Depression – A Long Winter: Types, Effects, and Impact on Relationships

January 17, 2011 · Print This Article

Anti-depressants are the number 1 prescribed medication in the United States. There are various forms of this mood disorder: Major Depression, Seasonal Affective Disorder, Dysthmia.  Within the clinical world of mental health, depression is as common as a cold. Most people with depression do are unaware of it at first although their significant others clearly are aware they are not their usual selves and are worried. They often try to persuade the other to get help with little success until the depression has gone from mild to moderate OR severe.

The first thing to know is that depression comes with various intensities: MILD, MODERATE, SEVERE, and EXTREME. When individuals think of depression, they often think of the most severe or extreme kind. Reality is the vast majority reside in the mild to moderate range and can be treated with psychotherapy, medication, or both.. A common response is “I don’t think I am depressed” but after a careful evaluation of symptoms and linking these symptoms to behavior does one come to understand the manifestation of depression.

Major Depression:

Depression is a disorder that impacts  the mind, body, and spirit.   Major Depression is also known as major depressive disorder and clinical depression, it affects how you feel, think and behave.

More than just feeling sad or blue (those go away and don’t often have very brief behavioral, emotional, and mental effects), depression is a chemical imbalance in the brain that may come on as a result of genetic, environment, or both. It is more that just adjusting to a stressful situation. It isn’t  weakness or is it something that you can simply “snap out” of. It requires treatment and most do recover from depression in a fairly short amount of time.

Signs and symptoms of clinical depression may include:

  • Loss of interest in daily activities
  • Persistent sadness or feeling of emptiness
  • Sleep disturbances
  • Significant weight loss or gain
  • Increase or decrease in sexual desire
  • Excessive guilt
  • Anxious thoughts (be described as an unquiet mind)
  • Loss of concentration
  • Fatigue or Lethargy
  • Suicidal thoughts or behavior

Seasonal Affective Disorder (SAD)

Onset is in fall and winter and is SADS is caused by less daylight during the fall and winter.

Melatonin is a hormone that our brains produce during the hours of darkness. It is involved with regulation of sleep, body temperature and release of hormones. As with any hormone, the amount produced is important.

People with SAD overly produce melatonin. This disrupts body’s ability to regulate itself and  leads to depressive symptoms. If you have had episodes of depression that clearly have an onset in fall or winter followed by feeling better and asymptomatic  in the spring or summer, you may have SAD. Many comment on feeling more tired and often try to self-medicate (unknowingly) through the use of increased caffeine use.

Symptoms of winter-onset seasonal affective disorder include:

  • Depressed mood
  • Irritability
  • Hopelessness
  • Anxiety
  • Loss of energy
  • Social withdrawal
  • Oversleeping (feeling like you want to hibernate)
  • Loss of interest in activities you normally enjoy
  • Appetite changes, especially a craving for foods high in carbohydrates such as pastas, rice, bread and cereal
  • Weight gain
  • Difficulty concentrating and processing information

Dysthmia (dis-THI-me-uh)

Dysthymia is a mild, chronic, form of depression. Dysthymia symptoms usually have been present for the  last  two years, but clients report it has been present for much longer than that – sometimes beginning in adolescence.

While the symptoms are more mild than other forms of depression, given the chronicity of it the consequences and impact are more severe. Individuals with dysthymia  often feel hopeless (“What’s the point?), have difficulty beginning and completing tasks (“I just don’t feel like it”) and have a low self-esteem (“My spouse, coworkers, etc..don’t care about me……Why should I care?”). People with dysthymia are viewed by others of as being overly critical, negativistic, constantly complaining and unable to losen up – only, they are unaware others view them this way and when it is brought to their attention, the person with dysthmia will say “that’s just the way I am” OR become defensive OR become critical. The glass is always half empty for a person with dysthmia and they believe someone must have stolen the milk!

Depression and Couples

Depression of any type can create what are known as “cognitive distortions” in a relationship/marriage.  Distortions are a set of internal beliefs that an individual takes as FACT when it is what they tell themselves about the facts. For example, a dumped coffee on the ground “I can’t believe someone dumped out their coffee here. They should have dumped it in the garbage can” or “Too bad, someone accidentally spilled their coffee” are beliefs and a story based on the coffee on the ground. We don’t know which is the real story because we were not there, but as human beings, we make inferences based on what is observable.

Depression strongly impacts a persons beliefs about marriage, their spouse, and themselves in a way that contributes to a negative cycle of interaction. It impacts a marriage at all levels; friendship; fondness and admiration, intimacy, positivity, resolving conflict, repairing the relationship, how issues are raised, being open to the others’ thoughts and opinions, de-escalating and calming down, compromising, and creating lifelong dreams and meaning (Gottman, 2002).

After a thorough assessment of each persons view of relationships in the above areas, a therapist can determine the issues a client brings to therapy that make marital interventions ineffective and develop solutions couple specific to reduce the impact of depression on treatment resistance to mariage therapy.

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