What are the symptoms of depression? How do you know if you have it? The DSM-IV-TR, known as the "Bible" of clinical psychology, defines a major depressive episode as having one or both of the following, lasting at least two weeks:

1. Sad, down, or "empty" mood, lasting almost all day, almost every day (dysphoria)
   
2. Loss of interest in activities you once enjoyed (anhedonia)

Other symptoms may include the following:

1. Changes in appetite (either increased appetite or loss of appetite) and/or sudden changes in weight
   
2. Sleep disturbances, particularly insomnia, early waking, or oversleeping
   
3. Physical symptoms such as digestive trouble, headaches, or backaches that do not respond to conventional medical treatment
   
4. Lack of motivation, which in severe cases may be experienced as "paralysis of the will"
   
5. Difficulty concentrating, remembering, or making decisions
   
6. Psychomotor agitation or retardation -- that is, a "speeding up" or "slowing down" of one's movements, observed by others
   
7. Irritability or restlessness
   
8. Low self-esteem and/or feelings of worthlessness, helplessness, guilt, or hopelessness
   
9. Social withdrawal
   
10. Fatigue, loss of energy, feeling run down or sluggish
    
11. Death or suicidal ideation -- that is, thoughts of one's own death, the death of others, or of taking one's own life
    
12. Suicide attempts

Major depressive disorder is diagnosed when a major depressive episode as described above is experienced without a history of mania or hypomania. If there is a history of mania or hypomania, a bipolar disorder is diagnosed.
Symptoms of mania include the following. Hypomania includes the same symptoms but is less severe than full mania.

1. Racing thoughts or "flight of ideas"
   
2. Extremely decreased need for sleep -- this is different from insomnia in that the person does not even seem to need sleep
   
3. Extremely high, happy, and euphoric mood, or a very intense and active bad (dysphoric) mood, perhaps rageful or anxious
   
4. Abnormally high energy levels
   
5. Grandiosity
   
6. Distractability, impulsiveness, and risk-taking, typically greater than what is seen in attention-deficit hyperactivity disorder (ADHD)
   
7. Pressured speech -- meaning that the person talks very fast as if there is a torrent of words pent up and the dam is bursting. A manic person with pressured speech is several steps of intensity beyond, for example, an auctioneer's calling
   
8. Hypersexuality

Take the Quick Depression Screening Quiz at Psych Central. Remember this is only a screening and cannot diagnose depression or any other illness. If you have a positive screening, it's recommended that you seek appropriate help, preferably from a psychologist or psychiatrist, or failing that, from your general physician.




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Anxiety in small doses is healthy, but it can grow out of control, causing significant suffering and disability. A number of different disorders result from anxiety gone awry.

Generalized Anxiety Disoder (GAD) is exaggerated worry about everything or nothing that is present most of the time. People with GAD worry about health, finances, career, family, etc. -- even when there is no sign of trouble. GAD is out-of-control anxiety that is greater than the normal anxiety that everyone experiences. Its prevalence of about 2.8% in the U.S.

Obsessive-Compulsive Disorder (OCD) disables by stealing time from its victims. It starts with obsessions, or intrusive worries, which can only be mitigated by engaging in compulsions, or rituals that soothe the worries. An obsessive-compulsive person may, for instance, worry that the stove was left on and have to go check it -- over and over again. People suffering from OCD know that their obsessions and compulsions are irrational but are helpless to resist them. Common themes in OCD include a need to check on things, worries about contamination, a need for symmetry or neatness, and a need to count things.

Phobias are extreme, irrational fears that are grossly out of proportion to the thing that is feared. Many phobias involve things that were dangerous in our ancestors' world, such as spiders and snakes. A mentally healthy person may fear snakes, but a phobic person may literally be affected all day by just hearing a conversation about snakes. (Sorry if you are snake-phobic and reading this!) Social phobia, also called social anxiety, is a particularly disabling phobia. Social phobia is far more than shyness; those suffering from it feel they are being constantly watched and judged by others and are petrified of being embarrassed or humiliated, to the point that it interferes with their daily lives. Its prevalence is a whopping 3.7% in the U.S. (that's over 10 million people).

Panic disorder involves recurrent panic attacks that have no apparent cause. In a panic attack, a person may sweat, have a racing heart, have trouble breathing, and may feel out of control. Some people describe panic attacks as feeling like things are "crashing down" on them, or as if they are dying. In fact, a panic attack may be mistaken for a heart attack. Fear of having a panic attack in public may lead to a person becoming homebound, a condition called agoraphobia.

