Kara seemed to have it all. Smart and attractive, she worked her way up the corporate ladder, attained respect and a prominent position. Her husband had also achieved success in his career. Together they shared a comfortable lifestyle and a seemingly happy marriage. Several weeks ago, Kara gave birth to her first child—a little girl—and all seemed to be perfect for them.

Kara’s friends admired her for various reasons. She could seemingly “do it all”, findings ways to balance a demanding career with family time, volunteer work, community projects, working out at the gym, and church involvement. Her home was decorated and landscaped beautifully and was kept in immaculate condition. Kara was always impeccably dressed and took pride in her personal appearance. But the first time I met Kara, it was evident that something was terribly wrong. She looked completely exhausted and made no attempt to brighten her appearance in any way. As soon as we began talking, she burst into tears.

Between bouts of crying, she was able to explain the devastating symptoms that finally compelled her to seek help. In the last few weeks, she had lost a significant amount of weight, had trouble falling asleep, felt totally exhausted, was easily agitated and highly irritable.

What Is Depression?

The emptiness, despair, and sadness that Kara described are symptoms of depression—a disorder now affecting as many as 13-14 million people annually. In the United States it is one of the most prevalent and serious emotional disorders, affecting about 20 percent of the population at some time in their lives, with only 20 percent of those receiving adequate help. Specifically diagnosing Kara’s problem was not difficult given the symptoms. She was suffering from postpartum depression, a disorder affecting approximately 10% of women following childbirth. Of those women most affected by depression are married more than singles, particularly in the childbearing years, and women between the ages of 25 and 44.¹

Some of history’s most well respected leaders such as King David, Winston Churchill, Martin Luther, and Abraham Lincoln struggled with depression. Although it can strike people of all races and socioeconomic backgrounds, women are twice as likely as men to experience its effects, as 20% of women develop clinical depression.

Signs of depression include sadness, hopelessness, pessimism, difficulty in making decisions, general fatigue, a loss of energy, and a lack of interest in work, sex, religion, hobbies, or other activities. Those suffering from depression may also experience low self-esteem and have feelings of guilt, shame, and worthlessness. A loss of spontaneity, insomnia, excessive crying, irritability, and loss of appetite are also common symptoms. Of the nine criteria mentioned above used to clinically diagnose depression, only four are needed.

Depressions are best viewed from a holistic perspective because they affect the way we think, feel, behave and relate. Besides feeling sad it affects the way we feel physically too. These episodes are not simply the temporary blues or the passing sad moods that everyone experiences after a loss. For some, depression is so serious that it interferes with their ability to function at work, to more severe forms that can include difficulties getting out of bed or eating. Approximately 15% of people hospitalized for depression eventually take their own lives. Of those who commit suicide, 67% visited their health care provider in the month prior.

Categories of Depression

Major Depressive Episode — 5 or more symptoms in same 2 week period mentioned earlier One of the symptoms must either be:
1. depressed mood most of the day, nearly every day, or
2. markedly diminished interest or pleasure in activities most of the day, nearly every day
Manic Episode — distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week with 3 other symptoms coexisting (i.e. inflated self-esteem, decreased need for sleep, more talkative than usual, flight of ideas or racing thoughts, distractibility, increase in goal-directed activity, excessive involvement in activities with dangerous consequences).

Disorders
Dysthymia — depressed mood nearly all of the time for at least two years. No manic or major depressive episodes are present.

Major Depressive Disorder — presence of one or more major depressive episodes

Bipolar I Disorder—evidence of manic and major depressive episodes

Information taken from Diagnostic and Statistical Manual of Mental Disorders (4th. ed-text revision). (2000). American Psychiatric Association: Washington, DC.

What Causes Depression?

Depression can be caused by several factors. Biological and genetic influences (i.e. heredity) can determine certain types of depression. Physiological issues such as an improper diet, lack of sleep, or more severe problems like brain tumors or glandular disorders can also be to blame.

In the majority of cases, depression is primarily influenced by emotional battles. One of the most common emotional struggles is strained relationships. Significant losses in life like the loss of opportunity or status, of health, or of a job can be devastating. Divorce, death, or prolonged separations are also known to be among the most powerful depression-producing events of life.

Depression can also be linked to negative thinking and repressed anger. In addition, sin and guilt usually evoke feelings of self-condemnation, frustration, hopelessness, and other depressive symptoms.

Why Are Women More Likely to Suffer From Depression?

Most argue that women are at a much higher risk for depression than men. Several unique factors are known to contribute to this risk. For example, women are more likely to live in poverty and suffer physical or sexual abuse.

Biological factors, however, seem to be the major cause:

Premenstrual Syndrome (PMS) — A recent study has shown that ninety percent of women report premenstrual mood symptoms. Most women are able to face and effectively cope with these mood changes each month. However, some women are so affected by the hormonal changes that they feel ashamed, helpless, or out of control. When the mood shifts become serious enough to interfere with relationships and daily functioning, it can contribute to or cause depression.

Childbirth (Postpartum Depression) — It has been estimated that one out of ten women has an episode of serious depression after giving birth. Experts in postpartum care have reported that the “baby blues”, a mild form of postpartum depression, affects fifty to seventy percent of all mothers. Mild postpartum depression includes crying spells, restlessness, and feelings of unreality and confusion. While the overwhelming changes of motherhood are partially to blame, hormonal shifts that occur seven to ten days following birth have been shown to contribute to this form of depression in women.

Menopause and “The Empty Nest” — As a woman ages, major changes in her life (emotionally and physically) often trigger episodes of intense sadness or serious depression. The psychological and physical changes of menopause clearly contribute to negative thoughts and struggles about self and life. The emotional effects and sudden lifestyle changes that occur when children leave the home can also be upsetting and cause turmoil in a woman’s life.

How Can I Conquer Depression?

Awareness — Get the facts. Awareness is the first step in overcoming depression.

Deal With Physical Issues — If you suspect that a physical problem exists which is causing you to struggle with depression, seek professional help immediately. One estimate suggests that 40 percent of depression may come as a result of physical illness. A complete physical examination and medical work-up is always recommended. In addition, talk with your doctor about an exercise program. Research show consistently that moderate exercise is very effective in helping reduce the grip of depression.

Deal With Negative Thinking — Depressed people want to feel better, but these feelings are hard to change. The only way to do so is to change the negative thinking patterns often characteristic of depression. Philippians 4:8 gives us guidelines for editing our thought patterns.

Seek Support — Depressed persons usually withdraw from friends, family and church in order to “get control of their lives” and/or “rest.” This withdrawal, while logical, often isolates a person from support and positive interactions in life. Keeping a balance between rest, God time, interaction with others and outside activities is important.

Psalm 46 was a powerful encouragement to Martin Luther in his depression—I’d encourage you to read it. In distresses, God can be found. In addition, a good support group can be of help.

Get Outside Help — Sometimes the very nature of depressive disorders can interfere with a person’s ability or wish to get help. There are effective counseling treatments and medications which can improve your overall life satisfaction, as well as prevent future relapses. Of those who seek help for severe depression, 80% are able to return to daily activities-usually within a matter of weeks. If you need help, don’t be afraid to seek out a pastor, physician, or counselor.

Remember, your pain right now may seem stronger than any hope for the future, but the burdens you are carrying need not be your burdens forever. Hope will return as you start to reach out for it—not by denying the present situation, but by knowing that even in the pain of today, there is hope for a better tomorrow.

¹ Statistics retrieved from http://www.add-adhd-help-center.com/Depression/statistics.htm on December 13, 2005.