How To Overcome Depression

How to Overcome Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Thu, 08 Nov 2012 22:01:00 +0000

Knowing for sure that you suffer from depression is the first step to overcome depression. However, the most important than knowing that we are depressed is Knowing that every action or step in life we do involves choice. Everything is choice. Every decision we made someday, we already choose to make it. We decide what we think and we decide what we think is best for us. We can perform a choice again if the result doesn't feel good or feel right. Thoughts are things and there are no thoughts that are neutral, meaning there are no thoughts that have no effect upon your world. Every thought we have has an effect on us because of its power, energy and vibration. No word we put forth from our mouth returns to us void.

Another important step to overcome depression is to learn how to forgive. Forgiveness is the key that parts the way of the Red Sea of your life. You can forgive yourself by saying "I forgive myself for what I thought I have done. I was mistaken. I apologize to myself."

Forgive another by saying, "I forgive you for what I thought you have done to me. I was mistaken. I apologize to you. I release you to your good. I no longer choose to hold you in my mental prison as responsible." If need to, you can forgive yourself or that person or persons 70 x 7 days until you no longer feel uncomfortable, irritated or depressed.

Another step you might decide or choose is to surrender the struggle, the pain, the anguish, the illness, the hopelessness, the unforgiving nature, and the depression and not claim it as yours anymore. Give it over and up to Infinite Intelligence. We can stop any thought of ours because it is ours, not anyone else's. Only we can think our thoughts and we can stop any oppressive thought. If it doesn't make us feel good, we can upgrade our thoughts one level at a time to that which makes us feel better emotionally.

How do I stop thinking I am unworthy of anyone's love, anyone's companionship or forgiveness. I can do it by deciding "I am worthy." So, that is what I say and own now, "I am worthy." That is what I claim as the truth for myself. The energy of the words that come forth from you in saying, "I am worthy" puts forth the command to the Universe that you desire something better of life. You will be attracting those aspects of life that prove to you, you are worthy of receiving any desire that is best for you. The Universe will agree with anything you say and believe as real. All you need do is trust, receive and accept your new life's energy.

Decide to change one habit a week. If you drink 10 sodas a day, choose to drink maybe 2 a day, or 2 every other day, or 2 once a week until you down to none a day. Soda wears away the enamel of your teeth and irritates the tissue of your colon and intestines. If you are a shopaholic for example, go on your shopping spree. Then return everything you bought that day and get money back for a vacation you've wanted to take. Or use the money to give to a charitable organization that arranges to give clothes to people looking for job interview apparel. Or you could tithe the money saved to an organization that you feel helps your spiritual growth.

Look into changing what you are now eating. See if some of the foods could be depleting your energy. See if caffeine, chocolate, artificial ingredients need to be taken out of your nutritional intake. See if artificial sweeteners could be adding undue stress to your nerves, muscles, etc. If what you are doing is not working, then you must choose to do something differently in order to see something different in your life. Claim a new world by claiming, "I have reasons to be happy. I claim happiness and gratitude." The Universe again, will prove to you that you are correct.

And lastly, be grateful. Be grateful where you are in your consciousness now because it is prompting you to know you are in a place that does not make you feel happy. I was homeless at one time and I would not be where I am today if it were not for my being grateful among other things, for everything, friends, churches, books, who I was, what desires were placed in my heart, my health, etc. Each level of gratitude I embraced, the Universe doubled it, and gave me back more to be grateful for so now my cup "runneth" over.

Tips:

* Surrender old thought and feelings and just chose the good ones.
* Learn to forgive. Forgive yourself first to be able to forgive others.
* Trust in yourself, you own a great power but you may not feel!
* The Law of cause and effect is always operating with our thoughts.

Do You Have Adult Separation Anxiety?

abo.elyosr@gmail.com (supporter2008@gmail.com) — Tue, 22 May 2012 19:21:00 +0000

Childhood separation anxiety is a serious problem, because it hurts healthy psychological development. When a child is too attached to their parents, they rarely strike out on their own socially or learn how to gain independence that will help them later in life. They may even develop anxiety disorders and abandonment issues – all of which can affect the child's ability to grow up emotionally healthy and happy.

But separation anxiety doesn't end in childhood. Many adults suffer from what appears to be adult separation anxiety. Adult separation anxiety is not a valid medical disorder in the DSM-IV-TR, and yet perhaps it should be, because many adults appear to show manifestations of separation anxiety issues.

Understanding Adult Separation Anxiety

Separation anxiety in adults manifests itself in many different ways. It's not simply an over-attachment to your parents – although that's certainly a possible symptom; it may also be seen in a variety of adult behaviors that are considered unhealthy. Some of these include:

• Jealousy – Some mild jealousy is a natural human emotion that many emotionally healthy people experience. But severe jealousy is not. Severe jealousy may be a form of adult separation anxiety. Those that are consistently worried that their partners are cheating on them or may leave them may have serious attachment issues brought on by fear of being separated.

• Harsh Parenting – It's possible that some parents are suffering from a type of reverse-separation anxiety. These parents may be so worried that their children will leave them or hurt them that they become strict parents that try their best to control their children as best as they can. There is evidence that strict parenting has a lot to do with attachment, and that many strict parents are the ones with attachment issues – more so than the children.

• Unhealthy Relationships – It's also possible that separation anxiety plays a role in unhealthy relationships, including friendships. Often there are adults that stay in friendships and romantic relationships even when it's clear that the relationship is unhealthy. Why? Because it's possible that their separation anxiety makes them fear being alone, and they would rather withstand the emotional abuse than strike out as a single person.

And yes, it's also possible that adult separation anxiety manifests itself in other ways as well. Perhaps you find yourself too close a family member to the point where you damage your other relationships due to that closeness. Some adults may actually leech off their parents in such a way that they appear to be simply mooching, but in truth they simply have a fear of embarking out on their own without their parents around.

Finding Help for Adult Separation Anxiety

Whether you believe in the idea that adult separation anxiety should be a diagnosable mental health problem or not, these emotions do have an impact on the quality of your life, and the resulting anxiety you experience can lead to further anxiety disorder issues.

That is why it is generally recommended that anyone that feels they're showing signs of some type of separation anxiety symptoms should strongly consider therapy. Therapy will look at what lead to your attachment issues, and what could be a recurring, contributing factor in the reinforcement of these issues. Therapy will also look at how your upbringing may have led to the creation of these attachment issues, and whether or not you have a condition that adds to the severity.

Adult separation anxiety may not yet be a diagnosable problem on its own, but there's no denying that it affects the lives of millions of people all over the world. If you believe you may have adult separation anxiety, seeking out treatment is always your best course of action.
About the Author: Ryan Rivera had adult separation anxiety in addition to his own anxiety disorder issues. He writes about anxiety and stress at http://www.calmclinic.com/.

Substance Abuse can cause Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 25 Dec 2010 19:35:00 +0000

Negative effects of drug and alcohol use on one’s life

Aside from medical conditions and terminal illnesses such as cancer or others that involve diseases of the body’s vital organs, there is no public health threat that is more serious on a global scale than substance abuse. In the US alone, there are roughly 40 million annually reported cases of serious illnesses associated with substance abuse as well as death due to overdose. It’s obvious that drug and alcohol use affects the individual emotionally, mentally, and physically, but there are other consequences involved as well.

What many individuals overlook when they are suffering from alcohol and drug addiction is that their families suffer as well from their compulsive behavior. Additionally, individuals who are wrapped up in their addictions run the risk of losing their jobs, having failed relationships, and encountering severe legal consequences as well. So substance abuse results in much more than just the physiological and psychological consequences. Let’s not forget the fact that there can also be spiritual issues involved as well for some individuals.

Long-term emotional effects

There are numerous drug rehab California facilities available today that treat all levels of substance abuse whether it is alcohol or drugs. The harsh reality is that the traditional facilities, or those that rely on the more conventional treatment methods and recovery therapies while addressing substance addiction with a one-size-fits-all approach with their clients. Unfortunately, these addiction treatment and recovery centers overlook the long-term emotional effects that result from substance abuse. One of the key side effects of alcohol and drug abuse is that depression results.

It is well known that depression is a common side effect and can progress to the point where the individual eventually becomes suicidal. Additionally, there are other long-term emotional effects that can result including black outs, confusion and disillusionment with one’s life, delusions, drug-induced psychosis, long-term or short-term memory loss, and paranoia. Along with suicidal tendencies, a person can display homicidal tendencies as well.

Ways to avoid this

For many individuals, it is difficult for them to identify when they truly have a problem with substance abuse. In many instances, the person is in denial or the addiction has progressed to the extent that the individual is no longer in control of their life. The alcohol or drug is in complete control and getting high becomes their sole reason for existing. For the addicted individual, the most difficult decision that they will have to make is recognizing that they have a problem and then outwardly admitting they do.

Today, there are a number of sober living California organizations and facilities that can help the addicted individual overcome their suffering. Additionally, if you live in the greater Los Angeles area, there are numerous Alcohol rehab Orange County facilities that are available to help you or a loved one. What you want to remember is that the longer you procrastinate, the more dangerous substance addiction becomes, not only to you but the people around you as well.

So You Think You Know How To Deal With Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 22:10:00 +0000

Depression have many ranges start from a minor levels to a very severe depression. Without seeking for an immediate help depression could become harder to undertake, even costing thousands of people their lives every year. Here are some tips about how to overcome depression.

There are many different types of depression and the same thing won't work on all of them. Understand that I am not a doctor and none of this is medical advice. If you have been depressed for an extended period of time and / or are having feelings of hopelessness and suicide, you should see a qualified medical professional as soon as possible. If this is not the case and you want to try to battle minor depression by yourself, here are some things you can do.

The first area to concentrate on is your health. If your body is not healthy it can have an affect on your mind. Start eating a healthy diet that includes plenty of fruits and vegetables and start a regular exercise routine. These will both help you feel better which in turn can help your depression. The next thing to do is make sure you stay active. Even though you don't feel like it, you need to get out of the house and do things. The worst thing you can do is stay home and shut out the outside world. This tends to deepen depression, not make it better. By socializing with close friends and family, you give your mind a chance to move away from whatever is causing the depression, even if it is just a short amount of time. Every minute you are able to not depressed and not dwell on the cause of your depression is a minute closer to being cured.

Finally, you need to make sure you get enough sleep. If your body does not have enough rest it will be more likely to get sick and have a direct effect on your mental state of being. To go along with this, make sure you aren't doing unhealthy things. These include excessive intake of alcohol and other stimulants like caffeine and even sugar. Some people start drinking heavily when they get depressed and this actually can make a depression worse instead of better. You also are more likely to make poor decisions when you are drinking.

Remember; the first one who should help you is yourself, you should seek for an immediate help if you don't notice any improve in your bad feelings, visiting a doctor could be the best option for your safety.

Methods To Conquer Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 21:51:00 +0000

Depression is a very common illness, however, the bad thing is that many people with depression don't try to find a suitable solution. If you are one of those suffering from depression, it is important to note that there are ways to overcome depression and you can actually seek treatment.

You have to understand that depression is more than just being down and sad. It can include symptoms like loss of interest in the things that you use to enjoy and may include difficulties of sleeping, loss of energy as well as weight loss. Not only that, it may also include thoughts of death or committing suicide, thus it is important for you to not wait for depression to destroy your life before seeking treatment.

Exercising your mind and body

Indeed, your thoughts, your emotions as well as your physical self will be drained with depression and finding ways to overcome depression as early as possible can be a wise move. You may start with some simple steps like having regular exercise to help you ease off the tension in your body. Meditation is also a good way to help you learn proper breathing and learning how to relax. It will also help you empty your mind and make you stay calmer.

Finding support groups

Finding support groups, from families, friends, to people suffering from the same disorder is also one of the good ways to overcome depression and manage its effects in your life. Talking about your disorder with people going through the same problem will also help you find new strength in dealing with the symptoms of depression.

Medical treatment

Medical treatment for depression often involves antidepressant medications, SSRIs and some anti-anxiety medications, although experts often recommend getting therapies together with medications and not just rely on drugs itself to successfully fight depression.

Psychotherapy and NLP

One of the most effective ways to overcome depression is through psychotherapy. In fact, psychotherapy is considered the most effective treatment for depression and other anxiety disorders and problems. Although there are many psychotherapy techniques used in treating depression, addiction and anxiety disorders
, NLP or Neuro-Linguistic Programming is found to have quick results when it comes to overcoming depression. NLP also allows you to overcome depression without having to take drugs and of course, a much healthier way to combat this disorder.

Not only does NLP help you fight your depression but also helps you in improving your life from your career, to interpersonal relationships and in gaining more self-confidence and self-esteem. Aside from depression, it also helps you overcome other hard to break habits as well as fears and phobias.

Aside from NLP, hypnotherapy as well as cognitive behavioral therapy or CBT are also other effective techniques that are used in overcoming depression, anxiety disorders
as well as treating phobias and fears.

Indeed, you can find more and more effective ways to help yourself overcoming depression, but the first step is to try to seek help, because when you do that, that will mean that you are aware and could do the best to help yourself.

Get Over Depression Without Any Medications

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 21:27:00 +0000

Any level of depression, even low level ones could prevent you from the daily required activities that you should do for yourself and your family. It also can drain the life out of activities that normally are a major source of enjoyment for you. Even though you may want to get back to your normal self as soon as possible, prescription medications may not be the best solution. You should learn how to overcome depression without medication before your symptoms gets worse.

Many times, mild depression can often be successfully self-managed. Depression treatment without drugs can involve many different approaches. Natural remedies and herbs for depression can help you feel more motivated to try new things and make positive life changes that you really want.

All that being said, natural treatments do work, they can be as beneficial if not more so than traditional medications, and the costs are not near as difficult to meet. Natural treatments include the use of herbs, botanicals, vitamins and other known nutritive substances. Taken either alone or in a supplement with other related nutrients, these treatments can be a true asset for sufferers.