Post-traumatic stress disorder (PTSD) is an abnormal reaction to a life-threatening situation such as a physical or sexual assault, an accident, a disaster, or military combat. It is important to note that the trauma is completely subjective -- PTSD can be triggered by an event that does not appear serious to outsiders, as long as the person experiencing it felt intensely threatened. Symptoms include flashbacks (ranging from dreams to waking hallucinations), hypervigilance, dissociation (a feeling of disembodiment or unreality), sleep trouble, depression and anxiety, feelings of guilt, and irritability. Physical symptoms are common too, such as headaches, digestive problems, chest pain, and immune system problems. Substance abuse is very common in those with untreated PTSD.

Sources and more information

• GAD, OCD, social anxiety, panic disorder, and PTSD (Freedom From Fear)

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This is National Anxiety and Depression Awareness Week, sponsored by Freedom From Fear, an American mental illness advocacy group. All this week, I will be posting about depression.

Facts about depression:

• Depression is an illness that affects one's body, mood, and thinking. It typically has real physical symptoms in addition to emotional and cognitive symptoms.
  
• It is not the same as a "blue mood" and you can't just "snap out of it." It's not an attitude problem, a sign of weakness, or a result of self-absorption.
  
• Women are twice as likely to be affected as men, and the overall prevalence in the United States is about 6-7%. That translates to some 20 million Americans experiencing some form of depression in any given year.
  
• Depression appears in several forms. Major depression is profoundly disabling, with symptoms lasting at least two weeks. Dysthymia is less severe but lasts for years, and may be more resistant to treatment. Bipolar disorders, also called manic-depressive illness, are characterized by fluctuations between depression and extremely high mood (mania and hypomania), and require very different treatment from so-called "unipolar" depressions (major depression and dysthymia).
  
• Depression very frequently occurs along with other illnesses and disorders, ranging from chronic medical conditions such as HIV and diabetes, to substance abuse and other mental health disorders.
  
• Depression can affect people in all age groups, including young children and the elderly.
  
• Up to 15% of depressed people die of the disease via suicide. In addition, people suffering from depression are at higher risk of other medical illnesses.
  
• Depression is one of the most treatable mental disorders. Most people can be helped by either psychotherapy or medication, or a combination of both.

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National Anxiety and Depression Awareness Week falls from May 4-10 in 2008. All next week, I will be posting about these illnesses, including facts, myth-busting, and personal stories. If you would like to share a personal story, e-mail me (check my profile for the e-mail address). You can leave your story anonymously if you like, or you can do a guest post.




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You may have heard of Father Adelir Antonio di Carli, the Brazilian priest who attempted to raise funds by breaking a world record. It involved being carried aloft by helium-filled party balloons. Yes, this is for real. Sister Mary Martha says so.

He is now lost at sea. They found a few of his balloons, but no sign of the priest. Thanks to my fallen human nature, I had an awfully hard time convincing myself this was more serious than hilarious. It would be hilarious, if only he had landed more or less safely.

Then I read an article in the Telegraph. The poor guy is not even known to be dead yet, but the Telegraph has already nominated him for the Darwin Awards. Not very nice of them.

I must give full disclosure: I'm not a huge fan of the Darwin Awards. That said, I don't see how Father di Carli could qualify. He was very well-prepared. He is an experienced sky diver and equipped himself with a helmet, a thermal flight suit, waterproof coveralls, a parachute, a satellite phone, and a GPS device. More practically, can a person sworn to lifetime celibacy even be in the running for the Darwin Awards? He removed himself from the gene pool when he took his vows.




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Protesters at the sites of the Holy Father's visit to the United States so far:

1. Protesters from SNAP calling for changes to policy regarding abusive priests
   
2. Protesters against the sex abuse scandal "cover-up"
   
3. Gay Catholics denouncing the Pope's lack of support for gay rights
   
4. Excommunicated supporters of women's ordination
   
5. Catholics who oppose the teachings of the encyclical Humanae Vitae regarding birth control (one of their major arguments is that American Catholics don't follow the teachings anyway)
   
6. Protestant protesters (I suppose that's redundant) complaining that Catholics have a Pope rather than "going directly to Jesus"
   
7. Hindu protesters who believe the Catholic faith is exclusionary to other religions
   
8. An atheist protesting the fact that a religious figure enjoys diplomatic status
   
9. The Westboro Baptist Church, for reasons only Satan knows (there are also protesters of these protesters)

It kind of seems to me that any organization that has ticked off that many disparate groups for so many diverse reasons (a) is very strong (almost... rock-like)in the face of fickle human opinion, and (b) might actually be getting something right, since it is at the center of a daisy of extreme views. And every bee knows that the center of the daisy is where the honey is.

Sources

• The BBC's slide show of the papal visit
  
• Reporter Glen Zimmerman's video blog
  
• NY1 online newschannel story
  
• Spero News story
  
• 365Gay story

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