bad case of the blues.
In truth, it’s more complex than that. Depression can alter how people think, feel, and behave, and it can even produce physical symptoms. Depression can look very different from one person to another. Men are more likely to feel tired, irritable, or angry, and they may abuse alcohol and drugs. Women typically experience feelings of guilt, worthlessness, or sadness. Older adults are more likely to have a medical condition that triggers or worsens depression, but they may be less likely to talk about feelings of depression. Depression in teenagers may be accompanied by anxiety, eating disorders, or substance abuse.
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Children with depression may have trouble in school or cling to their parents. Everyone has moments or periods of sadness in their lives, especially after a death or tragedy. But when a person feels down most days for at least two weeks, it can be a sign of depression. People with depression often have a diminished sense of self. They may see themselves as losers.
They may have negative thoughts about their life. Or they may inappropriately blame themselves for unfortunate things that happen to them. Being overwhelmed with negative thoughts is a hallmark symptom of depression. Pessimistic thinking can give way to feelings of despair that worsen depression. Loss of interest or pleasure in enjoyable activities.
Losing interest or joy in things that make life worth living, like hobbies, friends, work, sex, or food, is a main feature of depression. People with depression may have trouble falling asleep. Alternately, they may sleep too much rather than engage in activities. It can sap a person of the physical or emotional energy to actively engage in life, leading to constant lethargy. Some people with depression talk and walk more slowly. Less commonly, depression may lead to behaviors that seem more restless in nature, like pacing, fidgeting, or hand gesturing, called psychomotor agitation.
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Slow or distorted thinking and difficulty concentrating can be signs of depression. Trouble making decisions is another common sign of depression, perhaps because people with depression lack motivation and energy. With depression, some people lose interest in food, while others overindulge or seek out comfort in foods high in fat and sugar. Such shifts in appetite can lead to sudden, unintended weight loss or weight gain. Unexplained aches and pains or digestive problems.
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Depression is associated with a litany of physical symptoms. Common signs include headache, backache, stomachache, and joint or muscle pain. People with depression can lose interest in taking care of themselves and may neglect their personal hygiene. Thoughts of death or suicide or a suicide attempt. People who are depressed may see no way out of their misery other than taking their life.
Their thoughts may to turn to self-harm or suicide. Some may verbally express suicidal thoughts or even attempt to commit suicide. A depression diagnosis is typically based on a patient’s personal and family history of depression and reported symptoms. Patients may be asked to take a questionnaire to gauge the severity of their symptoms.
A physical exam and lab tests can rule out other medical conditions, such as a thyroid disorder, that can cause the same symptoms as depression. To be diagnosed with major depression, a person must experience symptoms on most days over at least a two-week period. Sometimes depression persists for two or more years. People can have multiple bouts of depression in their lifetime.
Depending on symptoms and their severity, your doctor may refer you to a psychiatrist, psychologist, or other mental health professional for treatment. Depression treatment Depression is managed mainly through psychotherapy and medication. The choice of treatment depends on the type of depression and its severity. Also known as talk therapy or counseling, psychotherapy may be the first line of treatment for people with mild depression. It can be combined with antidepressant medications for moderate to severe cases.
There are several types of counseling for depression. One of the most common forms is called cognitive behavioral therapy. CBT focuses on helping patients identify and change negative thinking and behaviors that cause or worsen their depression. Another type, called interpersonal therapy, seeks to improve a depressed person’s relationships with others. Several different classes of antidepressant medicines may be used to treat depression by affecting chemical messengers in the brain. Each acts on these brain chemicals slightly differently.
This class of medicines is widely prescribed. These drugs work on one or more chemical messengers in the brain but don’t fit into other classes of medications. This brain stimulation therapy is reserved for the most severe cases. Electric currents are delivered under general anesthesia to a patient’s brain, inducing a controlled seizure. Doctors believe the seizure changes the brain in a way that can help relieve depression symptoms.
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People with seasonal depression may feel better with phototherapy. It involves indirect exposure to bright light from a light therapy box for a short period of time each day. Can depression be cured or reversed? While there’s no one-size-fits-all cure for depression, the mood disorder is highly treatable in many cases. The sooner treatment begins, the better the outcome.
Likewise, the longer someone suffers from depression, the more difficult it is to manage or reverse. Untreated depression usually doesn’t go away on its own. Research suggests that healthy food can be medicine for the mind. In a randomized controlled trial published in BMC Medicine, depression sufferers with poor dietary habits were divided into two groups. One group was encouraged to follow a modified Mediterranean diet and the other received social support only. After three months, the healthy-diet group had a much greater reduction in depressive symptoms than their counterparts.
