20 September 2001 Edition
Lifting the lid on depression
BY MICHAEL PIERSE
It was Depression Awareness Week in the 26 Counties last week, and depression support group Aware was again attempting to develop public awareness around one of our most understated taboos.
This taboo accounts for more deaths than those incurred on the roads, yet receives far less coverage or public funding for support services and makes considerably less impact on the general public psyche.
The statistics are shocking. One in fourteen workers in the 26 Counties, or 300,000 Irish people, are currently suffering from depression - a whopping 7.7% of the state's population. The illness hospitalises 10,000 people each year and up to 500 depression sufferers take their own lives annually. One in ten 26-County adolescents aged 13 to 19 have a major depressive disorder. Overall, one in three people in the state will be linked to depression in their lives, either as a relative or friend of the depressed individual. And because the issue is so often brushed under the carpet, these statistics may be a little on the conservative side.
It's easy to see why `Aware' is a fitting name for an organisation that deals with depression. Formed in 1985 by interested patients, their relatives and mental health professionals, Aware aims to assist that section of the community whose lives are directly affected by depression. It runs 60 support groups around the country, for those who are depressed and for their relatives.
Fear of the unknown and ignorance of the realities of depression have maintained the code of secrecy that is attached to the illness, according to Aware's Information Officer, Lynn Greene.
``People often think that depression is not an illness and sufferers are often told to `cop on' to themselves,'' she told An Phoblacht. ``Even the word `depression' is used too casually, to describe a temporary condition, rather than a serious illness. But people are more aware now of depression.''
So what exactly is depression? The word itself has many meanings and associations. We may use it to describe a feeling of emotional distress and in this sense it is regarded as a symptom.
`Emotional distress' as a definition of depression is something common to us all at times, though normally this distress is transitory and tolerable. Such feelings, or `normal depressions', occur most frequently in response to the disappointments of everyday life and, to a lesser extent, our mood fluctuates with the seasons or in response to hormonal factors. Depression, manifesting itself over a prolonged period of time and causing such severe suffering as to render the sufferer incapable of coping with the mundane challenges of life, is termed `abnormal depression', or a depressive disorder.
Distinguishing one type from another, or prescribing medication or treatment, or one or the other, or neither, is, however, not as easy as this rather simplistic definition would suggest. ``For each individual it's different,'' says Greene. Whatever type is identified, treatment can alleviate the symptoms in eight out of every ten cases.
While depression is said to affect one in every two women and one in every four men, these figures are possibly more a reflection of the inhibitions most associated with men. ``Other factors may be involved in that. Men are more likely to be less open with their feelings - so more than one in four may actually suffer,'' Greene says. While experiences exclusive to women such as childbirth and menstruation are causes of depression, suicides are most common amongst young men.
One problem with depression is that it often goes undiagnosed and untreated, or is hidden by the sufferer for long periods of time. Besides people's unwillingness to face up to the illness, confusion, or ignorance as to what constitutes depression, or different types of depression, also causes anxiety and uncertainty for sufferers.
So-called `normal depression', or reactive depression, is an extension of the normal, upset feeling that follows an unhappy event in a person's life. The death of a close relative or friend, family strife or unexpected job loss are some of the common events that can evoke an extreme state of unhappiness. Typically, the person with reactive depression will feel low, anxious, often angry and irritable and will tend to be preoccupied with the upsetting event and usually will have difficulty sleeping. Treating this type of depression may, initially, merit the use of medication, but it is a process of psychotherapy that usually resolves it. Psychotherapy basically means encouraging the sufferer to talk about what they are going through and to ensure that they can cope better with future events.
Endogenous depression means depression coming from `within'. In its pure form, the person experiencing this type of depression is unable to account for his/her mood change, although traumatic events may provoke the condition. Many of the symptoms common to reactive depression may be present in endogenous depression. The person's thinking slows, he or she may have difficulty in concentrating and making decisions, and everything seems an effort. The symptoms of endogenous depression are usually worse in the morning and sufferers may not be able to sleep beyond 5am or 6am. Antidepressant medications are the mainstay of treatment for this type of depression.
Finally, there is manic depression, also known as bipolar disorder. 40,000 people in the 26 Counties suffer from bipolar disorder, with men and women suffering equally. The symptoms of the depressive phase are identical with those of endogenous depression, but the sufferer also experiences spells of elation, or mania. On average, 70% of the cause of bipolar disorder is genetic and the remaining 30% is attributable to environmental factors. Mood-stabilising medication is the usual treatment for this type of depression.
Aware recommends that those experiencing depressive tendencies for a period of two weeks or more should consult their GP. ``You can't force anyone to go for help - all we can do is give them the literature to get the help. This is always terrible for a family to handle,'' says Lynn Greene. Despite the fact that GPs in the past were reluctant to deal with depression, she is fully confident that times have changed in this regard.
``Nowadays, GPs are very well up on depression. Before, they wouldn't have wanted to deal with it so much, probably because they didn't realise it's so prevalent.''