One of the ways on how to overcome depression without medication includes herbs such as Chamomile known for its gentle relief of sleep problems. Dried Chamomile flower leaves are put in a cup and boiling water is poured over them to make a sweet tea. It is also known as a fever reducer and can boost metabolism and mood.

Dandelion is used in salads and as tea. Its roots are often used as a coffee substitute. The B vitamins' it contains supports the health of all internal systems. The leaves and roots of the Dandelion are used in supplements to treat liver, gall bladder, kidney, and joint problems. Because internal systems are working better, Dandelion may provide some relief of Depression and Anxiety problems.

B vitamins such as Thiamine, Riboflavin, and Pyridoxine provide relief of memory and mental functioning ability, supports a healthy nervous system, eases symptoms of depression and one Biotin in particular tends to help stabilize blood sugar, which improves metabolism, and finally depressive issues.

Omega 3/DHA Esters are found in fish oil and other foods as well. One of the purest and most effective sources of Omega 3 fatty acids is the Hoki fish found in the cold southern oceans of New Zealand. The oil comes from the body of the fish.

With all of these supplements, herbs, and vitamins on how to overcome depression without medication - in order to get the highest quality and most effective ones, they should be of pharmaceutical grade ingredients. To further ensure the purity and efficacy of supplements, the metabolic paths of each ingredient should have been evaluated at the molecular level and the interactions of the ingredients monitored.

This entire process will as already stated ensure the purity of the supplements, but it will further let you know that what is said to be in the supplements is actually in the particular one you are taking.

Get Over Depression and Anxiety Very Easily

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 21:00:00 +0000

The to disorders Anxiety and depression are considered as the worst disorders which a man can suffer. Anyone who suffer from him finds himself feels that they are impossible to overcome. If you are suffering from either depression or anxiety, here are some of the best ways to overcome both these illnesses.

Number 1: Inform the people you trust about your condition. This way, you can always have someone by your side whenever you feel anxious, worried, sad, hopeless or lonely. Having a support group can also be a big help in getting rid of anxiety and depression.

Number 2: You can go to a psychologist or therapist for consultations. Therapies have been developed and popularized specifically for dealing with depression and anxiety disorder. It will only take you a few sessions before you can get rid of these two mental ailments.

Number 3: Exercise as a part of your daily routine. It has been proven that regular exercise can help the body in producing serotonin and dopamine, which are chemicals essential for the feeling known as "pleasure".

Now, there are many types of exercises you can do. You can jog around your neighborhood or take a 15-minute brisk walk at the park. You can also try playing a good music and dance to it with your family members or friends. This way, you can enjoy, while staying in shape and getting rid of depression and anxiety disorder.

Number 5: You may also try to learn how to meditate. Deep guided meditation is a form of art that is recognized and practiced by many individuals for more than a thousand years. It has been proven to be effective in getting rid of many types of health problems aside from depression and anxiety disorder. It is also affordable and less time consuming. If you are new on this, you can start mediating for 3 minutes, and after a while you could expand it to 20 or 30 minutes per time.

Great Tips To Get Over Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 20:52:00 +0000

Depression is a very common illness today, due to fast and unmerciful life style many people get depressed very easily, however, there are some tips could help you overcoming depression very easily, here are some great ones:

1. Having self confidence and positive label to you yourself. Find back your self confidence is great start to overcome your depression and try to see you yourself with positive way. Then, how to make positive label? You must believe and convince yourself that you are awesome person, having good personality, having great skill, and you must rid negative thought to yourself and look back your successful.
2. Keep fighting and do not ever give up. Sometime, when depression comes in our life, our mind is covered by guilty feeling. Just calm yourself and try to think that there is still opportunity to fix it in the future. Don’t let your past follows your step, just forget it and look forward for your future. The past could not be changed and remember that the future is a golden chance. What you can do for this? First, try to make plan, what you must fix to overcome depress, second, re plan your goal, third make short goal as part of your long term goal. Those steps must be realistic. You can start from today by using resource you have and the place you live now. Avoid making unrealistic plan because it is not easy to reach it.
3. Limiting unsatisfied feeling. We know that depression comes from life’s pressure. Then, what make those pressures? Feeling not satisfied to your self has two effects, positive and negative effect but and it depend how to use it. Positive effect would build and encourage good satisfied feeling. It is because we need it to support us and give us more energy and spirit to look forward. Positive effect of depression could make us change, making new innovation, changing goal, improving skill, build positive character. It is better than you feel depression and blame other people.
4. Improving relationship. Sometime, we sink in the routine and forget to improve relationship. Relationship zone you must improve are; relationship to you yourself by self controlling, meditation and dialogue to you yourself; relationship to other; relationship to God.
5. Increasing tolerance. Sometime, we can’t tolerance what our fault while we demand perfection from other. Actually, we must try to build tolerance because it will improve our personality.

Just have your own decision, try some new activities, but focus on things you like. Don't try ever to look back what happened is already happened and you have all the future between your hands. Look forward . Believe in God.

Top 5 Methods to Help You Get Over Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 20:45:00 +0000

Nobody can think how depression is hard to be undertaken except a man who already suffered from depression. depression don't have an exact age for a human to come to him in, people of all ages, even children, can be depressed. Fortunately, there are ways to overcome your condition!

Here are the top five strategies to overcome your depression and regain your life:

1. Talk about it. If you find yourself unable to concentrate on anything, have lost your appetite, or are over-eating, try talking to a family member or trusted friend.

* Because you're depressed, you may not be able to get the help you need alone, so enlisting someone you trust is important.
* Don't feel embarrassed to talk about it. Chances are the people you confide in will know more about depression than you think.

2. Seek professional help. Many people avoid this for what they feel are good reasons: "My insurance won't cover it," or, "I can't afford it." In today's society, this is simply untrue.

* Many insurance companies do offer compensation for depression treatment because it's widely known as a serious medical condition. Plus, they aren't allowed to release treatment information to your employer.

* Even if you don't have medical insurance, many mental health centers or hospitals offer treatment free or on a sliding scale based on your income so that it can be affordable. Seek out help for your depression - it's the best thing you can do!

3. Become involved. Some people who suffer from depression find that the more they help others, the more they help themselves.

* For instance, a woman who was consumed with depression went to school and became a licensed therapist. Through her sessions with people, she was able to use her own depression experience to heal others.

* Volunteer at a local center for seniors or abused families. Many people in these centers tend to be depressed and working with them can give you insight on how to make yourself feel better.

4. Exercise. Surprisingly, exercise can help you feel better. The energy your body gets from yoga, walking, jogging, swimming, and fitness center exercise will help you immensely.

* The endorphins released during exercise can bring relief from your depression and give you the motivation to fight it.

* Enlist a friend if you don't want to exercise alone.

5. Get a pet. Animals of all sorts have been shown to help people with depression. Caring for a pet strengthens your ability to take on responsibilities. Plus, pets are joyful and can put a smile on your face!

* Even if you have allergies, there are many breeds of cats and dogs that don't produce allergens.

Using these tips can help you fight your depression, but the most important one is to seek professional help. A good therapist can suggest more techniques to help overcome your depression. Take these tips as suggestions and add your own creative spin to best suit your needs.

No advice can replace a full examination by your doctor. Depression comes in many forms and determining a plan of treatment for your individual needs is required.

If you're concerned about medication and side effects, there are also many homeopathic remedies available today that you can discuss with your health professional. Make a list of your concerns and share them during the exam. This way you'll be actively involved in choosing a treatment plan.

With some will, forgiveness to yourself, and a good plan with a therapist depression could be treated very effectively, just don't give up, will is every thing.

How to Get Over Depression Effectively

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 09 Oct 2010 19:51:00 +0000

Everybody of us experienced some times in his life when sadness and depression attacked him aggressively, in these time we felt extremely sad and bored. This feeling can be disturbing especially when a person seems so low and cannot overcome the obstacles that he is experiencing.
Many have thought that this emotional problem is not that serious to worry about. Studies have proven that this state of depression can be an illness and must be treated. Some depressed people may go to a physician for check up and consultation. It could be more advisable if the person would see a therapist.
Most depression therapists are very good in finding the reason why a person became depressed. The process in which a therapist treats depression is through emotional and psychological approach. On the other hand, a doctor will recommend patients to take anti depressant medicines. There are instances that have happened where a doctor treating a patient for depression was involved in such controversies where improper medications were applied.
An expert for depression would classify a depressed person if he shows some symptoms of significant weight loss, increase in appetite, loss of agility, or weight gain because of excessive eating. Others who are depressed may also encounter problems in sleeping or insomnia, over sleeping, decrease of sexual interest, and the lack of interest in lifestyle activities.
Some indications of depression may also come in a more emotional approach like the feeling of sadness and boredom, feeling of being a useless individual, the feeling of guilt to oneself, the feeling of being undecided to some simple decisions, and the decrease of the ability of the mind to think and concentrate. The most frightening symptoms of depression may come if a person is always thinking of his death or an individual wants to commit suicide.

Here are some ways to deal with depression in a personal approach:
1. A person must force himself to go outside. Do not even bother if the climate is not that good. Try to have a walk outside, read a book, or even try to write a poem. This can be an effective idea to overcome the depression rather than staying on the room alone.
2. It is always better if there are people that will support the person in depression. It is recommended that a person seek for a friend or a companion while he is still in the stage of recovering depression. If the individual is not use to this kind of therapy, the Internet should be a very good resort to find ways how to find ways to treat this kind of illness. It could be a little awkward to find some other people who are experiencing depression, but there is the possibility that there are others out there that can relate.
3. It is advisable for the individual to write what he feels at the moment. If there are no friends to tell what the problems are, he may try writing about the feeling so that the hatred or sadness will subside. Holding the feeling can just add more depression.
4. Meditation can be a good tool to overcome the depression. Deep breathing and good relaxation can relieve anxiety and pressure that may lead to depression.
Depression can be treated if the person realizes that he must also do his part on overcoming the illness. If you think all these methods can't do any good in helping you, or you have already tried some of them without a satisfying results, so, I would recommend you to visit a doctor or a therapist as soon as possible.

5 Methods to Overcome Depression After a Break Up

abo.elyosr@gmail.com (supporter2008@gmail.com) — Thu, 09 Sep 2010 20:48:00 +0000

Almost everyone of us suffered from a break up someday in our lives. The feelings of blues and sadness in this period is not easy and affects every activity we do in our daily work. Sometimes, symptoms persist and can become full blown depression. Lingering sadness, anxiety, lethargy, loss of joy in activities, changes in sleep and eating habits - these can be symptoms of depression that should be addressed. It is very important to take good care of yourself during this difficult time. Here are 5 strategies to help you get over the depression of a break up:

1. Eat well and healthy. Steer clear of junk foods and processed sugars, and eat mostly fruit, vegetables, lean proteins, and whole grains. If you have trouble with your appetite, try carrying around healthy snack foods to eat throughout the day. If the opposite is true and you overeat, try limiting your intake to meals, and be sure you aren't eating while distracted, like in front of the TV. Set a time to stop eating in the evening.

2. Try taking supplements. It is always advisable to consult your health care provider before trying new supplements. A food based multivitamin is a good start, as well as calcium if you need additional calcium, and fish oil. Fish oil has many physical benefits including the promotion of healthy brain function. L-theanine is a good anti-anxiety natural supplement, and 5 HTP (hydroxytryptophan) is a helpful natural antidepressant that increases serotonin, a mood regulating brain neurotransmitter.

3. Exercise regularly. Consult your physician to determine the appropriate level of physical activity for you, then adopt a regular cardiovascular-focused plan. This type of exercise releases endorphins into the body through the sustained elevation of heart rate. Try working up to 45 minutes 5 times a week. Not only will you feel better emotionally, but your physical health and body image will improve.

4. See a counselor to talk things out. Spend time with friends and family who can be supportive as well. A professional ear can be valuable and the feedback very beneficial. It may be helpful to have someone to help you sort out what went wrong in your relationship and how to avoid repeating future negative patterns in relationships.

5. Practice self care on a daily basis. Write a list for a daily activities that you like to do, cross every activity when you finish it, and when you finish the whole list make a new one.

How to Overcome Depression After having Divorce

abo.elyosr@gmail.com (supporter2008@gmail.com) — Mon, 09 Aug 2010 20:41:00 +0000

When a relation ship between a man and a woman such as marriage ends, the feeling of depression in that period is not easy. Whatever the reason for the split, whoever was responsible or even whether you wanted it or not- it still hurts. Your world is turned upside down and you are washed by a plethora of emotions and feelings. Holding your own and getting through this difficult time will take you time and effort. But believe me, you can do it. In all the stress, anger and sadness, you have the opportunity to come out as a wiser, stronger person. The best way to do it is to fight depression naturally.

If you are facing divorce, you must know that it is totally uncharted territory. It not only represents the loss of a relationship, but also of shared commitments and dreams. The world around you is disrupted, from responsibilities and routines, your relationships with the extended family to your home, your friends and even your own identity. You will find yourself wondering: What if I don't find someone else and end up alone? What does the future hold for me? True, all these questions hurt, but if you still find yourself mourning after months have passed, its time for treating depression the right way. Here are a few ways you can cure depression naturally:

* Accept the fact that it's the end of your marriage: Once you accept the fact that your relationship is no more, it will become easier to deal with it. Understand that it is ok to have varied emotions such as anger, betrayal, sadness, grief, frustration and confusion. Anxiousness about what the future holds is also common. Acceptance of these feeling will help you to fight the depression. Even if your marriage was not happy, thinking about life without your ex can make you distraught.
* Convince yourself to take a break: You are not a superman or a superwoman, right? Accept the fact that you are going through a difficult time and will not be able to behave as you normally do. Your productivity at work, your congeniality with friends and family or your eagerness to do daily chores may not be as high as before. That is normal. Give yourself time to heal. Snapping out of divorce depression is not easy. But you will move on, with time.
* Share: You had a divorce alone. That doesn't necessarily mean you have to fight depression alone. For fighting severe depression arising out of divorce, you need all the love and support you can get. Don't shun family and friends at this time. Talk to them, go out with them and let them into your life. Joining a support group of people in the same situation as you is a natural cure for depression. Do not get isolated.

