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Depression
Depression is a
treatable illness involving an imbalance of brain chemicals called
neurotransmitters. It is not a character flaw or a sign of personal
weakness. You can’t make yourself well by trying to "snap out of it."
Although it can run in families, you can’t catch it from someone else. The
direct causes of the illness are unclear, however it is known that body
chemistry can bring on a depressive disorder, due to experiencing a
traumatic event, hormonal changes, altered health habits, the presence of
another illness or substance abuse.
Symptoms of Depression
·
Prolonged sadness or unexplained crying spells
·
Significant changes in appetite and sleep patterns
·
Irritability, anger, worry, agitation, anxiety
·
Pessimism, indifference
·
Loss of
energy, persistent lethargy
·
Feelings
of guilt, worthlessness
·
Inability to concentrate, indecisiveness
·
Inability to take pleasure in former interests, social withdrawal
·
Unexplained aches and pains
·
Recurring thoughts of death or suicide
If you experience
five or more of these symptoms for more than two weeks or if any of these
symptoms interfere with work or family activities, consult with your
doctor for a thorough evaluation. This should include a complete physical
exam (some other illnesses can cause these symptoms) open and honest about
how you are feeling and and a review of your family’s history.
You cannot diagnose
yourself and you cannot be diagnosed by a friend or family member. Only a
properly trained health professional can determine if you have depression.
An
online self-assessment can help you communicate your symptoms to your
health care professional.
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If you or someone you know has thoughts of death or suicide, contact
a medical professional, clergy member, loved one, friend or hospital
emergency room or call 1-800-273-TALK or 911 immediately. |
Research has identified two major
types of depression
People who have major depressive disorder have had at least one
major depressive episode – five or more symptoms for at least a two-week
period. For some people, this disorder is recurrent, which means they may
experience episodes every so often – once a month, once a year, or several
times throughout their lives.
Dysthymia is a
chronic, moderate type of depression. People with dysthymia usually suffer
from poor appetite or overeating, insomnia or oversleeping, and low energy
or fatigue. People with dysthymia are often unaware that they have an
illness because their functioning is usually not greatly impaired. They go
to work and mange their lives, but are frequently irritable and often
complaining about stress.
People of all ages,
races, ethnic groups and social classes get depression. Although it can
occur at any age, depression frequently develops between the ages of 25
and 44. If you have depression, you are not alone. Approximately 20
million adult Americans experience depression every day.
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Depression in
Children
As many as one
in 33 children and one in eight adolescents has depression. If your child
has five or more symptoms for at least two weeks or if they interfere with
his or her daily activities (e.g., going to school, playing with friends),
then your child may be clinically depressed. Other warning signs of
childhood depression include headaches, frequent absences from school,
social isolation and reckless behavior.
Poor parenting does
not cause childhood depression. It may have many origins – genetics,
biochemistry and a variety of other factors. Fortunately, treatment for
childhood depression is highly effective. If you think your child may
suffer from depression, ask your pediatrician to do a screening or for a
referral to a health professional experienced in dealing with depression
in children. Research is now indicating that early diagnosis and treatment
might lessen future depressive episodes.
The FDA has
released a public health advisory on the reports of suicidality in
pediatric patients being treated with antidepressant medications for major
depressive disorder. Click here to read the advisory,
http://www.fda.gov/cder/drug/advisory/mdd.htm.
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Depression in
Late Life
Depression is
not a normal part of aging. Of the 32 million Americans over the age
of 65, nearly five million experience serious symptoms of depression and
one million suffer from depression. Elderly people with untreated
depression are more likely to have worse outcomes from treatment of
co-existing medical illnesses (e.g., hypertension, diabetes, heart
disease). Untreated depression is the most common psychiatric disorder and
the leading cause of suicide in the elderly.
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Depression and
Women
Women are almost twice as likely as men to experience depression. The
lifetime prevalence of major depression is 24 percent for women; it’s 15
percent for men. One in four women will experience clinical depression in
her lifetime. The hormonal and life changes associated with menstruation,
pregnancy, miscarriage, the postpartum period and menopause may contribute
to, or trigger, depression.
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During the
postpartum period, many women feel especially guilty about having
depressive feelings at a time when they should be or are expected to be
happy. In fact, one in ten mothers meets the criteria for depression in
the postpartum period. It’s extremely important to talk about postpartum
feelings, as untreated
postpartum depression can affect the mother-child relationship and, in
severe cases may put the infant’s or mother’s life at risk.
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Depression and Men
Although men are less
likely to suffer from depression than women, three to four million men in
the United States are affected by the illness.
Men are less likely
to admit to or seek help for depression, and doctors are less likely to
suspect it. Depression in men is often masked by alcohol or drugs, or by
the socially acceptable habit of working excessively long hours.
Depression typically shows up in men not as feeling hopeless and helpless,
but as being irritable, angry, and discouraged. Even if a man believes he
may be depressed, he may be less willing than a woman to seek help.
Support and encouragement from family and friends can make a difference.
For more
information, visit
NIMH's Men and Depression Web site.
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Depression and Other Illnesses
Depression often
co-exists with other mental or physical illnesses. Substance abuse,
anxiety disorders and eating disorders are particularly common conditions
that may be worsened by depression. A great deal of research is currently
underway into the relationship between depression and physical illnesses.
Several recent studies have noted that when co-existing depression is
treated, prognoses are substantially improved for conditions such as
heart disease,
AIDS,
cancer, Parkinson’s disease and
diabetes. It is important to tell your doctor about all of the
symptoms you are experiencing and all other illnesses for which you are
receiving treatment. For more information,
click here.