Aware
Information: (01) 661 7211
Helpline: (01) 676 6166
E-mail: [email protected]
Website: www.aware.ie
It was Depression Awareness Week in the 26 Counties last week, and depression support group Aware was again attempting to develop public awareness around one of our most understated taboos.
This taboo accounts for more deaths than those incurred on the roads, yet receives far less coverage or public funding for support services and makes considerably less impact on the general public psyche.
The statistics are shocking. One in fourteen workers in the 26 Counties, or 300,000 Irish people, are currently suffering from depression - a whopping 7.7% of the state's population. The illness hospitalises 10,000 people each year and up to 500 depression sufferers take their own lives annually. One in ten 26-County adolescents aged 13 to 19 have a major depressive disorder. Overall, one in three people in the state will be linked to depression in their lives, either as a relative or friend of the depressed individual. And because the issue is so often brushed under the carpet, these statistics may be a little on the conservative side.
It's easy to see why `Aware' is a fitting name for an organisation that deals with depression. Formed in 1985 by interested patients, their relatives and mental health professionals, Aware aims to assist that section of the community whose lives are directly affected by depression. It runs 60 support groups around the country, for those who are depressed and for their relatives.
Fear of the unknown and ignorance of the realities of depression have maintained the code of secrecy that is attached to the illness, according to Aware's Information Officer, Lynn Greene.
``People often think that depression is not an illness and sufferers are often told to `cop on' to themselves,'' she told An Phoblacht. ``Even the word `depression' is used too casually, to describe a temporary condition, rather than a serious illness. But people are more aware now of depression.''
So what exactly is depression? The word itself has many meanings and associations. We may use it to describe a feeling of emotional distress and in this sense it is regarded as a symptom.
`Emotional distress' as a definition of depression is something common to us all at times, though normally this distress is transitory and tolerable. Such feelings, or `normal depressions', occur most frequently in response to the disappointments of everyday life and, to a lesser extent, our mood fluctuates with the seasons or in response to hormonal factors. Depression, manifesting itself over a prolonged period of time and causing such severe suffering as to render the sufferer incapable of coping with the mundane challenges of life, is termed `abnormal depression', or a depressive disorder.
Distinguishing one type from another, or prescribing medication or treatment, or one or the other, or neither, is, however, not as easy as this rather simplistic definition would suggest. ``For each individual it's different,'' says Greene. Whatever type is identified, treatment can alleviate the symptoms in eight out of every ten cases.
While depression is said to affect one in every two women and one in every four men, these figures are possibly more a reflection of the inhibitions most associated with men. ``Other factors may be involved in that. Men are more likely to be less open with their feelings - so more than one in four may actually suffer,'' Greene says. While experiences exclusive to women such as childbirth and menstruation are causes of depression, suicides are most common amongst young men.
One problem with depression is that it often goes undiagnosed and untreated, or is hidden by the sufferer for long periods of time. Besides people's unwillingness to face up to the illness, confusion, or ignorance as to what constitutes depression, or different types of depression, also causes anxiety and uncertainty for sufferers.
So-called `normal depression', or reactive depression, is an extension of the normal, upset feeling that follows an unhappy event in a person's life. The death of a close relative or friend, family strife or unexpected job loss are some of the common events that can evoke an extreme state of unhappiness. Typically, the person with reactive depression will feel low, anxious, often angry and irritable and will tend to be preoccupied with the upsetting event and usually will have difficulty sleeping. Treating this type of depression may, initially, merit the use of medication, but it is a process of psychotherapy that usually resolves it. Psychotherapy basically means encouraging the sufferer to talk about what they are going through and to ensure that they can cope better with future events.
Endogenous depression means depression coming from `within'. In its pure form, the person experiencing this type of depression is unable to account for his/her mood change, although traumatic events may provoke the condition. Many of the symptoms common to reactive depression may be present in endogenous depression. The person's thinking slows, he or she may have difficulty in concentrating and making decisions, and everything seems an effort. The symptoms of endogenous depression are usually worse in the morning and sufferers may not be able to sleep beyond 5am or 6am. Antidepressant medications are the mainstay of treatment for this type of depression.
Finally, there is manic depression, also known as bipolar disorder. 40,000 people in the 26 Counties suffer from bipolar disorder, with men and women suffering equally. The symptoms of the depressive phase are identical with those of endogenous depression, but the sufferer also experiences spells of elation, or mania. On average, 70% of the cause of bipolar disorder is genetic and the remaining 30% is attributable to environmental factors. Mood-stabilising medication is the usual treatment for this type of depression.
Aware recommends that those experiencing depressive tendencies for a period of two weeks or more should consult their GP. ``You can't force anyone to go for help - all we can do is give them the literature to get the help. This is always terrible for a family to handle,'' says Lynn Greene. Despite the fact that GPs in the past were reluctant to deal with depression, she is fully confident that times have changed in this regard.
``Nowadays, GPs are very well up on depression. Before, they wouldn't have wanted to deal with it so much, probably because they didn't realise it's so prevalent.''
Aware
Information: (01) 661 7211
Helpline: (01) 676 6166
E-mail: [email protected]
Website: www.aware.ie