Depression is one of the most common health conditions in the world. Depression isn't a weakness, nor is it something that you can simply "snap out of." Depression, formally called major depression, major depressive disorder or clinical depression, is a medical illness that involves the mind and body. It affects how you think and behave and can cause a variety of emotional and physical problems. You may not be able to go about your usual daily activities, and depression may make you feel as if life just isn't worth living anymore.
Most health professionals today consider depression a chronic illness that requires long-term treatment, much like diabetes or high blood pressure. Although some people experience only one episode of depression, most have repeated episodes of depression symptoms throughout their life.
Effective diagnosis and treatment can help reduce even severe depression symptoms. And with effective treatment, most people with depression feel better, often within weeks, and can return to the daily activities they previously enjoyed.
Causes:
It's not known specifically what causes depression. As with many mental illnesses, it's thought that a variety of biochemical, genetic and environmental factors may cause depression:
Biochemical- Some evidence from high-tech imaging studies indicates that people with depression have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. The naturally occurring brain chemicals called neurotransmitters, which are linked to mood, also may play a role in depression. Hormonal imbalances also could be a culprit.
Genes- Some studies show that depression is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing depression.
Environment- Environment is also thought to play a causal role in some way. Environmental causes are situations in your life that are difficult to cope with, such as the loss of a loved one, financial problems and high stress.
Symptoms:
Symptoms of depression include:
Loss of interest in normal daily activities, Feeling sad or down, Feeling hopeless, Crying spells for no apparent reason, Problems sleeping, Trouble focusing or concentrating, Difficulty making decisions, Unintentional weight gain or loss, Irritability, Restlessness, Being easily annoyed, Feeling fatigued or weak, Feeling worthless, Loss of interest in sex, Thoughts of suicide or suicidal behavior, Unexplained physical problems, such as back pain or headaches, etc.
Diagnosis:
When doctors suspect someone has depression, they typically run a battery of medical and psychological tests and exams. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
Physical exam- This may include measuring height and weight; checking vital signs, such as heart rate, blood pressure and temperature; listening to the heart and lungs; and examining the abdomen.
Laboratory tests- These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
Psychological evaluation- A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You'll also discuss any thoughts you may have of suicide or self-harm.
There are several other conditions whose symptoms may include depression. It's important to get an accurate diagnosis so you can get the appropriate treatment. Your doctor or mental health provider's evaluation will help determine if you have major depression or one of these other conditions that can sometimes resemble major depression:
Adjustment disorder- An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect your feelings, thoughts and behavior.
Bipolar disorder- This type of depression is characterized by mood swings that range from highs to lows. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's very important to get the right diagnosis so that you can get the proper treatment and medications.
Cyclothymia- Cyclothymia, or cyclothymic disorder, is a milder form of bipolar disorder.
Dysthymia- Dysthymia is a less severe but more chronic form of depression. While it's usually not disabling, dysthymia can prevent you from functioning normally in your daily routine and from living life to its fullest.
Postpartum depression- This is depression that occurs in a new mother usually within a month of having a baby.
Psychotic depression- This is severe depression accompanied by psychosis, such as delusions or hallucinations.
Schizoaffective disorder- Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder.
Seasonal affective disorder- This type of depression is related to changes in seasons and a lack of exposure to sunlight.
Treatment:
Numerous treatments for depression are available. Standard depression treatment options include:
Medications-
Dozens of medications are available to treat depression. Most people find the best relief of depression symptoms by combining medications and psychotherapy. Some medications for depression are antidepressants that have been specifically approved by the Food and Drug Administration (FDA) to treat depression. Doctors also can use their medical judgment to prescribe other medications that haven't been FDA approved to treat depression but that may be effective anyway — a common and perfectly legal practice called off-label use.
There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring biochemicals in your brain to change your mood. To determine which antidepressant may be best for you, doctors typically follow general practice guidelines. They may also ask you to take a blood test called the cytochrome P450 test, which can help identify genetic factors that influence your response to certain antidepressants (as well as some other medications).
SSRIs (selective serotonin reuptake inhibitors) include fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).
Other common first choices for antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs), combined reuptake inhibitors and receptor blockers, and tetracyclic antidepressants.
Monoamine oxidase inhibitors (MAOIs) is often prescribed as a last resort, when other medications haven't worked. That's because MAOIs, while generally effective, can have serious harmful side effects. They also require strict dietary restrictions because of rare but potentially fatal interactions with certain foods. Newer versions of MAOIs that you stick on your skin as a skin patch rather than swallowing may have fewer side effects.
Psychotherapy
Psychotherapy is another key depression treatment. It's often used along with medication treatment. Psychotherapy is a general term for a way of treating depression by talking about your condition and related issues with a mental health provider. Psychotherapy is also known as therapy, talk therapy, counseling or psychosocial therapy.
Through these talk sessions, you learn about the causes of depression so that you can better understand it. You also learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life. Psychotherapy can help you regain a sense of happiness and control in your life and help alleviate depression symptoms, such as hopelessness and anger. It also may help you adjust to a crisis or other current difficulty.
Electroconvulsive therapy
In electroconvulsive therapy (ECT), electrical currents are passed through the brain to trigger a seizure. Although many people are leery of ECT and its side effects, it typically offers fast, effective relief of depression symptoms. Experts aren't sure how this therapy relieves the signs and symptoms of depression. The procedure may affect levels of neurotransmitters in your brain. The most common side effect is confusion, which can last from a few minutes to several hours. Some people also experience partial memory loss, but memory often returns.
