What happens to a car that is driven cross-country 50 times without a tune-up, oil change, or tire rotation? What happens to a car that is well maintained but driven coast to coast 1,000 times? Would some parts start to wear out? Might the car eventually cease to function altogether?

People aren't cars. However what happens to a car due to overuse or inadequate care is similar to what happens when they undergo prolonged severe stress or trauma and consequently don't have the time, money or ability to take care of themselves. Under such conditions, their emotional and physical reserves become taxed to the point where they can easily develop a clinical depression. Depression can also be caused by medical problems, by a history of drug or alcohol abuse, or by genetic factors. Dieting, especially when it leads to malnutrition, is another leading cause of depression.

Depression is by far the most common psychiatric problem in our country. Almost one third of women and one tenth of all men can expect to suffer at least one bout of depression in their life time. Unfortunately, few people individuals recognize the symptoms. Even if they do, they often fail to get help.

Don't you be one of them. Depression is a highly treatable condition. There is no necessity for, or purpose in, continuing to suffer needlessly.

What is Depression?

Everyone has "the blues" from time to time, and when it happens we often say we're depressed. But there are important differences between the "blahs" common to most people and biochemical or clinical depression.

For example, depression is part of the grieving process. If you are depressed because someone you love has died, this is not necessarily a sign of clinical depression. In normal grieving, the depression tends to lessen over time, even though it may take years. In clinical depression, however, the depression tends to increase over time. Clinical depression also involves mixed feelings towards yourself or others, self-hatred, and physiological problems such as sleep disturbances and fatigue. Indecision, inability to concentrate, memory problems, lowered sex drive, confusion and crying spells are other symptoms.

In clinical depression, the negative feelings are so overwhelming that they impair your ability to function. You can't make it to work, or it is a struggle to get there. You stop going out. You avoid socializing. The smallest task seems like a monumental chore and you can't concentrate enough to read a newspaper article, much less a book. You have trouble meeting the most basic obligations to your family or yourself. Indecision plagues you.

Depression is not only painful it itself, but creates fear. When you can't concentrate on the task at hand, you start to feel insecure about yourself and begin to worry that you won't be able to meet your responsibilities or take care of yourself. Your self-esteem becomes damaged, which, in turn, creates additional feelings of worthlessness. In our society, self confidence is valued. It isn't "popular" to have low self-esteem. If you are depressed, you might feel you have to hide your difficulties from others in order to be accepted by others. You might even feel you have to pretend to be happier than you really are.

But pretending is exhausting. Pretending creates further stress and only increases your fatigue and sense of isolation. Hence eventually you may give up trying to pretend and simply resign yourself to loneliness. Even when you feel like being with others, you might chose to be alone because pretending takes up too much energy and, if you are depressed, your energy is limited.

Clinical depression can make it difficult for you to know what is real and what is not. It is not unusual for people with depression to become hypersensitive to the reactions of others and to distort how others feel about them. Someone may say something to you, which under normal circumstances, you would hardly consider worth remembering. But under conditions of depression, you might experience that same comment as a major insult or slap in the face. Or, due to depression, you may feel utterly hopeless about situations in which there is, in fact, considerable hope.

Are you are plagued with feelings of fatigue, hopelessness, worthlessness? Are you having trouble concentrating and making decisions? Are you experiencing little pleasure in activities which used to interest you? Do you find yourself sleeping too much or too little?

If so, you may want to have yourself evaluated for depression. This would involve scheduling an appointment with your family doctor or a mental health professional, such as a psychiatrist, psychologist, social worker, or psychiatric nurse.

If you noticed a small lump on your body, you would probably make an appointment to have it checked out immediately. Perhaps you think that depression isn't as serious as all that, but it is. Left unchecked, depression grows worse over time and can not only make you feel miserable, but make you physically ill. Research has shown that depression harms the immune system and that people with depression are more susceptible to various illnesses and infections.

There is no need to go on suffering and put yourself at risk for more emotional and physical pain, when there is help available. Part 2 of this article, "Coping with Depression" provides specific suggestions. Additional information on depression , on how to find good mental health care and on related topics, such as guilt, trauma, helping children cope with fear, are available at www.matsakis.com

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