Does depression have to be constant to be diagnosed as such?

[2babes4us]

Youngest just turned 2, so I know this isn't exactly PPD, but thought I might get some answers here trying to figure out if what I have is depression.


I have felt like this off and on, honestly, looking back (I found an old post here from when DS was 3) probably since DS was about 1 yr old- he's now 7). But I always just chalked it up to being an isolated SAHM without any help (no family around) besides DH, who has been working 60 hrs / wk lately. DH works on weekends which is tough, especially for DS who has to write "weekend news" for school...our weekends are pretty uneventful. I don't have a car, and not a whole lot to do. We have a couple of neighbor friends but I don't want to interrupt their family time on weekends.



Anyway, for the past few months I've noticed it more so- there are days when I just can't handle it-I mean not being able to cope with even preparing breakfast, I'll break down crying trying to make pancakes or wrestling with DD to change her diaper - I just can't handle her "giving me a hard time" (ie, being a normal toddler). Seems like from the moment we wake up, DD is screaming and throwing fits (fueled by DS's teasing and laughter and thinking it's hysterical when she screams, which doesn't help of course). Getting ready to go out (which is probably what we need to do badly) is overwhelming, I'm just a mess crying about the littlest thing that doesn't go my way (yeah, and I wonder why my toddler acts that way!), yelling constantly at the kids for misbehaving/ not listening. Forget about going to do fun things, we're just staying home today. The TV has been a babysitter these past couple of days. DS was not kidding when he said , wow, I got like 4 hours of screen time today! (his limit is usually 1 hr). When we stay home, I try my hardest to sit down and play with them, but honestly, I'm not able to. I'm just choking up in tears, I just need to disconnect from the world and clean like crazy (lately this helps me to calm down) or go online to read parenting forums or just window shop. A handful of times I've literally broken down in front of the kids. DS is very sensitive and hugs me and tries to console me...DD just looks confused saying "mommy crying? mommy be happy"..I feel awful they have to see me like this, especially because I can't explain why- I just say "mommy's tired and cranky"- which I am. I'm sure sleep deprivation doesn't help- I'm studying part time, taking 2 online prereq classes to apply to grad school for next fall. and the only time I have to study is at night- which is after 10pm since DD doesn't fall asleep until then on the days she naps. Once I go to bed, I often toss and turn, lately with nightmares for an hour or so, often not falling asleep until 2am. So I often only get 4-5 hours of sleep at night. On weekdays, when DS is in school, I try to nap with DD, which helps a little.



I realize I don't get enough "me time"- definitely a big problem, but what I feel some days is beyond simply exhaustion or running on empty- it's just not having a desire to do anything. It's a feeling of just giving up on everything- eg. saying" Screw going back to school" (even thought it's something I want to do to be able to start a new career and provide for our family), "screw the job interview next week" (even though it could be a great opportunity, get me out of the house, but no I don't feel emotionally stable enough to have to go to work everyday), "I'll just stay home miserable everyday and just provide my kids with the basic food, care and love"....but other days I'll feel perfectly fine and sometimes overjoyed about everything. I guess my question is, could it still be depression even though it's not a constant state of mind? It's like an emotional rollercoaster, with very steep ups and down. I'm not sure if it could be hormonal.



It's hard to talk to DH about it- he perceives it as me constantly venting about being a SAHM when he works hard each day to provide for us. Before going back to school I was actually working from home, too, and he was very supportive and helpful in making sure he took care of the kids whenever I had to get work done. But once I started studying too, it was way too much for me, so we decided I would just concentrate on studying at night and being a SAHM during the day- therefore he picked up more hours at work, making it harder again for me. But I can't make him feel guilty for doing so...so it's an ongoing argument when I turn this in to the classic "SAHM vent about I work hard all day too with the kids, why do you get to come home and sit back on the sofa after working a 12 hr day"- which is unfair on my part too, I realize, but I feel like he just doesn't realize it's more than that.



I feel awful yelling at my kids so much, losing my patience- it goes against everything I want to be as a parent- I just want that connected feeling back - enjoying every moment- not letting the little tantrums become an uncontrollable tantrum of my own. I feel so much anger sometimes that I slam my fist down and hurt myself. I'm able to just walk away when I feel like I can't control my emotions when I'm holding my DD or feel like I might get physical with DS. I do call the parental stressline often, but got tired of their "canned responses"- I need a therapist who can not only listen to me but give me some insight on how to control my emotions, heck, or give me some medication if that's what I need. I need the help but I'm not sure if I'm just in denial sometimes- for example, tomorrow I might wake up fine and forget about looking to get help until I have another "bad day". So can you still have good days when you are clinically depressed?

