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Research Paper: Victory Over Depression
Liberty University






























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Abstract:

In todays society depression can be seen as taboo and something that is not socially
acceptable. However, it is the ongoing reality for many women. The struggle with
depression in the life of women is more common than not, whether it is undiagnosed or
diagnosis it is prevalent regardless of ones socioeconomical background. The paper will
explore depression onset, treatment and explore how individuals can have work towards
having complete victory over depression.















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Background:

The black box of depression can potentially have an unpredictable impact on the
life of an individual. Those who struggle with this diagnosis on a day to day basis at
times cannot predict the outcome of the situation if left untreated. That National Alliance
of Mental Illness reports nearly 15 million Americans averaging one and ten adults
experience some form of depression annually. The statistics amongst women are
considerably startling because one out of every eight woman are the ones who are
affected and suffer with the onset of major depression. That women are twice as likely as
men to have depression is a consistent finding in psychiatric epidemiology and is not
simply a consequence of females being more likely to report, recall or seek help for
depressive symptoms. Before puberty, boys are slightly more likely than girls to be
depressed, but between the ages of 11 and 13 this trend is reversed, with girls
outnumbering boys by two to one. This predominance of females over males persists for
the next 35 to 40 years (Smith DJ, Blackwood D, 2004 ).
The facts is that depression can present itself in various forms in a womens life
with very familiar emotions that can prove to be deceptive. At some point most women
have experienced some form of sadness, disappointment, loss of interest, less
enthusiasm, grief or even feelings of hopelessness. While these emotions are normal they
are not suppose to linger more than an extended period of time . One of the key
elements in determining if someone has a type of depressive disorder is that it requires
a form of self-reporting. The patient or client or representative has to share the changes
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they have experienced in they way that they are feeling, the way they are thinking and
the way that they are behaving in order to assist with the proper diagnosis of this illness.
The National Institute of Mental Health reports that there are three overall general
categories for which depression can fall under. The first category is Major Depressive
Disorder, it is the most serious form of depression, the symptoms are very severe and
disrupt every aspect of a woman's life it negatively impacts there ability to work, sleep,
study, eat, and simply enjoy life. An episode of major depression can potentially occur
once in a person's lifetime. But more research shows that often, a person can have several
episodes or major depression dependent upon life events. The DSM-IV provides a bit
more detail concerning the proper diagnosis for MDD. Major Depressive Disorder
diagnosis must include existence of depressed or irritable mood or inability to experience
pleasure. In addition, it must have four of the following symptoms must also be present:
feelings of guilt, hopelessness, and worthlessness; sleep disturbance (insomnia or
hypersomnia); appetite or weight changes; attention or concentration difficulties;
decreased energy or unexplainable fatigue; psychomotor agitation or retardation; and in
severe cases, thoughts of suicide (Marcus S, Heringham J 2009). The second category is
dysthymic disorder or dysthymia depressive symptoms while they last for a shorter
period of time than major depression (2 years or longer), it is still less severe than those
of major depression. The last category is minor depression, although similar to major
depression and dysthymia the overall symptoms are less severe and do not last as long as
the other two.
Regardless of the length of the symptoms or one having the experience of being in
a depressed state, it can be extremely difficult and a very painful experience that not only
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impacts the one who is diagnosed but also there family members. Depression has a wide
impact, influencing all members of the family and affects each family member
differently. It can potentially lead to marital distress, family conflict, and even loss of
income due to job loss or even disability (Wisner KL, Parry BL, Piontek CM, 2002).
There have been several studies that have been done which highlight that during a
womens reproductive years, there is an increased vulnerability to depression. The onset
of depressive symptoms is more frequently seen in women between the ages of 20 to 40
years old, the age range when many women become pregnant (Weissman MM, Olfson
M, 1995). A study done on pregnant women in 2003 discovered that a high percentage of
pregnant women screened by there OB-GYN doctors reported significant depressive
symptoms, sadly an estimated 86% were not receiving any form of treatment for the
prenatal onset of depression (Marcus SM, Flynn HA, Blow FC, Barry KL, 2003).
Studies have found, that while some women do not have a problem going to get
prenatal care during their pregnancies, others who are depressed are likely to participate
in unhealthy behavior patterns such as smoking and substance abuse. With such a high
rate it is unfortunate that many women do not voluntarily get treatment for any mental
health illness during pregnancy. One of the main reasons opted out of getting treatment
was because of the looming stigma associated with having a mental illness or being
treated for a mental illness (ACOG Practice Bulletin, 2008).

