Where do I find help if I think I am suffering from depression or anxiety?

A psychiatrist is the most qualified person to treat mental health issues. Depression can be difficult to diagnose because the signs and symptoms are often vague; and there are several different types of depression, including Seasonal Affective Disorder (S.A.D.), Dysthymia, and major depression. The first step in identifying a depressive disorder is to rule out physical causes of behavior or mood change. In people who have Spina Bifida and shunted hydrocephalus, this is especially important because many signs and symptoms of depression may be caused by medical conditions (shunt malfunction, infections, or medications) rather than depression. In those situations, the symptoms disappear when the underlying medical condition is treated or corrected.

Along with a physical assessment, it is critical to know the individual’s medical history which includes behaviors such as drug use, eating habits, sleep, and physical activity, and other pertinent information including:

• family history of mental health problems,
• recent trauma, and
• support systems that may be in place

What should a health care provider do if he/she suspects depression?

Two screening questions are asked:
1) During the past month, have you felt down, depressed or hopeless?
2) During the past month, have you been bothered by decreased interest or pleasure in life?
If the person answers “yes” to either or both questions, more screening is needed.

What should family or friends consider if they suspect depression?

Ask yourself these questions:

• Does he/she interact with peers and family?
• Does he/she sleep well? How is his/her appetite?
• Has he/she lost interest in pleasurable things?
• Is he/she able to go to work, do his homework, study and concentrate?
• Is he/she complaining about being generally unwell?

Everyone has been sad, anxious, or even a little depressed; but clinical depression is more serious. Symptoms of clinical depression are more severe, last longer and generally don’t go away on their own. Clinical depression affects daily functioning.

What are the symptoms of clinical depression?

According to the National Institute of Mental Health, symptoms of depression may include:

• Concentrating, remembering details, and making decisions
• Fatigue and decreased energy
• Feelings of guilt, worthlessness, and/or helplessness
• Feelings of hopelessness and/or pessimism
• Insomnia, early-morning wakefulness, or excessive sleeping
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable, including sex
• Overeating or appetite loss
• Persistent aches or pains, headaches, cramps, or digestive
• problems that do not ease even with treatment
• Persistent sad, anxious, or “empty” feelings
• Thoughts of suicide, suicide attempts

What causes depression?

Most experts believe that depression is caused by problems with certain chemicals in the brain. These chemicals, called neurotransmitters, send signals from one nerve to the other. There are many of these chemicals, but there are three that control our moods: 1) norepinephrine, 2) serotonin and 3) dopamine.

Who is at high risk for depression?

People with Spina Bida and hydrocephalus, chronic pain sufferers, women, especially those with hormonal imbalances. Also, people with Attention Deficit Hyperactivity Disorder (ADHD) and/or learning disorders have higher rates of depression. This may be because of school failures, low self-esteem or a chemical imbalance in the brain. Research suggests that depression is more common among people in northern climates, especially in winter.

Depression is linked to family history. If one person has depression, his family members are more likely to have depression at some time.

Stress, especially chronic stress, plays a role in depression. This stress could be from home, school or work, or from something else like a surgery. Depression is more common following a major personal loss, such as the death of a loved one.

Low self-esteem is associated with depression and is one reason why people with Spina Bifida are more likely to be depressed. Other risk factors include decreased social support and isolation. Learned helplessness—where people feel that there is nothing they can do to improve their situations—may contribute to depression.

How is anxiety related to depression?

If someone is anxious, he or she is more likely to be depressed. Many medications used to treat depression are used to treat anxiety. Like depression, anxiety runs in families. Symptoms of anxiety include feeling tense or afraid, having a persistent sense of dread, panic or terror. People who are anxious may worry a lot. Anxiety breaks up concentration and tends to result in a focus on oneself.

One type of anxiety disorder is obsessive-compulsive disorder (OCD). Signs include repeated, purposeful behaviors that try to reduce anxiety. Behaviors may include repeated hand washing, counting objects and needing objects to be arranged in a certain order. Severe OCD interferes with functioning and should be treated. The good news is that anxiety and depression are treatable.

How are depression and anxiety treated?

There are many ways to treat depression and anxiety. Studies show that exercise can have a great effect. The National Center on Physical Activity and Disability (NCPAD) offers great information on physical activity and health for people who have difficulty with mobility. Sports provide a good workout and make it easy to meet people. Horseback riding is fun, too. It stretches the muscles and joints.

Beyond exercise, medication and counseling may be needed. It is important that you speak with your physician about what medication is best for your situation.

Counseling (including a type called cognitive-behavioral therapy) can be valuable, especially with anxiety. Sometimes it’s very helpful for the entire family to receive counseling.

Get help

If you or someone you know seems to be depressed, talk to a health care provider. If you try to talk about depression or anxiety and your health care provider doesn’t react the way you think he or she should find another provider who will listen. You can also find help by calling your local mental health hotline.

This information does not constitute medical advice for any individual. As special cases may vary from the general information presented here, SBA advises readers to consult a qualified medical or other professional on an individual basis.