Karen Liberman was 37 years old when she fell into a deep depression. It was only years later, when she was better, that she realized she wouldn’t have suffered so much if she had sought help earlier. But at the time, she didn’t recognize what was happening.

“I was running so fast; I was doing so much,” she says. “Then the wheels fell off the bus.”

Depression is very common, striking one in every four or five women and one in every seven men. The good news is that much more is known about depression than even a few years ago, making it easier for people to recognize the signs and seek help.

“If you are feeling the symptoms of depression and not functioning well, see your doctor. It is highly treatable,” says Dr. Robert Levitan, head of the mood and anxiety research division at the Centre for Addiction and Mental Health in Toronto. “Catching it early is the key. Then you can work on preventing it rather than letting it hit home.”

A combination of genes, life circumstances and personality can make people more susceptible to depression.

“Life adversity is a long-term risk factor, but is not sufficient by itself. There is a strong genetic component,” says Levitan, who is also an associate professor of psychiatry at the University of Toronto.

Perfectionists have higher rates of depression, for example, as well as those who are very sensitive to day-to-day events. A typical example of the latter would be a boss walking by an employee’s desk and not saying anything to that employee. The employee who feels rejected by this and ruminates about it is more susceptible to depression than the personality type that lets it go, realizing there may be an explanation that has nothing to do with them. Substance abuse and social isolation may also make people more susceptible to depression.

While it may be obvious to others that a person is depressed, that person may be the last to realize it. This was the case with Liberman.

“I never thought that what I was going through was depression,” she admits. “You attribute it to everything else — it’s my marriage; it’s my job; it’s that I don’t have enough money.”

Recognizing the signs of depression is critical because people who seek help early in the illness will suffer less. Liberman, who is now the executive director of the Mood Disorders Association of Ontario, believes depression checklists can be effective. You should seek help if you have most or all of the following symptoms for two weeks:

> feeling that life isn’t fun anymore;

> feeling sad or down in the dumps;

> crying;

> feelings of restlessness;

> feeling worthless;

> changes in appetite and weight;

> low energy;

> feeling anxious;

> trouble sleeping, or sleeping too much;

> suicidal thoughts.

The two main treatments for depression are antidepressant medications and psychotherapy. “Most people do well on one antidepressant,” says Levitan.

The keys to Liberman’s healing were finding the right doctor and the right medication, undergoing psychotherapy and making major life changes such as leaving her 32-year marriage.

“Now,” she says, “I am the healthiest I have ever been in my life.”

Two types of psychotherapy are used in depression: interpersonal therapy, which focuses on understanding human relationships; and cognitive-behavioural therapy, which teaches patients how to identify and change the negative thoughts and beliefs that accompany depression.

Once depression is recognized, 80% of people affected can be successfully treated, according to the Canadian Mental Health Association.

If you feel depressed only in the wintertime, you may have seasonal affective disorder, or SAD. As many as one million Canadians suffer from significant clinical depression related to lack of natural light in the winter time. Another 15% of the population has a more mild form known as the “winter blahs.”

“This is the worst time of year,” says Levitan, adding that financial advisors may be at risk for SAD. “Lots of business types fall prey to seasonal affective disorder, probably because they are indoors a lot, not exposed to much natural light, and may not be sleeping well.”

Levitan, who is president of the Society of Light Treatment and Biological Rhythms, says that light therapy can be very effective in treating SAD.

“If you are unable to perform your regular work duties or are having mood problems at home and are not able to do the usual things,” he says, “you should talk to your doctor.” IE

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