Depression in EP: An explanation and some solutions

Every minute of every day, you feel utterly overwhelmed. Your mind projects only negative future outcomes. Looking back on the past, you have a negative filter that captures only moments of futility, humiliation, and failure. With grim humor, you say, “I don’t do happy.”

You are immersed in depression.

Eden Prairie psychiatrist James Van Doren, M.D., says depression is not “the blues.” Depression’s many and varied symptoms may include a general “withdrawal of interest,” an inability to experience joy or pleasure, loss of motivation, loss of energy, sleep disturbance in the form of insomnia or in oversleeping, a cloak of sadness, or a change in appetite.

To those symptoms, Eden Prairie psychiatrist Karin Ryan, M.D., adds isolation, a feeling of helplessness and hopelessness, difficulty concentrating, and thoughts of death. She notes that these are not feelings of the moment but rather last for at least two weeks.

Van Doren says that the mood disorder called depression can also manifest itself in a “bipolar” way, mingling mania (hyperactivity) and depression.

The National Institute of Mental Health (NIMH) notes that in early childhood, rather than adult-style depression, there can be a depressive disorder that manifests itself in extreme disruptiveness or irritability.

Depression can be genetic. Ryan points to frequent instances where there is a family history of depression.

Van Doren also allows for depression to be environmental and behavioral. Depression can come about as the result of overwhelming stress.

He notes that depression can be a “chronic” illness, responding to treatment but also reappearing later.

The NIMH has statistics that suggest that females are more susceptible to depression, but both psychiatrists are skeptical of the testing methods used to produce these statistics.

Although depression can affect anyone at any time, Van Doren sees a risk in the period between adolescence and adulthood. Ryan sees a clustering in the age group of 18-29 and also in the age group of 45-64.

The NIMH finds that at any given time about 10% of the population is experiencing depression. And, in the course of their lives, 21-22% of the population has some period of depression.

Ryan says, “Depression is a bully.” Van Doren says that depression “impairs” the ability to work or function. He notes that it distorts one’s thinking and can sometimes lead to suicide.

Does depression guarantee failure? In disagreeing with this question, one thinks of such well-known depressed people as Abraham Lincoln. Ryan responds that there are “different levels of depression.” There is moderate depression, known as dysthymia. NIMH also notes postpartum depression and deep depression with symptoms of psychosis.

Ryan says the best approach to treating depression is a combination of medication and talk therapy. Van Doren notes that medication is effective 40-60% of the time. He says that depression is a change in the person but does not affect the “core personality.” Ryan says that medication does not change that core personality. Rather, it helps you focus your skills.

Ryan strongly feels that a person’s awareness of his or her depression is a great help. You can turn to doing positive things (“behavioral activation”): getting a good rest each night, eating regular meals, and adding in pleasurable activities. She encourages journaling and being aware of how you are thinking. She believes that “people living with and working through depression show so much strength!”   

Van Doren advises that as you become conscious of your depression, seek help and break out of your depressed isolation to “work on connecting with other persons.” 

Ryan notes there are so many options in Eden Prairie for connecting with people: churches, exercise classes, and book clubs. “The library has already established book clubs!,” she says.

Happily, depression responds well to self-care and professional assistance.

INFORMATIONAL NOTE:

Psychiatrist James C. Van Doren, M.D., has his practice in Eden Prairie. Phone: 612.548.1502. He is taking new patients.

Psychiatrist Karin Ryan, M.D., is clinical site director of Nystrom & Associates, 11010 Prairie Lakes Drive, Unit 350, Eden Prairie. Phone: 952.746.2522. She is not taking new patients now, but there are several therapists at Nystrom.