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How to cope when depression hits


Last week's column was about the things that make it more likely for a woman to get depressed -- conditions such as aging, poverty, unemployment, marital status or loss of a loved one. Because one out of 12 women shows signs of depression, a lot of women are interested in this information.

Q: What are "precipitating" or serious life events that can bring on depression?

A: Serious life events generally involve a loss that throws a person's life into turmoil. The death of a loved one, job loss, divorce or breaking up are among the most difficult losses.

Transitions, like starting a new family, moving or starting a new job, can also be serious life events.

Sometimes, losing one's dreams can feel like a terrible loss. When people don't reach their goals, such as a career ambition )) or the hope of a new relationship, this can bring on depression.

Q: How can I cope with serious life events?

A: Different people have different coping strategies. If you have been depressed before, you have already learned some ways to cope.

Johns Hopkins psychiatrist Dr. Alan Romanoski explains that people responding to a traumatic event should take steps for coping that make them comfortable, and not ones that create additional pressure. When tragedy strikes, this is not a time to try new coping strategies, but a time to tap your strengths.

Q: What steps should I take after a serious life event?

A: In cases of catastrophe, Dr. Romanoski explains, it helps to divide the big problem into smaller pieces that are more manageable. Seek help to figure out what needs to be done. Often, social rules and routines are useful for avoiding uncertainty and solving the little problems along the way.

Q: What are "predisposing" or stressful conditions that make a person more likely to get depressed?

A: There are two kinds of depressive life conditions. One is a family history of depression. A family history may mean that you are by nature prone to depression, either because of your physical makeup or because of difficult circumstances in your family that have contributed to a tendency to get depressed.

The other life condition involves social situations. Poverty, isolation, abuse at home or at work and an unhappy marriage are commonly associated with depression.

Q: What are coping strategies I can use if I have a stressful life situation that I can't change?

A: Dr. Romanoski reminds us that social supports are extremely important. This may come in the form of family, friends or even structured social groups, like your church or synagogue. Q: What are signs which indicate professional help is needed?

A: Persistent hopelessness, guilt and morbid thoughts are common signals for professional help.

Having trouble with everyday tasks, like balancing a checkbook, may be a sign of trouble. People who start to be depressed will often have a series of mishaps, like minor traffic accidents.

Physical signs of depression include changes in weight or sleeping patterns, persistent headaches or an inability to concentrate.

Q: If I am concerned about depression, is there help?

A: There are numerous treatments for people with depression, including medication, psychotherapy or, most often, a combination of the two.

In Baltimore, the Depression and Related Affective Disorders Association (DRADA) provides information, support groups and seminars. Write Sally Mink, DRADA, Meyer 3-181, 600 N. Wolfe St. 21287-7381; or call (410) 955-4647.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Public Health.

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