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How does depression differ from
bipolar disorder?
Bipolar disorder, also known as manic depression, is a treatable
medical illness where a person’s mood alternates between the "poles" of
depression and mania, a heightened energetic state. (top)
Treatments
for Depression
Treatment of
depression may include medication, talk therapy, or other strategies that
you and your health care provider may want to try. The right treatment is
the one that works best for you.
The Depression and Bipolar Support
Alliance does not endorse or recommend the use of any specific treatment
or medication for mood disorders. For advise about specific treatments or
medications, individuals should consult their physicians and/or mental
health professionals.
The good
news is that of all psychiatric illnesses, depression is one of the most
responsive to treatment. With proper care, approximately 80 percent of
people with major depression experience significant improvement and lead
productive lives – even those with severe depression can be helped. Be
patient and persistent. Do not give up hope and remember you are not
alone. At DBSA, we’ve been there and we can help.
Medication
The Food and Drug Administration (FDA) has approved dozens of medications
to treat depression. These medications are divided into various classes;
each one having a distinct chemical structure that acts on different
chemicals in the brain. It is important to remember that all FDA-approved
medications for depression are effective – they just don’t work the same
for everyone. You should work closely with your doctor to determine which
medication might be best for you. Sometimes this may involve trying more
than one medication or a combination of medications. Never change your
dosage or discontinue your medication without talking to your doctor.
Talk therapy
Psychotherapy, or "talk therapy" is an important part of treatment of
depression for many people. It can sometimes work alone in cases of mild
to moderate depression or it can be used in conjunction with other
treatments. People who are severely depressed may not be able to benefit
from psychotherapy until their symptoms have been lifted through another
means of treatment.
A good therapist
can help you modify behavioral or emotional patterns that contribute to
your depression. There are several types of psychotherapy: interpersonal,
cognitive-behavioral, group, marriage and family, to name a few. Research
the different types and find one that is right for you. Psychotherapists,
while highly-educated professionals, are not medical doctors and therefore
cannot prescribe medication. If you or your therapist think you could
benefit from medication, you need to see a general practitioner or a
psychiatrist.
Learn more about talk therapy by clicking here.
Herbal or
Natural Treatments
Dietary supplements and other alternative treatments that are advertised
to have a positive effect on depression regularly enter the marketplace.
These alternative treatments include Omega-3, St. John’s wort, SAM-e and
others. DBSA does not endorse or discourage the use of these treatments.
However, remember that natural is not always synonymous with safe.
Different brands of supplements may contain different concentrations of
the active substance when processed in different ways and these
alternative treatments may have side effects, so read labels carefully and
discuss them with your doctor or pharmacist.
Recent studies have
suggested that herbal treatments, such as St. John’s wort, may interfere
with the beneficial effects of some medications. Be sure you tell your
doctor about all of the medications or herbal remedies you are taking.
Learn more about herbal or natural treatments by clicking here.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy is intended for people with severe symptoms of
depression or sometimes mania. When medications and psychotherapy fail to
reduce symptoms, ECT can be an alternative treatment. ECT is never forced
upon people or used as a means of submission.
Mild electrical stimulation to the brain causes brief seizures which, in
turn, relieve the depression. ECT is painless; muscle relaxants are
administered to the anesthetized person to eliminate shaking. An average
of six to 12 treatments over a three-to four-week period is usually
required. After successful treatment subsequent depressive episodes may
be managed by antidepressants or less frequent maintenance does of ECT.
Like all treatments, ECT has potential side effects. Although there have
been reports of memory disturbances, many ECT patients feel that the
benefits outweigh the risks. This is especially true for people who may
otherwise have carried out suicidal impulses if they had waited for
medication therapy to take effect.
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Emerging
Technologies (such as rTMS and VNS therapies)
Today many researchers are focusing their attention on technology to
develop new, more effective treatments. These treatments may help people
who have trouble finding relief with medication.
Click here to learn more.
How do DBSA
support groups help?
With a grassroots
network of over 800 support groups across the country, no one with
depression has to feel alone. DBSA support groups provide a caring
environment for people to come together to discuss their challenges and
successes in living with depression. They are not group therapy, though
each group has a professional advisor and appointed facilitators. DBSA
groups provide a forum for mutual understanding and self-discover, help
people stay compliant with their treatment plans and gain practical ideas
and tips from others who have "been there." For information on a DBSA
support group in your area, check our
support group locator or contact DBSA at (800) 826-3632.
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How do I help my
friend or family member who is depressed?
Often people who are
depressed do not recognize the symptoms in themselves. The most important
thing anyone can do for some who is depressed is to help him or her get an
appropriate diagnosis and effective treatment. This may involve helping
the person to find a doctor or therapist and make their first appointment.
You may also want to offer go with the person to their first appointment
for support. Encourage the individual to stay with treatment. Keep
reassuring the person that, with time and help, he or she will feel
better.
The second most
important thing is to offer emotional support. This involves
understanding, patience, affection, and encouragement. Engage the person
in conversation and listen carefully. Resist the urge to function as a
therapist or try to come up with answers to the person’s concerns. Often
times we just want someone to listen. Do not put down feelings expressed,
but point out realities and offer hope. Invite the depressed person for
walks, outings, to the movies, and other activities. Be gently insistent
if your first invitation is refused.
Do not ignore
remarks about suicide. Report them to the person's therapist. Never
promise confidentiality if you believe someone is close to suicide. If you
think immediate self-harm is possible, contact their doctor or dial 911
immediately. Make sure the person discusses these feelings with his or her
doctor.
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This site is for educational purposes only and is not to replace the
advice of a healthcare professional.
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