Schizoaffective Disorder and Atypical Depression

People with schizoaffective disorder, like those with bipolar disorder, may experience depression differently from people who have unipolar depression. It is common for people with schizoaffective disorder to experience atypical depression, which means that instead of experiencing insomnia, loss of appetite and being sad and tearful, which are common with typical depression, people feel the need to eat and sleep more and tend to feel very flat and slowed down when they are depressed. Other hallmarks of atypical depression are fatigue and being sensitive to rejection.

Not being able to feel
A lot of people with schizoaffective disorder experience what they describe as an absence of feeling as part of depressive episodes. This is sometimes also described as feeling flat or empty.

Not caring about anything
People suffering from depression often state that they are unable to care about anything, even things that used to be important to them.

Losing interest and motivation
People with schizoaffective disorder frequently experience a loss of interest in, and motivation to do, things. The things that they used to enjoy don’t give them pleasure any more.

Feeling tired and drained of energy
It is common for people experiencing an episode of depression to feel tired all the time. Some people have described this as feeling as though they have just run a marathon and have no energy left.

Feeling worse at particular times of the day
People experiencing an episode of depression may find that they feel worse at particular times of the day. For some people, mornings are worse, whilst for others it is during the evening that they feel worse.

Feeling worthless
People with schizoaffective disorder who are depressed often suffer from feelings of worthlessness. Their self-esteem drops considerably, leaving them lacking in confidence and feeling as though they are useless. Depression can make people forget about their strengths and make them only focus on their weaknesses.

Feeling guilty
Guilt is a very common problem for people experiencing an episode of depression. People tend to feel excessive guilt for minor mistakes and normal human errors.

Becoming more sensitive
When people are depressed they tend to become much more sensitive to both criticism and rejection.

Irritability
It is common for people experiencing depressive or mixed episodes to become much more irritable than usual.

Feeling hopeless and helpless
It is very common for people experiencing depression to feel extremely hopeless about the future and helpless because of feeling unable to change the way they feel.

Feeling worried and anxious
Worry and anxiety are common features of depression. Anxiety can be very disabling for some people. It can be ‘global’, where everything is a worry, or specific, where anxiety is focused on certain things, for example physical health.

Feeling lethargic
Lethargy, feeling tired, slowed down and unmotivated, is a common symptom for people experiencing episodes of depression. Lethargy can make people talk much slower than usual, use shorter sentences and move around more slowly. In severe forms, lethargy can make it difficult for people to get things done – or even to get out of bed.

Withdrawal and avoidance
It is common for people suffering from depression to withdraw from the things that they used to enjoy doing. They may also start to avoid social situations and turn down invitations from friends.

Thinking negatively Everyone can think negatively from time to time, but depression has the potential to make people think negatively all the time, or the majority of time. Rumination about past failings is also common in depression.

Sluggish thoughts
One of the hallmarks of depression is the way that people feel as though their head is full of fog. This causes them to have difficulty remembering things or concentrating on things a lot of the time. It can also make decision making and planning very difficult.”

Sources: Schizoaffective Disorder Simplified by Martine Daniel

Wanting to Die – by Anne Sexton

Since you ask, most days I cannot remember.

I walk in my clothing, unmarked by that voyage.

Then the almost unnameable lust returns.


Even then I have nothing against life.

I know well the grass blades you mention,

the furniture you have placed under the sun.


But suicides have a special language.

Like carpenters they want to know which tools.

They never ask why build.


Twice I have so simply declared myself,

have possessed the enemy, eaten the enemy,

have taken on his craft, his magic.


In this way, heavy and thoughtful,

warmer than oil or water,

I have rested, drooling at the mouth-hole.


I did not think of my body at needle point.

Even the cornea and the leftover urine were gone.

Suicides have already betrayed the body.


Still-born, they don’t always die,

but dazzled, they can’t forget a drug so sweet

that even children would look on and smile.


To thrust all that life under your tongue!–

that, all by itself, becomes a passion.

Death’s a sad Bone; bruised, you’d say,


and yet she waits for me, year after year,

to so delicately undo an old wound,

to empty my breath from its bad prison.


Balanced there, suicides sometimes meet,

raging at the fruit, a pumped-up moon,

leaving the bread they mistook for a kiss,


leaving the page of the book carelessly open,

something unsaid, the phone off the hook

and the love, whatever it was, an infection.

