you’ve probably come out of a,particularly sad movie and said,something like man that was depressing,in this case you’re talking about how at,that moment the movie made you feel sad,discouraged hopeless or anxious you,probably wouldn’t say something like man,that movie was clinically depressing the,latter expression refers to a much,different state of depression clinical,depression which is sometimes called,major depressive disorder or unipolar,depression is a serious mental disorder,that has a lifetime incidence of up to,20 percent in women and 12 percent in,men making it one of the most common,reasons people seek out mental health,services that being said as well as,being relatively common clinical,depression is in fact very serious it’s,so serious that it interferes with,someone’s day-to-day life like working,studying eating and sleeping essentially,leading to this overall feeling that,life isn’t enjoyable but what causes,someone to feel this way well we don’t,exactly know what specifically causes,clinical depression especially since it,could be so different between patients,it’s probably a combination of factors,though like genetic factors biological,factors environmental factors and,psychological factors it’s been shown,that people with family members who have,depression are three times more likely,to have it themselves and this link,seems to increase with how closely,related family members are biologically,though most medications focused,specifically on neurotransmitters,neurotransmitters are signaling,molecules in the brain that are released,by one neuron and received by receptors,of another neuron when that happens,essentially a message is relayed from,one neuron to the next regulation of how,many of these neurotransmitters are,being sent between neurons at any given,time is thought to play a super,important role in the development of,symptoms of depression since they’re,likely involved in regulating a lot of,brain functions like mood attention,sleep appetite and cognition the three,main neurotransmitters that we focus on,for depression are serotonin,norepinephrine and dopamine why do we,focus on these three well,because medications that cause there to,be more of these neurotransmitters in,the synaptic cleft this space between,the neurons are shown to be effective,antidepressants and this finding led,researchers to develop the mono amine,deficiency theory which says that the,underlying basis of depression is low,levels of serotonin norepinephrine or,dopamine which are all called mono,amines because they have one amine group,additionally it’s thought that each of,these might have an impact on certain,sets of symptoms with depression like,norepinephrine on anxiety or attention,or serotonin on obsessions and,compulsions or dopamine on attention,motivation and pleasure so if one of,these is down then that could lead to a,set of specific symptoms being felt by,the patient serotonin in particular is,thought to be a major player some,theories suggest it’s even capable of,regulating the other neurotransmitter,systems although evidence supporting,this theory is still pretty limited some,hard evidence implicating serotonin in,depression has to do a tryptophan,depletion which is the amino acid the,body uses to make serotonin so if you,take it away you can’t make as much,serotonin and it’s been shown that when,the body can’t make as much serotonin,patients start getting symptoms of,depression so that’s all well and good,but unfortunately the reasons why,serotonin or other neurotransmitters,might be lost or decreased in depressed,patients in the first place isn’t well,known and research remains ongoing,ultimately development of depression is,complicated right it involves these,biological components in combination,with the genetic components as well as,environmental factors which could be,specific events like a death or a loss,or sexual and physical abuse in order to,diagnose clinical depression patients,must meet certain criteria that are,outlined in the Diagnostic and,Statistical Manual for mental disorders,the fifth edition first they must be,affected by at least five of the,following nine symptoms most of the day,nearly every day depressed mood,diminished interest or pleasure in,activities significant weight loss or,gain inability to sleep or over sleeping,psychomotor agitation,pacing or ringing one’s hands or,psychomotor impairment like this overall,slowing of thought and movements fatigue,feelings of worthlessness or guilt,lowered ability to think or concentrate,and finally recurrent thoughts of death,or suicide ality including suicidal,thoughts with or without a specific plan,as well as suicide attempts and these,symptoms must cause significant distress,to the patient’s daily life also the,depressive episode can’t be due to a,substance or other medical condition the,symptoms can’t be better explained by,another mental disorder like,schizophrenia and episode at any point,additionally sometimes major depressive,disorder can be divided into subtypes or,closely related conditions postpartum,depression is a subtype that can happen,following childbirth although studies,have shown that in many cases onset of,depression occurs prior to childbirth as,well so it’s now diagnosed as depressive,disorder with peripartum onset in other,words the onset happens during pregnancy,or for weeks following delivery it’s not,quite understood why this happens,although hormonal changes likely play a,role especially estrogen and,progesterone also though an abrupt,change in lifestyle might be an,important causal factor especially,because this can happen in men as well,as women atypical depression is another,important subtype that’s characterized,by an improved mood when exposed to,pleasurable or positive events called,mood reactivity and this is in contrast,to other subtypes like melancholic,depression even during what used to be,pleasurable events also atypical,depression often includes symptoms like,weight gain or increased appetite over,sleeping heavy feeling limbs also known,as leaden paralysis and rejection,sensitivity essentially feeling anxiety,at the slightest evidence of rejection,finally dysthymia now known as,persistent depressive disorder is,sometimes used to describe milder,symptoms of depression that happen over,longer periods of time specifically two,or more years with two or more