D

Depression A Silent Disease

By: Susana Ramirez

Research Paper
HD 300
 Depression 2

Its a bit like walking down a long, dark corridor never knowing when the light will go on, Neil

Lennon. Depression is of the most common disorders but there is still a large stigma for those

diagnosed with it. I personally have had to deal with depression not only when I went through

it, but also watching several generations of my family struggle with it. Watching my loved ones

struggle to get through their daily lives and not be able to function is what made me want to

know more about the disorder. Knowing the signs and knowing how to treat depression is often

a struggle for many. I hope that out of doing this research paper I can gain insight and

knowledge that I can share with my family and any one I come across who might be suffering in

silence from this often deadly disease.

Growing up I remember how my grandmother struggled so much with just being comfortable

living her life. On the outside no one would no she struggled, she let on a happy exterior to

mask how sad she truly felt within. At times her saddens would translate to us, telling us we did

not love her making us feel like we needed to do more. She would always make us feel guilty;

this guilt was passed on to my mother and me. I remember how I always tried to please her but

nothing really was enough. I hardly received any compliments from her. My mom instead of

breaking the cycle she carried on the same mentality.

I felt that I was in a black hole and the only way of suppressing all my sadness and negative

emotions was by staying quiet and not expressing my feelings. This is a really challenging topic

for me it brings out so many mixed emotions. There are a few questions that I have, what are
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the symptoms of depression? What causes depression? Does an unhealthy physical, emotional,

social living lead to depression? How does depression affect our human development? What

are the current resources to treat or diagnose depression? I hope that through my research

journey I can have some answers.

Depression is a cruel disease that can affect anyone. It is very easy, once the symptoms

begin, for a person to slide down the black hole of depression where the symptoms spiral and

feed off of each other, increasing in severity. London, M., PsyD. (n.d.). 5 Warning Signs of

Depression, retrieved from http://www.powerofpositivity.com/. Depression does not

discriminate, it can affect anyone, and it sees no race, gender, age, or religion. Knowing the

warning signs and what do when you think someone might be going through depression is

critical and can potentially help save someones life. Depression is the second most common

illness after cancer, according to The Huffington Post nineteen percent of Americans will suffer

from depression at some time during their lives.

The remaining question is what can be done? The first step to be able to understand this

disease is to understand the symptoms. What are they? How can I tell if someone is going

through depression? Some of the common signs are difficulty concentrating, not being able to

remember details, and struggling with being able to make decisions. When your focus is on

your emotions or sadness and self-doubt it is hard to place attention to other aspects of your
 Depression 4

life. Depression can also manifest itself physically by causing a person to feel fatigued, sleeping

excessively, or not able to sleep, and also body and headaches. Depressions is different for

everyone where for some it might bring about overeating or binge eating, for others it might

cause loss of appetite. Others have reported having feelings of guilt, helplessness, or

worthlessness. Often people who suffer from this disease also report thoughts of suicide or

have even attempted suicide. It is important to pay attention to the people close to you and

around you and watch for these warning signs or symptoms.

Another important factor into understanding depression is knowing the different types of

depression and what can trigger them. It is normal for a person to feel sad once in a while or

when there is a sudden change or dramatic experience, but when their sadness begins to affect

their daily routine then it is considered depression. There are nine types of depression: major

depression, persistent depressive disorder, bipolar disorder, seasonal affective disorder (SAD),

psychotic depression, postpartum depression, premenstrual dysphoric disorder (PMDD),

situational disorder, and atypical depression. Major depression is often referred to as major

depressive disorder. People are often diagnosed with Major Depression when they exhibit five

or more of the warning signs or symptoms for 2 weeks or longer. One of the symptoms must

include glum mood of the loss of interest in doing certain activities that were once considered

routine. Persistent Depressive Disorder also known as dysthymia is when a persons depression

lasts for 2 years or longer. Bipolar Disorder which is often called manic depression is when a
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person has very distinct changes in their mood and temperament. The persons mood can go

from one extreme very happy up to a sudden drop to low depressed moods without cause.

This dramatic change in temperament is referred to as mood swings. Seasonal Affective

Disorder is when a person suffers from major depression during a certain period of time, which

is more often during winter. Postpartum Depression is when women experience major

depression in the weeks and months after giving birth, women have reported experiencing

unexplained sadness or sudden loss of interest in holding or being around their child.

Premenstrual Dysphoric Disorder is when women experience symptoms of depression at the

beginning of their period. Situational Depression is not a technical term that is used in

psychiatry but is used to explain when a person is feeling depressed when struggling to manage

a difficult situation in their life. Examples of when a person can be suffering from situational

depression or stress response syndrome is when there is a death in the family, divorce, losing a

job or home. Atypical Depression is exhibiting at least two of the symptoms associated with

depression, but not more than five symptoms. Atypical Depression differs from persistent

sadness because a positive event can occur causing for the persons mood to temporarily

improve.

The book Depression: Causes and treatment by Beck, Aaron T; Alford, Brad A 2009, 2nd

edition provides a contemporary review of causes and treatment of depression. It spoke about

revolutionary drugs that such as serotonin reuptake inhibitors (SSRIs), electroconvulsive

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therapy (ECT), and transcranial magnetic stimulation (TMS). Also the American Journal of

Psychiatry has an article by Kathryn R. Cullen, M.D. (January 01, 2012) on Imaging Adolescent

Depression Treatment which provided results from a neuroimaging study examining the neural

circuitry in adolescents with depression before and after treatment. It gave an overview of the

fluoxetine drug and the treatment effects on adolescents.

