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US Centers for Disease Control and Prevention (CDC) estimated 40 million Americans living today will suffer from major depressive illness during their lives. Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.
Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the �baby blues.� Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth. Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions. - mcmanweb.com
Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.
According to the National Institute of Mental Health, approximately 18.8 million American adults, or about 9.5 percent of the US population age 18 and older in a given year, have a depressive disorder. Depression is a chronic illness that exacts a significant toll on
America's health and productivity. It affects more than 21 million
American children and adults annually and is the leading cause of
disability in the United States for individuals ages 15 to 44.
Lost productive time among U.S. workers due to depression is estimated
to be in excess of $31 billion per year. Depression frequently
co-occurs with a variety of medical illnesses such as heart disease,
cancer, and chronic pain and is associated with poorer health status
and prognosis. It is also the principal cause of the 30,000 suicides
in the U.S. each year. In 2004, suicide was the 11 th leading cause of death in the United States, third among individuals 15-24.
According to the World Health Organization, depression is presently on track to becoming the world's second-most disabling disease (after heart disease) by the year 2020. Depression is responsible for some $87 billion a year in lost productivity in the US (a conservative estimate), and according to Bank One, is responsible for most lost work days in its employees after pregnancy and childbirth. Additionally, one million people worldwide die by their own hand, most as a result of a mood disorder. Finally, the linkage between depression and a host of physical illnesses makes it arguably the world's greatest killer.
Research presented at the 56th Annual Conference of the Canadian
Psychiatric Association shows a marked link between bipolar disorder
and migraines. The odds of migraine in persons with bipolar disorder were 40% higher than the general population. Data
obtained from 36,984 people aged 15 and over, who screened positive for
manic or depressive episodes with migraine, were compared against those
who screened positive for mania but who didn�t suffer from migraines. Amongst
males, 14.9% of those with manic episodes were also diagnosed with
migraines compared with 5.8% of the general population. Amongst
females, 34.7% had both migraines and bipolar disorder compared with
14.7% who only had migraines.unquote.gif While the research was
skewed towards persons who were already diagnosed with bipolar
disorders, what does it mean for people who suffer from migraines but
who may have an undiagnosed bipolar disorder?
Migraines and headaches aren�t fully understood but the manifestations are very real and debilitating for their sufferers: Throbbing pain Nausea Heightened sensitivity to light or sound Seeing dots, wavy lines, flashing lights, or blind spots Difficulty with speech, sensation, or movement
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Rejection is a fundamental law of the (social) universe. But if you laser in on every dis, you'll likely trigger a self-fulfilling prophecy. Rejection-sensitivity is on the rise, but you can learn to brave even the biggest brush-offs.
from Psychology Today
By:Carlin Flora
Everybody hurts. In ways big and small, we are all snubbed every day of our lives. Of course, we can't possibly like everyone who likes us or join every group that would have us as a member, so we constantly let others down, too. It's the way the social universe operates. And yet, when it happens to us, we tend to take it personally. Very personally. And, often enough, hard.
If you were to track the daily happenings that flatten people's moods, you would likely find rejection at the core. "A very high percentage of negative events are related to the feeling that someone else doesn't value a relationship as much as you do," says Duke University psychologist Mark Leary. Those are the sore feelings that accompany such thoughts as, "Why did my coworker brush me off in that meeting?" or "My husband is watching TV when he should be paying attention to me!"
The drive to bond lies deep in our DNA. Disappointment when we fail to connect is virtually guaranteed. That's why the ultimate rejection—the departure of a loved one—is among the most stressful of all experiences.
Even the tiniest of slights can rile our emotions and send our self-esteem into a tailspin. In part, self-esteem reflects who we are intrinsically, but is also a barometer of our standing with others. Leary found that social self-esteem neatly rises with any inkling of acceptance ("Would you like to join us for lunch?") and plummets with any cut-down ("I like you—as a friend!").
"It's an internal gauge that is independently programmed," he explains. "So when you feel bad, you tend to feel bad about yourself." Social self-esteem acts like radar, scanning the environment for any hint of disapproval or exclusion. A blip on the meter, felt as a drop in self-esteem, is unpleasant, designed to spur us to address the source of the discomfort. If the gauge weren't sensitive to all signs of rejection, it might miss the big ones, endangering happiness or even safety. "Nature designed us to be vigilant about potential rejection," says Leary, "because for most of our history we depended on small groups of people. Getting shut out would have compromised survival."
