Holiday season can trigger depression - www.icareguam.org

PDN Article: Nov. 30, 2013

As the holiday season approaches each year, more and more people suffer from holiday depression. Holidays are usually joyful occasions, filled with celebrations, parties and social gatherings with family and friends, but for many people, it is a time filled with sadness, loneliness and anxiety. The causes for holiday depression are as varied as the individuals experiencing it.

For many, the holiday season disrupts the normal routine of life and can result in a sense of chaos and a feeling of being unsettled. The kids are on school break, there is more shopping than usual that needs to be done, presents to buy, work parties to attend, family obligations and financial stress can contribute to feelings of being overwhelmed and increased tensions.

Although the holidays are about spending time with family and friends, this in itself can be stressful and cause depression. For those who have no family around or have a family system that is tumultuous and negative, the holiday season makes it much harder and unpleasant.

Family problems are often amplified during the holidays. This time can be especially difficult for those that have lost loved ones or are going through the anniversary of a loss or traumatic event, which can make unpleasant memories come back and dampen the spirits.

The elderly who have lost spouses and friends may find themselves struggling with depression as they remember life as it once was and trying to come to grips with how it is now. They may also be experiencing depression during this time as a result if being neglected or lonely.

Depression and suicides generally occur at a higher ratio during the holidays than at any other time of the year.

If you have had depression in the past, you need to be especially careful when coping with holiday stress. People who do not view themselves as depressed may develop stress responses such as: headaches, excessive drinking, overeating and difficulty sleeping.

Here are some ideas to find joy and balance during the holidays and reduce your stress.

• If you suffer from loneliness or holiday depression, do not be alone for the holidays. Reach out and volunteer your time to help the needy, feed the homeless and be around people.

• Attend a holiday celebration such as a church service or attend a musical activity to warm the heart.

• Acknowledge your feelings of loss of a loved one and realize it is OK to feel sad and take time to cry and express your feelings, and then work your way to finding some joy in the memories of your loved one.

• Be realistic and forget the unimportant stuff. Don't get hung up on what the holidays are supposed to be like or how you are supposed to feel. Take things as they come. It is OK.

• Try to accept family members and friends as they are even if they don't live up to your expectations, they may be feeling the effects of holiday stress and depression, too.

• Stick to a budget, consider doing something different such as giving homemade gifts.

• Learn to say "No". Agreeing to do things you really do not want to can leave you feeling resentful and overwhelmed.

• Plan ahead. Schedule days for shopping, baking and other activities.

• Lean on your friends and family members that are positive, encouraging and supportive.

• Do not abandon healthy habits such as healthy meals, snacks and exercise.

• Make time to pray, relax, meditate, listen to soothing music, sip a cup of tea or take a nice walk.

• Seek professional help if you find yourself feeling persistently sad or anxious, unable to sleep, irritable and unable to face routine chores.

• Call the local crisis hotline at 647-8833 if you need to talk to someone or make an appointment with a counselor.

Annie F.B. Unpingco, LCSW, is administrator of I Famagu'on-ta at the Guam Behavioral Health and Wellness Center.

Anxiety disorders require treatment - www.icareguam.org

PDN Article: Nov. 22, 2013

Anxiety is a normal human emotion that everyone experiences at times when faced with a problem, such as worrying about money, family relationships, a problem at work or school, taking an exam, or making an important decision. Anxiety disorders, however, can cause such distress that it interferes with the person's ability to function with everyday tasks.

For persons with anxiety disorders, worry and fear are constant, excessive, overwhelming and can be debilitating.

Anxiety disorders include the following types of anxiety:

• generalized anxiety disorder;

• panic disorder;

• post-traumatic stress disorder;

• obsessive-compulsive disorder; and

• social phobias.

Generalized anxiety disorder involves extreme and unrealistic worry about things, even when there is little or no reason to worry about.

Panic disorder involves sudden attacks of fear without warning that lasts for several minutes. It occurs repeatedly. Panic attacks occur at unpredictable times and some of the symptoms resemble that of the person having a heart attack.

Post-traumatic stress disorder is a condition that can develop following a traumatic and terrifying event such as a physical or sexual assault, a tragic loss of a loved one, serving in combat or as a result of a disaster. People with PTSD often have lasting and frightening thoughts and memories of the event that affects their ability to function.

