NEIGHBORHOOD HEALTHCARE: Watch for symptoms of depression as we turn back the clocks

By James Schultz, M.D., Chief Medical Officer, Neighborhood Healthcare | Sunday, November 2, 2008 1:13 AM PDT ∞

This is the time of year when many people begin to feel tired and "run down." Sometimes this is because of the added stress of going back to school, kids' activities keeping us running around, increased workload, or other external factors. But there is a common medical condition that can also cause these feelings ---- it is called depression.

Depression is a medical condition that is not totally understood by the medical and scientific community. Once it was thought that depression was strictly a mental illness; research and studies of people with depression have shown that in many cases depression has a physical component.

Although the mechanism is not well understood, we do know that in people with certain types of depression, there is an imbalance in some of the naturally produced chemicals in the brain called neurotransmitters. Some of the neurotransmitters in certain parts of the brain help keep our mood at a normal level. When these chemicals levels are low, or for some reason are not working correctly, then we can suffer from the symptoms of depression.

Depression symptoms can be mild, or they can be devastating. Common symptoms include feeling tired, feeling sad most or all of the time (for no apparent reason), lack of energy, lack of enjoyment in things you usually love doing, irritability or anxiety, poor sleep pattern, and change in appetite. It can be short-lived, or it can last a lifetime. Depression can become so bad that it leads to suicide, so it should never be treated lightly.

Depression is very common. In the US, 25 percent of women and 10 percent to 12 percent of men will suffer from depression at some point in their life. It tends to be more common, or the symptoms can become worse, in times of change or stress. Unemployment, loss of a loved one, moving, and even things that seem good, like a job promotion or wedding, can trigger depression symptoms. I have noticed in my practice over the years that as soon as the time changes to Standard Time, as happens at the end of October, people start coming in with symptoms of depression. This year, with all the economic turmoil, I expect depression will be more common than usual.

Depression also can run in families. Sometimes abuse of alcohol and other substances happens because a person who has underlying depression is trying to ease the pain. Depression is more common in people who have close relatives who are alcoholics. Some people get by without any problems most of the time, but in times of stress they are "tipped over" into a state of depression. Alcohol and depression do not mix ---- alcohol both worsens depression and makes it easier to do something self-destructive.

The good news is that depression can be treated. Certain types of depression and milder cases can be treated with lifestyle changes and counseling. A frequent brisk walk seems to be helpful in stimulating those neurotransmitters. More severe forms of depression, and long-standing depression may require medication to successfully reduce symptoms and improve the level of function.

Many depressed people feel hopeless ---- but there is hope and effective treatment. If you or someone close to you is having these symptoms, get to a physician. Sometimes other physical problems can cause depression symptoms, and your physician may want to do some tests to help sort it all out. If it is depression, you can get some help deciding what the best treatment approach would be for you. Now is the time to get some help before the stresses of holidays and shorter days take hold!

Dr. James Schultz is chief medical officer for Neighborhood Healthcare, an Escondido-based nonprofit community health agency that cares for those most in need at 11 health centers in San Diego and Riverside counties. Visit www.nhcare.org.