Divorce is hard even if the marriage wasn't successful. Getting over depression from divorce will take concerted effort from your side. Just be merciful towards yourself. Because, just time and love will help you beating depression.

How to Overcome Severe Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sun, 08 Aug 2010 21:14:00 +0000

Till today, there is no exact reason for why depression could be severe or normal. However, doctors and scientists are still doing a regular research to know for exact what is the real reason. Some of the causes that are believed to be the causes of depression are, Biological and genetic reasons. Apart from these stress and emotions also are the biggest reasons of depression. It is very difficult to get rid of depression when it is severe. There are so many types of depression that fall in the category of severe depression. Clinical depression, chronic disorders, bipolar disorders and major depression are some of the types of depression with severe symptoms. Depression with severe symptoms usually last for long time. Most of the treatment methods do not respond to severe depression. Here are the symptoms of severe depression :

1. Irritated, sad and angry mood all day.

2. Sleeping disorders Insomnia (conditions of sleeplessness) or Hypersomnia (conditions of over sleeping more than 20 hours a day) almost everyday.

3. Illusions, patient may hear sounds that a normal person does not. Inability to distinguish between reality and imagination.

4. Poor appetite as a result of which weight loss or weight gain.

5. Decreased interest in all the enjoyable activities.

6. Baseless feelings of illness.

7. Suicidal thoughts start developing in your mind, suicidal attempts by patient.

8. Inability to concentrate on even small things.

The best way to get over severe depression is to go for proper treatment at the right time. So many treatment methods are available to get over severe depression. One of the most commonly used methods are Medication, medicines and drugs are used in this form of treatment method. It is a good but not the best way to get over severe depression as there are so many side effects associated with it. The chance of relapsing with this type of depression is very much.

Psychotherapy is one of the best methods to get over severe depression. Psychotherapy responds very well to all forms of depression. Cognitive behavioral therapy and interpersonal therapy are the best psychotherapy methods. Various mood swings and behavior of the patient is monitored, a specialist talks to the patient and looks at those things that are the reasons for depression in the patient. This method does not respond to all the patients.

ECT (Electroconvulsive therapy) is also a very best method to get over severe depression. The best thing about this method is, it responds to those patients that do not respond to Medication and psychotherapy treatment methods. It is the fastest treatment method to get over depression. It is a bit expensive method as compare to the other methods. Those that have gone through this method have nothing to say against it. There are some fake rumors about ECT that it is not the best way to cure depression, that's the reason it is not as common as other treatment methods.

Other good method which could be done at home is to have a warm bath, classic music, have a daily workout and training as it is a proven way to convert your stress into a sweat, these methods are also proven and could give you amazing results if done in a regular basis.

Proven Ways To Overcome Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Wed, 07 Jul 2010 20:54:00 +0000

Antidepressants drugs are always the first things people think about when suffering from any kind of depression. However, for expert doctors this kind of drugs should only be used as a last option to overcome psychiatric disorder. The drawbacks of these drugs are their side effects such as anxiety, sleeplessness, weight gain and aggressive behavior. Though they are effective in some cases, they are sometimes not enough to relieve all the symptoms associated with depression like fatigue and physical pain.

The natural ways to treat depression are much cheaper than prescription drugs and are also considered to be effective. These include exercise, meditation, sleep, NLP and hypnosis as well as having a balanced diet.

Exercise is one of the good ways to treat depression because it acts as a mood booster and is believed to be better than prescription medications in preventing the recurrence of mild to moderate depression.

Meditation is beneficial in treating depression by controlling negative thinking like failure and worthlessness. Getting enough sleep at night is also good to avoid a depressed mood which is commonly associated with sleeplessness. Diet is about eating healthy foods especially those that help produce serotonin like oats, bananas and whole wheat. Other foods that are good for those with depression are foods that are rich in omega-3 fatty acids like salmon and tuna and folic acid like beans and peas.

Yoga and acupuncture are also some of the other alternative ways to treat depression. Yoga helps alleviate the symptoms of depression because it quiets the mind and gets you into focus. The old practice of acupuncture on the other hand, does not only restore your body's emotional balance but also lessens the physical pain associated with depression.

These natural ways to treat depression are more preferred by many over prescription drugs because antidepressants and sleeping tablets can be addictive and may result to additional problems. But if the patient is already taking prescription antidepressants, you have to check with your physician if any of these alternative treatments will be good for your case.

When it comes to natural supplements, the herb St. John's wort is also considered effective in managing symptoms of depression. Passion Flower is another remedy that helps dispel depressed feelings and supports a positive mental behavior.

Since stress helps trigger depression, you should also learn to manage stress effectively and avoid taking illegal drugs or those that were not prescribed by your doctor to avoid substance abuse.

Psychotherapy is another option in treating depression. It is recommended to help relieve the symptoms of depression like anger or despair to regain self-control and sense of happiness. NLP and hypnosis have also been used in conquering depression and the many psychological factors and symptoms that comes with it.

In some cases, supportive care that involves counseling sessions with your doctor is also as helpful as prescription antidepressants. It would also help a lot if you get support from family as well as from other people having this disorder. Other treatment being considered is the combination of behavioral, cognitive and interpersonal therapy.

Aside from these ways to treat depression, there is also the electroconvulsive therapy or electroshock, which uses electric current in stimulating nerve cells. However, this method is still under experiment because of its long term and side effects which can give to the patient.

Descriptive Aspects Of Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Mon, 17 May 2010 11:34:00 +0000

Depression is one of the most common psychiatric disorders and, from a societal perspective, is perhaps the most costly. Depression is also a highly recurrent disorder with an increasingly younger age of onset for the initial episode. In the six chapters in this part, the authors discuss issues concerning the onset and course of depression, its prevalence and societal costs, and important factors involved in studying this disorder. Kessler (Chapter 1) describes epidemiological aspects of depression: its prevalence and its economic cost.

Boland and Keller (Chapter 2) discuss the course and outcome of this disorder, describing the results of several large-scale longitudinal investigations that have monitored the course of depression over many years. Nezu, Nezu, McClure, and Zwick (Chapter 3) describe the most widely used interview-based and self-report measures of depression, and discuss important issues involved in the assessment of this disorder. Extending this discussion, Ingram and Siegle (Chapter 4) describe a number of methodological issues in the study of depressive disorders, and make several noteworthy recommendations concerning how research in this area might proceed most fruitfully. Klein, Durbin, Shankman, and Santiago (Chapter 5) then describe the nature of the relation between depression and various aspects of personality functioning. Finally, Johnson and Kizer (Chapter 6) discuss similarities and differences in the clinical phenomenology and psychosocial predictors of unipolar and bipolar depression.

Epidemiology of Depression

Ronald C. Kessler

The first modern North American general population epidemiological surveys that included information about depression were carried out in the late 1950s in the Midtown Manhattan Study (Srole, Langner, Michael, Opler, & Rennie, 1962) and the Stirling County Study (Leighton, Harding & Macklin, 1963). These early surveys used dimensional screening scales of nonspecific psychological distress to pinpoint respondents with likely mental disorders and then administered clinical interviews to these respondents. The outcome of primary interest was a global measure of mental disorder rather than individual diagnoses. No prevalence estimates of depression were reported. However, the screening scales in these studies included a number of items that assessed depressed mood and other symptoms that have subsequently come to be seen as part of the depressive syndrome. It is possible to make rough estimates about the prevalence and correlates of depressive disorders from these data (Murphy, Laird, Monson, Sobol, & Leighton, 2000).

In later surveys, variants on the screening scales used in the Midtown Manhattan and Stirling County studies were generally used without clinical follow-up. (See Link & Dohrenwend, 1980, for a review.) Scale scores were sometimes dichotomized in order to define “cases” of mental disorder based on some external standard of a clinically relevant cutpoint, although there was ongoing controversy about the appropriate decision rules for defining cases (Seiler, 1973). In order to resolve this controversy, structured diagnostic interviews appropriate for use in community surveys were developed in the late 1970s. The Diagnostic Interview Schedule (DIS; Robins, Helzer, Croughan, Williams, & Spitzer, 1981) was the first of these instruments. Dimensional screening scales continued to be widely used to screen for mental illness in primary care (Goldberg, 1972) and to assess symptom severity and treatment effectiveness among patients in treatment for mental disorders (Derogatis, 1977) even after the introduction of the DIS. However, psychiatric epidemiologists, influenced by the widely published results of the Epidemiologic Catchment Area Study (Robins & Regier, 1991), which was based on the DIS, abandoned the study of dimensional distress measures in favor of dichotomous caseness classifications in general population surveys. We now have had 2 decades of experience with community epidemiological surveys using fully structured diagnostic interviews like the DIS and the more recently developed CIDI (Robins et al., 1988), PRIME-MD (Spitzer et al., 1994), and MINI (Sheehan, Lecrubier,

Sheehan, Amorim, & Janavs, 1998). It is clear from this experience that fully structured diagnostic interviews, while very useful, are inadequate by themselves to provide the information needed by health policy planners on the magnitude of the problem of untreated seriousdepression. The reason for this is that the DSM and ICD criteria are so broad that close to half of the people in the general population receive one or more diagnoses on a lifetime basis (Kessler et al., 1994) and close to one-fifth at any one point in time (Kessler & Frank, 1997). With prevalences as high as these, the dichotomous caseness data provided in diagnostic interviews need to be supplemented with dimensional information on severity to be useful to health policy planners (Regier et al., 1998).

Unfortunately, the most recently available adult general population epidemiological data on the prevalence of major depression do not include dimensional severity measures.

This is an especially important omission in light of the suggestion by some commentators that the majority of community cases who meet criteria for major depression have fairly mild disorders (Regier, Narrow, Rupp, Rae, & Kaelber, 2000). The World Health Organization (WHO) is currently carrying out a massive worldwide epidemiological survey of mental disorders, known as the World Mental Health 2000 (WMH2000) Initiative, that aims to correct this problem by evaluating a wide range of mental disorders both with dichotomous diagnostic measures and with dimensional clinical severity measures (Kessler & Ustun, 2000). However, WMH2000 results will not be available for another 2 years.

The first section of this chapter presents a broad overview of the main findings in the literature regarding the descriptive epidemiology of major depression. The overview is brief because much of this literature has recently been reviewed elsewhere (Lewinsohn, Rohde, Seeley, Klein, & Gotlib, 2000; Merikangas, 2000; Blazer, 2000; Horwath & Weissman, 1995; Bland, 1997). The second section of the chapter addresses the issue of severity by reviewing available data on the consequences of depression as assessed in community surveys. The third section, finally, reviews epidemiological data on patterns of help seeking for depression.

DESCRIPTIVE EPIDEMIOLOGY

Point Prevalence

Community surveys that assess depression with symptom screening scales find that up to 20% of adults and up to 50% of children and adolescents report depressive symptoms during recall periods between 1 week and 6 months (Kessler, Avenevoli, & Merikangas, 2001). There is a U-shaped distribution of mean scores in these surveys in relation to age, with the highest scores found among the youngest and the oldest respondents and the lowest scores found among people in midlife (Kessler, Foster, Webster, & House, 1992). Point prevalence estimates for DSM major depression in surveys that use structured diagnostic interviews are considerably lower. Rates of current major depression are typically less than 1% in samples of children (reviewed by Merikangas & Angst, 1995), as high as 6% in samples of adolescents (reviewed by Kessler, Avenevoli, & Merikangas, 2001), and in the range 2–4% in samples of adults (WHO International Consortium in Psychiatric Epidemiology, 2000).

The discrepancy between the high prevalence of symptoms in screening scales and the comparatively low prevalence of depressive disorders means that many people have subsyndromal depressive symptoms. Recent epidemiological studies have started to investigate these subsyndromal symptoms using the diagnostic criteria for minor depression and recurrent brief depression (RBD) stipulated in DSM-IV-TR (American Psychiatric Association, 2000). Major depression (MD) requires 2 weeks of clinically significant dysphoria or anhe
Epidemiology of Depression 25

donia (or irritability among children) along with a total of five symptoms. Minor depression (mD), in comparison, requires two to four symptoms with the same severity and duration requirements as MD, while RBD requires the repeated occurrence of the same number and severity of symptoms as MD for several days each month over the course of a full year.

These recent studies have documented rates of subsyndromal depression among both adolescents (Gotlib, Lewinsohn, & Seeley, 1995; Kessler & Walters, 1998) and adults (Judd, Akiskal, & Paulus, 1997; Kessler, Zhao, Blazer, & Swartz, 1997) that are as high as, if not higher than, the rates of MD. In addition, a longitudinal study of adolescents followed into adulthood found that subsyndromal depression is a powerful predictor of the subsequent onset of MD (Angst, Sellaro, & Merikangas, 2000).

Subtypes

A number of proposals have been made to subtype the diagnosis of MD based on symptom profiles (reviewed by Kendell, 1976). The only stable subtyping distinction that has emerged consistently in empirical epidemiological studies, however, is between depression with vegetative symptoms (e.g., weight loss, insomnia, appetite loss) and reverse vegetative symptoms (e.g., weight gain, hypersomnia, appetite increase) (Davidson, Woodbury, Pelton, & Krishnan, 1988; Eaton, Dryman, Sorenson, & McCutcheon, 1989). Between onefourth and one-third of all people with MD have a reverse vegetative symptom profile, with some evidence that this atypical depression is more common among women than men and more strongly associated than vegetative depression with a family history of depression. There is little evidence, in comparison, that atypical depression is more persistent or severe than typical depression. Indeed, in one recent analysis of depression subtyping, typicality and severity emerged as separate and largely independent subtyping dimensions (Sullivan, Kessler, & Kendler, 1998).

