Too many disabled people experience some level of depression. Depression can hurt their health, their happiness, and their quality of life.
The first step to treating depression should be finding out why it exists. Çağan and Ünsal (2014) found that social isolation and loneliness often cause depression in disabled adults. Society shuts out disabled people too often. Thus, they might not get to participate in social events, learning opportunities, or even work. Coping with progressive conditions can be hard too. In addition, disabled people can face everyday problems. Grief, abuse, or financial problems can cause or worsen depression.
This means that disabled people are more likely to face depression. Understanding the type of depression is important for finding the right treatment.
Types of Depressive Disorders
There are several types of depressive disorders. It’s important for doctors to figure out which type someone has. That way, they can find the right treatment.
Major Depressive Disorder
Major depressive disorder lasts for at least two weeks, usually longer. Symptoms include:
- Fatigue
- Hopelessness
- Loss of pleasure
- Suicidal thoughts
This can last for years. Sometimes it may go into remission (Culpepper, Muskin & Stahl, 2015).
Bipolar Disorder
Bipolar disorder, sometimes called manic depression, is more than just mood swings. Symptoms involve changes in:
- Mood
- Behavior
- Amount of sleep
- Energy levels
During a manic episode, the person may act very cheerful or irritable. They can’t think clearly. This means they may make impulsive shopping or romantic choices. They also might have high energy and not sleep or eat much. Sometimes they might have delusions or hallucinations.
Depressive episodes involve sleepiness, low energy, and despair. The person feels awful.
Checking for extreme mood swings and unsafe behavior can help doctors identify bipolar disorder.
Dysthymia
Dysthymia is a type of depression that lasts many years. The person may feel sad often and rarely feel happy. Relationships, daily activities, and work may suffer as a result. The person may seem pessimistic, so other people may not want to talk to them.
Just like other types of depression, dysthymia is treatable.
Health Impacts of Depression
Depression isn’t just an emotional problem. The mood and energy changes can cause physical problems.
Suicide risk
When someone feels miserable all the time, they might look for a way to stop suffering. Depression can cloud their judgment so they think there’s no way out. As a result, they might feel hopeless about life.
Unfortunately, society often treats disabled people like burdens. Because of this, they might think that people are better off without them. This is a very dangerous idea.
Nutrition problems
Depression affects appetite. Some people with depression lose their appetites, and others eat too much.
Undereating can weaken someone’s health. As a result, they might end up with nutritional deficiencies or a weakened immune system. Taking vitamins can help a little, but it can’t prevent everything. Poor nutrition can cause health problems.
Overeating is also harmful. Weight gain, diabetes, and high blood pressure can become problems. If they gain weight, their body image and self-esteem may suffer. Then their mental health may suffer even more.
A doctor or nutritionist can help with these problems.
Heart Problems
It’s hard to exercise when you feel sad and tired all the time. People with depression may spend lots of time sitting or lying down. That isn’t good for their heart health.
Sadly, that’s not the only problem. Depression releases brain chemicals that increase the risk of coronary heart disease (Dhar and Barton, 2016). This, combined with little exercise, can be a serious problem.
What This Means
Treatment for depression is important for both physical and mental health. Therefore, doctors should ask about eating habits and exercise. This can help them check for issue.
People living with depression will need to try to take care of themselves, even when it’s hard. For example, doing a little exercise is better than doing nothing. For example, taking a walk or bouncing on an exercise ball can help. Small eating changes can also help. For instance, eating frozen vegetables is better than eating no vegetables.
Treating Depression
The best way to treat depression depends on the patient. There are several options. The doctor and patient can talk about what to try.
Medication
Medicine for depression can help someone feel like their “old self” again. That’s because it balances the chemicals in their brains, helping them think clearly and feel more optimistic.
Different antidepressants work for different kinds of people. Patients will need to think about:
- Their symptoms
- Possible side effects
- Possible drug interactions
- Cost
It may take a few tries to find the right medication.
Unfortunately, it can take a while for the pills to start working. It usually takes 2-4 weeks to notice changes. Naturally, this can be frustrating for patients who are really suffering.
Of course, medication isn’t perfect. It can help a patient feel better. However, it doesn’t always fix the root cause of their depression. Also, the effect may not last if they stop taking the pills.
That’s why doctors usually recommend therapy.
Therapy for Depression
Therapy helps many people with depression. The therapist can help identify why the patient has depression. Then they can choose a treatment method that may help. Sometimes they may use more than one method, depending on what the patient needs.
Interpersonal therapy can help people improve their relationships with others (Van Hees, Rotter, Ellermann & Evers, 2013). Since disabled people are often isolated, building relationships makes a difference. Improving their relationships can help them feel less lonely.
Psychodynamic therapy focuses on the person’s experiences to look for the source of depression. Together, therapists and patients talk about life events and problems. Then the therapists can help handle these problems.
Cognitive-behavioral therapy (CBT) is known for being very effective (Vara et al., 2018). Therapists help patients challenge negative thoughts. That way, patients can fight back when their thoughts turn bad. They can also build coping skills.
Choosing a Treatment Plan
The right therapy depends on the patient’s needs. Sometimes a combination works best. Medication can help someone feel better sooner, and therapy can help fix the problems that caused the depression.
Finding the cause is critical for making sure the depression doesn’t come back. Fixing the core problem can help improve the patient’s quality of life. In short, it’s important for treatment to stay patient-centered. After all, everyone has different needs. Treatment must reflect that.