Major Depressive Disorder | Hawaii Psychiatric

Depression and Suicide

Depression is typically one of the biggest risk factors for experiencing thoughts of suicide. The deep feelings of hopelessness and despair that go hand in hand with clinical depression can cause suicide to feel like the only available way to get through the pain. Thoughts of suicide or thoughts of dying should be perceived as a serious symptom that clinical depression is being experienced, and so suicidal talk, suicidal thoughts and suicidal behavior should absolutely be taken seriously. This is not only a warning sign that the person is currently thinking of suicide, but when someone talks about suicide, they are most commonly reaching out for help.

Here are some of the warning signs of suicidal thoughts and feelings:

- The person might talk about killing one’s self or harming one’s self,

- The person might express strong feelings of being trapped or feeling hopeless.

- The person might be unusually preoccupied with dying or death in general.

- The person might act in a reckless manner, as if they had a death wish, such as by driving recklessly or otherwise acting like they would not mind getting hurt or becoming killed.

- The person might call people or visit them in order to say goodbye.

- The person may seem to be getting their affairs in order.

- The person may give away prized belongings.

If you believe that a friend or a family member could possibly be considering suicide, then you need to express the concerns that you have and seek out professional help as quickly as you possibly can. It is important that you talk openly about thoughts and feelings of suicide in order to save the life of someone in need.

Filed Under: Health, Mental Health Tagged With: Major depressive disorder, Suicidal ideation, Suicide

The Signs and Symptoms of Depression

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The signs and symptoms for depression can vary significantly from one person to the next, but there are definitely some more common symptoms and signs of this mental illness. It is important that you remember that all of these symptoms can come and go as part of life, but when you have more symptoms and stronger symptoms, or if they are lasting longer and longer periods of time, then it is possible that you are dealing with real clinical depression. When these specific symptoms become overwhelming and increasingly disabling, that is when you need to get help.

Feelings that you are helpless or hopeless. You may have a bleak outlook about your life, feeling like nothing is going to get better and that there isn’t anything available for you to do to improve the situation that you are in.

Loss of interest in things that you are normally interested in from day to day. Your hobbies, social activities, past times and even sexual interactions may no longer be fulfilling.

Changes in weight or in appetite.

Changes in sleep such as insomnia or oversleeping, which is known as hypersomnia.

Restlessness and feelings of irritability. You may feel on edge, restless or agitated. Your coping mechanisms may seem nonexistent and your level of tolerance may be low. When you are feeling this way, everyone and everything may get on your nerves.

Loss of energy or lacking energy in comparison to normal. You may feel fatigued or sluggish, or you may simply feel completely physically drained. Small tasks may even feel exhausting for you.

Feelings of self loathing. You may feel guilty or worthless, and you may criticize yourself harshly for thoughts or mistakes that you perceive.

Problems with concentration including problems focusing, remembering things and making decisions.

Unexplained pains and aches throughout the body including back pain, headaches, stomach pain and aching muscles.

Filed Under: Health, Mental Health Tagged With: Major depressive disorder, Mental disorder, Symptom

Are You Depressed?

Everybody is capable of experiencing ups and downs when it comes to our moods. Sadness is a completely normal reaction to the struggles, the setbacks and the disappointments that we deal with on a daily basis. Many people commonly refer to these kinds of feelings as depression, though feelings of depression are actually much more severe in comparison to sadness. Many people have described having depression as feeling as if you are living in a black hole, or possessing a feeling reminiscent of impending doom. Some people that have depression do not actually feel sadness at all, but instead they experience feelings of apathy, emptiness and lifelessness.

Whatever symptoms you experience, depression is definitely different from a normal type of sadness in that it will completely engulf your life on a day to day basis, interfering with things like your ability to study, work, sleep, eat and simply enjoy yourself. There are a number of intense and even unrelenting feelings that you will experience including helplessness, worthlessness and hopelessness, and it is likely that you will very rarely if ever experience periods of relief.

There are a number of signs and symptoms associated with true depression. If you have any of these symptoms and they do not seem to be capable of going away, then you may be suffering from true clinical depression: difficulty sleeping or sleeping too much, inability to concentrate, previously simple tasks have become more difficult, hopelessness, helplessness, uncontrollable negative thoughts, loss of appetite or inability to control eating, irritable more than often, short-tempered more often than usual, or you experience thoughts that your life is no longer worth living. If you experience any of these symptoms on a consistent basis, then now is the time for you to request help from someone that can help you understand your feelings.

Filed Under: Mental Health, Psychiatric Consultant Tagged With: depression, Major depressive disorder, Symptom

Choosing an Antidepressant

If you are suffering from depression, there are a myriad of antidepressant products that you may try, but choosing an antidepressant must be an agreement between you and your doctor. One of the first steps is that your doctor may choose one for you.