the,symptoms a change in appetite a change,in sleep fatigue or low energy reduced,self-esteem decreased concentration or,difficulty making decisions and feelings,of hopelessness or pessimism knowing,that so many factors are probably,involved in depression it can be a,challenge to treat although with the,right treatment seventy to eighty,percent of patients with clinical,depression can significantly reduce,their symptoms treatment can come in,many forms and are most commonly grouped,into one of two major categories one,nonpharmacologic approaches in other,words things other than medications and,two pharmacologic approaches either a,single medication or combinations of,medications starting with an on,medication approach a number of studies,have shown the benefits of physical,activity in helping with depression,there are various reasons why it’s,thought to work ranging from the release,of neurotransmitters endorphins and,endocannabinoids to raising the body,temperature and relaxing tense muscles,regardless of the exact mechanisms data,suggests that exercising for 20 minutes,three times a week can help alleviate,depression symptoms there’s also a lot,of research exploring the relationship,between diet and depression and although,there are no silver bullet foods many,experts suggest healthy eating habits,like more fruits and veggies beyond,physical activity and healthy eating,which is more helpful for a number of,reasons,another major non pharmacologic approach,is psychotherapy or talk therapy which,is definitely preferred for young,patients and for those with milder,symptoms there are a few popular,approaches including cognitive,behavioral therapy and interpersonal,therapy and the most important thing,here is that these approaches depend,heavily on the relationship between the,patient and the therapist as well as the,clinical skills of the therapist if,patients have more severe depression or,mild depression for a longer period of,time then antidepressant medication,might be prescribed along with the,therapy the most commonly prescribed,medications are selective serotonin,reuptake inhibitors or SSRIs in the,synaptic cleft,after neurotransmitters get released,those neurotransmitters are normally,reabsorbed,SSRIs block the reabsorption or inhibit,the reuptake of serotonin which means,that there’s going to be more serotonin,in the synaptic cleft other classes of,antidepressants that are less commonly,prescribed are mono amine oxidase,inhibitors or Mao is and tricyclics as a,final last line treatment for severe,depression ECT might be performed under,written concent EC T stands for electro,convulsive therapy and is when a small,and controlled amount of electric,current is passed through the brain,while patients are under general,anesthesia and this induces a brief,seizure,although ECT has been used for decades,and actually does seem to be effective,for about 50% of patients the reason why,electrically induced seizures seem to,improve symptoms is not well understood,alright clinical depression is tough,right both for those experiencing it and,for those trying to help treat it unlike,many other illnesses depression carries,with it a lot of social stigma and can,lead to moral judgments that can make a,person with depression feel even worse,love and support from friends and family,helps tremendously and having a strong,social support network has been proven,to lead to better outcomes,you
RODOLFO: I didn’t want to face anyone;
I didn’t want to talk to anyone.,I didn’t really want to do anything for myself
because I felt so, I felt like,I was such an awful person that there was
no real reason for me to do anything for myself.,NARRATOR: Depression is more than just a feeling
of being down in the dumps or blue for a few days.,It is a serious illness that affects many people.,Symptoms can vary, but many depressed people lose interest,in activities they normally enjoyed,
have feelings of sadness, guilt, and worthlessness,,and have trouble concentrating.,RODOLFO: I couldn’t sit down for a minute really
to do anything that took deep concentration.,I tried a journal and I tried to do things
but I couldn’t do that, I couldn’t.,I didn’t read a book, didn’t really do,
I barely went to class. I wouldn’t get out of the house.,I was in college so I wouldn’t go to classes at all.
I gained a lot of weight.,NARRATOR: A person with depression can feel
irritable and restless, and have sleep problems.,RODOLFO: Sometimes I would sleep only 3 hours a night
or cause I couldn’t sleep for weeks.,And then but most of the time the opposite happened,,where I would sleep 10, 12, 15 hours a day even.,NARRATOR: People who are depressed can feel numb
and tired all the time.,In some cases it can even lead to thoughts of suicide.,RODOLFO: It was like I had big huge weights on my legs
and I was trying to swim and just kept sinking.,And I’d get a little bit of air, just enough to survive
and then I’d go back down again.,It was just constantly, constantly just fighting,
fighting, fighting, fighting, fighting.,NARRATOR: Depression is a real and complex illness
that is not yet completely understood.,We do know that the brains of people with depression
are different from those,without the illness, but we aren’t sure why.,Scientists at the National Institute of Mental Health
are studying brain images of people,who suffer from depression trying to learn
why it affects some people but not others.,Treatments for depression do work.,One type of effective psychotherapy is called
cognitive behavioral therapy or CBT.,CBT can help you change ways of thinking and,behaving that may be damaging or contribute to depression.,RODOLFO: I had one really good therapist
and through her I think I started really thinking about that,I did have depression.,NARRATOR: Medications called antidepressants can also help.,NIMH researchers are getting closer
to figuring out exactly how these medications work,,who benefits from them the most,
and how to make better, more effective ones.,For many people, a combination of medication
and psychotherapy may be the best choice.,Depression can be successfully treated in many people,,but sometimes treatments fall short.,For this reason, NIMH continues to study
the genetic, biological and environmental factors,that influence depression so that
new and better treatments can be developed.,RODOLFO: With people it became easier.