While prenatal depression is common based off the study presented, there is also
postpartum depression which effect 10% to 20% of women after giving birth to their
children. Postpartum depression is often undetected similar to prenatal depression. Many
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women naturally anticipate a short period of adjusting to having a newborn baby and are
likely not able to recognize that the symptoms of depression are unusual, because of the
familiarity of emotions. More often than not they tend to find it challenging to admit
they actually have a problem. They can feel shame for having those type of feelings, or
even they may feel the need to show that they are actually being good parents. Many
women do not explore treatment options for various reasons such as the demanding
responsibility for caring for a newborn child, unmotivated, lack of energy or even not
wanting to disappoint there spouses or partners.
Although, the diagnosis of depression in child bearing age women can be high,
there are other factors that can contribute to a diagnosis of depression. The other factors
which actively influence the onset of depression may include traumatic experiences. For
these individuals who have had exposure to extreme life stressors early in life , such as
death of parents, being sexual assaulted, victims of physical abuse has been well
documented to increase the risk for depression and suicide (Kendler, K. S., Kessler, R.
C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C. & Eaves, L. J, 1995).
Another factor, which can contribute to depression, is familial history of depression or a
genetic connection. Studies have shown that early age of onset and multiple episodes of
depression seem to increase the familial aggregation, and different affective disorders are
often present in the same family.

(Kovacs M, Devlin B, Pollock M, Richards C, Mukerji
P, 1997 ). Lastly, biochemical factors such as low serotonin levels also contribute to a
diagnosis of depression.
Treatment:
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There are various ways that depression can be treated which the level of treatment
needed depends on the level of depression as previously described. For women with
severe symptoms such as Major Depressive Disorder it is recommended that a
combination of antidepressant medication and general psychotherapy be provided for this
individual. For those women in the stage of depression who are experiencing milder
symptoms such as dysthymic disorder or dysthymia, it is recommended that there is an
inclusion of various treatment options such as the nutritional approach, the psycho-
behavioral approach oppose to medication being the primary source of treatment in the
milder cases it would be secondary (Altshuler LL, Cohen LS, Moline ML, Kahn DA,
Carpenter D, Docherty JP, 2001).
In addition to commonly known treatment of depression, spirituality also plays a
role in treatment. Research indicates that patients actually want their physicians to
address issues of faith and spirituality as part of their treatment; and that patients with
strong spiritual and religious tendencies are receptive to physicians referring them to
pastoral counselors. Some authors suggest that physicians routinely use a spiritual needs
assessment with patients, by asking patients whether or not they consider themselves to
be religious or spiritual, how important faith is in the patient's daily life, whether or not
the patient belongs to a community of faith, and how the patient would like the physician
to address these issues in their health care (Cooper L, Brown C, Hong V, Ford D, Powe
N, 2001).
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Having a diagnosis that has a societal stigma associated with it more often than
not will cause shame for believers who struggle with the black box of depression. In the
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Christian community there is also a stigma associated with mental illness. There are
clichs that are used frequently, for example the term To Blessed to Be stressed. While
this may hold some truth to it. It is important that individuals do not stay in the mindset
of being embarrassed or in denial for what they are dealing with. Many in the churches
will often tell people to simply pray about their situation, without any follow up. There is
no doubt that God can absolutely change a situation around in his time, it does not negate
the fact of the strong importance of being practical. While there is certainly power in
prayer, at times people need more than what can be considered surface solution.
Many will proceed after prayer, with the same issues and continue on without
ever speaking to a Christian counselor or a professional who can offer guidance for what
is being experienced. While prayer works as Christians there is a responsibility to learn to
embrace that there are truly biological and psychological reasons that an individual can
have which contribute factors to a diagnosis of mental illness such as depression (Van der
Kolk, Bessel 1997). There is an ever growing need for those in leadership in churches to
have a responsibility in being practical about guiding people for help when needed, and
not over spiritualizing issues.
The key to having victory over depression is really understanding that it does not
make you any less of a woman, because you have a diagnosis or because you ask for help
to deal with your challenges. There must be a clear understanding on behalf of each
individual experience is different and there is no reason to suffer or go through this
journey alone. Dependent on the level of depression whether it is Major, Mild of Minor
the process of recovery may vary. Some are able to pray and the can receive instant
relief; others are able to do it with a combination of going to counseling, and then others
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can do it based of off environmental changes and with out medication, for some they may
need clinical and spiritual guidance to put them on track to have victory over depression.
Each individual has there own process of healing, God does not love anyone less because
of there process.
The blessing that is given to believers is the understanding that regardless of what
experience, situation or circumstance that has taken control of ones life as Christian
believers there is absolute freedom in Christ Jesus to be set free from guilt and shame
based off of the word of God. There is liberty in believing in the healing power of Jesus,
having a general understanding of his ability shifts the burden from us to Him. The bible
tells us in Romans 12:2 Do not conform to the pattern of this world, but be transformed
by the renewing of your mind. Then you will be able to test and approve what God's will
is--his good, pleasing and perfect will; and also in Philippians 2:5 Let this mind be in
you, which was also in Christ Jesus.

