Depression

Depression is a whole-body illness. It involves the body, mood, and thoughts. Depression affects the way you eat and sleep. It also can affect the way you feel about yourself and things. It's not the same as being unhappy or in a “blue” mood. It is not a sign of personal weakness or a condition that can be willed or wished away. When you have depression, you can’t “pull yourself together” and get better. Treatment is often needed and many times crucial to recovery.

Depression has different forms, just like many other illnesses. The most common types of depressive disorders include:

• Major depression. This is a mixture of symptoms that affect your ability to work, sleep, eat, and enjoy life. This can put you out of action for awhile. These episodes of depression can happen once, twice, or several times in a lifetime.
• Dysthymia. This is a long-term (chronic) depressed mood and other symptoms that are not as severe or extensive as those in major depression. These symptoms can still keep you from functioning at "full steam" or from feeling good. People with dysthymia sometimes also have major depressive episodes.
• Bipolar disorder. This is a long-term (chronic) condition that includes cycles of extreme lows (depression) and extreme highs (hypomania or mania).

There is no clear cause of depression. Experts think it happens because of chemical problems in the brain. Many factors can play a role in depression. These include environmental, mental health, physical, and inherited factors.

Some types of depression seem to run in families. But no genes have yet been linked to depression.

Women have depression about twice as often as men. Many hormonal factors may add to the increased rate of depression in women. This includes menstrual cycle changes, premenstrual syndrome (PMS), pregnancy, miscarriage, postpartum period, perimenopause, and menopause. Many women also deal with additional stresses such as responsibilities both at work and home, single parenthood, and caring for both children and aging parents.

Many women are especially at risk after giving birth to a baby. Women have hormonal and physical changes on top of the added responsibility of caring for a baby. These can lead to postpartum depression in some women. The “baby blues" are common in new mothers and last a week or two. A full-blown depressive episode is not normal and needs treatment.

These are the most common symptoms of depression. But each person may have slightly different symptoms. Symptoms may include:

• Lasting sad, anxious, or empty mood.
• Weight or appetite changes because of eating too much or too little.
• Changes in sleeping patterns. These include fitful sleep, inability to sleep, early morning awakening, or sleeping too much.
• Loss of interest and pleasure in activities formerly enjoyed, including sex.
• Increased restlessness and irritability.
• Decreased energy, fatigue, and being "slowed down."
• Feeling of worthless or helpless.
• Lasting feelings of hopelessness.
• Feelings of inappropriate guilt.
• Not being able to concentrate, think, or make decisions.
• Frequent thoughts of death or suicide, wishing to die, or attempting suicide. (Note: People with this symptom should get treatment right away.).
• Physical symptoms, such as headaches, digestive problems, or chronic pain that doesn’t get better with treatment.

Without treatment, symptoms can last for weeks, months, or even years. The correct treatment can help most people who suffer from depression.

Depression can occur alone or with other health problems such as heart disease, cancer, or diabetes. It can also happen with other mental health disorders such as substance abuse or anxiety disorders. Getting an early diagnosis and treatment is important to recovery.

A diagnosis is made after a careful mental health exam and health history done by a psychiatrist or other mental health provider.

Generally, depressive disorders may be treated with one or a combination of the following:

• Medicine. Many different medicines are available. But it often takes 4 to 6 weeks to feel the full effects of antidepressants. It’s important to keep taking the medicine, even if it doesn’t seem to be working at first. It’s also important to talk with your healthcare provider before stopping. Some people have to switch medicines or add medicines to get results.
• Psychotherapy. This is most often cognitive-behavioral or interpersonal therapy. It focuses on changing the distorted views you have of yourself and your environment. It helps you work to improve your interpersonal relationship skills, and how to identify and manage stress in your life.
• Electroconvulsive therapy (ECT). This treatment may be used in people with severe, life-threatening depression that has not responded to medicines. An electrical current is passed through the brain, triggering a seizure. For unknown reasons, the seizures help to restore the normal balance of chemicals in the brain and ease symptoms.

You can also do things to help yourself. Depressive disorders can make you feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings may make you feel like giving up. It's important to realize that these negative views are part of the depression. They often don't accurately reflect true circumstances. Negative thinking fades as treatment starts to take effect. In the meantime, if you think you have depression, consider the following:

• Get help. If you think you may be depressed, see a healthcare provider as soon as possible.
• Set realistic goals in light of the depression. Take on only what you reasonably think you handle.
• Break large tasks into small ones and set priorities. Do what you can as you can.
• Try to be with other people and confide in someone. It is usually better than being alone and secretive.
• Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
• Get regular exercise.
• Expect your mood to get better slowly, not right away. Feeling better takes time.
• Eat healthy, well-balanced meals.
• Stay away from alcohol and drugs. These can make depression worse.
• It is best to put off important decisions until the depression has lifted. Before deciding to make a major life change—change jobs, get married, or divorced—discuss it with others who know you well. They will have a more objective view of your situation.
• Remember, people rarely “snap out of” a depression. But with treatment they can feel a little better day-by-day.
• Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression. The negative thoughts will disappear as your depression responds to treatment.
• Let your family and friends help you.