{"id":9846,"date":"2017-03-01T13:29:12","date_gmt":"2017-03-01T20:29:12","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=9846"},"modified":"2023-06-23T11:02:21","modified_gmt":"2023-06-23T17:02:21","slug":"are-you-sad-or-depressed","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/are-you-sad-or-depressed\/","title":{"rendered":"Are you just sad … or depressed?"},"content":{"rendered":"
<\/div>
\"A
Photo: Getty Images.<\/figcaption><\/figure>\n

Everyone feels emotional pain at times<\/a>. We lose a job, have relationship difficulties, or a loved one dies. It\u2019s normal to feel grief, sadness and loss in these situations.<\/p>\n

But when those feelings last too long or become debilitating, it\u2019s time to ask for help, said Dr. Adria Pearson-Mauro, a clinical psychologist and Assistant Professor in the Departments of Family Medicine and Psychiatry at the University of Colorado School of Medicine. Her clinical practice at the University of Colorado Depression Center includes adults with a wide range of psychiatric diagnoses.<\/p>\n

She also practices part time at the Women\u2019s Health Integrated Services Clinic<\/a> (WISH) as part of a grant for the development of integrated behavioral healthcare.<\/p>\n

In addition to her clinical work, Dr. Pearson-Mauro provides training and supervision to psychiatry residents and teaches courses in the doctoral program in clinical health psychology at CU Denver.<\/p>\n

Needless to say, she sees a lot of patients, often women, suffering from various mood disorders, including major depressive disorder, commonly referred to as depression.<\/p>\n

Is it depression?<\/strong><\/h3>\n

Major depressive disorder includes a set of symptoms that may vary, depending on the age, gender and how they present themselves in the patient.<\/p>\n

\u201cIt doesn\u2019t look the same for all women,\u201d she said. \u201cSo it\u2019s important to assess it carefully. It may not be what you would normally assume they are \u2013 like somebody staying in bed all day \u2013 but can include headaches, stomach aches or fatigue.\u201d<\/p>\n

\"This
Dr. Adria Pearson-Mauro, a clinical psychologist and professor in the Departments of Family Medicine and Psychiatry at the University of Colorado School of Medicine, says depression doesn’t look the same for all women.<\/figcaption><\/figure>\n

When the symptoms are physical, a diagnosis of depression is sometimes missed because \u201csome adults, especially older adults, feel like they can\u2019t express those feelings, so they manifest as physical symptoms. There\u2019s still a stigma attached to anything like mental illness. But if a patient is not sleeping well or sleeping too much, has chronic headaches or unexplained chronic pain, you need to check all those things out.\u201d<\/p>\n

In addition, a medical professional should also ask: \u201cCould they be depressed?\u201d<\/p>\n

Dr. Pearson-Mauro said the first thing she asks is this: \u201cDo you feel that way most days for two weeks? If the answer is yes, then the patient may have major depressive disorder.\u201d<\/p>\n

Then she asks: \u201cHave you ever had this before?\u201d If so, the topic deserves additional exploration.<\/p>\n

Mood disorder in all its forms<\/strong><\/h3>\n

If somebody presents with depression symptoms, she also wants to assess for hypomania or mania. When a patient presents with depression, it is important to assess the patient for a history of bipolar disorder.<\/p>\n

\u201cThe common myth about mania and hypomania is that people feel great, but that\u2019s not always true,\u201d she added. \u201cThey can quickly become irritable or agitated, and won\u2019t listen to feedback from those around them. They may have trouble sleeping and can even become hypersexual.<\/p>\n

\u201cThey might stay in that state long enough to get reactions from a spouse or partner or coworkers. It can create relationship problems,\u201d she said.<\/p>\n

If a patient has a bipolar 2 disorder, she can have a period of hypomania followed by a depressive state, or vice versa. If she has what is called bipolar 1, she can experience full-blown mania (sometimes requiring hospitalization) or even psychosis \u2013 hallucinations or delusions of one sort or another. Individuals with bipolar disorders may stop sleeping for days at a time, and do impulsive things. They may talk very fast in a pressured manner.<\/p>\n

Bipolar disorder usually initially manifests itself at a young age \u2013 from pre-teen to young women \u2013 and that window can extend to the early 30s. However, some people may have symptoms but not get diagnosed until later in life.<\/p>\n

Depression can occur at any time in a woman\u2019s life, Dr. Pearson-Mauro said.<\/p>\n

It may take the form of dysthymia \u2013 manifested as a \u201clow mood, not a major depressive disorder,\u201d that lasts pretty consistently for at least two years.<\/p>\n

\u201cThey\u2019ll notice that they have changed over time, that they can function but not at full capacity.\u201d<\/p>\n

Some patients complain that they get depressed only in the fall. Seasonal affective disorder is related to major depression but only happens in autumn, when the daylight shortens.<\/p>\n

\u201cSome patients tell me, \u2018I feel fine, except in the fall,\u2019 indicating a possible seasonal affective component to depression. Those patients often respond to light therapy, which some clinics can provide.\u201d<\/p>\n

Peripartum (before delivery) or postpartum (after delivery) specifying criteria for depression are important to assess. This type of depression which onsets just before or after childbirth is crucial to talk openly about with both expectant and new mothers to provide education and services if needed. As with any other manifestation of depression, it can be mild or severe.<\/p>\n