As anyone who has ever watched American Idol knows, sensitivity to rejection exists along a continuum. The clueless party host who spews a string of tasteless jokes, as guests squirm, sits at the low end. At the high end is the vigilant scavenger who finds rejection in every empty inbox and between every ambiguous line. How she perceives and reacts to rejection is instructive for all of us—because we're all moving closer to her end of the continuum. Observers see a wave of psychological fragility pushing individuals in our culture toward oversensitivity to rejection.
A jittery rejection-detection radar zeroes in on empty threats—creating needless anxiety and groundless jealousy. Unfortunately, those at the high end of the rejection-sensitivity scale pay a particularly steep price just for wanting to belong. Their overwrought responses to slights may even have the unintended effect of bringing about what they fear most. And although such pain may be borne privately, it has public repercussions. There is a collective cost of individual hypersensitivity to rejection. People become unwilling to take even the smallest social risks. Preoccupied with their own performance evaluations, people shy away from approaching strangers or questioning authority. Public life shrinks and civil society withers.
Hypersensitivity Rising
There are a number of reasons why rejection-sensitivity is growing more pervasive. Major depression, a condition tightly linked to rejection sensitivity, has been on the rise among all age groups except the elderly for well over a decade. What's more, parents and educators overprotect and over-praise children, actions that backfire because they breed a preoccupation with evaluation by others. "If praise isn't based on anything specific, it gives you a sense of insecurity," Leary points out. "It makes you wonder whether your rejection radar is working at all." If you suspect you're not getting honest feedback, you'll be more sensitive to all possible slights or acceptances. You'll think, "Do people really like me?"
Then, too, adds New York psychologist Robert Leahy, we're on our way to becoming a performance-based culture. Young people in particular feel an urgency to grab the spotlight, instead of working toward becoming a stable member of a group. That makes them especially concerned with how others are evaluating them—and more sensitive to rejection.
But the primary reason we're becoming more rejection-sensitive, Leary contends, is that our fragmented, mobile society has decreased the number and weakened the strength of our social bonds. "Even 200 years ago, people were part of a small clan. They likely lived their entire lives in the same town. We now constantly have to reintegrate ourselves into new social networks. The sheer number of strangers with whom we interact creates many more opportunities for rejection."
Leahy, clinical professor at Weill-Cornell Medical College and author of The Worry Cure, agrees. "Because families are less intact and society is more segmented, we're all less secure. Further, an increased general sense of uncertainty makes us more vulnerable to rejection."
However subtle these background influences are, they all rub up against a stark fact: Our rejection radar is just not adapted to a world in which we're thrown against new and often strange situations daily. If the corner fruit vendor ignores your cheery "good morning!" it doesn't mean he won't sell you an apple; if your coworkers forget to invite you to after-work drinks, you're not necessarily the office pariah. Still, Leary says that he would rather err on the side of over-reading signals of rejection. Imagine if you had no pain receptors to warn you of impending bodily harm—you wouldn't feel scrapes or punches, but you wouldn't survive long, either.
From Fear to Eternity
When starting out as a psychologist, Geraldine Downey, now a professor at Columbia University, sought to discover how children whose early years were marked by parental rejection fared in adult relationships. She hypothesized that those whose needs for care and attachment were repeatedly met with rejection would likely grow up to anticipate it, see it where it might not exist, and overreact to it, as if life itself were on the line. After more than a decade of research, she has unveiled a fairly detailed portrait of people who are highly sensitive to rejection.
Awash in anticipatory anxiety or pre-emptive anger, they expect to be rejected by those they grow to value. They interpret neutral or negligent actions (a delay in phoning, say) as intentional slights. They are primed to find firm evidence of whatever feels threatening to them, cognitively poised to interpret situations negatively. They don't give anyone the benefit of a doubt. Women are no more likely than men to be overly rejection-sensitive, but gender does influence the way they react to imagined or actual slights: Men express more jealousy, women become more hostile and unsupportive. To ferret out a person's expectations of rejection, Downey asks questions such as:If you must approach your family for a loan, how anxious would you be? Would you expect them to help you?
Through a set of ingenious studies, Downey has discovered that, just as we have a nervous system that makes us reflexively recoil in self-protection when we spot a snake, we also have a defensive system that tries to protect us from rejection. Automatically triggered by the merest hint of rebuff, it throws our body into physiologic alarm mode, riveting our attention on the need to do something fast and urging us to head off an impending relationship rupture.
Improbably, the finding owes something to artists Edward Hopper and Pierre-Auguste Renoir. Hopper's scenes of urban desolation, Downey observed, are generally perceived as depictions of rejection, while Renoir's soft scenes come across as acceptance. After showing images of paintings by both artists to subjects in her study, she startled them with a loud noise. And then, via eyelid sensors, she counted their eye blinks.