Obsessive-compulsive disorder is a condition involving constant disturbing thoughts or fears that cause the person to perform certain rituals or routines. The disturbing thoughts are called obsessions and the rituals are called compulsions. An example is a person with an unreasonable fear of germs constantly washes his or her hands.

Social anxiety disorder, also known as social phobia, involves overwhelming worry and strong feelings of being judged by others and of being embarrassed. This fear often gets in the way of going to school or work or doing other everyday things.

Specific phobias are intense fear of a specific object or situation, such as snakes, heights or flying. The fear is usually inappropriate to the situation and may cause the person to avoid common everyday situations.

General symptoms

General symptoms of anxiety disorders include the following:

• muscle tension and inability to be calm and relax;

• unexplained bodily pains and feeling tired all the time;

• problems sleeping and nightmares;

• difficulty concentrating;

• feelings of panic, fear and uneasiness;

• uncontrollable, obsessive thoughts;

• ritualistic behaviors, such as repeated hand washing, checking if the door is locked;

• cold or sweaty hands and/or feet;

• shortness of breath and palpitations;

• numbness or tingling in the hands or feet;

• trouble controlling their constant worries;

• dry mouth and trouble swallowing; and

• using the bathroom a lot.

The exact cause of anxiety disorders is unknown, but like some forms of mental illness, personal weakness or poor upbringing are not the causes. Researchers have found that several parts of the brain are involved in fear and anxiety.

Combination of factors

As research continues on mental illness, it is becoming clear that many of these disorders are caused by a combination of factors including changes in the brain and environmental stress. Trauma or significant events may trigger an anxiety disorder in people who have an inherited susceptibility to developing the disorder.

By learning more about fear and anxiety in the brain, scientists may be able to create better treatments.

If you, or someone you know, is experiencing any of these anxiety symptoms, talk to your doctor or a mental health professional about it. A thorough exam is necessary to make sure another physical problem isn't causing the symptoms.

Anxiety disorders are generally treated with psychotherapy, medication or both, and early identification and treatment is essential.

In helping children cope early on with fear and anxiety, encourage them to ask questions and to talk about fears they may have. Listen to what they say. Communicate with your children in simple ways that they can understand.

In addressing death, be honest and tell them the person has died rather than has "gone to sleep," or children may become afraid of going to sleep. Provide comfort and assurance that address their specific fears.

It is OK to admit you can't answer all their questions and then find someone who can help.

Annie F.B. Unpingco, LCSW, is administrator of I Famagu'on-ta at the Guam Behavioral Health and Wellness Center.

Watch for signs of depression in kids - www.icareguam.org

PDN Article: Nov. 8, 2013

In today's world, toughness and glamour rule, especially if you are a teenager. Teens who buy into the myth that image is everything risk losing it all when they experience a letdown, a rejection or a broken heart.

Teenage girls are more vulnerable to this serious form of the blues than are teen boys. The majority of depressed adolescents are teenagers, girls between the ages of 12 to 19. Girls are more open emotionally and tend to talk about it more. Boys, for the most part, have more physical outlets for stress and emotions than do girls.

Depression in contemporary teenage girls are fourfold:

• the zooming divorce rate;

• the message our culture sends about sex;

• the increase of violence and abuse against children and women; and

• increasing teen addiction to drugs and alcohol.

A big factor in depression in young people is the breakdown of the family or divorce. It's hard on teenagers when their primary support system, the family, is gone.

For a female, she gets a lot of identity from her father and he isn't there to guide her or talk to her or tell her how pretty she is. Missing a mother figure can be just as terribly damaging to young people.

Attitudes about sex are a toxic societal factor driving teen girls into depression. The culture sends a mixed message to girls. Sex is something sacred, but on TV, sex is what's selling and there's too much pressure to be attractive to the opposite sex.

Over-emphasizing female sexuality causes girls to focus on their bodies, rather than on their intelligence, ability or spirituality. This lends to girls finding fault with themselves and each other if their appearance doesn't measure up.

Body image

The gold standard for an adolescent girl is to be slim and sexy. Girls have become more likely today than ever before to internalize society's message and "scapegoat" peers who don't meet that standard.