I totally think it is a lot easier when people know.,I think that was one of the key things that helped me do it,,so that I wasn’t doing it all alone.,NARRATOR: If you have depression,
telling friends, family, or someone you trust,,and finding a doctor or therapist
are the first steps on the road to recovery.,Depression treatment can take time to work, so don’t give up.,Read more about depression on this Web page.
If the symptoms fit, get help now.
my name is dr. Ryan Denee and I’m a,licensed psychologist here at Connexions,I’d like to talk a little bit about men,and depression because depression often,presents itself differently in men than,it doesn’t women now there are some,common symptoms and signs of depression,that everyone experiences man or woman,for example sadness crying hopelessness,feeling worthless and blue socially,withdrawing not caring about anything,suicidal thoughts even but in men some,common signs of depression can also be,anger and chronic irritability alcohol,or substance abuse aggressiveness even,arrogance or macho bravado can sometimes,indicate a man feeling depressed or,insecure and so it’s important that a,man goes to a therapist who is well,versed in men’s issues and how,depression and other issues present in,and uniquely clinical experiences taught,me that most men struggling with,depression need help in certain areas,certain specific areas first of these is,that he usually needs help to become,more assertive,now let’s may seem counterintuitive,because a lot of men come to therapy,because they have anger issues right but,I’m not talking about aggression as much,as being assertive as learning to ask,appropriately for what they need in life,and in the relationships in their life,to get their needs met appropriately and,to stop people in their lives from,violating their boundaries or treating,them poorly and to learn to do this in,an assertive appropriate way rather than,by using anger and aggression,another important masculine issue is,increasing emotional intelligence men,feel deeply they feel deep emotions,they’re not always sure how to express,them or what to do with them when they,rise so men can learn to identify those,core emotions what causes them into an,appropriate effective ways to handle,those emotions and often men find,therapy useful in helping them do that,another thing that therapy can help men,do is to deal with trauma many men have,survived traumatic experiences whether,in childhood or adulthood,and I’m talking here about physical even,sexual abuse however it’s far less,socially acceptable or okay for a man to,discuss his too openly at least discuss,his trauma from his past life and so,it’s important for a man to be given,space an opportunity to talk about that,in an environment that is non-judgmental,in which he doesn’t feel shamed another,important task for men who come to,therapy is to understand their anger I,remember I said that anger is often a,sign and inordinate anger is a sign that,they may be depressed men can learn to,recognize their anger as a signal that’s,something in their life is out of,balance it’s like a red flag that goes,up and they can channel that energy,learn to channel that angry energy more,adaptively more appropriately for,example using that energy to,appropriately be assertive or get their,needs met another important issue is to,help the man foster his spirituality men,are capable and very much in need of,intense meaningful spirituality much of,the time and helping a man access his,reserves of faith and surrender to the,divine is often a big part of his,ultimate healing process another,important issue is to help the man learn,to take responsibility in order to grow,and heal it’s important for men to stop,blaming other people for their sorrow,and their pain to take responsibility,for their own emotions behavior and,decisions healing and this is true for,men and women doesn’t start and to,always take responsibility for our lives,many men also need to deal with father,issues many men need to forgive their,father either for what their dad did or,what their dad failed to do this may or,may not mean having or building a better,relationship with their dad now their,father may or may not even be alive but,it it refers to dealing with the,emotional issues that come from their,relationship with their dad and so many,people do have issues in relationship,with their father and pain,that they live with from that finally,it’s very important for men men,struggling with depression in particular,to increase their connections,particularly their connections with,other men now women s’en seem to be,pretty good at this intuitively they,they talk to each other they’re open,about their feelings they understand the,idea of emotional intimacy and shared,experiences men need the same thing they,just experience it and go about it in a,bit of a different way so what a woman,would call a best friend or or an,intimate friend a man might call a,brother so men need to learn how to,create communities of brotherhood it’s,very important for men struggling with,depression or men looking for therapy in,any way to seek out a therapist who is,competent in male issues and understands,what a man needs in terms of his,therapeutic process,you