Another important subtyping distinction concerns the existence of cyclical depression.

Two cycling depressive subtypes have been identified: seasonal affective disorder (SAD; Rosenthal et al., 1984) and premenstrual mood disorder (PMD; Halbreich, 1997). Community surveys find that 10% or more of people in the general population report seasonal variations in depressed mood and related symptoms (e.g., Booker & Hellekson, 1992; Rosen et al., 1990). Seasonal depression is typically most common in the winter months and more prevalent in northern than southern latitudes. However, the prevalence of narrowly defined DSM seasonal affective disorder, which requires a lifetime diagnosis of recurrent MD or mD and at least two-thirds of all episodes following a seasonal pattern, is much less common. Blazer, Kessler, and Swartz (1998) found that only 1% of the population meet narrowly defined criteria for SAD, representing only about 5% of all people with mD or MD. Among people with clinical depression, Blazer et al. found that SAD was somewhat more common among men than women and older than younger respondents.

Community surveys show that the majority of women report experiencing some symptom changes associated with their menstrual cycles (Pearlstein & Stone, 1998; Olive, 1991).

Only between 4 and 6%, however, report what appears to be a PMD (Sveindottir & Backstrom, 2000). A diagnosis of PMD requires a clear and recurring pattern of onset and offset of five or more mood and related symptoms at specific points in the majority of menstrual cycles over the course of a full year. Assessments with daily mood diaries over two or more menstrual cycles (Freeman, DeRubeis, & Rickels, 1996) typically show that only about half of the women who report cyclical mood problems actually suffer from PMD. The others have more chronic syndromal or subsyndromal mood disorders that are sometimes exacerbated by menstrual symptoms. There is currently a great deal of interest in PMD among depression researchers based on evidence of family aggregation with major depression (Yonkers, 1997) and responsiveness to selective serotonin reuptake inhibitors but not tricyclic antidepressants (Freeman, Rickels, Sondheimer, & Polansky, 1999). However, there is also controversy regarding appropriate diagnostic and assessment criteria (Severino, 1996). Community epidemiological data are scant due to the logistic complications created by the fact that a definitive diagnosis requires the collection of daily mood diaries across two or more menstrual cycles. Such diaries are typically collected only in clinical samples, although there are a few small community surveys that have collected diary data as well (e.g., Sveindottir & Backstrom, 2000). Given the existence of so many uncertainties in this area of investigation, a large representative epidemiological survey of PMS using dairy methods would be very valuable.

Lifetime Prevalence

Epidemiological surveys that administer diagnostic interviews generally assess lifetime prevalences of MD and estimate age of onset distributions from retrospective reports (e.g., Christie et al., 1988). Lifetime prevalence estimates of MD in U.S. surveys have ranged widely, from as low as 6% (Weissman, Bruce, Leaf, Florio, & Holzer, 1991) to as high as 25% (Lewinsohn, Rohde, Seeley, & Fischer, 1991). The only nationally representative general population data in the United States based on a structured diagnostic interview come from the National Comorbidity Survey (NCS; Kessler et al., 1994), where 15.8% of respondents met criteria for a lifetime MD episode and an additional 10.0% of respondents met criteria for lifetime mD (Kessler, Zhao, et al., 1997).

The wide variation in prevalence estimates across surveys is probably due to a combination of at least three factors. First, as discussed in more depth below, the prevalence of depression has probably increased in recent cohorts. This means that earlier surveys would be expected to have lower prevalence estimates than more recent surveys. Second, reluctance to admit depression has decreased in recent cohorts, which will also increase prevalences in more recent surveys. The third factor involves an important methodological difference between the diagnostic interviews that were used in early surveys based on the Epidemiologic Catchment Area (ECA) program (Robins & Regier, 1991), which uniformly produced very low prevalence estimates, and the more refined diagnostic interviews used in recent surveys such as the NCS, the Mental Health Supplement to the Ontario Health Survey (Offord et al., 1994), and the Mexican-American Prevalence and Services Survey (Vega et al., 1998). Both types of interviews use a stem–branch structure to assess mental disorders. In this approach, respondents are first asked one or more initial questions about core symptoms of the disorder under investigation. For example, a stem question for MD might be “Did you ever have a time lasting 2 weeks or longer when you felt sad or depressed most of the day nearly every day”? The respondents who are affirmative are then administered a more detailed set of follow-up questions that assess all criteria of the disorder. This same stem–branch approach is used to assess each of the dozen or more diagnoses evaluated in the surveys.

While both the type of interview used in the ECA and the type of interview used in the NCS were based on this stem–branch structure, only the NCS interview was designed to minimize the underreporting problems that methodological studies have shown to occur in interviews of this sort. A detailed discussion of the instrument design issues is presented elsewhere (Kessler, Wittchen, Abelson, & Zhao, 2000). In brief, methodological studies show that stem–branch questions are prone to two types of underreporting bias (Bradburn, Sudman, & Associates, 1979; Turner & Martin, 1984). One is that some respondents underreport stem questions once they recognize that positive responses lead to more detailed questions. The other is that most respondents fail to appreciate the cognitive complexity of he memory search involved in answering stem questions that require lifetime recall. These problems were addressed in the NCS by developing a Life Review Section near the beginning of the interview that included the stem questions for all the disorders assessed in the survey. The respondent instructions in this section were designed to facilitate and motivate active memory search. This entire section was administered before probing any positive stems, thus avoiding conscious nondisclosure once respondents recognized that positive stem responses led to further questioning. A field experiment carried out after the completion of the NCS randomly assigned respondents to either asked stem-and-branch questions in sequence throughout the interview or a version that included the Life Review Section and then validated diagnoses with clinician-administered reinterviews. Two important results emerged from this experiment. First, the Life Review Section was found to increase the prevalence estimates of depression and other disorders enough to explain the large observed differences in prevalence estimates between the ECA and the NCS. Second, the clinical reinterviews showed that the additional cases discovered with the Life Review Section were genuine cases of depression rather than false positives (Kessler, Wittchen, et al., 1998).

Based on these results, it seems safe to conclude that at least one out of every six adults in the U.S. population has met criteria for an MD episode at some time in their life and one in four has met criteria for either MD, mD, or recurrent brief depression. It is important to recognize, though, that these are estimates of prevalence-to-date risk rather than lifetime risk. Kaplan–Meier (KM) age-of-onset curves can be used to generate lifetime risk estimates. As shown in Figure 1.1, which presents KM curves separately for MD and mD based on the NCS data, the lifetime risk projections based on these curves are considerably higher than the lifetime-to-date prevalence estimates.

In evaluating the KM curves in Figure 1.1, it is important to recognize that the lifetime risk projections they generate are based on the assumption that conditional risk of first onset at given ages is constant across cohorts. This assumption is incorrect. As shown in FIGURE 1.1. Age of onset of major and minor depression in the NCS.

Figure 1.2, the KM curves for MD and mD combined in the NCS differ substantially by cohort. The same general pattern holds when we examine MD and mD separately (Kessler, Zhao, et al., 1997). This pattern of intercohort variation could be due to the risk of depression increasing in successively more recent cohorts. Other possible causes are that willingness to admit depression in a survey might have increased in recent cohorts (Kessler, 2000a) and that forgetting a past history of depression might increase with age (Giuffra & Risch, 1994). There is no way to adjudicate among these contending interpretations definitively with available data, although indirect evidence strongly suggests that at least part of the apparent cohort effect is due to a true increase in risk of depression in recent cohorts (Weissman & Klerman, 1992).

Course

Little longitudinal research has been done to study the course of depression in general population samples (but for important exceptions, see Angst & Merikangas, 1997; Lewinsohn et al., 2000). However, cross-sectional surveys consistently find that the prevalence ratio of 12-month MD versus lifetime MD is in the range between .5 and .6 (Kessler, McGonagle, Swartz, Blazer, & Nelson, 1993; Weissman et al., 1991). This means that between half and two-thirds of people who have ever been clinically depressed will be in an episode in any given year over the remainder of their lives. At least three separate processes contribute to the size of this ratio: the probability of a first episode becoming chronic; the probability of episode recurrence among people with a history who are not chronically depressed; and speed of episode recovery among people with recurrent episodes.

Epidemiological studies show that the first of these three processes is quite small, with only a small fraction of 1% of people in the population reporting a single lifetime depressive episode that persists for many years (Kessler et al., 1993). The prevalences of dysthymia FIGURE 1.2. Age of onset of major and minor depression by cohort in the NCS.

and chronic mD are somewhat higher, but still only in the range 3–4% combined in the total population (Kessler et al., 1994). Episode recurrence, in comparison, is very common, with more than 80% of people with a history of MD having recurrent episodes. In the NCS, the median number of episodes was seven among respondents with an age of first onset more than a decade prior to the interview. Moreover, over 90% of all episodes in the year prior to the interview were recurrences rather than first onsets. Speed of episode recovery, finally, appears to be highly variable, although the epidemiological evidence is slim. Only two large community surveys have studied speed-of-episode recovery. One found that 40% of cases of MD recovered by 5 weeks and over 90% by 1 year (McLeod, Kessler, & Landis, 1992). The other found that the median time to recovery was 6 weeks, with over 90% recovered within a year (Kendler, Walters, & Kessler, 1997). Very few of the people with short episodes ever come to clinical attention, which means that time to recovery is considerably longer in clinical samples (e.g., Brugha et al., 1990).

Distinguishing First Onset from Recurrence

It is important to distinguish between first onset and recurrence in studying the predictors of depression episode onset because the two types of episodes have different predictors (Lewinsohn, Allen, Seeley, & Gotlib, 1999). For example, women are nearly twice as likely as men to become depressed for the first time, while most epidemiological studies find no sex difference in recurrence risk (Kessler et al., 1993). History of depression is not only a powerful predictor of episode onset, but it is also strongly related to stressful events such as divorce and job loss and to presumed stress buffers such as social support and neuroticism (Kessler & Magee, 1993). Because of these relationships with all three of the main variables in models of the relationship between stress and depression (i.e., stress, stress buffers, and depression), failure to control for history of depression can lead to substantial bias in stress models. Yet most epidemiological studies that attempt to discover risk factors for episode onset of depression fail to include a control for history of prior episodes (Kessler, 1997a). A complicating factor is that risk of spontaneous recurrence of depressive episodes increases with number of prior episodes (Ghaziuddin, Ghaziuddin, & Stein, 1990). This means that it is important not only to control for history of depression in studies of the predictors of episode onset, but also to control for number of prior episodes and to estimate interactions between number of prior episodes and other predictors (Hammen & Gitlin, 1997).

Comorbidity

Studies of diagnostic patterns in community samples show that there is substantial lifetime and episode comorbidity between depression and other mental and substance use disorders. Indeed, comorbidity is the norm among people with depression. The ECA study found that 75% of respondents with lifetime MD also met criteria for at least one of the other DSM-III disorders assessed in that survey (Robins, Locke, & Regier, 1991), while the comparable proportion of DSM-III-R (American Psychiatric Association, 1987) comorbidity in the NCS was 74% (Kessler, 1995). There is controversy concerning the extent to which these high rates of comorbidity are artifacts of changes in the diagnostic systems used in almost all recent studies of comorbidity (Frances et al., 1992). In the United States, these systems, beginning with DSM-III (American Psychiatric Association, 1980) and continuing through DSM-IV-TR (American Psychiatric Association, 2000), dramatically increased the number of diagnostic categories and reduced the number of exclusion criteria so that many people who would have received only a single diagnosis in previous systems now receive multiple diagnoses.

differentiating information that could be useful in refining understanding of etiology, course, and likely treatment response (First, Spitzer, & Williams, 1990). However, it could also be argued that it had the unintended negative consequence of artificially inflating the estimated prevalence of comorbidity.

This uncertainty will presumably be resolved in the future by using established criteria to determine the validity of diagnostic distinctions (Cloninger, 1989). Until that time, though, we are left with a situation in which it appears that depression is highly comorbid with a number of other disorders. The strength of these comorbidities is remarkably consistent between the ECA and NCS surveys, the two largest general population surveys in the United States that have estimated comorbidities among DSM disorders (Kessler, 1995). The strongest lifetime comorbidities (odds ratios) of depression in both these surveys are with anxiety disorders, especially generalized anxiety disorder (6.0), panic disorder (4.0), and posttraumatic stress disorder (4.0), although less powerful but still significant comorbidities are found with a wide range of other mental disorders (Kessler, 1997b). Episode comorbidities are generally somewhat stronger, indicating that comorbidity is associated with recurrence risk (Kessler, 1995).

The majority of comorbid depression is temporally secondary in the sense that the first onset of depression occurs subsequent to the first onset of at least one other comorbid disorder, although this is more true among men than among women. Survival analysis of the cross-sectional NCS data using retrospective age-of-onset reports to determine temporal priority shows that a wide range of temporally primary anxiety, substance abuse, and other disorders predict the subsequent first onset of depression (Kessler et al., 1996). Time-lagged effects are strongest for generalized anxiety disorder (7.6) and simple phobia (4.2). There is little evidence of change in these odds ratios as a function of time since onset of the primary disorder. This absence of a time gradient is inconsistent with the hypothesis that secondary depression is a general exhaustion response to unremitting anxiety (Akiskal, 1990). At the same time, most of these odds ratios are confined to effects of active primary disorders as opposed to remitted primary disorders. This means that people who currently have these other disorders are at risk of depression. The fact that history of remitted anxiety is generally not associated with risk of depression suggests indirectly that anxiety is a risk factor rather than a risk marker. Two important exceptions, though, are early-onset simple phobia and panic, both of which appear to be markers rather than risk factors. The key evidence here is that people with a history of these disorders have elevated risk of subsequent first onset of depression even when the primary disorders are no longer active (Kessler et al., 1996).