Failure to be thin and beautiful can lead to depression in teen girls who place exaggerated value on appearance. Teen girls' concern with appearance may occur in part because looks seem to be all society recognizes them for. This also can lead to eating disorders and self-mutilation in girls who are trying to regain the control over themselves that they feel they have lost.

Girls already brainwashed to believe that their bodies are their most valuable commodity are likely to become involved in casual sex, which in turn can trigger depression.

One cause of depression in girls is peer pressure to fit in. Their friends are having sex, so they get involved in sex out of loneliness and wanting to be accepted. They give sex to get love, and if the relationship ends, they're thrown into depression.

Depression treatable

Depression is widespread among our teens, especially girls, who are most vulnerable to peer pressure. The assuring news about depression is that it's treatable.

Watch for signs, such as:

• a marked downturn in mood;

• negativity;

• sleeplessness or sleeping too much;

• a drastic change in eating habits; and

• self-isolation.

These symptoms usually last for more than two weeks. A lot of parents don't realize what's going on and they think it's normal moodiness.

A network of educators and professionals in our community can serve as a safety net for young people in the brink of an emotional breakdown, but the primary responsibility for our young people rests with the parents.

Parents, be aware, get to know your children and talk with them. And when you sense something isn't right, make the decision for your child to seek professional help.

Annie F.B. Unpingco, LCSW, is administrator of I Famagu'on-ta at the Guam Behavioral Health and Wellness Center.

Depression serious; needs treatment - www.icareguam.org

PDN Article: Nov. 1, 2013

Are you sad most of the time and take no pleasure in things you used to enjoy? Do you feel very tired, helpless and hopeless? Having trouble sleeping, trouble working and not wanting to eat? Have you felt this way for a long time?

Everyone feels sad sometimes, but these feelings usually go away after a few days. When you have depression, you have trouble functioning with daily life for weeks at a time. Depression affects different people in different ways.

Children with depression may: express feeling sick, refuse to go to school, cling to a parent or worry that a parent may die. Older children may be irritable and get into trouble at school.

It may be difficult to accurately diagnose a young person with depression, because these signs can also be part of normal mood swings associated with certain childhood stages.

Women experience depression more often than men and their symptoms are typically feelings of sadness, worthlessness and guilt. Men with depression are more likely to be very tired, irritable and even angry. Older adults may have less obvious symptoms, and more likely have medical conditions such as heart disease or strokes, which may contribute to the depression.

Signs to watch out for

These are signs of depression to look out for:

• not being able to concentrate or remember details;

• feeling sad and "empty";

• feeling very tired;

• feeling hopeless, irritable, anxious and guilty;

• not able to sleep, or sleeping too much;

• Oovereating, or not wanting to eat at all;

• aches or pains, headaches, cramps or digestive problems;

• loss of interest in favorite activities; and

• thoughts of suicide and suicide attempts.

According to the National Institute of Mental Health, several factors or a combination of factors may contribute to depression. Individuals with a family history of depression may be more likely to develop depression that those who do not have the illness. Individuals with depression have different brain chemistry than those without the illness. Any stressful situation such as loss of a loved one or a difficult relationship may trigger depression.

Illness needs treatment

Depression is a serious illness and needs treatment. Treatment for depression starts by visiting a doctor or a mental health professional for an exam or lab test to rule out other conditions that may have the same symptoms as depression. A complete personal history and history of the symptoms need to be obtained to determine factors contributing to the depression as well as for treatment purposes.

Medications such as antidepressants can work well to treat depression, but it takes several weeks for the medication to start working. Antidepressants can have the following side effects:

• headache;

• nausea; and

• difficulty sleeping, among others.

But most side effects lessen over time. Anyone, but especially young people, taking antidepressants should be under a doctor's careful supervision.

Psychotherapy can also help treat depression by teaching new ways of thinking and behaving, and changing habits that may be contributing to depression. Therapy can help the person understand and work through difficult situations or relationships that may be causing the depression or making it worse.

If you know someone who has depression, help him or her see a doctor or mental health professional. Talk to the person, listen patiently, and carefully. Offer support and encouragement, and let the person know that with treatment and time, the depression will lift.

Never ignore comments about suicide without letting the person's doctor, therapist or someone who could help know.

Annie F.B. Unpingco, LCSW, is administrator of I Famagu'on-ta at the Guam Behavioral Health and Wellness Center.