Suicide Statistics

statistics from the cdc:

There are on average 41,149 deaths by suicide in the United States each year. Suicide is the 10th leading cause of death; homicide ranks 16th. It is the second leading cause of death for 15 – 24 year olds. Suicide results in an estimated $51 billion in combined medical and work loss costs. An estimated 9.3 million adults reported having suicidal thoughts in the past year. An estimated 1.3 million adults aged 18 or older attempted suicide in the past year. Of the most at risk population: Patients diagnosed with a serious mental illness die 25 years earlier than other Americans.

Take a moment to think about it. We have a little over 112 suicide deaths everyday. If 112 people were dying in a terrorist attack everyday the spending would be astronomical to prevent it. Will we ever reduce the suicide rate to zero? Of course not, but a large percentage of these deaths are preventable through proper funding, therapy, and reducing the stigma of mental illness.

#EndStigma #IncreaseMentalHealthFunding #MentalHealth #MentalIllness

On Depression

On Depression:

“Depression, contrary to popular belief, isn’t simply sadness; it’s physical exhaustion. It’s dragging a corpse through your life. It’s the inability to care about or enjoy most parts of your life, even the things you used to like. And if you find yourself enjoying something, it’s usually somewhat separated from you, like seeing a loved one through prison glass. It’s there, but not as you hoped it would be.”

~ Thomas Wallingford, The Mighty Contributor

#MentalHealth #Depression #EndStigma

Dan Harmon on Depression

On Depression:

“For One: Admit and accept that that it’s happening. Awareness is everything. We put ourselves under so much pressure to feel good. It’s okay to feel bad. It might be something you’re good at! Communicate it. DO NOT KEEP IT A SECRET. Own it. Like a hat or jacket. Your feelings are real.

Two: try to remind yourself, over and over, that feelings are real but they aren’t reality. Example: you can feel like life means nothing. True feeling. Important feeling. TRUE that you feel it, BUT…whether life has meaning? Not up to us. Facts and feelings: equal but different

The most important thing I can say to you is please don’t deal with it alone. There is an incredible, miraculous magic to pushing your feelings out. Even writing “I want to die” on a piece of paper and burning it will feel better than thinking about it alone. Output is magical.

Dark thoughts will echo off the walls of your skull, they will distort and magnify. When you open your mouth (or an anonymous journal or blog or sketchpad), these thoughts go out. They’ll be back but you gotta get em OUT. Vent them. Tap them. I know you don’t want to but try it.”

~ Dan Harmon, Creator of ‘Rick and Morty’

#MentalHealth #Depression #EndStigma

Postpartum Depression: Symptoms

The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.

Most new moms experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues typically begin within the first two to three days after delivery, and may last for up to two weeks.

But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.

Postpartum depression isn’t a character flaw or a weakness. Sometimes it’s simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby.

Symptoms

Signs and symptoms of depression after childbirth vary, and they can range from mild to severe.

Baby blues symptoms

Signs and symptoms of baby blues — which last only a few days to a week or two after your baby is born — may include:

• Mood swings

• Anxiety

• Sadness

• Irritability

• Feeling overwhelmed

• Crying

• Reduced concentration

• Appetite problems

• Trouble sleeping

Postpartum depression symptoms

Postpartum depression may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, and may eventually interfere with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ― during pregnancy ― or later — up to a year after birth.

Postpartum depression signs and symptoms may include:

• Depressed mood or severe mood swings

• Excessive crying

• Difficulty bonding with your baby

• Withdrawing from family and friends

• Loss of appetite or eating much more than usual

• Inability to sleep (insomnia) or sleeping too much

• Overwhelming fatigue or loss of energy

• Reduced interest and pleasure in activities you used to enjoy

• Intense irritability and anger

• Fear that you’re not a good mother

• Hopelessness

• Feelings of worthlessness, shame, guilt or inadequacy

• Diminished ability to think clearly, concentrate or make decisions

• Restlessness

• Severe anxiety and panic attacks

• Thoughts of harming yourself or your baby

• Recurrent thoughts of death or suicide

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first week after delivery — the signs and symptoms are severe. Signs and symptoms may include:

• Confusion and disorientation

• Obsessive thoughts about your baby

• Hallucinations and delusions

• Sleep disturbances

• Excessive energy and agitation

• Paranoia

• Attempts to harm yourself or your baby

Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

Postpartum depression in new fathers

New fathers can experience postpartum depression, too. They may feel sad or fatigued, be overwhelmed, experience anxiety, or have changes in their usual eating and sleeping patterns ― the same symptoms mothers with postpartum depression experience.

