Depression can initially make a person feel down, though lingers and deepens. Sometimes depressive symptoms are a result of stressful events and lasts only a short time. Though when feeling “blue” from a bad day or an argument can make you feel sad for a while.

If sadness lingers or affects your daily routine and work schedule. Yet when depressive symptoms interferes with the way one eats, sleeps and daily functions, then it’s time to seek help. Without treatment, symptoms can last for weeks, months or years. Depression is a serious health problem that affects feelings, thoughts and actions, can be life-threatening and can include symptoms of physical illness such as a headache, stomach pain or tiredness.

Symptoms can include:

Constant sense of sadness, hopelessness or emptiness.

Loss of motivation or interest in daily activities.

Lack of appetite or eating too much.

Sleep interruption or over sleeping.

Sluggish, lacking energy.

Feeling worthless or guilt.

Poor concentration or memory or making decisions.

Thoughts of life is not worth living.

If someone you are helping feels 4 - 5 of these symptoms over a 12-14 day period, they may suffer from clinical depression. Though this is not for you to diagnose, send them to their doctor for an evaluation. If feeling that life is not worth living, take them to a hospital emergency room for an evaluation.

Every year, millions of Americans suffer from depression. It affects men, women and children of all races and economic groups. Depression often goes untreated for many reasons. Sometimes people don’t recognize the early warning signs or think they have a physical problem. Sometimes people think they should be able to “just get over it.” Depression is not something you can “get over.” The good news is that most people who get adequate treatment can recover.

Patient Health Questionnaire (PHQ-9)

Anxiety is an emotion that can signal that can either prompt a person to an appropriate response or a negative reaction in any given situation. Exaggerated anxiety can stop disrupt a person’s life. Like many other illnesses, anxiety disorders often have an underlying biological cause and frequently run in families.

Anxiety disorders range from feelings of uneasiness to immobilizing bouts of terror. Anxiety can be experienced due to an actual, real experience (riding a roller coaster) or be biologically induced (not from an experience). If you believe you or a loved one has an anxiety disorder, seek competent, professional advice or another form of support. Keep in mind that new research can yield rapid and dramatic changes in our understanding of and approaches to mental disorders.

Everyone will experience anxious thoughts, feelings and stress throughout their life time. However, if a person cannot shake unwarranted worries, or the feelings are jarring to the point of avoiding everyday activities, he or she most likely has an anxiety disorder.

Symptoms of Generalized Anxiety: Chronic, exaggerated worry, tension, and irritability that appear to have no cause or are more intense than the situation warrants. Physical signs, such as restlessness, trouble falling or staying asleep, headaches, trembling, twitching, muscle tension, or sweating, often accompany these psychological symptoms.

Formal diagnosis: When someone spends at least six months worried excessively about everyday problems. However, incapacitating or troublesome symptoms warranting treatment may exist for shorter periods of time.

Treatment: Anxiety is among the most common, most treatable mental disorders. Effective treatments include cognitive behavioral therapy, relaxation techniques, and biofeedback to control muscle tension.

Panic: When a person experiences heart-pounding terror that strikes suddenly and without warning, that causes increased heart rate, difficulty breathing and panic sensations, a panic attack may be experiencing a panic attack. Since one cannot predict when a panic attack will occur, the person may live in persistent worry that another one could overcome them at any moment.

Most panic attacks last only a few minutes, but they occasionally go on for ten minutes, and, in rare cases, have been known to last for as long as an hour. They can occur at any time, even during sleep. The good news is that proper treatment helps 70 to 90 percent of people with panic disorder, usually within six to eight weeks.

Symptoms of a Panic Disorder: Pounding heart, chest pains, lightheadedness or dizziness, nausea, shortness of breath, shaking or trembling, choking, fear of dying, sweating, feelings of unreality, numbness or tingling, hot flashes or chills, and a feeling of going out of control or going crazy.

Formal diagnosis: Either four attacks within four weeks or one or more attacks followed by at least a month of persistent fear of having another attack. A minimum of four of the symptoms listed above developed during at least one of the attacks.

Treatment: Cognitive behavioral therapy and medications such as high-potency anti-anxiety drugs like alprazolam. Several classes of antidepressants (such as paroxetine, one of the newer selective serotonin reuptake inhibitors) and the older tricyclics and monoamine oxidase inhibitors (MAO inhibitors) are considered "gold standards" for treating panic disorder. Sometimes a combination of therapy and medication is the most effective approach to helping people manage their symptoms.

Phobia: When a person avoids or “steers clear of certain things” -- for instance, stinging insects or hazardous situations from irrational fears, this person may have a “phobia”. This condition can lead a person to altogether avoid specific things or situations that trigger intense anxiety.

Symptoms: Phobias occur in several forms. Specific phobia is an unfounded fear of a particular object or situation -- such as being afraid of dogs, yet loving to ride horses, or avoiding highway driving, yet being able to drive on city and country roads. Virtually an unlimited number of objects or situations -- such as being afraid of flying, heights, or spiders -- can be the target of a specific phobia. Agoraphobia is the fear of being in any situation that might trigger a panic attack and from which escape might be difficult. Many people who have agoraphobia become housebound. Others avoid open spaces, standing in line, or being in a crowd. Many of the physical symptoms that accompany panic attacks - such as sweating, racing heart, and trembling - also occur with phobias. Social phobia is a fear of being extremely embarrassed in front of other people. The most common social phobia is fear of public speaking.

Formal diagnosis: The person experiences extreme anxiety with exposure to the object or situation; recognizes that his or her fear is excessive or unreasonable; and finds that normal routines, social activities, or relationships are significantly impaired as a result of these fears.

