The Experience of Depression

Notes from Understanding Depression by J. Raymond DePaulo Jr. and  Leslie Alan Horvitz 

Chapter 1 - The Experience of Depression

Those with depression often see no way out. Idea that there is light at the end of the tunnel goes on and off until you stop believing it.

Depression can drain the trust that others have in you

• 3 criteria for depression

• • changes in mood, vitality, mental liveliness, self regard and self esteeem; episodic; and tends to run in families

• Hallmark Symptoms of depression 

• • Self Image - Despair, feel worthless and that everyone is bound to find out; the prospect of receivung help may fail to lift your spirits; feel worthless, useless and no prospect for the future; feel drained, inability to focus or concentrate; only able to read words one at a time, but unable to take in a whole paragraph; unable to focus on what others are saying
   
  • Physical vitality - tend to feel fatigued, lack stamina that you used to have to do things; getting started in morning is difficult, and you don't have the energy to do things that would normally be second nature to you; decreased ability to perform tasks that require concentration or mental effort - this inability can transform minor challenges to major crisis, especially at work; feel worse in the early morning hours and better in the evening; 
   
  • Health and weight - overly preoccupied with physical condition that was previously seen as merely an inconvenience; increased symptoms of existing conditions, like migraine; sex drive may disappear and appetite may decrease to weight loss or even increase to weight gain.  Weight gain in more normal in depressive state of bipolar, seasonal depression or those with long standing depression.  1/3 of people see no change in weight.
   
  • Probably able to get through most days, but with difficulty. May take 6 hours to accomplish what you would normally do in 2 or 3; more errors and performance may become inconsistent 
   
  • Sleeping - increases for people with chronic and seasonal depression; those with episodic experience and extreme forms of depression loss of sleep. Typically have fewer problems falling asleep, but staying asleep is harder. Usually wake at 3 or 4 am and find it difficult to fall back asleep.
   
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  Chapter 2 - Feeling Worthless

  
  
  Self criticisms from depression can creep without raising any alarms.

  
  

  The sense of worthlessness can be so pronounced that the most heartfelt reassurances are not heard. 

  
  

  Warped reasoning

  Some feel that friends are secretly angry at them, but won't come out and tell them because they are just being polite. This is why close relations are hard to maintain. One patient felt that his wife's reassurances about loving him were not genuine and that she was insincere or stupid because if she knew how hollow he was, she would not want to stay with him.

  
  

  Other observations of depression

  Loss of muscle tone - causes them look exhausted all the time. 

  Some walk or talk more slowly. May take one to two minutes to answer a question, even that requires a yes or no.

  Stupor - unable to move; so uncertain what to say or do that they could not act. 

  
  

  Depression and Anxiety 

  Depression is often associated and clustered with anxiety.  Severe anxiety can even be seen as a manifest of dpression. Not all people with depression have anxiety, but they are associated, and many of the same neural pathways and brain regions are involved in both. Depressed people can become so fearful (phobic) of scrutiny that they feel that other people are staring at them. Even walking into a room to exchange a few words may overwhelm them. For many people, when the depression lifts, the anxiety does too. However with some, the anxiety remains.

  
  

  Anxiety types - panic attacks, phobias, Obsessive Compulsive symptoms