Depression – What it is and What it is Not

A family caregiver is in depression

Types of Depression
Common Causes of Depression
Self-Assessment Screener
Family Caregivers Share their Experiences with Depression

Major depression is significantly more than feeling sad, unhappy, or moody. Most people experience these feelings for short periods. Major depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended time and requires a doctor’s supervision.

A family caregiver suffering from major depression experiences a combination of at least five of the following for at least a 2-week period:

  • Depressed mood, loss of interest or pleasure in most daily activities
  • Significant change in weight or change in appetite
  • Trouble sleeping or excessive sleeping
  • Feeling tired and a lack of energy
  • Feelings of hopelessness and helplessness
  • Feelings of worthlessness, self-hate, and inappropriate guilt
  • Feelings of low self esteem
  • Sudden outbreaks of anger
  • Difficulty in thinking, concentrating or making decisions
  • Recurring thoughts of death or suicide

What major depression does NOT include:

  • Substance induced depressed moods e.g. drugs or alcohol
  • Schizoaffective disorder and other similar diagnosis
  • Feelings of loss brought about by the death of a loved one


Types of Depression

Depression is generally ranked in terms of severity — mild, moderate, or severe. The degree of your depression, which your doctor can determine, influences how you are treated. The primary types of depression include:

  • Major Depression — five or more symptoms listed above must be present for at least 2 weeks. Major depression tends to continue for at least 6 months
  • Minor Depression — if less than five depressive symptoms are present for at least 2 weeks.
  • Dysthymia — a chronic, generally milder form of depression but lasts longer, sometimes for as long as two years.
  • Atypical Depression — depression accompanied by unusual symptoms, such as hallucinations or delusions.
  • Bipolar Disorder — In this condition, moods cycle between mania and depression.


Common Causes

Depression is a nature-nurture phenomenon. That means that it’s always a matter of genes and environment interacting to produce the depressive changes. As arduous as family caregiving can be, if you become depressed it is more than likely that you have a genetic vulnerability to developing depression. The stress associated with family caregiving, in conjunction with your innate tendency to become depressed, can result in the development of major depression. Yet, even with a genetic predisposition, it is usually a stressful or unhappy life event that triggers the onset of a depressive episode.

  • Family caregivers who provide care 36 or more hours weekly are more likely than non-caregivers to experience symptoms of depression or anxiety.
  • Family caregiving spouses experience symptoms of depression or anxiety at a rate of six times higher than non-caregivers.
  • Family caregivers caring for a parent experience symptoms of caregiver depression or anxiety at a rate that is twice as high as non-caregivers.

Factors that increase a family caregiver’s susceptibility to caregiver depression include:

  • Tending a loved one with disruptive behavior
  • personality changes caused by neurological conditions
  • having frequent conflict with the healthcare team
  • lacking available social and emotional support


Family Caregivers Share their Experiences with Depression

Quotes from Individuals:

“Major caregiver depression clicks in when I am experiencing three very stressful things at the same time, at least one of which is related to my being a family caregiver. To me depression is a thick dark menacing cloud that hovers over me wherever I go. The sky may be blue but this cloud is always with me. It is not high above but rather it hovers just a foot or so over my head, and it slowly moves downward until it is touching my head, forcing me to double over. I can’t outrun it, or hide from it. It is always there, and at the worst times it continues to descend, getting darker and heavier all the time so that I am forced to my hands and knees and then flat on my stomach, but still it keeps coming, as if it is trying to push all the air out of my body.”

“My depression looks and feels to me like a large and fierce-looking German shepherd. He sits at the foot of my bed and each time I try to get up, he growls and his eyes have a menacing stare, challenging me, as if to say “If you put one foot on the floor I am going to leap up and tear you to bits.”

“Depression to me was everything moving in slow motion. Just walking felt like I had shoes on that weighed tons, but because I have teenage children I had no choice but to keep moving and hold everything together.”