Past experience with an antidepressant. Your doctor may choose an antidepressant that he or she has prescribed before, primarily for familiarity’s sake. If your doctor has experience with the drug interactions and side effects, then they may be more comfortable prescribing it. Some doctors have a tendency to prefer certain types of antidepressants or certain groups of antidepressants if they have had a track record of being effective for certain types of depression.

Past history with an antidepressant. If you have history with an antidepressant in the past, then the odds are good that your doctor will try prescribing it again, but only if you had any successful history with it. Your doctor will not likely revisit an antidepressant that was not effective for you in the past. Your doctor may ask you specifically which antidepressant products have or have not worked well for you in the past.

Family considerations with antidepressants. If you have family members with depression, your doctor may look to the medications that have worked for them in the past, and might make a suggestion based on that information. What has worked for a parent or a sibling may also be effective to treat your type of depression as well.

Health issues and antidepressants. Your doctor will also consider any health issues that you may have, and may end up choosing an antidepressant product based on any potential interactions. If you have a health issue that will prevent a certain type of antidepressant from being ideal, let your doctor know so that they can make choices about your depression treatment accordingly. It is important that your antidepressant benefit you without potentially interacting poorly with a medication that you are taking, or an issue with your health.

Filed Under: Health, Psychiatric Consultant Tagged With: Antidepressant, Major depressive disorder, Mood disorder, Past medical history

Bipolar Disorder in Teenagers

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Bipolar disorder is a serious mental illness that usually only affects adults. Sometimes, however, this disorder can be seen in teenagers. Oftentimes the symptoms of bipolar disorder will begin in childhood and will manifest as manic or depressive behavior. Diagnosing bipolar disorder in teenagers is imperative in order that they begin immediate treatment.

Bipolar disorder is non-discriminating. It can be found in teenagers in wealthy homes or poor ones. It can be found in seemingly well adjusted teenagers or those who are having social difficulties. One thing is consistent, however. Families with a history of drug or alcohol abuse results in a higher percentage of teens with bipolar disorder.

Some of the symptoms of bipolar disorder in teenagers include severe changes in mood. Their mood will go from being silly or very happy and can plummet in a second to aggressiveness or agitation. Teenagers with early symptoms can believe that they are invincible or develop the ability to go for days on end without sleep. They can be distracted very easily and move from task to task very quickly without completing any of them.

Bipolar disorder in teens is difficult to diagnose due to the sheer number of possible symptoms, and differentiating between normal teenage behavior and bipolar disorder can be difficult. However difficult the diagnosis may be, bipolar in teens can be successfully treated. Treatment includes education for the family and patient and mood-stabilizing drugs as well as psychotherapy. Drugs are necessary at first to ensure that there are no more episodes while the patient begins therapy.

It is imperative that parents remain vigilant if they suspect their teenager is suffering from abnormal mood behaviors, and if there is any doubt they should consult a physician. Early diagnosis can lead to a completely stable adult, not to mention the resumption of normal teenage behavior and activities.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Bipolar disorder, Diagnosis, Major depressive disorder, Mania, Mental disorder, Mental health, Mood stabilizer, Symptom

The Skinny On SAME

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What if your severe depression didn’t respond to drugs, but instead to high-end caviar? Initially you’d be elated, but over time the high costs of fancy antidepressant dining would be a source of distress to themselves. And since caviar is not an approved drug, your insurance company would not lift a finger to help you cover the costs.

This is exactly the situation encountered by users of S-adenosyl methionine, or SAMe. SAMe is a molecule that is already present in the body, and it is available as a dietary supplement. In Great Britain, SAMe has been widely used as an antidepressant. Like most antidepressants, nobody is quite sure how SAMe works, but study after study confirms that whatever it does, it does it well.

For example, a July 2010 study in the American Journal of Psychiatry showed that 77% of antidepressant-resistant patients who followed their usual drug cocktail with a dose of SAMe shed their symptoms of depression. This is especially good news, because antidepressant-resistant patients have little recourse; mainstream psychiatric drugs do little to ease their suffering. Doctors think that SAMe works by a significantly different medical mechanism than most prescription drugs, allowing it to help an underserved group of patients.

Because SAMe is classified as a dietary supplement in the US, you can buy it at Wal-Mart. But beware-the dosage recommended by most clinicians can cost $150-250 per month. Unless your own doctor is open-minded about complementary medicine, you’ll have to experiment on your own to find your correct dosage. And you’ll have to read up-for example, SAMe is also used in Britain to relieve arthritis and cirrhosis, but don’t use it for bipolar depression. SAMe seems to make it worse.

