The measure for clinical depression is defined by the Diagnostic Statistical Manual (DSM) of the American Psychiatric Association. Five of the following symptoms must be present most days for a minimum of two weeks:
In 2001, a Canadian Mental Health COMPAS Public Opinion and Customer Research survey looked at mental health among Canadians. When asked how often they felt stressed, 24 per cent said about once a month, 43 per cent a few times a week, and nine percent all of the time. Only five per cent said they never really felt stressed.
A 1994/95 National Population Health Survey found seven per cent of Albertans were probably experiencing depression during the year. The World Health Organization estimates that by 2020, depression will be the leading worldwide cause of disability.
Stress is the body’s response to a challenge, while the term ‘stressor’ refers to the stimulus causing stress. A stressor can come from within. For instance, worry about how you will make time to attend your son’s hockey game tonight when you have a work report due tomorrow. It can also be external, such as being frightened by an oncoming car while crossing a street.
Stress can also be acute (short-term) or chronic (long-term). You might feel acute stress while preparing for a meeting, and chronic stress when you think about finances or health concerns.
Both hormones and the nervous system influence the body’s stress response. Stress is both psychological and physical – the same fight-or-flight-reaction our ancestors had when chased by wild beasts. Without a stress response, it would be difficult to survive danger.
The body reacts in many ways to stress. The heart races, breathing is faster, blood pressure rises, the hands and feet may get cold, and muscles tighten to prepare for battle. You might need to empty the bladder or bowel, or sweat more. Sensory organs such as the eyes and ears are put on alert. The mind sharpens, but can go blank if overwhelmed. Psychologically, the person may feel more alert, wired or frightened.
When surveyed, 44 per cent of Canadians listed time pressure as the most common source of stress. Others included financial problems (38 per cent) and not being able to meet the expectations of others (31 per cent). Being unable to change a home’s location was a stress for 21 per cent of people. Statistics differ for men and women. Women report feeling stressed more often by a wider range of stressors. Worries include time pressure, other’s expectations, marital issues, children and family health. Men are stressed by employment issues such as job demotion, pay cuts or lack of money. Stress levels seem to reduce with age and with increase of income.
Check out the the Statistics Canada web site:
Although acute stress may actually protect you, chronic or prolonged stress can do harm. Think about how stressful situations and worry have affected you in the past. What would happen to your body if it remained on high alert day after day, year after year? Just as a motor would burn out on a blender or car engine left running on high speed for hours, your body would eventually collapse.
Although stress is associated with psychological problems, remaining on high alert for long periods of time is both physically and mentally damaging. Statistics Canada followed up with stressed individuals after a five-year lapse and found they had more difficulties with their health. Problems included arthritis and rheumatism, back problems, chronic bronchitis, emphysema, and stomach or intestine ulcers. Stress placed men at higher risk of heart problems, while more women suffered asthma and migraines.
If you are chronically stressed, you risk depression and anxiety. You may also have problems with substance abuse if you turn to alcohol and drugs to help cope. Work and home life can suffer, starting a chain of related problems.
In medical terms, clinical depression is referred to as major depression. It is different from chronic low-grade depression, or dysthymia. Depression involving periods of feeling highly energetic, happy and excited can contrast with dark, low moods. If these two extremes cycle like a yo-yo, it may indicate bipolar or manic-depressive disorder.
Distress, sadness and tears do not necessarily mean clinical depression, but can be an appropriate response to a given situation. On the other hand, someone can smile, act normally and dress neatly but still be clinically depressed. Major depression is a medical condition, not simply a state of mind. In clinical depression, the symptoms will be extreme enough to interfere with work and social relationships.
Since stress involves both physical and psychological problems, biological, psychological and social aspects of your life can all play a role. Stressors later in life may spell trouble for someone medically at risk of developing depression or who has suffered trauma in childhood. In the same way that having a family history of diabetes can increase your chance of developing the condition, your doctor needs to know if depression or mental illness exists in your family.
Current research suggests that past life events or stressors can damage the brain. Much like a broken leg, the brain heals but may be less able to recover in future. The risk of depression happening again seems to increase with each episode. Chronic stress can help depression continue. Still, there is hope. Through a process known as neurogenesis, the brain seems to mend over time when treatments work and you recover.
You can do a great deal to protect yourself from stress and depression.
First, admit stress is a problem. Your intellect or position in life cannot protect you from the negative effects of living an unbalanced, stressful life. While some denial may be necessary, too much can be harmful.
Take charge of your health. Devoting time and effort to staying well pays off physically, emotionally, socially and financially. Prevention is essential. Educate yourself about health issues by talking to health care experts, researching and reading. When using the Internet, ask a health professional about the quality of websites and the accuracy of information you find.
Get control of your life. Be careful if you are becoming too pressured and scattered. Learn to say no, and understand that your resources are limited. Since you cannot please everyone, expect some people to be unhappy with you. Develop priorities for what you do and when you do it. Set boundaries on the expectations and requests from others. Take a few minutes every day for yourself, and question the value of relationships in which you give more than you are receive. If there is conflict in your workplace, try to resolve it. Seek help from an experienced colleague, friend, family member or health care provider.
Stay in shape physically. You don’t have to spend money on a club membership! Make time to walk and talk with a friend or your spouse on a regular basis. Even simple changes like taking the stairs instead of the elevator can make a big difference.
Eat well. Many people, when stressed, develop cravings for comfort or junk foods. Recognize that this is common, and punishing yourself with a fad diet is not the best solution. Although it’s not glamorous, following the Canada Food Guide or a diet developed for diabetes control (if you have no health problems) is an excellent option. Try to eat more meals at home. If you are too heavy, developing healthier eating habits may be better for you than simply trying to lose weight. Changing your habits can help you take weight off naturally.
Socialize. Friendships help support you and offer relief from work and family problems. Staying connected to others seems to protect mental health.
Exercise your mind and enhance your spirit. Using your mind by reading, playing cards or even dancing helps maintain your mental functioning. Strong spirituality may also fight depression. Relaxation exercises such as meditation and yoga may improve your quality of life.
If you are overwhelmed and think you may be depressed, see your doctor. Write down your symptoms and all that is not going well in your life. Mention the role emotional support plays for you. Indicate if your job performance is being affected. If others in your family have had the same condition, that knowledge and their response to treatment is valuable. Remember to discuss the use of over-the-counter medications, painkillers, street drugs or alcohol. Your doctor’s course of action will depend on the quality of information you provide.
Counselling and medication, each with advantages and disadvantages, can be used to treat depression. Since your doctor will look at medical, psychological and social factors in evaluating you, treatment will depend on your own unique circumstances.
Be an active participant in making decisions about your treatment. Talk to your doctor about any concerns. Regardless of the chosen treatment, educate yourself about your options. A spouse, pharmacist, counsellor or other health care worker can provide valuable information as part of your decision-making process. If more than one health care professional is involved, you can help coordinate your care.
Stress is a common and necessary part of life. By taking an active role in managing it, you may be able to avoid complications. In most cases, clinical depression is reversible. It is not a character flaw. If stress or depression is getting the better of you or someone you know, seek help from a health care professional