THE CONSEQUENCES OF DEPRESSION

Psychiatric epidemiologists have traditionally been much more interested in estimating prevalences and discovering modifiable risk factors (e.g., Eaton & Weil, 1955) than in studying the consequences of mental illness (e.g., Faris & Dunham, 1939). This situation has changed in the past decade, though, as the managed care revolution and the rise ofevidence-based medicine have made it necessary to document the societal costs of illness (Gold, Siegel, Russell, & Weinstein, 1996). Depression has emerged as an important disorder in this new work. Indeed, the World Health Organization Global Burden of Disease (GBD) Study ranked depression as the single most burdensome disease in the world in terms of total disability-adjusted life years among people in the middle years of life (Murray & Lopez, 1996).

Role Impairment

It was noted in the introduction that the estimated prevalence of depression and other mental disorders in recent epidemiological surveys has been so high that some commentators have speculated that most must be mild cases (e.g., Regier et al., 2000). This speculation is superficially inconsistent with the GBD conclusion that depression is associated with more societal burden than any other condition. However, the GBD relied on expert opinion rather than epidemiological data to rank-order the impairments of chronic conditions. The expert raters were most familiar with clinical cases. It is possible that the cases found in community surveys are less seriously impaired.

The Medical Outcomes Study (Wells et al., 1989) collected data on this issue by screening samples of primary care patients for a small number of sentinel conditions that included MD and following these patients over time to evaluate their medical costs and role functioning. The role impairments caused by depression were comparable to those caused by seriously impairing chronic physical disorders. Similar results were found in the nationally representative general population sample assessed in the MacArthur Foundation’s Midlife Development in the United States (MIDUS) survey. The MIDUS results suggest that the role impairments caused by depression are comparable to those caused by such chronic physical disorders as arthritis, asthma, diabetes, and hypertension (Kessler, Mickelson, Barber, & Wang, 2001).

A substantial part of the role impairment caused by depression involves reduced work performance. A recent economic analysis of the costs of depression in the workplace estimated that the annual salary-equivalent costs of depression-related lost productivity in the United States exceeds $33 billion (Greenberg, Kessler, Nells, Finkelstein, & Berndt, 1996).

This is an underestimate of the overall workplace costs of depression because it excludes such potentially important components as the effects of depression on the performance of coworkers, industrial accidents, and turnover. It is important to note that these effects of depression on work performance disappear among remitted cases (Kessler & Frank, 1997), suggesting that effective depression treatment would reduce workplace costs. Simulations suggest that employers could recover between 45% and 90% of the direct treatment costs of depression in improved salary-equivalent work performance over the course of a single year (Kessler, Barber, et al., 1999). It is plausible to imagine that a complete cost accounting that considered the effects of depression on a broader set of workplace outcomes would show that the direct costs of depression treatment are fully offset by decreased indirect workplace costs. A definitive effectiveness trial to evaluate this hypothesis has not yet been carried out, although depression treatment trials have consistently documented significant effects of treatment on work outcomes (Mintz, Mintz, Arruda, & Hwang, 1992; Wells et al., 2000).

Role Transitions

It was noted in the discussion of the GBD study that depression has a unique constellation of characteristics leading to its rating by the World Health Organization as the single most burdensome chronic condition in the world among people in the middle years of life.

Perhaps the most important of these is early age of onset. The median age of onset of MD (see Figure 1.1) is in the mid-20s. This is at least 2 decades earlier than the median ages got-1.qxd 4/4/02 11:34 AM Page 31DESCRIPTIVE ASPECTS OF DEPRESSION 32 of onset of the chronic physical disorders that have prevalences and impairments comparable to those of depression. One important implication of this early age of onset is that depression, unlike most chronic physical disorders, occurs at a time in the life course when it can have a profound effect on critical life course role transitions. The latter include educational attainment, entry into the labor force, parenting, and marital timing and stability.

A series of analyses based on the NCS used retrospectively dated age of onset reports to estimate the effects of depression and other mental disorders on early life role transitions.

An investigation of the effects of early-onset depression on educational attainment found that depression prior to completing high school significantly predicted (odds ratio) high school dropout (1.5) and, among high school graduates, predicted failure to enter college (1.6) (Kessler, Foster, Saunders, & Stang, 1995). Depression as of the age of high school completion powerfully predicted college dropout among respondents who went to college (2.9). A separate investigation of the effects of early-onset depression on teen childbearing found that depression is associated with a 2.2 relative odds of teenage pregnancy among both girls and boys as well as with elevated rates of failure to contracept (Kessler, Berglund, et al., 1997). An investigation of the effects of early-onset depression on marital timing and stability, finally, found that prior depression predicts both teenage marriage (2.3) and subsequent divorce (1.7) (Kessler, Walters, & Forthofer, 1998).

It is important to appreciate that this constellation of truncated education, early childbearing, and marital instability are central components of welfare dependency. It is little wonder, then, that the welfare-to-work experiments that have been carried out in conjunction with recent state welfare reform programs have documented high rates of depression among welfare mothers and significant adverse effects of maternal depression on making a successful transition from welfare to work (Danziger et al., 2000; Olson & Pavetti, 1996).

This is another example of a case in which the societal costs of not treating depression may be greater than the costs of treatment. We are unaware, though, of any trial to evaluate the cost-effectiveness of providing mental health treatment as a component of the services provided to welfare mothers to facilitate the transition from welfare to work.

Other Adverse Consequences of Depression

It was noted in the last subsection that the financial savings to the employer due of increased work productivity with the remission of depression might approach or exceed the direct costs of treating depressed workers. The critical experiment needed to test this hypothesis has not yet been carried out. However, another type of experiment has been carried out that documents a cost saving of depression treatment for managed care.

Specifically, services research shows that people with untreated depression are often heavy users of primary care medical services for vaguely defined physical complaints. This observation has led some clinical researchers to speculate that systematic screening, detection, and treatment of primary care patients with depression might lead to an overall reduction in primary care costs. A series of experiments have shown that a partial offset effect of this sort exists (Katon et al., 1996; Katzelnick et al., 2000). The vast majority of depressed patients detected in primary care screening accept treatment for their depression. The average total cost of these patients to the managed care system exclusive of the cost of their depression treatment decreases significantly after their depression is treated.

This reduction partially offsets the cost of depression treatment over a follow-up period of 1 year. It is conceivable that the total costs of depression treatment are recovered over a longer time period, but long-term follow-up studies have not yet been carried out to determine whether this is the case.

EPIDEMIOLOGICAL STUDIES OF HELP SEEKING

Speed of Initial Treatment Contact

The findings reviewed above concerning the adverse effects of early-onset depression on role transitions raise an obvious question: Would timely treatment prevent these effects? We do not know the answer because the critical experiment has never been carried out. We do know, though, that timely treatment is the exception rather than the rule and that this is especially true for early-onset cases. This evidence comes from parallel studies of speed of initial treatment contact based on analysis of the NCS (Kessler, Olfson, & Berglund, 1998) and the Mental Health Supplement to the Ontario Health Survey (Olfson, Kessler, Berglund, & Lin, 1998). Both of these surveys asked respondents with a history of depression if they had ever sought treatment and, if so, their age of first obtaining treatment.

Comparisons of reported ages of onset with ages of first obtaining treatment were used to study patterns and correlates of delay in seeking treatment. The results were consistent in the two surveys in showing that delays in initial help seeking are pervasive. Only about onethird of the people who ever sought treatment did so in the same years as the first onset of their MD, while the median delay among those who did not seek immediate treatment was more than 5 years. Even more striking was the consistent finding that speed of contact is strongly related to age of onset. The vast majority of respondents who reported first onsets of depression in middle age or later sought treatment soon after the onset. Respondents with first onsets in early adulthood, in comparison, were much slower to seek treatment.

Respondents with child or adolescent onsets, finally, were by far the slowest of all, with median delays of more than a decade. It is not clear why this is the case, but one plausible hypothesis is that youngsters must rely on adults to initiate a treatment referral. Whatever the case may be, this is an especially disturbing pattern for two reasons. First, early-onset depression is often more severe than later-onset depression. Second, as noted above, earlyonset depression has powerful effects on critical developmental transitions that affect wellbeing throughout life. These results strongly suggest that special efforts are needed to reach out to children and adolescents with depression

Current Service Use

Turning from speed of initial lifetime help-seeking to treatment at a point in time, data from two nationally representative epidemiological surveys in the United States show that between one-third and one-half of the people who meet criteria for MD in a given year obtain some type of treatment for their depression during that year (Kessler, Zhao, et al., 1999; Wang, Berglund, & Kessler, 2000). A substantial proportion of this treatment occurs in the general medical sector. Unfortunately, analysis of the content of this treatment in comparison to published treatment guidelines (Agency for Health Care Policy and Research, 1993; American Psychiatric Association, 1993) shows that no more than 30% of these patients receive even minimally acceptable treatment (Katz, Kessler, Lin, & Wells, 1998; Wang et al., 2000). There is clear evidence that depression treatment that fails to conform with treat ment guidelines is associated with incomplete recovery and increased risk of recurrence (Melfi et al., 1998). These results show that advances in the development and implementation of treatment quality improvement programs are clearly needed.

Another development of great importance in depression treatment involves the rise of complementary and alternative (CAM) therapies. Three recently completed national surveys have documented that a substantial proportion of people with depression use a variety of CAM therapies, such as St. John’s wort and relaxation therapy, to treat their depression got-1.qxd 4/4/02 11:34 AM Page 33DESCRIPTIVE ASPECTS OF DEPRESSION 34 (Eisenberg et al., 1993; Eisenberg et al., 1998; Unutzer et al., 2000). In the most detailed of these surveys, which was carried out in 1997–1998, 54% of the respondents with selfdefined “serious depression” in the year prior to the interview reported that they used some form of CAM for their depression (Kessler et al., 2001). An alternative medicine professional, such as an energy healer or herbalist, was seen during that same year for the treatment of depression by 19% of the respondents with self-defined serious depression. This compares to 36% who reported seeing any conventional physician or mental health professional for their depression during that same time period. The patients who used CAM were more likely to see a conventional provider than those who did not use CAM, with 66% of the patients who saw a conventional professional for their depression also using CAM.

Importantly, only a small minority of CAM users who are also in treatment with a conventional provider tell the latter about their CAM use (Eisenberg et al., 1998). It is important to recognize that this type of unsupervised joint use of CAM and conventional therapy can be dangerous, as case studies show that some types of CAM can create potentially dangerous interactions with pharmacotherapies (Yager, Siegfried, & DiMatteo, 1999; Almeida & Grimsley, 1996). For example, recent case reports suggest that the mixture of St. John’s wort with selective serotonin reuptake inhibiters can induce a mild serotonin syndrome (Ernst, 1999). In vitro studies also suggest that hypericum extracts, which are commonly used herbal treatments for depression, are potent inducers of hepatic enzymes that can reduce plasma concentrations of a variety of concomitant prescription medications (Fugh Berman, 2000). Opening up lines of communication between conventional mental health professionals and patients with regard to CAM use is consequently of great importance.

FUTURE DIRECTIONS

Developmental Epidemiology

There is an increased interest in developmental studies of the onset and course of depression as part of a larger interest in developmental epidemiology (Angold & Costello, 1995). The realization that first onset of depression often occurs early in life and that gender differences in depression begin to emerge in midadolescence are fueling this interest. It is likely that future developmental epidemiological studies will collect blood or saliva samples that can be used to measure sex hormones in an effort to tease out the biological and social effects of pubertal status and timing. Two epidemiological studies of adolescents have already collect ed data of this type and has shown that increases in sex hormones appear to explain much of the emerging sex difference in depression in midpuberty (Angold, Costello, & Worth man, 1998; Patton et al., 1996). It is also important, though, that these future studies give equal attention to social changes that occur at about the same time. The importance of this equal treatment is illustrated nicely in a recent report from the National Longitudinal Study of Adolescent Health (Bearman, Jones, & Udry, 1998), which showed that the greater in crease in exposure to stresses associated with dating among girls than boys can explain much of the increasing sex difference in depression in midpuberty without reference to hor monal changes (Joyner & Udry, 2000).

Genetic Epidemiology

Psychiatric epidemiologists have been greatly interested in behavioral genetic studies of depression and other major mental disorders, with most of the focus being on twin and twin–family designs. Such studies use structural equation models to partition variances and got-1.qxd 4/4/02 11:34 AM Page 34Epidemiology of Depression 35 covariances into genetic and environmental components (Neale & Cardon, 1992). Although convincing data have been presented in these studies that depression is clearly heritable (Kendler et al., 1996), behavioral genetic studies have been disappointing in not ad vancing far beyond this basic fact. Some commentators on the future of psychiatric epidemiology have suggested that our greatest hope for a breakthrough in understanding the etiology of depression is likely to come from genetic epidemiology (Robins, 1992).

However, there is no indication that this promise has begun to be fulfilled in the nearly two decades since epidemiological studies based on genetically informative designs (i.e., twin–family and adoption designs) have been actively pursued. Linkage studies have been unable to identify a single specific gene or gene marker for any mood disorder. If such markers can be identified, integration of psychiatric epidemiology with population genetics would be valuable in a number of ways (Risch & Merikangas, 1996). It is not clear, though, when and if such markers will be identified.

Experimental Epidemiology

Epidemiology has played a major part in the development of many public health interventions. Important epidemiological contributions along these same lines are beginning to emerge in psychiatric epidemiology as well. Included here are studies that have documented effects of obstetrical complications on childhood-onset schizophrenia (Nicholson et al., 1999), of childhood nutritional deficits on conduct disorder (Neugebauer, Hoek, & Susser, 1999), and of childhood lead exposure on early-onset Alzheimer’s disease (Prince, 1998).

