Learning About The Symptoms Of Depression

By Jan Howard

Depression, its causes and symptoms and what can be done to cure it, was the topic of a presentation, “Diagnosing Depression,” by Dr Daniel Wollman, PhD, at the November Lunch and Learn sponsored by The Learning Center at Ashlar of Newtown.

Dr Wollman is the director of the Center for Comprehensive Care, LLC in Shelton and medical director of the Lutheran Home of Southbury.

Dr Wollman said in diagnosing depression it is important to work in partnership with the patient to find out what the person needs, noting these concerns can often be discovered through discussions with the person.

“It is a more positive relationship because you’re asking what people need,” he said.

“Depression is a disturbance in our well-being,” Dr Wollman said. “It is a major problem that affects how we feel as people. It affects a person’s inner sense of comfort.

“It is a sense of not enjoying life that is underrecognized and sometimes untreated,” he said.

Some people are embarrassed to admit that they suffer from depression, he said. “They don’t want people to know. It’s hidden.”

Depression can be experienced as an ongoing persistence of feeling low, a lack of happiness, he said. Some other symptoms may include difficulties with sleep or activities and problems with concentration. Some people may be depressed without a sense of feeling blue.

Depression is diagnosed if these feelings are persistent and ongoing and interfere with activities a person likes to do, he said. “It is a disorder that limits the willingness to participate. Unfortunately it makes people feel embarrassed.”

Some causes of depression are grief, medications, changes in life situations, holidays, expectations, and the weather, commonly termed seasonal affective disorder, among others. Use bright lights to counter the effects of seasonal affective disorder, which affects internal chemistry, Dr Wollman suggested.

 “We have no control over the weather or changes in life,” Dr Wollman said. “There are parts of depression that are out of our control, but there are real biological changes that take place.”

He said that certain chemicals produced by the brain make it possible for us to know we feel good. “As our bodies age, so, too, is the case for the brain. It doesn’t manufacture enough of the chemical to have good memories and to experience that feeling of well-being. This is biological depression. The brain is not working like it used to.”

However, he noted, “There is really no word to describe that good feeling. What feels good to one person is different than another’s.”

Medications are helpful with biological depression, and will make a person feel well, Dr Wollman said. Many of these medications need to be readjusted, he added, so it is important to stay in close contact with your health care provider because the doctor may need to decrease or eliminate the medication. “It is an important issue to discuss,” he said.

Certain medications can cause some symptoms of depression. “Interactions between medicines should be monitored for these things,” Dr Wollman said. Small increases in side affects may be difficult to pin down, he added, noting that people react differently to medicines.

There are many different medications for depression, he said. “Some work right away, or not, or have side affects, or not. It is important to find out the problems a person is experiencing.”

If the person is sensitive to the medications, a low dosage may be recommended, he said. “It can always be increased.”

How to measure sadness is very subjective, Dr Wollman said, and more difficult to treat. “There is no easy answer. It’s a challenge.”

External events, the affect of things that have happened, are a strong part of depressive feelings, he said. “Medications alone are not the answer,” he said. “Medicine is not the be all and end all.”

Instead, Dr Wollman recommends a more comprehensive approach to help with depression, such as allowing people to work through a problem through therapeutic means. “You need to speak with someone who is objective.”

He recommends getting involved in activities. “Retreating is not helpful,” he said. “Share your thoughts with someone who has experienced similar occurrences,” he said. He noted, however, that support groups, while helpful for some people, might not be for others.

“It is hard for individuals to address that,” he said. “They can talk to their doctor, but not in large groups.” He said it is important to have someone with whom to share your thoughts.

Everyone needs a purpose, Dr Wollman said. “It is risky not having a feeling of self worth. You have to have a reason to get up each day.”

The problem may be in finding that purpose, he said. “There is a value in every single person.”

Dr Wollman said while depression sometimes runs in families, severe depression is more likely from genetic causes, especially if it starts when a person is in their 20s.

Dr Wollman said people should be flexible and open to new challenges that are different from what they used to do. “There are certain priorities at different times of life,” he said, noting, however, that the need for exercise does not change.

To find activities to do, make a list of things you have always wanted to do, he said. “A routine is very helpful.”