Moderate exercise is a powerful mood enhancer. It can help people with depression manage their symptoms. And, according to a review in the American Journal of Preventive Medicine, even low levels of exercise can lower the likelihood of being diagnosed with depression later in life. Most adults should aim for at least 150 minutes of aerobic exercise a week, plus muscle-strengthening activities two or more days a week. The relationship between sleep and depression is complex. Being depressed can interfere with sleep, and poor sleep can cause or worsen depression. If you have insomnia at night, avoid afternoon naps.
For better shut-eye, sleep in a cool, dark room. Drinking to improve your mood can actually worsen depression in the long run. It can also make antidepressant medications less effective. Get a daily dose of sunshine. Sunlight is a natural mood enhancer. Aim for 15 minutes of sunlight exposure a day. A light therapy box can be an effective substitute.
Having a social support system of friends and family can help you battle feelings of isolation, which can fuel depression. Make time for things you enjoy. You may not feel like doing fun things. But you may find you feel better when you’re taking trips, participating in a hobby, playing sports, or going out with friends. Stress can lead to or worsen depression, so it’s important to find ways to release tension and relax. Adopting good sleep habits, reducing caffeine intake, exercising regularly, and having a social support system are just a few of the strategies that may ease physical and psychological stress. Sign up to receive our best tips, workouts, recipes, and more.
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All products and services featured are selected by our editors. Offers may be subject to change without notice. You can never be too rich or too thin. In fact, being too thin can be seriously unhealthy. This is just the latest piece in a growing body of evidence that shows how being skinny can expose people to a range of serious problems.
These include a raised risk of miscarriage, lung disease, male infertility and even death in car accidents. Officially, it means a body mass index, or BMI, below 18. Your BMI is your weight in kilos divided by your height in metres squared. Last week’s study showed that a gene called IRS1, which keeps some people skinny, is linked to a raised risk of Type 2 diabetes and cardiovascular disease.
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Dr Ruth Loos, a Cambridge University scientist involved in the study, says that though the gene makes people look slim, men who have it may deposit fat internally in dangerous places around the liver and heart. The research is still in its infancy, but scientists have calculated that being underweight is associated with 34,000 deaths a year in the U. This compares with 112,000 deaths annually from serious obesity. While being clinically overweight is the main size-related danger, being skinny brings its own hazards. Sian Porter, a consultant dietitian and spokeswoman for the British Dietetic Association, says that underweight people are often unaware that any of their health problems may be due to their size. All the headlines are about the dangers of obesity.
One of the causes of problems may be hormonal. Lack of body fat is also linked to the loss of other chemicals essential for physical and mental health. Women who have always been thin are at a raised risk of hip fractures in middle age, according to a study of 3,683 women in the Archives of Internal Medicine. Hip fractures are a leading cause of injury among women in middle age and death among older people.
The thinner a woman is, the lower her bone density. Fat fuels oestrogen production, which the body needs for healthy bones. Too little oestrogen can make bones porous and brittle. Also, bones need to carry weight to remain strong. This makes weight-bearing exercises, such as running, jumping and lifting, important for thin people. One strategy for preventing bone breakage in thin middle-aged women is to put on a few pounds. The study in the Archives Of Internal Medicine found that a weight gain of at least 10lb between the ages of 40 and 60 appeared to increase bone density and reduce the fracture risk.
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Other studies have found that a weight gain from underweight to normal after the age of 25 is associated with a reduced risk of a broken hip. Dietitian Sian Porter says it is relatively straightforward for most people who are underweight to put on pounds. It is not difficult for people with low BMIs to gain weight. Having snacks between meals, drinking a glass of milk before bedtime and adding cereal or toast to their breakfast — it doesn’t take much, particularly as slim people often don’t eat much. In fact, they often eat less than they think.
ARTHRITIS AND HEART DISEASEUnderweight people who have arthritis are three times more likely to die from heart disease in middle age than people of normal weight. Experts at the Mayo Clinic in the U. They believe thin people are more prone to the effects of inflammation elsewhere in the body triggered by severe arthritis, and this can have a deadly effect on the heart. Research shows that chronic inflammation plays an important role in atherosclerosis, the process in which fatty deposits build up in the inner lining of arteries. The study of 603 women who had suffered early miscarriage did not find a precise reason for the link.
But according to pregnancy expert Heidi Murkoff, the oestrogen produced by fat cells is closely tied to fertility and healthy pregnancies. Very thin women are also at risk of severe nausea during pregnancy, according to a study of 943,000 Swedish women. In a small percentage of women, morning sickness spirals into a condition called hyperemesis gravidarum. This causes unrelenting vomiting that puts them at risk of malnutrition and dehydration. The dangers for mother and foetus mean that the woman may need to be hospitalised and put on a drip.
The study found that women who are underweight before pregnancy are 43 per cent more likely to end up in hospital with the condition. Sian Porter often sees underweight women because they are having trouble conceiving. I think it’s nature protecting itself,’ she says. It stops women menstruating when their food intake is limited and potentially lacking in key nutrients, because it sets off alarms about famine. Thinner men carry a significantly higher suicide risk.