Fathers who are young, have a history of depression, experience relationship problems or are struggling financially are most at risk of postpartum depression. Postpartum depression in fathers ― sometimes called paternal postpartum depression ― can have the same negative effect on partner relationships and child development as postpartum depression in mothers can.

If you’re a new father and are experiencing symptoms of depression or anxiety during your partner’s pregnancy or in the first year after your child’s birth, talk to your health care professional. Similar treatments and supports provided to mothers with postpartum depression can be beneficial in treating postpartum depression in fathers.

Causes

There’s no single cause of postpartum depression, but physical and emotional issues may play a role.

• Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed.

• Emotional issues. When you’re sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression.

Risk factors

Any new mom can experience postpartum depression and it can develop after the birth of any child, not just the first. However, your risk increases if:

• You have a history of depression, either during pregnancy or at other times

• You have bipolar disorder

• You had postpartum depression after a previous pregnancy

• You have family members who’ve had depression or other mood disorders

• You’ve experienced stressful events during the past year, such as pregnancy complications, illness or job loss

• Your baby has health problems or other special needs

• You have twins, triplets or other multiple births

• You have difficulty breast-feeding

• You’re having problems in your relationship with your spouse or significant other

• You have a weak support system

• You have financial problems

• The pregnancy was unplanned or unwanted

Complications

Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems.

• For mothers. Untreated postpartum depression can last for months or longer, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a woman’s risk of future episodes of major depression.

• For fathers. Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s father may also increase. And new dads are already at increased risk of depression, whether or not their partner is affected.

• For children. Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying, and delays in language development.

Prevention

If you have a history of depression — especially postpartum depression — tell your doctor if you’re planning on becoming pregnant or as soon as you find out you’re pregnant.

During pregnancy, your doctor can monitor you closely for signs and symptoms of depression. He or she may have you complete a depression-screening questionnaire during your pregnancy and after delivery. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants may be recommended — even during pregnancy.

After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier it’s detected, the earlier treatment can begin. If you have a history of postpartum depression, your doctor may recommend antidepressant treatment or psychotherapy immediately after delivery.

Agoraphobia: Symptoms

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.

The anxiety is caused by fear that there’s no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again.

People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.

Agoraphobia treatment can be challenging because it usually means confronting your fears. But with psychotherapy and medications, you can escape the trap of agoraphobia and live a more enjoyable life.

Symptoms

Typical agoraphobia symptoms include fear of:

• Leaving home alone

• Crowds or waiting in line

• Enclosed spaces, such as movie theaters, elevators or small stores

• Open spaces, such as parking lots, bridges or malls

• Using public transportation, such as a bus, plane or train

These situations cause anxiety because you fear you won’t be able to escape or find help if you start to feel panicked or have other disabling or embarrassing symptoms.

In addition:

• Fear or anxiety almost always results from exposure to the situation

• Your fear or anxiety is out of proportion to the actual danger of the situation

• You avoid the situation, you need a companion to go with you, or you endure the situation but are extremely distressed

• You experience significant distress or problems with social situations, work or other areas in your life because of the fear, anxiety or avoidance

• Your phobia and avoidance usually lasts six months or longer

Panic disorder and agoraphobia

Some people have a panic disorder in addition to agoraphobia. Panic disorder is a type of anxiety disorder in which you experience sudden attacks of extreme fear that reach a peak within a few minutes and trigger intense physical symptoms (panic attacks). You might think that you’re totally losing control, having a heart attack or even dying.

Fear of another panic attack can lead to avoiding similar circumstances or the place where it occurred in an attempt to prevent future panic attacks.

Signs and symptoms of a panic attack can include:

• Rapid heart rate

• Trouble breathing or a feeling of choking

• Chest pain or pressure

• Lightheadedness or dizziness

• Feeling shaky, numb or tingling

• Excessive sweating

• Sudden flushing or chills

• Upset stomach or diarrhea

• Feeling a loss of control

• Fear of dying

Causes

Biology — including health conditions and genetics — temperament, environmental stress and learning experiences may all play a role in the development of agoraphobia.

Risk factors

Agoraphobia can begin in childhood, but usually starts in the late teen or early adult years — usually before age 35 — but older adults can also develop it. Women are diagnosed with agoraphobia more often than men are.

Risk factors for agoraphobia include:

• Having panic disorder or other phobias

• Responding to panic attacks with excessive fear and avoidance

• Experiencing stressful life events, such as abuse, the death of a parent or being attacked

• Having an anxious or nervous temperament

• Having a blood relative with agoraphobia

Complications

Agoraphobia can greatly limit your life’s activities. If your agoraphobia is severe, you may not even be able to leave your home. Without treatment, some people become housebound for years. You may not be able to visit with family and friends, go to school or work, run errands, or take part in other normal daily activities. You may become dependent on others for help.