Treatment: Cognitive behavioral therapy has the best track record for helping people overcome most phobic disorders. The goals of this therapy are to desensitize a person to feared situations or to teach a person how to recognize, relax, and cope with anxious thoughts and feelings. Medications, such as anti-anxiety agents or antidepressants, can also help relieve symptoms. Sometimes therapy and medication are combined to treat phobias.

Traumatic Stress: Researchers state anyone, even children, can experience traumatic stress if they have experienced, witnessed, or participated in a traumatic occurrence-especially if the event was life threatening. From traumatic stress can result from terrifying experiences such as rape, kidnapping, natural disasters, or war or serious accidents such as airplane crashes. The psychological damage such incidents cause can interfere with a person's ability to hold a job or to develop intimate relationships with others. Without treatment or interrupted treatment, traumatic stress can lead to Post Traumatic Stress Disorder.

Symptoms: The symptoms of PTSD can range from constantly reliving the event to a general emotional numbing. Persistent anxiety, exaggerated startle reactions, difficulty concentrating, nightmares, and insomnia are common. In addition, people with PTSD typically avoid situations that remind them of the traumatic event, because they provoke intense distress or even panic attacks. Many people with PTSD also develop depression and may, at times, abuse alcohol or other drugs as "self-medication" to dull their emotional pain and to forget about the trauma.

Formal diagnosis: Although the symptoms of PTSD may be an appropriate initial response to a traumatic event, they are considered part of a disorder when they persist beyond three months.

Treatment: Psychotherapy can help people who have PTSD regain a sense of control over their lives. Many people who have this disorder need to confront what has happened to them and, by repeating this confrontation, learn to accept the trauma as part of their past. They also may need cognitive behavior therapy to change painful and intrusive patterns of behavior and thought and to learn relaxation techniques. Another focus of psychotherapy is to help people who have PTSD resolve any conflicts that may have occurred as a result of the difference between their personal values and how behaviors and experiences

Childhood mood disorders has often been debated, now acknowledged as a “dysregulation of mood” within a child. While teen mood disorders from anxiety to depression if often identified by family doctors in adolescents. Symptoms both in children and adolescents can be observed behaviorally, cognitively, socially and emotionally, affecting their academic work, identity, family and social relationships and perceptions of spirituality.

Typical symptoms displayed by an child or adolescent (out of the ordinary), can be irrational thinking, mood swings, impulsivity, unorganized, aggressive or withdrawn, insecure, disrespectful, uncooperative, disruptive/attention seeking, fearful, etc.. Depressive and anxious symptoms for teens can be similar to adults like feeling sad, overly fearful/worried, uninterested in activities or restless, sleep disturbance, poor appetite or over eating and poor concentration. Symptoms are generally more situational, like the loss of a family member, peer or pet; moving out of town; physical injury or environmental catastrophe. Situations can often cause both or either depressive and/or anxious symptoms, though typical diminish over a few days or week.

Concern for persistent symptoms over time if worthy of an evaluation by a pediatrician and/or counselor. Stress form difficult situations, especially related to academics, sports and peer relations are normal and can affect a child/adolescent’s self-esteem, identity or view of them self. Depression and/or anxiety can be results from these situational effects.

Children from 10-12 years old can typically experience fear, worry and/or anxious thoughts when going to school, going to sleep or facing new challenges in life. While teens, unlike typical children, can experience mood related symptoms without significant stress or difficult situation; more from biological and/or puberty causation. All symptoms can be normal in the course of development, though can be significant when symptoms continue more than one week or show a pattern of reoccurrence that interferes with their daily functioning. Medical evaluations can often rule out or rule in the need for treatment. Therapy can often provide the child/adolescent with an outlet and better understanding of their symptoms and how to handle it. Parents can often find help from the medical and psychological professionals as well.

The content described in this section is not meant for diagnosis of anyone’s observed symptoms. Mental health symptoms are first evaluated, then diagnosed by a medical professional.

The content of Help People, including it’s resources are for educational information only.

Underlying Problems

Suppose a parent approaches you, knowing you help people, like parents and tells you about their child’s bed wetting issue. Are you quick to give advice to the desperate parent? Or do you ask yourself, what’s underneath this issue?

What lies beneath a person’s identified problem? Regarding bed wetting, usually a young child with this concern is a deep sleeper and doesn’t wake up or get up when their bladder signals it is full or too full to hold it any longer. Yet can family stress affect this child’s inability to get up to use the bathroom in the middle of the night? What about how the child copes with stress in general from peers, school, sports, etc.?

Often, psychologists and counselors learn to look under the “identified problem” to more of a root issue, that may be a blind spot for the person and problem in question. Other times, people lack awareness of their inner world and/or reasons for certain behaviors. So, it is important for the person with the identified problem, to meet you face to face, in a quiet and private setting to answer some probing questions.

In many situations, one consideration after being a good listener, reflecting and reviewing the identified problem, give the most practical advice possible to initially try to address the problem. Consider an initial behavioral approach, like for the bed wetting concern. Recommend the parent to initially try to wake the child up 2 – 3 hours after going to sleep to use the bathroom to see if this alleviates the problem. The counselor may have to coach the parent how to help the child to cooperate and/or wake up enough to go to the bathroom. The initial, practical, simple interventions can often alleviate the initial problem.

What happens when the individual returns for more help, stating, “What you recommended is not working.” Or maybe the initial recommendation is not enough to help over time? Now it’s time to probe deeper, below the surface to get a better understanding. Avoid giving a quick, second recommendation without probing to understand the context and individual problem.