Bust the Blues

e’ve all had a case of the blues. So what distinguishes these emotions from clinical depression? Area experts tell you what to look for.

“There is an increased risk for women in the 35- to 45-year age range,” says Nancy Barklage, UW Health psychiatrist. “The previous cohort was in the later years. The risk keeps coming down, which is fascinating. What’s happening socially is that this group is taking care of young children while taking care of elderly people. Also, childbirth is delayed so you will get some women in that age range with postpartum depression, which increases the risk.”Barklage also says that up until menstruation the risk for depression is a one-to-one ratio between girls and boys. After that it jumps to two-to-one: “Clearly, there is a hormonal component,” she adds.In addition, those with substance abuse issues, chronic illness and family history have increased risk, says Tyler Rickers, UW Health psychiatrist and Meriter adult psychiatrist hospitalist.

See a primary care physician if you think you have symptoms of depression or take an online screening. Webmd.com has a Depression Health Check tool and Nami.org and Meriter.com/risks have excellent fact sheets on symptoms, treatments and more. Of course, with any online research it’s recommended you talk to your doctor afterward.Typically a primary care physician will refer you to a psychologist or psychiatrist. From there the specialist will evaluate the severity of your symptoms and recommend different courses of treatment, sometimes psychotherapy, lifestyle changes, medication or a combination of these.Barklage also recommends maintaining a healthy lifestyle. “Continue social interaction. Even if a person doesn’t feel like going out, changing one’s environment can be helpful. Simply spending time with people and helping others can be beneficial.”

For some, depression is a lifelong disease; for others, it’s not.”The current theory is to treat [depression] like a chronic illness like diabetes,” says Rickers. “For some people it does go away completely but for others it can be recurrent. Generally if you’ve had one depressive episode that was successfully treated and no reoccurrence, chances are less that it’ll reoccur. If it’s recurrent, chances are that you’ll need lifetime treatment.”Rickers says research is ongoing right now at the UW for depression causes and treatments.”There are areas [in the brain] that are abnormal in patients with depression and researchers are looking at the data to determine where those areas are and how we can affect those areas,” he says. “Some studies have indicated that deep brain stimulation and trans cranial stimulation can help. It’s in the embryonic stages at this point but I can foresee a time when medications and psychotherapy aren’t the only options; I can see other treatments working with fewer side effects.”

The holidays can either help or exacerbate symptoms of depression. Those with a good support system will have added “protection” against symptoms worsening. Those with strained family dynamics or social anxiety may struggle, which can lead to abusing a holiday party standby: alcohol.”Alcohol can mask the signs and symptoms but it’s a temporary benefit and the overall effect increases anxiety and depression,” says Rickers. “A practical tip is don’t feel obligated to go to every event, or if you do go, don’t feel pressured to stay a long time. This can limit consumption.”The ease of obtaining alcohol and its initial calming and uplifting effects are what can lead to abuse, say both experts.”For those struggling with alcohol abuse the holidays can be challenging. For people who don’t really use alcohol it can mean more drinking. And that can affect mood and sleep patterns,” says Barklage.The takeaway? Don’t use alcohol if you’re tempted to abuse it and it’s not recommended at all for those on antidepressants or those with depression.

Shayna Miller is associate and style editor of Madison Magazine.