It is not uncommon for anyone to feel sad or less interested in daily activities on an occasional basis. However, the diagnosis of depression requires those types of feelings, particularly for activities that previously gave a great deal of pleasure to one’s life, to persist for two weeks or more.
Depression can be difficult to diagnose because of the opposite effects it may have on particular people. Some patients oversleep as a result of depression, and some experience complete sleep deprivation. Some people overeat as a result of depression, while some don’t eat enough. Additional symptoms that are usually associated with depression are feelings of restlessness or sluggishness to the point that others notice, fatigue or loss of energy, feelings of worthlessness, excessive or inappropriate guilt, diminished ability to think or concentrate, and recurrent thoughts of death or suicide.
As indicated above, depression is often related to Chronic Pain Syndrome or fibromyalgia and often those conditions are treated with, among other things, antidepressant medication.
Bipolar disorder, sometimes also referred to as manic-depressive disorder, is another psychiatric disorder which can often be related to patients with long-term soft-tissue injury claims and/or chronic pain. This syndrome is characterized by wild mood swings from euphoria and extreme optimism on one end of the spectrum, to sadness, hopelessness, and anxiety at the other end. Interestingly, the depressive phase of bipolar disorder is often associated with chronic pain.
There is a subset of bipolar disorder known as cyclothymia, which is a mild form of bipolar disorder, that includes mood swings, but the highs and lows are not as severe as those of actual bipolar disorder. Although doctors do not know the specific causes of bipolar disorder, there is some evidence that it may be related to physical changes in the brain. Additional causes may be genetic and environmental. Risk factors for bipolar disorder include other biological family members with the disease, periods of high stress, drug abuse, and major life changes such as a death of a loved one and/or traumatic physical injury.
Post-traumatic stress disorder is an emotional illness that develops as a result of a terribly frightening, life threatening, or otherwise traumatic event. Post-traumatic stress disorder was first associated with soldiers returning from World War I, when it was first referred to as combat fatigue or “shell shock.” Other events that can cause the disorder outside of the combat situation include plane crashes, severe automobile accidents, natural disasters, terrorism, and torture.
Symptoms, which may vary in severity, include flashbacks, sleep disturbances, occupational instability, and family discord. A primary component of post-traumatic stress disorder is that the patient will take every opportunity to avoid stimulation associated with the occurrence. For example, someone truly suffering from post-traumatic stress disorder related to surviving an airplane crash will most likely never get back on an airplane. This type of analysis can be useful when dealing with a plaintiff who claims post-traumatic stress disorder as a result of an automobile accident. A simple inquiry might be to ask how the plaintiff got to the deposition that morning. A true plaintiff suffering from post-traumatic stress disorder related to an auto accident would not have driven to the deposition in a car.
Treatment for post-traumatic stress disorder often includes both psychotherapy and medication, including the anti-depressants Zoloft or Paxil. These medications help control the PTSD symptoms such as sadness, worry, and anger, and may also help facilitate the psychotherapy process.
Author: Partners of Claims Resources and Solutions LLC publishes this article as a public service. It is provided for general information and is not intended to replace legal advice for specific cases.