Besides the articles from the website and other sources, I also went around asking questions to
professional clinicians, and friends that have encounter a family member or patients with a
depression disorder. I wanted to gather different perspective on the personal point of view and
experiences. I work for a non-profit health organization and I was able to interview two
clinicians one from the mental health department and the other from our family medicine
department. When I asked them what are the most common stigmas on depression? Dr. Lopez
our family medicine provider stated most men try to avoid any emotional circumstances, they
rather hide their feelings and not recognize that they have an emotional disorder and that they
need help Dr. Manabo stated the stigma of depression or any emotional disorder is often by
the fear of what perception will their love ones or friends will have of them. The clinicians
comments brought back the struggles my grandmother as well as my mother had
acknowledging that they needed professional and medical help. I met with two of my close
friends to kind of gather their personal story and struggles with their own family member living
with depression. They requested for their names to be anonymous and not mentioned. The
statements they mentioned were I always lived in fear and with anxiety always worried that
my mom would not be at home or having suicidal thoughts My memories of my mother was
that she slept her live away, struggling to get through her daily live and getting things done.
Sometimes our light bill or water bill will get cut off because my father use to forget and lose
track of time I also interviewed my sister who is in her early thirtys and was diagnoses with
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bipolar depression disorder, one of the questions I asked her was: What is it like to live with
depression? Her answer was I feel embarrassed about my diagnosis. I know that our culture
fears anything that its out of the norm, and the idea of being seen as different, disabled, or
dysfunctional really frightened me. When I was diagnose I was a teenager and I didnt tell
anyone about my bipolar depression disorder, I kept my medication hidden and kept
my feelings of fear a secret. I remember feeling inadequate when I wanted to be a preschool
teacher because I thought, how could I take care of others as a professional?

These live testimonies and opinions are significantly important to me as they answer
one of my questions, What are the common stigmas? Do we all have similar experience
with depression? Is sharing our depression experiences a healing process? After my friends
shared their experiences with me and I asked them did they felt any relieve or pain talking
about this topic ? Their response was that it is always a difficult conversation but that it was
definitely therapeutic sharing their thoughts and feelings and how it has impacted them.

With this information I want to gather more data so I will conduct surveys and will
share some of the stories of the individuals who are willing to. The survey will consist of the
below questions:

When did you notice you had depression?

What do you think caused or influenced your depression?
How has depression affected your life so far?
Do you have a family history of depression?
Have you been medically diagnosed and when?
Have you reached out for help?
What are the challenges that you are facing at the moment to overcome/cope with
depression?
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Method of delivery: I will use a questionnaire containing five questions related to depression.

The questionnaire will be anonymous. It will contain a separate paper in which an individual

could write down their life story about depression if the individual wishes to. I will disperse my

questionnaires in several colleges medical centers/ mental health center. At the end of a two

week period I will collect the questionnaires. With end goal of collecting at least twenty

questionnaires having in mind most folks are inclined to not participate.

With this I hope to achieve if there is a pattern that emerges with our focus group. With this

research I hope to shed a light on the subject of depression that most know little about due to

misplaced sense of shame or stigmas. Depression is a serious disorder and should be treated as

such. Depression can handicap ones life. Below are fifteen surveys:
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I handed fifty surveys at a community health center that provides mental health services and

family counseling. From the fifty surveys only fifteen were completed. Honestly I didnt felt very

accomplished as I was expecting at least thirty surveys turned in. While I was reviewing their

feedback I was able to identify patterns and age groups. I will highlight the data the stood out

to be the most. Identify any communality with my own experience and how this relates to the

peer reviewed literature and outside research. Also what was my overall experience?

The first question I asked was, when did you notice you had depression?

Eleven out of fifteen answered that it was during their young adulthood, two out of fifteen said

mid-ages and there was one during their teenage years and one during their childhood. Overall

the main population answered that their depression happened during their young adulthood-

this made me questioned, is stage of intimacy vs. isolation stated by Erikson the most

challenging to cope and transition, if so what are the factors that makes it the most challenging

stage. The second question answered this questioned as it focused in them providing the cause

or influenced of their depression. Main factors were financial hardship, debt, family

issues/problems, being separated from their partners because of deportation or divorce,

postpartum depression and addiction to drugs or alcohol. Through these answers I was able to

make a few correlations

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within Eriksons stage of intimacy vs isolation. Most of them were not able to cope with a loving

relationship or sustain any close relationships with others and this caused isolation. Is this a

challenging stage definitely as this stage is when you define who will be in your social circle and

influence of decisions.

The third questioned was based on the overall symptoms which were fatigue, eating

disorders, trust issues, hopelessness, low/no self-esteem, anxiety, irritation, negative thoughts,

addiction to drugs or alcohol. Most of these symptoms are very similar to the peer literature

and research. In the fourth and fifth questioned I gather data if there was any family history and

if they have reached out for help. Eight out of the fifteen said there was no family history, three

said yes and four were not sure. Nine out of fifteen had reached out for help and six said no.

Overall I was satisfied with the data I was able to gather, my conclusions of this research

is that there is a huge need of awareness and resources for people with depression. It can

affect anyone of us and the stigmas should not label who we are. Depression definitely affects

the transition of any of Erikson development stages. Most of the data I collected I felt very

familiar with their comments. As said by Lao Tzu it is always safe to assume not that the old way

is wrong but there might be a better way There is still a lot to be discovered regarding

depression and we need better treatments and resources.

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Bibliography
Beck, A. T., & Alford, B. A. (2009). Depression: Causes and treatment.

The American Journal of Psychiatry February 04, 2015 Depression-Related Increases and Decreases in
Appetite

The American Journal of Psychiatry January 01,2012 Imaging Adolescent Depression Treatment

http://www.powerofpositivity.com/