[lalasmama]

It sounds like it could definitely be some depression. Depression isn't an "all or nothing" frame of mind--it doesn't mean you are always "blah"--you are allowed "good days". It's when the good days outweigh the bad days that it becomes an issue.

At my clinic, we use a "PHQ-9". Here's the questions:

On a scale of 0-3, 0 being not at all, and 3 being every day or nearly every day, were you bothered by:

Little interest or pleasure in doing things

Feeling down, depressed, or hopeless

Trouble falling or staying asleep, or sleeping too much

Feeling tired or having little energy

Poor appetite or overeating

Feeling bad about yourself — or that you are a failure or have let yourself or your family down

Trouble concentrating on things, such as reading the newspaper or watching television

Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual

Thoughts that you would be better off dead or of hurting yourself in some way

How difficult is it for you to deal with the above issues? (Not at all, A Little difficult, Difficult, Extremely Difficult)

[BabyDahl]

First,

Now, short answer to your question: yes. You can have better days, followed by not so good days when you have major depression.

Long answer: the criteria generally state that you must have 5 symptoms most days for most of the day during a 2 week period. The symptoms must include either depressed mood or decreased interest in pleasurable activities (hobbies, things you once enjoyed, etc: this is called anhedonia). The other symptoms include: sleep changes, guilt/hopelessness/worthlessness, decreased energy, poor concentration, appetitie changes, physical feelings of heavy limbs/moving in slow motion/etc, and feelings of wanting to harm yourself or suicidality. This is not by any means all inclusive, these are just the symptoms for diagnosis.

I would encourage you to see a therapist. Even if you don't meet criteria for major depression (which you might, based on what you listed), you can still benefit from therapy. It sounds like you recognize that there is a problem, so you should seek help in finding a remedy, whether it be meds or therapy or both. The timeline does not sound like PPD, but you need to work this out with someone IRL. Good luck and again,

ETA: I cross posted with PP. PHQ 9, Beck depression scale, Zung self rating scale, all those are helpful for identifying depression, but please seek help. Therapy is just as effective, if not more, than meds.

[tiapam]

Hugs to you, things sound very hard for you right now. One thing I always suggest for women who are feeling like this, esp since having kids, is to get your thyroid thoroughly checked out. Find out your actual test scores and research them, a lot of times a diagnosis is missed even when a person has obvious symptoms. There is more info here, please take a look esp at the possible symptoms of hypothyroid, but also this whole website which is one of the best:

http://www.stopthethyroidmadness.com/long-and-pathetic/

I am sure a lot of people will add on their experiences with PPD. I personally was never diagnosed with PPD but it sounds an awful lot like how I feel when I am hypothyroid. And though in my case I already had thyroid problems before having kids, I def became more hypo after. The postpartum period is a time when thyroid problems often get triggered, by stress and/or hormonal changes. Your sleep issues and nightmares sound familiar to me. Also, your going back and forth about getting help and not getting help. Is there any history of thyroid disease in your family? I would ask extended family as many people do not readily offer this info.

I am reading a very good book right now, you might want to read it and see if it resonates with you:

http://www.amazon.com/Solved-Riddle-...1162199&sr=8-1

I hope you get better soon. I can sympathize with how you feel, but I am fortunate that my circumstances make it easier for me to cope. I have family nearby and DH does not work crazy hours.

[echoesofspring]

lots of hugs, mama!

I'm so sorry you're going through this but it sounds like you have a lot on your plate, not enough support and are exhausted/overwelmed. All of which sounds like a recipe for some depression. I don't have nearly as full a plate as you do, but I just spoke to my DH this evening about struggling with what I think is depression, and I could echo a lot of what you wrote - spontaneous tears, lack of energy, to name a couple.

I don't have any words of advice, except that I went through this (w/out kids) a few years ago and seeing a therapist for even just a couple sessions helped tremendously. If cost is a concern, many will work on sliding scales.

I really hope you can seek out some help - a therapist, more support emotionally from DH. And I hope you can start feeling better soon.

[vludmilla]

I don't have time to read your whole post now but I will later today. I did want to respond to your title question...it is not necessary to have depressed mood constantly to be dx'd with depression but there are also other mood diagnoses for situations that are milder in intensity or length. The best way to get a clear answer, however, is to see a qualified mental health clinician. Your GP may be able to give you a good referral to one.