ECT is usually used for people who don't get better with medications and for those at high risk of suicide. It may be the only treatment available for older adults with severe depression who can't take medications because of heart disease.
Most health professionals today consider depression a chronic illness that requires long-term treatment, much like diabetes or high blood pressure. Although some people experience only one episode of depression, most have repeated episodes of depression symptoms throughout their life.
Effective diagnosis and treatment can help reduce even severe depression symptoms. And with effective treatment, most people with depression feel better, often within weeks, and can return to the daily activities they previously enjoyed.
Causes:
It's not known specifically what causes depression. As with many mental illnesses, it's thought that a variety of biochemical, genetic and environmental factors may cause depression:
Biochemical- Some evidence from high-tech imaging studies indicates that people with depression have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. The naturally occurring brain chemicals called neurotransmitters, which are linked to mood, also may play a role in depression. Hormonal imbalances also could be a culprit.
Genes- Some studies show that depression is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing depression.
Environment- Environment is also thought to play a causal role in some way. Environmental causes are situations in your life that are difficult to cope with, such as the loss of a loved one, financial problems and high stress.
Symptoms:
Symptoms of depression include:
Loss of interest in normal daily activities, Feeling sad or down, Feeling hopeless, Crying spells for no apparent reason, Problems sleeping, Trouble focusing or concentrating, Difficulty making decisions, Unintentional weight gain or loss, Irritability, Restlessness, Being easily annoyed, Feeling fatigued or weak, Feeling worthless, Loss of interest in sex, Thoughts of suicide or suicidal behavior, Unexplained physical problems, such as back pain or headaches, etc.
Diagnosis:
When doctors suspect someone has depression, they typically run a battery of medical and psychological tests and exams. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
Physical exam- This may include measuring height and weight; checking vital signs, such as heart rate, blood pressure and temperature; listening to the heart and lungs; and examining the abdomen.
Laboratory tests- These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
Psychological evaluation- A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. He or she will ask about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You'll also discuss any thoughts you may have of suicide or self-harm.
There are several other conditions whose symptoms may include depression. It's important to get an accurate diagnosis so you can get the appropriate treatment. Your doctor or mental health provider's evaluation will help determine if you have major depression or one of these other conditions that can sometimes resemble major depression:
Adjustment disorder- An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect your feelings, thoughts and behavior.
Bipolar disorder- This type of depression is characterized by mood swings that range from highs to lows. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's very important to get the right diagnosis so that you can get the proper treatment and medications.
Cyclothymia- Cyclothymia, or cyclothymic disorder, is a milder form of bipolar disorder.
Dysthymia- Dysthymia is a less severe but more chronic form of depression. While it's usually not disabling, dysthymia can prevent you from functioning normally in your daily routine and from living life to its fullest.
Postpartum depression- This is depression that occurs in a new mother usually within a month of having a baby.
Psychotic depression- This is severe depression accompanied by psychosis, such as delusions or hallucinations.
Schizoaffective disorder- Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder.
Seasonal affective disorder- This type of depression is related to changes in seasons and a lack of exposure to sunlight.
Treatment:
Numerous treatments for depression are available. Standard depression treatment options include:
Medications-
Dozens of medications are available to treat depression. Most people find the best relief of depression symptoms by combining medications and psychotherapy. Some medications for depression are antidepressants that have been specifically approved by the Food and Drug Administration (FDA) to treat depression. Doctors also can use their medical judgment to prescribe other medications that haven't been FDA approved to treat depression but that may be effective anyway — a common and perfectly legal practice called off-label use.
There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring biochemicals in your brain to change your mood. To determine which antidepressant may be best for you, doctors typically follow general practice guidelines. They may also ask you to take a blood test called the cytochrome P450 test, which can help identify genetic factors that influence your response to certain antidepressants (as well as some other medications).
SSRIs (selective serotonin reuptake inhibitors) include fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro).
Other common first choices for antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs), combined reuptake inhibitors and receptor blockers, and tetracyclic antidepressants.
Monoamine oxidase inhibitors (MAOIs) is often prescribed as a last resort, when other medications haven't worked. That's because MAOIs, while generally effective, can have serious harmful side effects. They also require strict dietary restrictions because of rare but potentially fatal interactions with certain foods. Newer versions of MAOIs that you stick on your skin as a skin patch rather than swallowing may have fewer side effects.
Psychotherapy
Psychotherapy is another key depression treatment. It's often used along with medication treatment. Psychotherapy is a general term for a way of treating depression by talking about your condition and related issues with a mental health provider. Psychotherapy is also known as therapy, talk therapy, counseling or psychosocial therapy.
Through these talk sessions, you learn about the causes of depression so that you can better understand it. You also learn how to identify and make changes in unhealthy behavior or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals for your life. Psychotherapy can help you regain a sense of happiness and control in your life and help alleviate depression symptoms, such as hopelessness and anger. It also may help you adjust to a crisis or other current difficulty.
Electroconvulsive therapy
In electroconvulsive therapy (ECT), electrical currents are passed through the brain to trigger a seizure. Although many people are leery of ECT and its side effects, it typically offers fast, effective relief of depression symptoms. Experts aren't sure how this therapy relieves the signs and symptoms of depression. The procedure may affect levels of neurotransmitters in your brain. The most common side effect is confusion, which can last from a few minutes to several hours. Some people also experience partial memory loss, but memory often returns.
ECT is usually used for people who don't get better with medications and for those at high risk of suicide. It may be the only treatment available for older adults with severe depression who can't take medications because of heart disease.
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