However, the enormous complexity of environmental etiological processes in bringing about mental disorders has led most psychiatric epidemiologists to focus their efforts on broad nonspecific risk factors such as stress, social support, social class, and gender that do not have clear intervention implications. As a result, psychiatric epidemiologists have been less actively involved in targeting interventions than epidemiologists working in other areas of research. (For an important exception, see Harris, Brown, & Robinson, 1999a, 1999b.)

As described in more detail elsewhere (Kessler, 2000b), the way in which analytic epidemiological research is carried out differs in important ways depending on whether the researcher sees the work as important for hypothesis testing or for guiding intervention development and targeting. If future psychiatric epidemiologists are to become closely involved in intervention work, changes will be needed in the types of questions asked, the kinds of analyses carried out, and the standards of proof required for epidemiological studies.

Childhood Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Mon, 17 May 2010 10:59:00 +0000

Clinical depression goes beyond sadness. It's more than having a bad day or coping with a major loss such as the death of a parent, grandparent, or even a favorite pet. It's also not a personal weakness or a character flaw. Youth suffering from clinical depression cannot simply "snap out of it."
As many as one in every 33 children and one in eight adolescents may have depression. Two-thirds of children with mental health problems do not get the help they need. Suicide is the third leading cause of death for 15- to 24-year-olds and the sixth leading cause of death for 5- to 15-year-olds.

Depression is a brain disorder (mental illness) that affects the entire body. Depression affects the way one feels, thinks, and acts. Early-onset depression in children can lead to school failure, alcohol or other drug use, and even suicide. Fortunately, it is highly treatable.

Misconceptions

There are two main misconceptions about childhood depression. The first actually applies to both adults and children. This misconception is that someone can just get over depression. Clinical depression is more than just feeling "blue." Everyone can feel "down" from time to time. This can be attributed to stress or unhappiness with some aspect of their life. While depression may appear similar to these down moods, it is much more pervasive and can even be life threatening. Clinical depression also is not triggered by a single event in a person's life.
The second misconception is that children do not have any reason to be depressed.

Childhood is viewed as a carefree period of life. Adults forget that children are essentially powerless and have no control over their lives. Children also have to deal with peer acceptance, school life, and any pressures or expectations that their parents have. This can be a difficult situation to live with day to day.

Risk Factors

In childhood, boys and girls appear to be at equal risk for depressive disorders; but during adolescence, girls are twice as likely as boys to develop depression. Diagnosis of depression in children is not as clear-cut as it is for other ailments. There are no tests that can be given which will positively say that an individual has depression, much less pinpoint the causes. Studies have shown that certain children have risk factors in their lives which could predispose them to depression or "trigger" depression. Some of the recognized risk factors are:

• Stress
• Cigarette smoking
• A loss of a parent or loved one
• Break-up of a romantic relationship
• Attention, conduct, or learning disorders
• Chronic illnesses, such as diabetes
• Abuse or neglect
• Other trauma, including natural disasters

However, some infants exhibit depressive symptoms at an early age before most of these factors come into play, so an argument can be made for depression being wholly chemical in some children. Researchers also feel that children inherit a predisposition to depression and anxiety, but that environmental triggers are necessary to elicit the first episode of major depression.

Family history and genetics can have a connection to whether a child develops depression. Factors associated with childhood depression include inconsistent parenting, stressful life experiences, and a negative way of viewing the world. Research suggests that parental patterns of irritability and withdrawal lead to low self-esteem in the child, and this poor self-image predisposes the child to depression. Childhood depression is also associated with a family history of mood disorders and with the existence of other psychiatric conditions. If a parent has had childhood or recurrent depression, the child is at an even higher risk of developing depression. When depressed adults are asked about their childhood experiences, they are more likely to report neglect, abuse, rejection, and parental conflict. It is also noteworthy that 30-40% of affectively ill children will have a biologic parent who is also affectively ill (most commonly depression) at the time the young person presents for initial evaluation.

Each child's depression is individual, and causes will be different for each one. The depression could be wholly chemical, wholly due to psychological factors, or a combination of the two. More important than the cause is identifying the illness and treating it.

Early Signs

Before a child ever receives professional attention, they exhibit symptoms of depression.
Family, friends, and even some doctors may discount this behavior as being part of adolescence or side effects of growing older. But in depression the symptoms are pervasive and long lasting. They do not pass with the "bad day" or the mood swing.

Here is a list of symptoms that can indicate a child is suffering from depression.

• Bad temper, irritable, easily annoyed, quarrelsomeness, lack of respect for authority, and difficulty getting along with others
• Change in sleep habits, insomnia
• School performance has dropped, indecision, lack of concentration, or forgetfulness
• Withdrawal from friends and loss of interest most activities
• Repeated physical complaints without medical cause (unexplained aches and pains)
• Fatigue and loss of energy nearly every day
• Significant increase or decrease in appetite
• Persistently discouraged and sad, and feelings of being helpless, hopeless, or worthless

Serious And Critical Symptoms

• Suicidal thoughts, feelings, or self-harming behavior
• Abuse or prolonged use of alcohol or other drugs
• Symptoms of depression combined with strange or unusual behavior

There are several useful tools that evaluators use for screening children and adolescents for possible depression. When a youngster screens positive, a comprehensive diagnostic evaluation by a mental health professional is warranted. The evaluation should include interviews with the youth, parents, and when possible, other informants such as teachers and social services personnel.

Diagnosis

It usually takes more time to diagnose major depression in a child than in an adult. The diagnostic process includes interviews of parents and the child. Parents are more likely to report outward signs of depression, while the child may be more aware of inward signs.

But children and young adolescents with depression may have difficulty in properly identifying and describing their internal emotional or mood states. For example, instead of communicating how bad they feel, they may act out and be irritable toward others, which may be interpreted simply as misbehavior or disobedience. Research has also found that parents are even less likely to identify major depression in their adolescents than are the adolescents themselves. Sometimes a parent's report is skewed by the parent's own agenda, so school and other outside reports are useful.

The correct diagnosis of depression is complicated. There are many alternative diagnosticsystems and criteria for depressive syndromes. Using the Diagnostic and Statistical Manual of Mental Disorders, there are four diagnostic categories involving depression.

1. Major Depression - A severe form of depression that may involve disturbed sleep, appetite, suicidal thinking or self-harming behavior, loss of interest, problems thinking or concentrating, fatigue or loss of energy, restlessness or lethargy, and lowered self-esteem.
2. Dysthymia - A less severe form of major depression in which symptoms are less evident and may appear chronic and last more than 2 years.
3. Separation anxiety disorder - Depressive symptoms that are clearly associated with a child's separation from those to whom he or she is attached.
4. Adjustment disorder with depressed mood - Depressive symptoms that emerge as a reaction to an identifiable psychosocial stressor. The reaction is viewed as maladaptive and the symptoms are considered in excess of what is usually expected.

To diagnose a child with depression, both dysphoric moods (a state of feeling unwell) and self-deprecatory ideation must be manifest. Examples of these criteria are listed on the Early Signs page of this training module. A depressed child should exhibit at least four of the listed behaviors. Most young people diagnosed with depression actually match seven or eight of the criteria.

Other Syndromes

Depression in children often co-occurs with other mental disorders, most commonly anxiety, disruptive behavior, or substance abuse disorders, and with physical illnesses, such as diabetes. Children can also suffer Attention Deficit Disorder, and, especially in teenage girls, eating disorders and self-injury. Studies have shown a cyclical effect between eating disorders and depression. Clinical depression can lead to eating disorders and eating disorders can lead to clinical depression.

Here is a list of several of the illnesses that can effect depressed children.

• Addiction
• Anxiety and Panic
• Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder
• Borderline Personality Disorder
• Eating Disorders
• Obsessive-Compulsive Disorder
• Seasonal Affective Disorder
• Self-Injury

Almost one-third of 6- to 12-year-old children diagnosed with major depression will develop bipolar disorder within a few years. Children diagnosed with one of the above syndromes may also have depression as an underlying illness. In any case, when there are multiple disorders affecting a child, all of the disorders need to be treated at the same time for treatment to be effective.

Treatment

Depression and other patterns of manic-depressive disease are chemical disorders of the brain. They can occur spontaneously or be promoted or induced by other medical illnesses, drugs and medications, and environmental events.

A large number of strategies have been developed for the treatment of depression. Many of these approaches can be implemented individually, in groups, or family therapy environment. The management of children, adolescents, and young adults with affective illness should be multimodal. Patients must be informed about the nature, course, and treatment of this disease. There is considerable evidence to suggest that interventions which emphasize treatment of the family, and not just the "identified patient," are critical to positive treatment outcomes. Peer group approaches have been found to be effective for children. Play therapy is sometimes appropriate with younger children.

Here is a list of different treatment methods that are used for depression.

• Cognitive - Cognitive approaches utilize specific strategies designed to alter negatively-based cognitions. Depressed patients are trained to recognize the connections between their thoughts, feelings, and behavior; to monitor their negative thoughts; to challenge their negative thoughts with evidence; to substitute more reality-based interpretations for their usual interpretations; and to focus on new behaviors outside treatment.
• Behavioral - Behavioral approaches designed to increase pleasant activities include several components such as self-monitoring of activities and mood; identifying positively reinforcing activities that are associated with positive feelings; increasing positive activities; and decreasing negative activities.
• Social Skills - Social skills training consists of teaching children how to engage in several concrete behaviors with others. Initiating conversations, responding to others, refusing requests, making requests, etc. Children are provided with instructions, modeling by an individual or peer group, opportunities for role playing, and feedback. The object of this approach is to provide children with an ability to obtain reinforcement from others.
• Self-Control - Self-control approaches are designed to provide the self-control strategies including self-monitoring, self-evaluation, and self-reinforcement. Depressive symptoms are considered to be the result of deficits from one or more areas and are reflected in attending to negative events, setting unreasonable selfevaluation criteria for performance, setting unrealistic expectations, providing insufficient reinforcement, and excessive self-punishment.
• Interpersonal - Interpersonal approaches focus on relationships, social adjustment, and mastery of social roles. Treatment usually includes nonjudgmental exploration of feelings, elicitation and active questioning on the part of the therapist, reflective listening, development of insight, exploration and discussion of emotionally laden issues, and direct advice.
• Medications - Several classes of medications are used with adult populations.
Major types include monoamine oxidase inhibitors (e.g., phenelzine), tricyclics (e.g., imipramine and amitriptyline) and SSRIs (e.g., Prozac, Paxil, Zoloft, Serazone, Luvox), but other classes have emerged as well. While these drugs are not without side effects, they have been shown to be 50-70% more effective with adults than placebos and no other treatment. Very little is know about the safe use of antidepressants with children. The risks and side effects of medications, and the findings that competent therapy and counseling interventions may be more effective restrict, the use of medications with children.

Medication as a first-line course of treatment should be considered for children and adolescents with severe symptoms that would prevent effective psychotherapy, those who are unable to undergo psychotherapy, those with psychosis, and those with chronic or recurrent episodes. Following remission of symptoms, continuation treatment with medication and/or psychotherapy for at least several months may be recommended by the psychiatrist, given the high risk of relapse and recurrence of depression.

Discontinuation of medications, as appropriate, should be done gradually over a period of 6 weeks or longer.

Antidepressant medication for children is a controversial topic. Currently no medications have FDA approval for use with children, although most of the major drug companies have submitted data. There are no long-term studies that show what kind of impact this medication will have on a child's development.

If a child's depression has been caused wholly or in part by psychological factors, medication may relieve the depression, but the underlying cause will not be "cured" by medication alone. Therapy can help the child deal with his past in a healthy manner, and to learn ways to cope with the very difficult process of growing up.

Recent research shows that certain types of short-term psychotherapy, particularly cognitive-behavioral therapy (CBT), can help relieve depression in children and adolescents. CBT is based on the premise that people with depression have cognitive distortions in their views of themselves, the world, and the future. CBT, designed to be a time-limited therapy, focuses on changing these distortions. A study supported by the National Institute of Mental Health (NIMH) found that CBT led to remission in nearly 65 percent of cases, a higher rate than either supportive therapy or family therapy. CBT also resulted in a more rapid treatment response.

Psychotherapy is almost always the first treatment of choice, except in cases where depressive symptoms are so severe or critical that immediate relief is necessary to restore functioning and to prevent immediate and severe consequences. Medication is usually the second choice after a comprehensive and competent trial of psychotherapy.

Combined use of medications and psychotherapy at the onset of treatment can confound evaluation of treatment effectiveness and the observed source of change. It is harder in a combined medication and therapy approach to tell which approach is or is not helping and how much it is helping. However, research has found that combined psychotherapy and medication is often necessary and beneficial. Psychotherapy can be a very effective alternative to the use of medications.

Psychotherapy requires significant commitment whereas treatment of depressive disorders with medication requires less effort. Since normal depression can improve over time and without therapy, a brief period of medication may not be of benefit.

Psychotherapy can be helpful in cases of normal depression and can help insure the condition does not become chronic. Psychotherapy can generally be considered ineffective if a trial of three months has not produced a measurable and noticeable improvement. A decision to change therapists or to start a medication may be necessary at this point. Antidepressant medications require a substantial period of time before they take effect and several trials of different medications may be necessary to find a medication that actually works. Medications alone appear to be helpful in approximately 50% of the cases. However, the use of medications require a substantial commitment for a period of time up to nine months. In some cases, a patient can terminate their medications after six to nine months without a risk of relapse. Unfortunately, there is no way to know if a person will relapse. Several trials of psychotherapy or medications may be necessary to successfully treat depressive disorders. The prognosis for treatment of depression in children is good. Positive treatment outcomes are primarily dependent on a correct diagnosis, an understanding of the etiology, and implementing an appropriate intervention.

Family Advice

If parents or other adults in a child's life suspect a problem with depression, there are a couple of tasks they can do to help the child. First, be aware of the behaviors and note how long the behaviors have been going on, how often they occur, and how severe they seem. This will allow a professional to better diagnose what is happening in the child's life and set up possible treatment options. Second, see a mental health professional or the child's doctor for evaluation and diagnosis. The child can not fully recover without the help of professionals. Some individuals have only one episode of depression, but often depression becomes a recurrent condition. A doctor can educate the child and family about the early warning symptoms of depression so that the family can recognize when depression is reoccurring and get immediate help. The doctor can also teach the child and family about therapies to help reduce the chances of reoccurrence.