Indeed, those who were highly rejection-sensitive reacted to the Hopper paintings, but not the Renoirs, with an amplified eye blink when startled by the noise—a sign that their bodies and minds had been pitched into panic. The threat of social rejection exaggerated their physiological response. By contrast, those low in rejection-sensitivity reacted equally to the noise whether viewing Hopper or Renoir scenes.
Although the defensive system is designed to motivate relationship repair, it backfires on those who are highly rejection-sensitive. They live life in panic mode, which not only brings them relentless emotional turmoil, but also sets off the most frustrating feature of rejection-sensitivity: It becomes a self-fulfilling prophecy. Magnifying oversights and seeing slipups as proof of catastrophe, they unleash hostility, anger, despondency, or jealousy. Their emotional storms often drive away the very people they hoped to hook.
"It happens in all contexts," says Leary. "A coworker may respond exaggeratedly to a tiny slight, which then leads office mates to avoid her, which makes her more defensive. Or your teenage son may blow you off, which makes you more distant and stern, which makes him shut you out even more."
An Early Start
There's no one path to rejection sensitivity. Clinicians and researchers know that children of emotionally or physically abusive, neglectful, or critical parents tend to become highly sensitive to rebuffs. Also at risk are children who grow up in poverty or war zones, situations that can divert parental attention and undermine formation of secure bonds.
The quality of a child's relationship with parents is hardly the sole determinant of rejection-sensitivity. Also influential is the child's innate level of reactivity to stress. Genetic makeup or premature birth may set the nervous system on the skittish side, making a child hypersensitive to rejection even if parents are not abusive or neglectful. To counteract a riled-up rejection radar, however it gets set, says Downey, a child would need "superparents" attentive to his needs and feelings.
There's some evidence that a heavy dose of peer rejection in childhood can also precipitate rejection-sensitivity. A child who is constantly taunted by peers may, as a young adult, begin to expect rejection from romantic partners and coworkers, in spite of a secure attachment to Mom and Dad.
It's rare for anyone to become rejection-sensitive in adulthood. A young man whose fiancee leaves him may approach dates with wariness, but he wouldn't also expect rejection from everyone he encounters, including friends or coworkers.
Depression and Rejection: Chicken or Egg?
Unsurprisingly, people who are rejection-hypersensitive have lower "trait" self-esteem, the feeling you have about yourself in the absence of any feedback. "You will take rejection personally if you don't think you are particularly valuable to begin with," says Leary. Slights will only confirm your suspicion that you deserve to be left out.
Depressed people are more sensitive to rejection than the nondepressed. Rejection-sensitivity is a hallmark of so-called atypical depression, which is actually the most common type of the disorder. Those with atypical depression uniquely experience a temporary lift in mood when something good happens to them. But they are then more susceptible to feeling down in response to any negative event—and less likely to bounce back quickly.
It's not clear which comes first—depression or rejection-sensitivity. "People who are depressed do tend to get rejected," observes Downey. Even if others understand and know that a person is depressed, it's hard to put up with the irritability, the negativity, and the self-doubt that accompany the condition.
Among those who suffer from seasonal affective disorder, interpersonal difficulties and feelings of rejection rise in the winter months when the blues are most acute. And people who score in the red zone of rejection-sensitivity on Downey's test are more likely than others to become clinically depressed in the aftermath of a breakup.
A Fine Line
The difference between a normal response to rebuffs and an oversensitive one may be summed up in one word: rumination. Highly rejection-sensitive people are also more likely to be "overthinkers" who ruminate excessively about everyday experience. Overthinking may be the engine of hypersensitivity to rejection, says Susan Nolen-Hoeksema, professor of psychology at Yale and author of Eating, Drinking, Overthinking. If you begin to dwell on the fact that your friend has not returned your recent e-mail, your brain will run a file search and pull up possible reasons for why she is angry with you and why she may even be on the verge of cutting you out of her life.
As you stew in your negative thoughts, hostility and anxiety rise, all in the absence of any real information about why your pal is incommunicado. Overthinking stirs people who are rejection-sensitive to sabotage themselves. "When you are ruminating, you get immobilized because you discount the effectiveness of taking preventive action," says Nolen-Hoeksema.
Instead of working constructively to repair what may be a severed tie, you build a case for why you've been rejected. And when you do finally see your friend, your emotions will be so disproportionate to any slight that she will likely be annoyed—and yes, perhaps even reject you.