Agoraphobia can also lead to or be associated with:

• Depression

• Alcohol or drug abuse

• Other mental health disorders, including other anxiety disorders or personality disorders

Prevention

There’s no sure way to prevent agoraphobia. However, anxiety tends to increase the more you avoid situations that you fear. If you start to have mild fears about going places that are safe, try to practice going to those places over and over again before your fear becomes overwhelming. If this is too hard to do on your own, ask a family member or friend to go with you, or seek professional help.

If you experience anxiety going places or have panic attacks, get treatment as soon as possible. Get help early to keep symptoms from getting worse. Anxiety, like many other mental health conditions, can be harder to treat if you wait.

COVID-19 and your mental health

The COVID-19 pandemic has likely brought many changes to how you live your life, and with it uncertainty, altered daily routines, financial pressures and social isolation. You may worry about getting sick, how long the pandemic will last, whether you’ll lose your job, and what the future will bring. Information overload, rumors and misinformation can make your life feel out of control and make it unclear what to do.

During the COVID-19 pandemic, you may experience stress, anxiety, fear, sadness and loneliness. And mental health disorders, including anxiety and depression, can worsen.

Surveys show a major increase in the number of U.S. adults who report symptoms of stress, anxiety and depression during the pandemic, compared with surveys before the pandemic. Some people have increased their use of alcohol or drugs, thinking that can help them cope with their fears about the pandemic. In reality, using these substances can worsen anxiety and depression.

People with substance use disorders, notably those addicted to tobacco or opioids, are likely to have worse outcomes if they get COVID-19. That’s because these addictions can harm lung function and weaken the immune system, causing chronic conditions such as heart disease and lung disease, which increase the risk of serious complications from COVID-19.

For all of these reasons, it’s important to learn self-care strategies and get the care you need to help you cope.

Self-care strategies

Self-care strategies are good for your mental and physical health and can help you take charge of your life. Take care of your body and your mind and connect with others to benefit your mental health.

Take care of your body

Be mindful about your physical health:

Get enough sleep. Go to bed and get up at the same times each day. Stick close to your typical schedule, even if you’re staying at home.

Participate in regular physical activity. Regular physical activity and exercise can help reduce anxiety and improve mood. Find an activity that includes movement, such as dance or exercise apps. Get outside in an area that makes it easy to maintain distance from people, such as a nature trail or your own backyard.

Eat healthy. Choose a well-balanced diet. Avoid loading up on junk food and refined sugar. Limit caffeine as it can aggravate stress and anxiety.

Avoid tobacco, alcohol and drugs. If you smoke tobacco or if you vape, you’re already at higher risk of lung disease. Because COVID-19 affects the lungs, your risk increases even more. Using alcohol to try to cope can make matters worse and reduce your coping skills. Avoid taking drugs to cope, unless your doctor prescribed medications for you.

Limit screen time. Turn off electronic devices for some time each day, including 30 minutes before bedtime. Make a conscious effort to spend less time in front of a screen — television, tablet, computer and phone.

Relax and recharge. Set aside time for yourself. Even a few minutes of quiet time can be refreshing and help to quiet your mind and reduce anxiety. Many people benefit from practices such as deep breathing, tai chi, yoga or meditation. Soak in a bubble bath, listen to music, or read or listen to a book — whatever helps you relax. Select a technique that works for you and practice it regularly.

Take care of your mind

Reduce stress triggers:

• Keep your regular routine. Maintaining a regular schedule is important to your mental health. In addition to sticking to a regular bedtime routine, keep consistent times for meals, bathing and getting dressed, work or study schedules, and exercise. Also set aside time for activities you enjoy. This predictability can make you feel more in control.

• Limit exposure to news media. Constant news about COVID-19 from all types of media can heighten fears about the disease. Limit social media that may expose you to rumors and false information. Also limit reading, hearing or watching other news, but keep up to date on national and local recommendations. Look for reliable sources, such as the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

Stay busy. A distraction can get you away from the cycle of negative thoughts that feed anxiety and depression. Enjoy hobbies that you can do at home, identify a new project or clean out that closet you promised you’d get to. Doing something positive to manage anxiety is a healthy coping strategy.