\u201cSome women with postpartum depression may even have some level of psychosis. They may have thoughts of killing their baby or intrusive thoughts like \u2018What if I dropped my baby?\u2019 or \u2018What if I shook my baby?\u2019<\/p>\n

\u201cWomen are very scared to talk about this because they think we will take the baby away from them, but not talking about it only makes it worse.\u201d<\/p>\n

There are treatment options<\/strong><\/h3>\n

Psychological treatment for mood disorders includes psychotherapy and medication, often in conjunction. Psychotherapy prominently now includes more modern approaches to evidence-based cognitive behavioral therapy. Cognitive behavioral therapy refers to a very broad umbrella of psychotherapy treatment approaches, many of which are based in research evidence. The newest of these cognitive behavioral therapies, developed in the past 25 years, is acceptance and commitment therapy \u2013 ACT.<\/p>\n

ACT is a current evidence-based treatment for depression as well as some other psychological disorders.<\/p>\n

\u201cInstead of aiming at complete symptom reduction, ACT emphasizes pushing people towards meaningful work and activities even in the presence of the difficult thoughts, feelings and physical sensations that accompany depression.”<\/p>\n

In using ACT as well as other cognitive behavioral therapies, Dr. Pearson-Mauro helps patients develop a strategic plan for coping with their problem. The focus is on \u201cHow can I do that in a way that is meaningful \u2013 like maybe it means a lot to me to paint or draw but I haven\u2019t done it in years because I don\u2019t think I do it very well,\u201d she said.<\/p>\n

People coping with depression often abandon those things they enjoy just because they spend so much time managing the disorder.<\/p>\n

\u201cPsychiatry plays an important role in dealing with these disorders.\u201d Dr. Pearson-Mauro said. \u201cThat, and medication, can make all the difference in the world.\u201d<\/p>\n

For mild depression, psychotherapy alone often can handle the situation, she said, \u201cbut with more moderate to severe depression or bipolar disorder, it is usually recommended that patients take medication.\u201d<\/p>\n

She warns patients to not stop taking meds without consulting a physician. \u201cYou can have symptoms from uncomfortable to dangerous. You can stop if you choose, but you need to do it under the guidance of a psychiatrist,\u201d she said.<\/p>\n

Other techniques for managing these disorders include tracking moods, perhaps with a journal, or even using apps on smartphones.<\/p>\n

Suicide<\/strong><\/h3>\n

The most extreme result of mood disorders is, of course, suicide.<\/p>\n

She noted that Colorado has a very high suicide rate \u2013 one of the highest in the nation \u2013 so she always asks about suicidal thoughts.<\/p>\n

\u201cJust because somebody has the thoughts, we don\u2019t put them in the hospital. There may be urges, but without a plan and means, it doesn\u2019t always go any further.\u201d<\/p>\n

Suicide often happens when a patient is coming out of a depressive state because they finally have the energy to act on their thoughts. A decision to die can provide relief to a patient who might claim they are \u201cfine now.\u201d<\/p>\n

Suicide is one of the leading causes of death in teens \u201cbecause they do experience depression, but have less experience dealing with it, or have poor impulse control. They don\u2019t have the foresight to see something as temporary.\u201d<\/p>\n

It\u2019s important for parents to start conversations early about \u201cthe difference between a bad day and depression.\u201d<\/p>\n

\u201cTalk to your kids about suicide,\u201d she said. \u201cStudies show that 85 percent of the population has thought about suicide at one time or another,\u201d but as a clinical psychologist, she said: \u201cIt\u2019s scarier when they\u2019re not talking about it. If they\u2019re talking about it, they are realizing their humanity, that they have a life, and that they have some control over it.\u201d<\/p>\n

Society\u2019s stigma about mental illness is slowly changing, but it\u2019s still there, she said, especially among older adults.<\/p>\n

\u201cIt\u2019s hard for them to come see somebody like me. But women are more likely to come than men. Women attempt suicide more often than men, but men succeed more often.<\/p>\n

\u201cThere\u2019s less of a cultural stigma with women talking about their feelings, particularly in that age group.<\/p>\n

\u201cFrom my perspective, I tell them that human pain is universal. At some time in their lives, everybody experiences it. Some people try to avoid it, drink alcohol or overwork or over-exercise, but over time \u2026 they are not finding the solution.\u201d<\/p>\n

Sometimes depression just goes away on its own \u2013 but not always.<\/p>\n

\u201cSometimes we get stuck. We need help.\u201d<\/p>\n

Contact the UCHealth Depression Center at\u00a0303-724-3300<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Everyone feels emotional pain at times. We lose a job, have relationship difficulties, or a loved one dies. It\u2019s normal to feel grief, sadness and loss in these situations. But when those feelings last too long or become debilitating, it\u2019s time to ask for help, said Dr. Adria Pearson-Mauro, a clinical psychologist and Assistant Professor […]<\/p>\n","protected":false},"author":18,"featured_media":20556,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[113,9187,212],"class_list":["post-9846","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-behavioral-health","tag-readysetco","tag-womens-care"],"acf":[],"yoast_head":"\nAre you just sad ... or depressed? - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Everyone feels emotional pain at times. 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