Early Warning Signs Of Depression

June 05, 1997

ANN ARBOR, Mich.--The initial stage of a major depression, which recurs in 50 percent to 85 percent of all patients who experience a first episode, is like a stealth bomber. It seems to fly under a patient's radar in the guise of vaguely negative, uncomfortable emotions that patients don't at first identify as warning signs of depression.

Instead--even though they have experienced major depression before--patients deny what they glimpse on their psychic screens, attribute their fatigue and stress to external demands, and put on a front to conceal their distress, according to a study from the University of Michigan School of Nursing.

"It is important for patients and their families to learn how to recognize the early warning signs of an oncoming depression because early intervention can prevent or minimize relapse or recurrence," said Bonnie M. Hagerty, assistant professor of nursing. "There is some evidence that the 'prodromes' or early symptoms of depression, while they vary from patient to patient, are fairly consistent within each patient.

"Also, research suggests that patients generally experience at least one psychiatric symptom prior to the onset of depressed mood--generalized anxiety, perhaps, or sadness, irritability, impaired work, decreased initiative, loss of interest, fatigue or insomnia."

Hagerty's study of the early warning signs and subsequent course of major depression is reported in the April issue of the Journal of Orthopsychiatry. Hagerty and her colleagues conducted a series of focus group sessions over the course of a year with 16 people who had experienced more than one episode of depression.

The U-M researchers identified four consistent themes in the onset stages of depression:

Hagerty's colleagues on the study were Reg A. Williams, associate professor of nursing, and Michelle Liken, U-M doctoral candidate in nursing.

University of Michigan

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