Depression overall and how it affects prisoners or former prisoners.

Overview

Depression is a common illness worldwide. Approximately 280 million people in the world have depression. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when recurrent and with moderate or severe intensity, depression may become a serious health condition. Although there are known, effective treatments for mental disorders, more than 75% of people in low- and middle-income countries receive no treatment. Barriers to effective care include a lack of resources, lack of trained health-care providers and social stigma associated with mental disorders.

What is depression?

Depressed people don’t all shuffle around with a long face, or cry at any provocation. MentalHealth.gov, a US government website, defines it as “losing interest in important parts of life”. Symptoms include eating or sleeping too much or too little; pulling away from people and usual activities; having low or no energy; feeling numb or like nothing matters; feeling unusually confused, forgetful, on edge, angry, upset, worried or scared; and thinking of harming yourself or others.

A visceral description is quoted by the UK campaign group Mind: “It starts as sadness, then I feel myself shutting down, becoming less capable of coping. Eventually, I just feel numb and empty.”

Depression is also often mixed with other health problems: long-term illness, anxiety, obsessive compulsive disorder or schizophrenia, for example. The term dysthymia is also used for mild, long-term depression – usually lasting two years or more.

Symptoms of depression

For people that are not in the prison system depression can have many symptoms that are often disregarded as stress or anxiety. Symptoms of depression can vary. They may manifest themselves differently from person to person. However, for most people, depression symptoms affect their ability to perform daily activities, interact with others, or go to work or go to school. If you suffer from depression, you may often experience several or more of the following: The most common symptom of depression is a feeling of sadness or emptiness that lasts for more than two weeks. Continual feelings of worthlessness, guilt, or helplessness often accompany the condition. Depression may cause people to get easily frustrated or angered, even over small or insignificant matters. Anxiety is a feeling of impending doom or danger, even when there isn’t a justifiable reason.

The depressed prisoner exhibits certain symptoms which may include: Distress at constantly seeing the prison gate, which makes prisoners feel trapped. The depressed prisoner constantly engages in negative thinking or may even try some negative acts, like escaping from the prison. They lose confidence in themselves and feel as if they might lose their mind and become mad. They experience a lack of appetite and lack of sleep in the prison environment. Behavioral changes occur making such prisoners restless and nervous.

Unfortunately, one of the symptoms are thoughts of suicide. Thinking or fantasizing about death is a serious sign that needs to be addressed right away. Depression and especially suicidal thoughts are never normal emotions.

Contributing factors

Depression, as an illness for the general public, results from a complex interaction of social, psychological, and biological factors. People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and the depression itself.

For former inmates leaving prison isn’t as simple as walking out the door and returning to the life you had before. For many, jobs have been lost, relationships have been harmed, and living situations have changed. You may not have a social network, financial support, insurance, or the resources needed to secure a job, find a home, meet with a therapist, or reconnect with the community. Individuals who end up in prison can be some of the most vulnerable or traumatized members of society, and the experience of prison itself is traumatic on top of that. In some ways, the entire family is incarcerated, or at the very least deeply affected. Without a support system and the resources needed to reintegrate back into the community, recently released prisoners will experience harmful mental health effects. No matter your situation, adjusting to life after prison is difficult and requires ongoing support.

For inmates some of the main factors that can lead to anxiety and depression are as follows:

Memories of illegal acts: During their time in prison, the offenders tend to relive the moments of their crime. This can make them feel guilty and remorseful. Constantly having these thoughts may result in severe depression. Prison: Prisoners are confined to a restricted space. Prolonged stay in the prison may lead to intense depression, which can persist even after their release. Missing loved ones: Prisoners feel loneliness, as they are isolated from their family and loved ones. They recall the days spent outside prison. These thoughts of loneliness create the mental conditions of anxiety and depression. Life with other prisoners: Living with other prisoners who may be violent can raise serious feelings of insecurity and fear in the mind of the prisoner.

Therapy for Depression and Treatments

Good therapy is like driver’s education for the mind. It enables people to understand what sets off their descent into depression and not only helps them develop suitable tools for finding their way out but teaches ways of regulating difficult emotions going forward. Clinicians and researchers have long known that a prime contributor to depression is the inability to process negative emotions in constructive or adaptive ways. Medication can relieve some of the psychic pain of depression, but it does not help people learn good ways of coping with distressing experiences and feelings—which make them feel overwhelmed—or learn how to manage the kinds of thoughts that can trigger such feelings. As a result, they are always at the mercy of circumstances, ever-susceptible to depression. The goal of psychotherapy is to build the pillars of mental health.

Can therapy help someone who is suicidal?

Studies show that about 5 percent of depressed patient have thoughts about suicide—suicidal ideation. Suicide is seen as a way of escaping the mental pain of depression, which distorts patterns of thinking and feeling so that sufferers cannot see a way out their current state of mind or envision a future possibility of feeling better.

Good therapy includes a specific assessment of suicide risk separate from the depression evaluation. It also includes specific measures to manage the risk of suicide in the present and the future. Many therapists draw up anti-suicide pacts with their patients. A contract may be written or verbal but, either way, patients at risk agree to commit no self-harm and to call the therapist if they ever have thoughts of ending their life, or to call an emergency number such as 911. In addition, studies show that such widely used treatments for depression as cognitive behavioral therapy (CBT) can be very helpful when adapted to specifically target the ways distorted thinking leads to depressive despair and thoughts of suicide.

Treatments

The WHO estimates that fewer than half of people with depression are receiving treatment. Many more will be getting inadequate help, often focused on medication, with too little investment in talking therapies, which are regarded as a crucial ally.

Among pharmacological treatments for depression, the most commonly prescribed antidepressants are selective serotonin re-uptake inhibitors (SSRIs) which reduce the absorption of serotonin, increasing overall levels. Another popular class of drugs is serotonin norepinephrine re-uptake inhibitor (SNRIs), which work on both serotonin and noradrenaline.

The most common talking therapy is cognitive behavioral therapy, which breaks down overwhelming problems into situations, thoughts, emotions, physical feelings and actions to try to break a cycle of negative thoughts.

Other types are interpersonal therapy, behavioral activation, psycho-dynamic psychotherapy and couples’ therapy. All talking therapies can be used on their own, or with medication.

Away from the medical approach, doctors can prescribe physical activity or arts therapy, while some patients opt for alternative or complementary therapies, most popularly St John’s Wort herbal pills, mindfulness and yoga.

Conclusion When you have depression, treating your symptoms isn’t something you can easily overcome. You simply can’t will it away and “decide” to feel better one day. Instead, treating depression can require participating in psychotherapy or taking medications. These treatments (or a combination of these treatments) can help you feel better. If you experience depression symptoms, talk to your primary care doctor or mental health professional.

Suicide Hotlines/Websites

Sources

https://www.who.int/news-room/fact-sheets/detail/depression https://www.verywellmind.com/mental-health-effects-facing-former-inmates-5195312 https://www.news-medical.net/health/Prisoner-Depression-and-Low-Mood.aspx https://www.psychologytoday.com/us/basics/depression https://www.theguardian.com/news/2018/jun/04/what-is-depression-and-why-is-it-rising https://www.healthline.com/health/depression/symptoms#Conclusion