A normal response to intimations of rejection would be some attempt to gather information or move directly into repair mode. But rejection-sensitive souls cling to losing strategies. They might desperately seek out intimacy and make unreasonable demands of a partner—appearing overly invested yet anticipating the partner's departure. Or they avoid intimacy altogether—averting stormy relationships but losing out on the chance to find acceptance and support. Either path puts them at risk for loneliness and depression.
Eggshell Existence
To say that rejection hurts is not to speak metaphorically. UCLA neuroscientist Naomi Eisenberger and colleagues have found that rejection activates the same brain area that generates the adverse reaction to physical pain, causing a sharp spike of activity in the anterior cingulate. Being ditched by your best friend is as threatening to your well-being as touching a hot stove.
Kids who constantly expect rejection are more aggressive and get into trouble more with teachers than do their classmates. Young adults who are sensitive to rebuffs tend not to open up and reveal themselves in the early stages of friendship. They may have a hard time with transitions and adjusting to new settings. A diary study of college freshman found that rejection-sensitive students made fewer friends and liked school less than did their peers at the end of the year.
Rejection-phobes are also less willing to have friends who are different from themselves—from other ethnic backgrounds, for instance. A tendency to stick to one's own kind could impede young adults from gaining an enriched perspective on life.
Hands down, the rejection-sensitive suffer most in the realm of romance. No matter how committed their partners are, they worry about being dumped. They attribute hostile intent to innocuous behavior. Unsurprisingly, both they and their partners are less happy than other couples.
"Living with someone who is sensitive to rejection is like walking on eggshells," says Leary. "Any little slip up on your part—like calling at 6:03 instead of 6:00—could trigger their anger." They tend to seek constant reassurance from partners, but even if told repeatedly that they are loved, the information isn't trustworthy—because the affirmation had to be elicited. It's maddening for others to deal with. "People who feel secure have a hard time understanding a partner like this," Leary notes.
Still, there are situations that bring out the rejection-phobe in even the sturdiest soul. Starting a new school or moving to a new neighborhood makes everyone vulnerable to self-doubt. And power differentials—say, between boss and employee—attune everyone to the slightest hint of rejection. "I am the department chair," says Downey. "I don't think of myself as being in a position of power, yet I notice that people read more into my behavior. Sometimes I look at my watch during a meeting simply because I'm trying to figure out how much time I have left. But people misinterpret that and apologize, or even get up to leave."
Cushions and Buffers
Dismantling a hypersensitive rejection-detection system is far easier said than done. Asked how becoming a prominent expert on rejection has helped him deal with personal brush-offs, Leary responds with a sigh. "I don't know that it has. But in retrospect, I understand very well what happened after I've overreacted to rejection. I know exactly what went wrong. But it still went wrong." Awareness, though, is the first step in breaking the rejection-sensitivity cycle.
The best remedy for rejection-sensitivity is caring friends who can tolerate defensive antics and engender trust. Downey found that among rejection-sensitive people who did manage to find and keep a loving romantic partner, reactivity abated over time. Perhaps the support of a good person kicks the subversive cycle into reverse mode: The rejection-phobe begins to feel more secure, which paves the way for an even happier relationship, until an empty inbox is no longer a cold reproach or a sign of impending doom—but rather just an empty inbox.
Source: Psychology Today
Copyright Sussex Publishers, LLC
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Depression & Mental Health FAQs 2
What is Clinical Depression? Clinical
depression can affect your body, mood, thoughts, and behavior. It can
change your eating habits, how you feel and think about things, your
ability to work and study, and how you interact with people. Clinical
depression is not a passing mood, a sign of personal weakness or a
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"pull themselves together" and get better. Depression can be
successfully treated by a mental health professional or certain health
care providers. With the right treatment, 80 percent of those who seek
help get better. And many people begin to feel better in just a few
weeks.
Depression a Big Factor in Poor Health World Health Organization Finds Depression Often Goes Untreated By Salynn Boyles WebMD Medical News Reviewed by Louise Chang, MD Sept.
6, 2007 -- Depression has a greater impact on overall health than
arthritis, diabetes, angina, and asthma, but it all too often goes
unrecognized and untreated, a report from the World Health Organization
(WHO) suggests. more... Depression a Big Factor in Poor Health
For Additional Information About Depression Write To: The National Institute of Mental Health (NIMH)6001 Executive Boulevard, Room 8184, MSC 9663 Bethesda, MD 20892-9663
For free brochures on depression and its treatment call: 1-800-421-4211. or visit: http://www.nimh.nih.gov
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