Until the FDA tests and approves SAMe, antidepressant resistant patients are left adrift. SAMe is an expensive experiment to try without expert guidance. If you think SAMe might help you where prescriptions have not, your best bet is to try to find a mental health care provider who is open to alternative and complementary treatments.

Filed Under: Mental Health Tagged With: American Journal of Psychiatry, Antidepressant, Dietary supplement, Food and Drug Administration, Major depressive disorder, Mental health, United States, Wal-Mart

Cognitive Behavioral Therapy

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People are unique, but not totally unpredictable. Even the least routine life is a slave to patterns. We all develop patterns and systems of thought and behavior in our life. For example, given a conflict, some of us always come up fighting; some shy away. Some of us can congratulate ourselves on a job well done, and some always denigrate their achievements. Some people place blame exclusively on others, and some people always blame themselves when things go wrong.

You might be able to identify some of your own patterns, and if so, you’ll probably recognize that we all have a few that drag down our quality of life. For example, if you habitually downplay your own achievements, you’re likely to feel that you’re not good at anything.

But this may go further-as the result of your negative self-image, you won’t strive to do great things. As a result, you’ll consistently appear to be a ne’er-do-well to yourself, reinforcing your original beliefs. This ever-strengthening spiral of negativity may eventually crush you into a serious depression.

Cognitive behavioral therapy is designed to help us to confront and break these patterns. A cognitive behavioral therapist acts as a kind but impartial outsider, seeing the biases and negative patterns that we are too close to see. To defeat these biases, the counselor challenges them-she tries to show in conversation that our assumptions are harmful and untrue. She often coaxes us to confront our fears in real life. As we boldly face the things that we want to avoid, and our worst fears don’t come to pass, the fears dissipate and we gain new, constructive patterns of thought.

Cognitive behavioral therapy is especially effective for many people because it is concerned with changing your life in the present. It was developed in part as a reaction to psychological practices that dealt mostly with the emotions of our childhood. Cognitive behavioral therapy is the therapy method of choice for many counselors, and has proven effective across a wide range of afflictions, difficulties, and disorders.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Behavior, Cognitive behavioral therapy, Disorders, Emotion, Health, Major depressive disorder, Mental health, Psychology

The Stigma of Childhood Mood Disorders

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When it comes to your mental health, age isn’t a factor. Modern psychology is tearing down the assumption that certain disorders must be associated with certain stages of life. We now recognize depression in toddlers, ADHD in adults, and body dysmorphic disorder in children and the elderly.

While the psychology community and the public generally accept novel adult diagnoses, society hesitates when it comes to children. For example, in the August 25, 2010 New York Times Magazine article, Can Preschoolers Be Depressed? doctors admitted that health care providers often sugarcoat their diagnosis of childhood depression. In order to shield the child from the burden of such a heavy psychological label, doctors report euphemistically: “adjustment disorder with depressed mood- or “N.O.S.”, meaning not otherwise specified.

Other doctors decry this practice-by denying children the gravity of their diagnosis, they are doing a disservice to the child’s distress. Without specifying the child’s disorder, they are preventing the child from getting specific care. Doctors who diagnose euphemistically are also preventing widespread understanding and acceptance of childhood mood disorders.

This is especially unfortunate, because children’s brains are excellent candidates for cognitive therapy. As a child’s brain grows, it is capable of learning and forming neural pathways at a much faster rate than adults. Without good psychiatric care, the child’s disorder is likely to amplify by adulthood. A good child counselor can help a child with mood disorder to work through his anxiety so that it will diminish greatly as he grows older.

If you suspect that your child has a mood disorder, you may experience a similar aversion to the stigma of a conclusive psychological diagnosis. Many parents feel guilt over their child’s mood disorder. It is important to keep in mind that the disorder is not your fault-child mood issues are often hereditary, or caused by the child’s specific reactions to situations that aren’t threatening to most children. As a child’s caretaker, you have the most power over his psychology, and you can use this to help him out of his disorder into a functional and wonderful adulthood. Start by getting him diagnosed.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Attention-deficit hyperactivity disorder, Child, Disorders, Health, Health care, Major depressive disorder, Mental health, Mood disorder

Checking In For Psychiatric Care

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As any therapist will tell you, asking for help is the first step on the pathway towards a more productive lifestyle. You might not even be aware of all the clinical definitions of your mental health issues but you are certainly aware when something isn’t right. You might be surprised to know that most of the patients at a psychiatric care facility are there voluntarily. This means they have all essentially checked themselves in and want to get better. These are the folks you’ll be sharing your time with as you join them in group therapy sessions and daily interactions. Like you they can be suffering from a range of typical mental health disorders such as depression, anxiety or low self-esteem. But you’ll all have a common goal: to get better.

