Depression

A depression checklist outlining symptoms includes the following:

• Sadness, emptiness, a depressed mood
• Lack of interest or enjoyment in activities previously found pleasurable
• Reduced or increased need for sleep, energy
• Reduced or increased appetite
• Difficulty in concentrating, paying attention, making decisions
• Thoughts of harming oneself or others

While major depressive disorder is the most common, other types of depression also exist based on additional specific symptoms. Clinical depression classifications include:

• Major depressive disorder (MDD) – a period of two or more weeks in a depressed (low or sad) mood episode 
• Depression with melancholic features – depression, as above, but with additional symptoms like waking up two hours earlier than usual. Depression that is worse in the morning. Feeling excessive guilt.
• Depression with catatonic features – depression, as above, but with additional symptoms like extreme negativism or mutism, motor immobility and uncontrollable repetition of words spoken by another
• Atypical depression – depression that includes symptoms like an increased need for sleep, increased appetite, weight gain and feelings of heaviness in the arms or legs (see: What is Atypical Depression? Symptoms, Causes, Treatment)
• Seasonal affective disorder (SAD) – depressions that occur corresponding to a season, generally the winter, in the last two years or more; often atypical depression (see: What is Seasonal Depression Disorder? Symptoms, Treatment)
• Postpartum depression – major depression immediately following childbirth (see: What is Postpartum Depression (PPD), Postnatal Depression?)
• Depressive disorder not otherwise specified (NOS) – depression identified by a clinician but of a type that does not explicitly fit into a defined category

For many years, Nigerians  had suffered from depression and suicidal urges. I tried to determine why it was happening to Nigerians and what they could do to address these epidemics. 

This is an attempt to help those who are depressed with suicidal thoughts, better understand what they are going through and help them find possible solutions.

Most people who are suicidal are also depressed. The two prime reasons that a person becomes depressed, are a loss of control, over their life situation and of their emotions, and secondly a loss of a positive sense of their future (loss of hope). Any therapy which is to be effective in reversing our depressed state, and the resultant suicidal urges, will have to help us regain control, and help us regain hope.

Being depressed causes us to narrow our view of the world around us to such an extent that reality becomes distorted. The negative in our lives is constantly reinforced and the positive around us is discounted as being irrelevant, or even nonexistent. Options to help solve our problems are rejected as having no merit until it seems as if there is no possible solution.

An unrelenting and oppressive sadness comes over us which causes very real pain, as if the pain of the sudden loss of a parent stays with us for weeks, months, and even years. It is as if we are trapped in a dark cave or possibly a tunnel that runs only from our constant pain to somewhere near hell, with no exit to heaven and no exit to joy. We begin to think that there is no relief and that this pain will never end. Tomorrow will be the same, or worse. 

Death may be the only solution!

Suicide is not a solution, it is an end before a solution can be found. It cannot be considered an option, for an option denotes we have a choice and death robs us of both, option and choice. Death is an irreversible act that does not end the pain, for it remains in those who are left behind. Even people who are totally alone, and take their own lives, transfer their pain to those of us in society who do care, and we do - care!

Many people have suicidal thoughts at some time during their lives. For most the thought is fleeting, happening after a major life loss, or at some point in life where they perceive the future as becoming hopeless. For others, life is not quite so kind, they may have a strong genetic propensity to become depressed, a chemical imbalance or a series of unfortunate life experiences may eventually end in depression. Still others have much to do with causing their own pain by using an unrealistic cognitive thought process and having expectations in life that are not possible to achieve. Whatever the cause, we are all at risk of having strong suicidal urges when it seems as though the future has become hopeless.

There is no class or type of person that is exempt from having suicidal thoughts. Doctors, therapists, and teenagers from all walks of life are all high on the percentage lists of completed suicide, although it seems that those people with strong religious convictions are least likely to attempt.

Given a person is depressed and having suicidal thoughts, there are certain triggers which intensify the suicidal urge. Recognizing those triggers of renewed suicidal urges which are present in your life will help you to understand what is happening to you and begin to allow you more control of your emotions.

Suicidal urges are particularly high just after a depressed patient first enters therapy. When beginning therapy the very symptoms give rise to thoughts such as "this will never work", or "why should I put myself through this, when there is no possible hope of success". Combined with these thoughts may be the possibility that the patient and therapist do not connect or bond (as may happen between any two strangers when they first meet). 

The antagonists in our lives (the oppressive boss, the abusive spouse or partner, or that jerk who never quits) can easily trigger renewed suicidal urges. Strangers, at first meeting, soon recognize or sense that we are depressed. 

The effect that natural events have on depression is extremely important, especially when one is beginning to overcome the depressive response. Fast moving weather front lows, the full and new moons, changes of the seasons, and decreased sunlight in winter, will cause an increased state of anxiety when a person is depressed. One is especially at risk when there is a fast-moving weather front approaching the two days before the full moon. This must not be discounted as hearsay or superstition! 

A statistical correlation has not been identified concerning suicidal attempts and the full moon because the full moon does not cause one to commit the act. The full moon and the other listed natural events cause an increased state of anxiety which exacerbates depression and increases the risk of the suicidal urge becoming strong. Actually, the risk of attempts of suicide is greatest during the week after the full moon, as increased depression and the resultant suicidal urges begin to take their toll.

Nicotine, caffeine, alcohol, illegal drugs, obsessive overeating, and some prescription drugs, all have a detrimental effect on depressed persons. Many times the thought is that if the abuse can be overcome then the pain will end. In some cases this may be true, but what if attempts to overcome substance abuse fail? The failure may cause further depression making it difficult to even attempt subsequent withdrawal, let alone be successful. The truth is that it is possible to separate the depression from the substance abuse. Once the depression is overcome the substance abuse can be worked on from a position of strength rather than from a depressed state.

During times of increased stress and trauma some may try to escape the pain of life by fantasizing that they are dead. The fantasy may begin with the thought that one has died, and the family and friends are standing at the graveside, they grieve and are very sorry we are dead. 

The bipolar, manic depressive person (one who alternates between periods of manic euphoria and a depressed state) should be extra careful to identify those triggers which may cause a reversal of mood. Some people seem to be able to control their manic periods, others cannot. Even those who outwardly seem to be in control are at risk if they have a reversal of fortune, and their sometimes unrealistic endeavors turn sour. The mood swing can be swift, unexpected, and dangerous. In an instant we can be slammed back into a depressed state with strong suicidal urges.

The human conscious mind is the only entity on the face of this planet which is able to conceptualize and abstract the future. The need for a positive sense of the future is one of the prime motivators of human life. This need transcends even the event of our ultimate demise and is the motivation to envision a continuation of life after death. We do not want to think that death is the end. Heaven, and life after death with God fulfills this need for the religious person, others have envisioned reincarnation, or that we enter (body whole) into another dimension without the need to believe in God. For others, the legacy of their works or the continuation of their genes through their offspring is enough to give them a positive sense that death is not a complete end.

In the short-term, and for those who do not concern themselves with what happens after we die, there is still the need for a positive sense of our future. It is what makes us get up in the morning and face the coming day. Even in the face of adversity or drudgery, we are motivated to endure, because we envision an end to these conditions and a better future at some later date. The anticipation of future events is what makes our body ready itself for the sex act, it is what motivates us to amass wealth and power, to buy a lotto ticket, to set goals and have aspirations.

Even the diehard sofa potato looks to the future as told to him by the upcoming programs in the television listings, and of course there is that next thirst quenching beer and resultant belch, to look forward to. We all have a need for something to look forward to, if we lose all hope that the future holds anything positive or that our present pain will ever end, most of us will depress.