Conclusion:
In conclusion, this paper initially started off coining the phrase the black box of
depression. It is challenging at times to deal with the very root of the issues which would
cause a women into such a deep place and stay there. As discussed there can be a variety
of reasons why depression may exist in the life of a women. Life in fact is not fair, there
will be circumstances that come in your life that will literally knock your socks off. How
you choose to respond to those issues and situations is key. While the emotions
associated with depression may not in fact be avoidable being aware of them can
potentially help one stay clear of depression . This very black box can also be considered
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an open book, by allowing the love of Christ to infiltrate your heart and your mind will
give you the ability to have victory.










































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References:

Smith DJ, Blackwood DHR. (2004). Depression in young adults. Advances in Psychiatric
Treatment 10(1):4-12.
Marcus S, Heringham J (2009). Depression in Childbearing Women: When Depression
Complicates Pregnancy Prim Care. 36(1): 151ix.

Wisner KL, Parry BL, Piontek CM. (2002) Clinical practice. Postpartum depression. N
Engl J Med. 347(3):194199.

Weissman MM, Olfson M(1995). Depression in women: implications for health care
research. Science.1995;269(5225):799801

Marcus SM, Flynn HA, Blow FC, Barry KL. (2003) Depressive symptoms among
pregnant women screened in obstetrics settings. J Womens Health (Larchmt) 12(4):373
380.

ACOG Practice Bulletin(2008): Clinical management guidelines for obstetrician-
gynecologists number 92, (replaces practice bulletin number 87, November 2007). Use of
psychiatric medications during pregnancy and lactation. Obste Gynecol. 111(4):1001
1020.

DSM-IV, Association AP, editor. Diagnostic and statistical manual of mental
disorders. 4th Washington, DC: American Psychiatric Association; 1994.
O'Hara MW, Stuart S, Gorman LL, Wenzel A. Efficacy of interpersonal psychotherapy
for postpartum depression. Arch Gen Psychiatry. 2000;57(11):10391045.

Kovacs M, Devlin B, Pollock M, Richards C, Mukerji P (1997). A controlled family
history study of childhood-onset depressive disorder. Arch Gen Psychiatry ;54:613-23.

Altshuler LL, Cohen LS, Moline ML, Kahn DA, Carpenter D, Docherty JP(2002), Expert
Consensus Panel for Depression in Women. The Expert Consensus Guideline Series.
Treatment of depression in women..

Cooper L, Brown C, Hong V, Ford D, Powe N, 2001 How Important Is Intrinsic
Spirituality in Depression Care? J Gen Intern Med. 16(9): 634638

NAMI: National Alliance on Mental Illness, Article Title: Woman and Depression, Date
Accessed: June 29, 2014
NIMH: National Institute of Mental Health, Article Title: Woman and Depression,
Discovering Hope: Date Accessed June 30, 2014Women and Depression: Discovering



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