In addition to your interacting with other patients, you’ll have the chance for some direct one-on-one counseling with trained psychiatric professionals. One of the benefits of working with psychiatrists is that they’ll be able to prescribe possible drug therapies to help your through your healing process. Because you’ll be living at the facility, you’ll be able to instantly make any dosage adjustments in order to find the perfect fit. The purpose of a vacation is to take you away from your daily routines and give you the chance to rejuvenate. Take away the word “vacation” and you’ll be essentially establishing the same goals at a psychiatric care facility. With the potential positives results, that stay can be better than any vacation!

Don’t let Hollywood scare you. Not every psychiatric care facility is like the one in “One Flew Over The Cuckoo’s Nest.” In fact, most of today’s psychiatric care facilities are clean, well maintained and staffed by dedicated professionals. Why is this important to know? Because if you ever reach a point in your life when coping with daily matters has become a burden, it might be time to check into a psychiatric care facility to help get your life back to normal.
As any therapist will tell you, asking for help is the first step on the pathway towards a more productive lifestyle. You might not even be aware of all the clinical definitions of your mental health issues but you are certainly aware when something isn’t right. You might be surprised to know that most of the patients at a psychiatric care facility are there voluntarily. This means they have all essentially checked themselves in and want to get better. These are the folks you’ll be sharing your time with as you join them in group therapy sessions and daily interactions. Like you they can be suffering from a range of typical mental health disorders such as depression, anxiety or low self-esteem. But you’ll all have a common goal: to get better.
In addition to your interacting with other patients, you’ll have the chance for some direct one-on-one counseling with trained psychiatric professionals. One of the benefits of working with psychiatrists is that they’ll be able to prescribe possible drug therapies to help your through your healing process. Because you’ll be living at the facility, you’ll be able to instantly make any dosage adjustments in order to find the perfect fit. The purpose of a vacation is to take you away from your daily routines and give you the chance to rejuvenate. Take away the word “vacation” and you’ll be essentially establishing the same goals at a psychiatric care facility. With the potential positives results, that stay can be better than any vacation!

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Major depressive disorder, Medical Specialties, Mental health, Psychiatry

Don’t Let the Holiday Blues Bring You Down

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But there can also be a down side to the holiday zone. For some people it’s a time of immense stress as they strive to make things perfect for everybody. It can also be a period where feelings of loneliness come to the forefront of your mind. These feelings can lead to depression and that depression can actually linger well beyond the holidays.

If the approach of the holidays begins to weigh you down with apprehension and dread then clearly you’re missing the spirit of the times. Could there be an underlying stress factor that is being triggered by the holidays? Do these feelings come upon you every year? Are they becoming harder and harder to shake off? Seeking out the answers to those questions can put you on a positive path towards stronger mental health. The solution can be found by taking a proactive stance when it comes to your own mental well being.

Just like accounts find themselves rushed for business at tax time, psychiatrists find an up tick in patients during the holidays. You might consider treating yourself to an early present by scheduling a visit with a therapist just to check in and see how grounded you are. You might just discover that talking to an objective and outside observer is just what you need. Being able to “vent” without judgment can be a wonderful stress reliever. And if, on the outside chance that some of your concerns run deeper you can make a resolution to stay in therapy and get better.

The holiday zone is considered to start around Thanksgiving and end at New Years Day. Some people extend this zone all the way through Valentine’s Day. Within those several weeks you can experience great times of gathering with friends and family. You can reconnect and reassess where you’re at and where you’re headed in your life. And generally, it’s a perfect time to share your own personal blessings with the ones you love.
But there can also be a down side to the holiday zone. For some people it’s a time of immense stress as they strive to make things perfect for everybody. It can also be a period where feelings of loneliness come to the forefront of your mind. These feelings can lead to depression and that depression can actually linger well beyond the holidays.
If the approach of the holidays begins to weigh you down with apprehension and dread then clearly you’re missing the spirit of the times. Could there be an underlying stress factor that is being triggered by the holidays? Do these feelings come upon you every year? Are they becoming harder and harder to shake off? Seeking out the answers to those questions can put you on a positive path towards stronger mental health. The solution can be found by taking a proactive stance when it comes to your own mental well being.
Just like accounts find themselves rushed for business at tax time, psychiatrists find an up tick in patients during the holidays. You might consider treating yourself to an early present by scheduling a visit with a therapist just to check in and see how grounded you are. You might just discover that talking to an objective and outside observer is just what you need. Being able to “vent” without judgment can be a wonderful stress reliever. And if, on the outside chance that some of your concerns run deeper you can make a resolution to stay in therapy and get better.

Filed Under: Discussion, Health, Mental Health Tagged With: Health, Holidays, Major depressive disorder, Mental health