Focus on positive thoughts. Choose to focus on the positive things in your life, instead of dwelling on how bad you feel. Consider starting each day by listing things you are thankful for. Maintain a sense of hope, work to accept changes as they occur and try to keep problems in perspective.

Use your moral compass or spiritual life for support. If you draw strength from a belief system, it can bring you comfort during difficult times.

Set priorities. Don’t become overwhelmed by creating a life-changing list of things to achieve while you’re home. Set reasonable goals each day and outline steps you can take to reach those goals. Give yourself credit for every step in the right direction, no matter how small. And recognize that some days will be better than others.

Connect with others

Build support and strengthen relationships:

Make connections. If you need to stay at home and distance yourself from others, avoid social isolation. Find time each day to make virtual connections by email, texts, phone, or FaceTime or similar apps. If you’re working remotely from home, ask your co-workers how they’re doing and share coping tips. Enjoy virtual socializing and talking to those in your home.

Do something for others. Find purpose in helping the people around you. For example, email, text or call to check on your friends, family members and neighbors — especially those who are elderly. If you know someone who can’t get out, ask if there’s something needed, such as groceries or a prescription picked up, for instance. But be sure to follow CDC, WHO and your government recommendations on social distancing and group meetings.

Support a family member or friend. If a family member or friend needs to be isolated for safety reasons or gets sick and needs to be quarantined at home or in the hospital, come up with ways to stay in contact. This could be through electronic devices or the telephone or by sending a note to brighten the day, for example.

Recognizing what’s typical and what’s not

Stress is a normal psychological and physical reaction to the demands of life. Everyone reacts differently to difficult situations, and it’s normal to feel stress and worry during a crisis. But multiple challenges daily, such as the effects of the COVID-19pandemic, can push you beyond your ability to cope.

Many people may have mental health concerns, such as symptoms of anxiety and depression during this time. And feelings may change over time.

Despite your best efforts, you may find yourself feeling helpless, sad, angry, irritable, hopeless, anxious or afraid. You may have trouble concentrating on typical tasks, changes in appetite, body aches and pains, or difficulty sleeping or you may struggle to face routine chores.

When these signs and symptoms last for several days in a row, make you miserable and cause problems in your daily life so that you find it hard to carry out normal responsibilities, it’s time to ask for help.

Get help when you need it

Hoping mental health problems such as anxiety or depression will go away on their own can lead to worsening symptoms. If you have concerns or if you experience worsening of mental health symptoms, ask for help when you need it, and be upfront about how you’re doing. To get help you may want to:

• Call or use social media to contact a close friend or loved one — even though it may be hard to talk about your feelings.

• Contact a minister, spiritual leader or someone in your faith community.

• Contact your employee assistance program, if your employer has one, and get counseling or ask for a referral to a mental health professional.

• Call your primary care provider or mental health professional to ask about appointment options to talk about your anxiety or depression and get advice and guidance. Some may provide the option of phone, video or online appointments.

• Contact organizations such as the National Alliance on Mental Illness (NAMI) or the Substance Abuse and Mental Health Services Administration (SAMHSA) for help and guidance.

If you’re feeling suicidal or thinking of hurting yourself, seek help. Contact your primary care provider or a mental health professional. Or call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use its webchat at suicidepreventionlifeline.org/chat.

Continue your self-care strategies

You can expect your current strong feelings to fade when the pandemic is over, but stress won’t disappear from your life when the health crisis of COVID-19 ends. Continue these self-care practices to take care of your mental health and increase your ability to cope with life’s ongoing challenges.

Sources: McLean Hospital, The Mayo Clinic, NAMI

Does caffeine make depression worse?

Does caffeine make depression worse?

There’s no clear link between caffeine intake and depression. However, caffeine intake and depression may be linked indirectly for people who are particularly sensitive to the effects of caffeine or who have too much caffeine.

Caffeine can cause sleep problems that affect mood.Caffeine can make it harder to fall asleep and stay asleep. Lack of sleep can worsen depression. If you have trouble sleeping, don’t drink caffeinated beverages late in the day. Some people need to limit caffeine to the morning or quit drinking caffeinated beverages completely to avoid sleep problems.

Also, anxiety and depression often occur together, and caffeine can worsen anxiety.

Stopping abruptly can worsen depression. If you regularly drink caffeinated beverages, quitting can cause a depressed mood until your body adjusts. It can also cause other signs and symptoms, such as headaches, fatigue and irritability.

If you have depression, consider limiting or avoiding caffeine to see if it helps improve your mood. To lessen these withdrawal effects, gradually reduce the amount of caffeinated beverages you drink.