It is very important for parents to understand their child's depression and the treatments that may be prescribed. Physicians can help by talking with parents about their questions or concerns, reinforcing that depression in youth is not uncommon, and reassuring them that appropriate treatment with psychotherapy, medication, or a combination can lead to improved functioning at school, with peers, and at home with family.

The following are some suggestions about how caregivers can help a depressed child function in normal life and aid in their recovery.

• Seek advice and consultation as soon as possible from a qualified mental health professional if the symptoms of depression are severe, prolonged, debilitating, unexplained, or unusual.
• Learn more about any medications the child is taking. Ask the child's physician and pharmacist about potential interactions and side effects.
• A normal depression is usually temporary, can come and go, but should diminish over time. Allow the child space and time.
• Maintain a regular and nutritional diet. Avoid meal skipping. A proper diet is a critical source of energy and the child's ability to cope and recover.
• Maintain a regular sleep cycle. Avoid the child sleeping or napping during the day if it is difficult to sleep during regular times. Irregular sleep patterns prolong or worsen symptoms of depression.
• Maintain regular or routine physical activity that is appropriate for any existing medical condition. Activity can help relieve or manage depression.
• Spend time with the child, be caring, listen well, and be understanding.
• Stay involved and avoid extended isolation from positive activities and influences.
• Take time on a regular basis to help the child enjoy pleasurable activities and recreational interests.

With proper treatment children with depression can have functional happy lives. If depression goes untreated, it can dramatically impact a child's entire life and even lead to suicide. Family support is critical in helping a child deal with depression and to improve self-image.

How Do People Experience Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Mon, 17 May 2010 10:36:00 +0000

How do women experience depression?

Depression is more common among women than among men. Biological, life cycle, hormonal and psychosocial factors unique to women may be linked to women’s higher depression rate.
Researchers have shown that hormones directly afect brain chemistry that controls emotions and mood. For example, women are particularly vulnerable to depression ater giving birth, when hormonal and physical changes, along with the new responsibility of caring for a newborn, can be overwhelming. Many new mothers experience a brief episode of the “baby blues,” but some will develop postpartum depression, a much more serious condition that requires active treatment and emotional support for the new mother. Some studies suggest that women who experience postpartum depression oten have had prior depressive episodes.

Some women may also be susceptible to a severe form of premenstrual syndrome (PMS), sometimes called premenstrual dysphoric disorder (PMDD), a condition resulting from the hormonal changes that typically occur around ovulation and before menstruation begins. During the transition into menopause, some women experience an increased risk for depression. Scientists are exploring how the cyclical rise and fall of estrogen and other hormones may afect the brain chemistry that is associated with depressive illness.

Finally, many women face the additional stresses of work and home responsibilities, caring for children and aging parents, abuse, poverty, and relationship strains. It remains unclear why some women faced with enormous challenges develop depression, while others with similar challenges do not.

How do men experience depression?

Men oten experience depression diferently than women and may have diferent ways of coping with the symptoms. Men are more likely to acknowledge having fatigue, irritability, loss of interest in once-pleasurable activities, and sleep disturbances, whereas women are more likely to admit to feelings of sadness, worthlessness and/or excessive guilt.

Men are more likely than women to turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, irritable, angry and sometimes abusive. Some men throw themselves into their work to avoid talking about their depression with family or friends, or engage in reckless, risky behavior. And even though more women attempt suicide, many more men die by suicide in the United States.

How do older adults experience depression?

Depression is not a normal part of aging, and studies show that most seniors feel satisied with their lives, despite increased physical ailments. However, when older adults do have depression, it may be overlooked because seniors may show diferent, less obvious symptoms, and may be less inclined to experience or acknowledge feelings of sadness or grief.

In addition, older adults may have more medical conditions such as heart disease, stroke or cancer, which may cause depressive symptoms, or they may be taking medications with side efects that contribute to depression. Some older adults may experience what some doctors call vascular depression, also called arteriosclerotic depression or subcortical ischemic depression. Vascular depression may result when blood vessels become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood low to the body’s organs, including the brain. hose with vascular depression may have, or be at risk for, a co-existing cardiovascular illness or stroke.

Although many people assume that the highest rates of suicide are among the young, older white males age 85 and older actually have the highest suicide rate. Many have a depressive illness that their doctors may not detect, despite the fact that these suicide victims oten visit their doctors within one month of their deaths.

he majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. Research has shown that medication alone and combination treatment are both efective in reducing the rate of depressive recurrences in older adults. Psychotherapy alone also can be efective in prolonging periods free of depression, especially for older adults with minor depression, and it is particularly useful for those who are unable or unwilling to take antidepressant medication.

How do children and adolescents experience depression?

Scientists and doctors have begun to take seriously the risk of depression in children. Research has shown that childhood depression oten persists, recurs and continues into adulthood, especially if it goes untreated. he presence of childhood depression also tends to be a predictor of more severe illnesses in adulthood.

A child with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children may sulk, get into trouble at school, be negative and irritable, and feel misunderstood. Because these signs may be viewed as normal mood swings typical of children as they move through developmental stages, it may be diicult to accurately diagnose a young person with depression.
Before puberty, boys and girls are equally likely to develop depressive disorders. By age 15, however, girls are twice as likely as boys to have experienced a major depressive episode.

Depression in adolescence comes at a time of great personal change—when boys and girls are forming an identity distinct from their parents, grappling with gender issues and emerging sexuality, and making decisions for the irst time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, disruptive behavior, eating disorders or substance abuse. It can also lead to increased risk for suicide.

An NIMH-funded clinical trial of 439 adolescents with major depression found that a combination of medication and psychotherapy was the most efective treatment option.Other NIMH-funded researchers are developing and testing ways to prevent suicide in children and adolescents, including early diagnosis and treatment, and a better understanding of suicidal thinking.

Anxiety Treatment - The Natural Remedy for Anxiety Relief

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sat, 30 Jan 2010 01:13:00 +0000

Summary:
L-theanine, naturally occuring in green tea, proves effective in dealing with anxiety sypmtoms and providing anxiety relief.

Keywords:
anxiety, natural anxiety treatment, anxiety attack, anxiety cure, anti-anxiety, overcoming anxiety

Article Body:
L-Theanine, naturally occurring in green tea, proves effective in dealing with anxiety symptoms and providing anxiety relief

Anxiety is a state of intense fear, uncertainty, uneasiness, or apprehension due to anticipation of an imagined or real threatening future event. Anxiety can be both physically and psychologically devastating to the Anxiety sufferer's life. Anxiety is often sub-categorized according to the focus of the perceived threat. There is social anxiety, separation anxiety, dating anxiety, performance anxiety, math anxiety, etc. Stress and anxiety often go hand in hand and can result in anxiety depression as the individual feels powerless to receive any anxiety help.

There are a variety of anti-anxiety treatments to consider in overcoming anxiety. For some, anxiety medications prove to be a source of anxiety relief. Other's prefer not to use any of the anti-anxiety drugs and opt for more natural cures for anxiety management. These may include herbs for anxiety, acupuncture anxiety treatments, anxiety vitamins, aromatherapy for anxiety relief, even hypnosis has has proved beneficial overcoming anxiety.

This article discusses the perhaps little known amino acid L-Theanine as a natural remedy for anxiety relief.

L-Theanine is a unique free form amino acid found only in the tea plant and in the mushrooms Xerocomus badius and certain species of genus Camellia, C. japonica and C. sasanqua. Often drinkers of green tea report a feeling of calmness they feel after ingesting a cup or two even though green tea has roughly half the caffeine of coffee. This is due to the high L-Theanine content.

In addition to reducing anxiety symptoms, studies have shown L-Theanine may be effective in promoting concentration, supporting the immune system, improving learning performance, lowering blood pressure, increasing formation of the inhibitory neurotransmitter GABA, and increasing brain dopamine levels among other positive benefits with no known downside.

Studies in cooperation with Taiyo Kagaku Co., The University of Shizuoka, and The Family Planning Institute of Japan have shown that women taking 200 mg L-Theanine daily have lower incidence of PMS symptoms. These symptoms include physical, mental, and social symptoms. Overall, a significant alleviation of PMS symptoms by L-Theanine was observed.

While still under investigation, L-Theanine appears to have a role in the formation of the inhibitory neurotransmitter Gamma Amino Butyric Acid (GABA). GABA blocks release of the neurotransmitters dopamine and serotonin, playing a key role in the relaxation effect.

Everyone knows the effects stress and anxiety can have on an individual's physical state of well-being. Fascinating neurochemistry research has revealed that given a shot of GABA essentially turned back the clocks in the brains of older monkeys, whose brain function briefly operated at levels normally seen in monkeys less than half their age.

GABA, or gamma-amino butyric acid, is a neurotransmitter chemical that is essential for optimizing how brain cells transmit messages to each other and acts to put a damper on unwanted brain signaling activity. Although GABA's age-related decline has not been documented in humans, a host of studies in mammals, including other primates, suggests that a similar process is at work in people.

Monkeys ages 26 and 32 -- considered old age for monkeys -- that got GABA directly delivered to their neurons responded to visual patterns, such as flashing vertical and horizontal lines, in much the same way as monkeys aged 7 to 9 years old did.

Without GABA delivery, the monkeys' aged brains had more difficulty firing neurons that specifically gauge various aspects of depth perception, motion and color. Instead, older monkeys have more random firings that make it difficult to observe visual nuances. In younger monkeys, GABA had no effect since their brains already had optimal GABA functioning.

L-Theanine is considered to be safe based on its historical use as a component of tea and on favorable toxicology studies. Tea is the most consumed beverage worldwide after water, and has been consumed for thousands of years by billions of people. It is estimated that a heavy tea drinker (6-8 cups daily) will consume between 200 to 400 mg of L-Theanine daily.

While dosage for depression and anxiety disorder remain individual, it is recommended to take 100 to 200 mg 1 to 3 times daily for anxiety relief. Based on the results of clinical studies, it has been established that L-Theanine is effective in single dosages in the range of 50-200 mg. It is suggested that subjects with higher levels of anxiety take a dose at the higher end of the effective range (100 - 200 mg) for overcoming anxiety.

Anxiety Ends With Us

abo.elyosr@gmail.com (supporter2008@gmail.com) — Mon, 25 Jan 2010 01:13:00 +0000

Summary:
The positive behavior will occur if you practice relaxation techniques.

Keywords:
anxiety

Article Body:
The positive behavior will occur if you practice relaxation techniques. The stress and anxiety free lifestyle you adapt will be a normal part of your life if you eat correctly and hold tight to the conviction that less is most times more. Other wise anxiety can affect us in an unhealthful manner quite rapidly.

Anxiety is not a hidden agenda in our lives. It is powerful, available and gratefully controllable. As a wise man once said we should not ask why we are anxious we should ask why not? With every aspect of modern life being fast paced and overloaded we have to make a concerted effort to slow down. We also have to be careful not to cause anxious behavior to overflow and spill into the lives of the people with which we are in contact.

Coworkers, spouses, and our children can all be affected by the power our anxiety has on us. Sometimes others can see it long before we even notice it is crowding in on us. Sometimes we can inadvertently create anxiety in others merely by our choice of words or actions. If the cycle of anxiety is going to end it has to be recognized, addressed, and extracted from every aspect of our lives.

Coworkers or employees can experience inadequate work performances simply by working in a stress filled workplace. Slowing the pace and considering how people work better in a stress-free environment is a major step in the right direction. It is not a difficult step and has so many great benefits for everyone involved.

Spouses may only realize there is something wrong yet not fully recognized that stress and anxiety are occurring and causing ripples in the marriage. It is very likely that if one marriage partner is anxious due to money problems, working too much, or parenting issues the other partner is also anxious. This vicious cycle can wreak havoc on a typically loving home and the people who dwell within.

Children live what they learn. They may truly believe they are creating the anxious behavior in mom or dad because of something they did. Young children will internalize and reflect their concerns in guilt. Older children will more likely rebel and act out in school to attempt dealing with the emotional overload of dealing with parents who are not relaxed.

The good news is anxiety is effectively treated in various ways. You can choose to treat anxiety medically, holistically, or personally and gain immediate results. The key to successful treatment of anxiety is to recognize it for what it truly is. There are numerous self-help books, web pages, and meetings available to all ages.

Bring An End To Depression

abo.elyosr@gmail.com (supporter2008@gmail.com) — Wed, 20 Jan 2010 01:13:00 +0000

Summary:
Everybody gets the blues once in a while. It’s normal to feel sad on a rainy day, get sentimental over a lost love, or feel so terribly lonely during really low moments of your life.

But once depression gets out of hand, it can wreak havoc on your mental state and drive you to such emotional lows - to the point that you might seriously choose ending your life. So if you think you’re experiencing extreme emotional lows, then you’d better do something about it.

What are...

Keywords:
depression

Article Body:
Everybody gets the blues once in a while. It’s normal to feel sad on a rainy day, get sentimental over a lost love, or feel so terribly lonely during really low moments of your life.

But once depression gets out of hand, it can wreak havoc on your mental state and drive you to such emotional lows - to the point that you might seriously choose ending your life. So if you think you’re experiencing extreme emotional lows, then you’d better do something about it.

What are the signs of depression?

1. Feeling sad without any apparent reason.

2. Getting mad at anything, everything, anyone, and everyone around you.

3. Thinking that your life is getting nowhere.

4. Feeling that whatever you do is not enough.

5. Feeling that you’re not good enough for anything.

6. Always feeling tired.

7. Feeling that there is no more hope for whatever troubles you.

8. Feeling that you don’t deserve to live in this world anymore.

These are some of the most common symptoms of depression. Recognizing these telltale signs can help lead you to take action before it becomes more serious. Knowing the root cause of these symptoms further boosts the chance of recovery.

