One out of every ten Americans will have at least one episode of major depression in his or her life. Far more than just feeling downcast from time to time, this clinical psychiatric condition has profound effects on one’s ability to carry out the activities of daily living, and can even lead to suicide in the most desperate of cases. With that in mind, it is impossible to overstate the importance of being able to spot the symptoms of clinical depression in oneself or another person so that treatment can be obtained immediately.
Clinical depression is a syndrome or set of symptoms indicated by a sad or downcast mood that goes beyond normal blues. It is characterized by negative thoughts, moods and behaviors. Those who are depressed also show changes in bodily functions, including altered sleep patterns, changes in appetite (either lesser or greater), and often a reduction in sexual functioning. While some patients may appear lethargic and unable to get out of bed or participate in daily activities, the opposite may also be the case. Depression-induced agitation can also cause an inability to cope, concentrate, remember, work, and otherwise participate in society. In the most extreme cases, the patient may have thoughts of ending his or her life, and may make mention of this to others. This behavior should always be taken seriously and never be brushed off as faking or attention-seeking.
These relatively clear-cut symptoms are usually easy to pinpoint in a patient who is otherwise physically healthy. However, the challenges to medical professionals are amplified exponentially in cases where a person is depressed as a result of brain damage. Take, for example, the case of a man with Parkinson’s disease. This progressive condition results from the loss of the brain cells that produce dopamine, a chemical that controls movement. Its symptoms include trembling of body and hands, loss of balance or coordination, rigidity or stiffness in the limbs or trunk, and slowness of movement.
Depression is a very common accompaniment to this condition; however, care-givers and patients often assume that the person’s sadness or anxiety have been caused only by the Parkinson’s disease. There is no laboratory test that can diagnose depression, and its identification comes from a complete physical work-up as well as a full review of symptoms. For this reason, it is imperative that no assumptions be made and that the patient is seen by a professional well-versed in Parkinson’s disease. Such a person will recognize that the depression symptom profile for a Parkinson’s patient differs from the norm; Parkinson’s patients exhibit higher anxiety, sadness without guilt, and lower suicide rates despite high incidences of suicidal ideation. In addition, endocrine and hormonal issues are especially prevalent in these patients and can trigger depression.
Another degenerative disease that can lead to depression is multiple sclerosis. This progressive condition can cause loss of muscle control, vision, balance, and sensation (such as numbness). Depression can occur as a result of being diagnosed with MS, with the onset of new symptoms, and/or because of fear of the unknown. MS-related brain damage is also possible, although researchers have not yet been able to identify which areas are affected. Finally, medication interactions can bring on depressive symptoms. As with Parkinson’s, it is important to take symptoms seriously, to address them with medical professionals, and not to assume that they must be endured as inevitable byproducts of multiple sclerosis.
Depression is a serious, quantifiable condition. Even in and of itself, it can lead to severe limiting or curtailment of a person’s lifestyle, and can be fatal in the worst cases. When coupled with the difficulties associated with brain injury, it can be even more devastating. Ongoing monitoring of symptoms by both patient and family, as well as dialogue with medical professionals and other members of the treatment team, can make a huge difference. In a very real sense, these conversations often lead to an accurate diagnosis and give clinicians and patients the keys to working toward rehabilitation and partial or total recovery.