Whatever the reason behind depression, it is always related to your state of mind, environment, and/or present circumstance. You may feel low if you are facing issues on work, marriage, or your financial status. The process of resolving these issues, however important, will inevitably result in stress and/or body aches. Emotional pain coupled with physical ills can really affect the way you view your life.

Another cause of depression is bad experiences: the death of someone important, loss of something significant, or similar unpleasant experiences that would haunt you for a long time. This could mean a humiliating event at your workplace or school, traumatic environment at home, etc.

The best way to treat depression is to think positively. Thinking negatively about an already gloomy situation would only aggravate your mental state. It’s not the end of the world, and there’s a solution to every problem, yours included. Moping and sulking about it won’t do any good.

Unfortunately, not all people see it that way. This is when depression starts to settle in. You think you’re the unluckiest person alive. No one is there when you need help the most. It’s better to die than suffer all the injustice being delivered to you.

Going to a psychiatrist to ask for help is one step toward finding the cure for depression. Various drugs can help you cope. However, these medications treat not the actual cause of depression, but only the symptoms. Complete recovery rests solely on your ability to have a positive outlook in life. Admittedly, this is easier said than done, so going to a psychiatrist doesn’t immediately mean that you’re going to ask medication for your depression. You could also ask your psychiatrist for help in developing a positive outlook and in controlling your depressive mood swings.

Depression is a serious matter. It causes emotional and mental breakdown, and it can result to suicide if left untreated. This is why depression should be diagnosed immediately. It is not a disorder that is easy to cure; but always remember: you’re not alone in the world. Even if you live your life as a recluse, there’s at least one person out there who cares for you and would be devastated if you allow yourself to lose the battle. You’re a strong person. You’re not alone. Keep your loved ones close to you and you will feel invincible.

Anxiety Depression: Learn How to be worry free.

abo.elyosr@gmail.com (supporter2008@gmail.com) — Fri, 15 Jan 2010 01:13:00 +0000

Summary:
“Which of you by worrying can add a single hair to your head?” Jesus.
“That thing I so worried about has eventually happened to me” Job.
“Anxiety depression from worry is that great modern plague” Anonymous.
From the quotes above, needless to say friends, to overcome anxiety depression, we’ve got to break the worry-habit. Let’s see how we can be worry-free today folks.

Keywords:
Anxiety Depression

Article Body:
From a religious stand-point, Jesus once asked his 12 disciples: “Which of you by worrying can add a single strand of hair to your head?” Now, you may be of a religious background or maybe not, but, think about that statement and you’d see why worrying, a main symptom of anxiety depression is quite unnecessary.

Reduced to its simplest form, what is worry? It is simply an unhealthy and destructive mental habit that- believe it or not folks-you were not born with but simply acquired out of practice. The good news is, with aggressive actions, as with any habit and acquired attitude; we can be worry free and eliminate it from our lives successfully.

In the words of Dr. Smiley Blanton, a noted Psychiatrist: “Anxiety depression is the great modern plague.” Other psychologists go on to say ‘worry’ a noted symptom of any form of depression, is the most subtle and destructive of all human diseases. When we worry excessively, we disintegrate our inner workings as humans and really put a lot of things out of order. Needless to say avoiding worry as a step of treating depression and anxiety will be the first step for our own benefit.

Anxiety Depression: Steps to take to be Worry Free:

The following steps should be used to deal with anxiety depression and its main symptom, worry. When used wisely and effectively, you will inevitably be successful at these natural depression help techniques.

1. Practice Mind-drainage: Empty your mind of pessimistic and negative thoughts, especially before going to and after waking up from sleep. This involves some degree of imagination friends. (the same imagination-mind you-that you are actually using to aggravate your present situations…didn’t realize that eh?). This mind-draining strategy cannot be overemphasized as I will let you know, if you fear something for a long period of time, it may actually come to pass. “For the thing which I feared has come upon me…” (Job 3:25)

2. Fill up the mind with powerful thoughts of faith and success to fill up the vacuum now left in the mind. You become a worrier by practicing it, you can be worry-free by practicing the opposite.

3. Say positive things about those things you previously spoke negatively of.

4. Never participate in a worry conversation. Induce your conversation with faith and worry-free statements.

5. Make friends with optimistic people, practice prayer and meditation.

6. Exercise and eat right. You’ll be making yourself look and feel better and consequently stronger through the process for overcoming depression, anxiety and becoming worry free.

No one is saying things will be automatically changed overnight. No, it takes work. However with direct and equally aggressive actions as the destructive worry habits one may be indulging in, anxiety depression can be overcome and you too can be worry free if you believe in your mind you can.

Best Hawaii Vacation with Hawaii Spas

abo.elyosr@gmail.com (supporter2008@gmail.com) — Sun, 10 Jan 2010 01:13:00 +0000

Summary:
Since, Hawaii offers a safe and tropical atmosphere, it is very ideal for visitors to enjoy spa treatments. The Hawaii spas offer different types of massages and therapies like the hydrotherapy, neuromuscular therapy, normal spa treatments, reflexology and therapeutic massage to provide health and wellness, sports massage, clinical massage and deep tissue massage integrating the body and the mind.

Keywords:
spa, spas, day spa, infrared spa, Hawaii spa, health resort spas, spa yoga, spa types, health spas, spa treatment

Article Body:
Hawaii is frequented by travelers very often since it is considered to be a tropical paradise. Hawaii offers a lot to its visitors and it is very popular. Apart from the beautiful ocean views and sandy beaches, Hawaii is a famous destination of spas. The local environment of Hawaii is really great and is very much known for the friendly hospitality shown towards the visitors or travelers. Since, Hawaii offers a safe and tropical atmosphere, it is very ideal for visitors to enjoy spa treatments. Several locations of Hawaii like the Kauai, Molokai, Oahu, lanai, Maui and the big island are very famous for the spas. The Hawaii spas offer different types of massages and therapies like the hydrotherapy, neuromuscular therapy, normal spa treatments, reflexology and therapeutic massage to provide health and wellness, sports massage, clinical massage and deep tissue massage integrating the body and the mind.

They also offer exotic forms of massage treatments branching out from the eastern styles of massages like the Reiki, Jin shin, Thai, Hawaiian lomi lomi massage, shiatsu, acupressure and aromatherapy. More advanced natural healing practices like the acupuncture or chiropractic therapies are also offered.

Lomi Lomi massage offered in the spas is the traditional massage technique of Hawaii. The techniques of Lomi Lomi massage vary with the family, region and island and it was earlier conducted with intention and prayer. Ancient Polynesian settlers got their own kind of massage form that evolved to be something unique to Hawaii practiced from child to chief by every one. Today Lomi Lomi other wise known as loving hands is very popular and common massage form practiced all over the world especially in Hawaii, Europe and Japan.

Traditionally learnt practitioners of the Lomi Lomi massage do not willingly work in any spa or massage parlor, as they treat only selected clients in a private and quiet setting often in their own homes. While treating them the clients may be asked to pray, change their diet plans, meditate and made to do their own activities apart from the massage therapy provided to them. It is a holistic way of healing tradition beyond just simple massage technique. Before performing the massage, the therapist will offer prayer to make the healing process effective and efficient. Then it is believed that the ancient spirit and wisdom of Aloha will guide, inspire and heal the clients towards their true potential. The lomi lomi massage provides a unique experience overwhelming the mind with sensation when it is done with intuitive movements, rhythm, breathing and focused intentional long and flowing strokes. It is said to cover a broader area of the body by working out the muscles encouraging the consistent flow of harmony and love and at the same time washing away harmful patterns, memories, thoughts and behaviors from the cells of the bodies. When the positive energy is allowed to flow uninterrupted, the body on the whole is healed. Hawaii spas offer some of the best spa treatments within the reach of everyone at an affordable cost. Many Hawaii spas offer special discounts and promotions online. If time is spent on doing some research regarding the offers, one can easily hit the jackpot.

Anxiety and Responsibility

abo.elyosr@gmail.com (supporter2008@gmail.com) — Tue, 05 Jan 2010 01:13:00 +0000

Summary:
An article about coping with stress and anxiety by trying to become as responsible as you can in all aspects of your life,not taking your bad moods out on people is being responsible,for example.

Keywords:
anxiety,coping,stress,self,esteem,disability,justify,parents,negative.

Article Body:
I am diagnosed as bipolar with severe depression/anxiety. At times, the anxiety is a very crippling thing. There are days that I can only handle doing one thing at a time. If you add going to the store, crowds of people, commotion, loud traffic or personal relationships, things become very hard to cope with.

One big thing I have been able to accomplish in the last few years is not taking it out on other people when I am so stressed out. It's possible that I am able to refrain from doing that partly because I try to stay away from people as much as possible. Living by myself accomplishes most of that, but it's still a special thing I have learned to do and it comes from an action that is called being responsible.

After I started receiving Veterans Administration Disability, it was very difficult managing my money. Well, I went through this for about four years. Then, I guess I got tired of it. It started appealing to me to be comfortable as opposed to spending money frivolously. This special newly acquired trait of being responsible soon spread over to other aspects of my life.

I started paying more attention to my children as far as the important things are concerned, even though I deeply affected them in a negative way prior to my getting help eight years ago. I have come to the realization that the best and only way I can help them from now on is by the example I set with the rest of my life. That awakening and the one regarding not taking my hardships out on other people helped me to stop justifying my negative actions or words that I thought were the result of someone else's actions or words directed toward me.

I guess if I had to wrap it all up into one word, I couldn't. It means more using two words....."being responsible". When we all turned eighteen we became (officially) our self's own individual. It didn't matter whether we had the most perfect parents of all time or whether they were only human ones who made mistakes. We were who we were, a confused person with both negative and positive qualities and probably unaware at the time of how to retain the positive and discard the negative.

It is a shame that if we are lucky, twenty years later we may see the light when our children are resenting us because we made mistakes being a parent. After eighteen years of age there is no one responsible for you but you. You may try to hide from that truth your entire life, but you will never truly be happy.

Links And Directories

abo.elyosr@gmail.com (supporter2008@gmail.com) — Fri, 01 Jan 2010 20:59:00 +0000

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Beating Depression By Action

abo.elyosr@gmail.com (supporter2008@gmail.com) — Wed, 30 Dec 2009 01:13:00 +0000

Summary:
Depression can come on us at any time of the year. Sometimes, holidays are the worst times for those that feel this down-in-the-dumps fear and worry and things just seem to happen to make us feel gloomy and sad. Note that this feeling happens to all of us at one time or another. How to recognize the feeling and know what to do about it is the purpose of this article.

No one can or should ignore this feeling. It is universal and the blues are very much ingrained in our wor...

Keywords:
depression, anxiety, help, sad

Article Body:
Depression can come on us at any time of the year. Sometimes, holidays are the worst times for those that feel this down-in-the-dumps fear and worry and things just seem to happen to make us feel gloomy and sad. Note that this feeling happens to all of us at one time or another. How to recognize the feeling and know what to do about it is the purpose of this article.

No one can or should ignore this feeling. It is universal and the blues are very much ingrained in our world. Music and movies are legendary in handling this subject. If the feeling is too overwhelming, then sometimes professional help is the desired action. We will just talk here about the funk of depression, the knotted thinking that nothing is right and it will only get worse. The following things are suggested to help:

1. Laughing is the best medicine is an old adage, but so true. It is amazing how when you are depressed, just laughing about something and releasing the stress, can make you feel better. If you are having trouble finding something to laugh about, maybe you can find some people to keep close that cheer you up, that you can call when you feel bad, those who you know will let you apply the "strength in numbers" theory. Invite a few good friends over just to talk and have an appetizer and you will see how much better you feel afterwards.

2. Listening to music is another key to overcoming depression. If you can just relax and let the type of music you love drift over you and enter your senses, you will find that you calm down and feel better. Even as babies in the womb, we respond to music. Maybe you will find you want to get up and dance and there is nothing wrong with that - even without a partner! Just move to the beat and let all your stress flow out of your fingertips and toes.

3. Do some work and you will find you feel less depressed. There is something about a clean bathroom, living room, or kitchen that gives most women a sense of pride and order and joy. Men sometimes enjoy doing some of the same work and experiencing the same attitudes. The point is you just need to get out and do something that moves your body. Maybe you can shoot hoops in the driveway, ride a bicycle through the neighborhood and say "HI" to a few of your neighbors. There is something to be said for just watching a sunset and realizing how mighty the world is and how we are just one part of it. That sometimes seems to put our troubles more in perspective.

4. While we are on that thought, why not try prayer when you feel depressed? Try helping out someone less fortunate. Think of hospital patients and know that they most likely have things worse than you. Yet, you see happier children and adults in some of the worst settings in the hospital. Count your blessings. Hug someone or maybe go through some old pictures of happy times with your family.

Doing productive activities will always perk you up. Think positively about your life and the things you have been given and do not dwell on the problems. Take your dog for a walk and relish in the animal's unending enjoyment at seeing you and being with you. Sometimes simple undemanding love is all we need to overcome the blue feeling.

The last suggestion may sound unusual, but here it is. EAT ICE CREAM! Yes, just swirling that cold stuff around on your tongue and all the different flavors can make you feel good! The idea is to eat something that you totally enjoy and see how hard it is to be depressed when you have your favorite food and are enjoying it. The world just seems a little better!

Of course, all the suggestions given above may not apply to everyone. But give them a try and who knows...maybe they can help just a little. Keep this list handy and the next time you are feeling a little down, find something that triggers the best response to get you to feel happy again. Be aware that when depression creeps in, you need to take action and beat the depression back to the corner where it belongs.

We all have more important things to do in life than feel blue and depressed. Keep this thought in-mind and may your life be filled with joy.