Depression

Everyone goes through moments of feeling down from time to time.  However, if that low mood lingers day after day, it could be a sign of depression. Depression is a diagnosable condition that’s classified as a mood disorder and can bring about long-lasting symptoms such as overwhelming sadness, low energy, loss of appetite, and a lack of interest in things that used to bring pleasure. Depression is not a sign of weakness or a negative personality. It is a major public health concern and a treatable mental health condition. There are an estimated 16.2 million adults in the United States who have had at least one major depressive episode in a give year. Women are twice as likely as men to have had a depressive episode. 

Many people who experience depression may also have other mental health conditions. Anxiety disorders often go hand in hand with depression.  If you think you are depressed‚ talk with your doctor or a mental health professional immediately. This is especially important if your symptoms are getting worse or affecting your daily activities. If left untreated, depression can lead to serious health complications. The following information is not intended to provide a medical diagnosis of major depression and cannot take the place of seeing a mental health professional.

  • Types of Depression
  • Signs & Symptoms
  • Diagnosis
  • Causes
  • Treatment
  • Complications
Major Depression (Unipolar) – This is the most common type of depression. People often experience recurrent episodes throughout their lives. Major depression is an episode of sadness or apathy along with other symptoms that lasts at least two consecutive weeks and is severe enough to interrupt daily activities. Major depression focuses on the ‘lows’ or the negative emotions and symptoms experienced. As opposed to Bipolar, which switches between highs and lows.  
 

Persistent Depressive Disorder (dysthymia) – A depressed mood that last for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder. These ongoing feelings of deep sadness and hopelessness occur in 1.5% of American adults in a given year.

Postpartum Depression – More intense than “baby blues”, many women experience postpartum depression after giving birth.  The “baby blues” strikes about 75% of new mothers, who experience a mild depression and anxiety symptoms that typically lasts two weeks. Women with postpartum depression experience full-blown major depression during pregnancy or after delivery. The feeling of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their baby. 

Seasonal Affective Depression (SAD) – This is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective depression. SAD affects 3-20% of all people, depending on where they live. 

Bipolar Disorder (formally manic depression) – This is different from depression, but is included in this list because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (unipolar depression). A person with bipolar disorder also experience extreme high – euphoric or irritable moods called mania or less severe form call hypomania. Bipolar disorder affects about 2.8% of the US populations in a given year. 

Psychotic Depression – This occurs when major depression or bipolar disorder is accompanied by hallucinations, delusion, or paranoia. It is considered major depressive disorder with psychotic features. About 25% of patients who are admitted to a hospital due to depression actually have psychotic depression. 

If you experience the following symptoms for most of the day, nearly every day, for at least two weeks, you may be suffering from depression. Symptoms include:
 
  • Persistent sad, anxious, restlessness, or empty mood
  • Feelings of hopelessness or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
  • Insomnia or oversleeping
  • Difficulty concentration or making decisions

Not everyone who is depressed experiences every symptoms. Some people only experience a few symptoms while other may experience many. Symptoms may also vary depending on the stage of the illness. 

Depression can be difficult to identify because its symptoms can vary depending on age and gender. Adults with depression generally feel overwhelmed by sadness, while depression in adolescents tends to express itself as irritability. Women with depression are more likely to notice symptoms of anxiety and indecisiveness, while men are more likely to report anger and aggression. 

If you or someone you know has symptoms of depression, your doctor can help. Make an appointment if the symptoms last more than 2 weeks. It’s important to report all symptoms. Your doctor may perform a physical exam and blood tests to rule out other health disorders or conditions that can be similar to or contribute to depression.  

A diagnosis of depression usually requires symptoms to occur for two weeks or more. The symptoms will also cause significant distress in social, occupational, or other important areas of functioning. Discussing moods, behaviors, and daily activities can help reveal the severity and type of depression, which is critical in determining the most effective treatment.

Health professionals are unsure what causes depression, but the prominent theory is involves the brain structure and chemical function/imbalance. Brain circuits that regulate mood may work less efficiently during depression. Drugs that treat depression are believed to improve communication between nerve cells, helping them run more normal. Experts also believe that while stress can trigger depression, a person must first be biologically prone to develop the disorder. Other triggers could include certain medications, alcohol or substance abuse, hormonal changes, or even the season. 

Risk Factors that can contribute to the chance of developing depression are:

  • Family history of depression
  • Your brain’s physical structure and chemistry
  • History of other disorders (anxiety, post traumatic stress disorder)
  • Hormone changes (pregnancy, menstrual cycles, hormone therapy)
  • Medications (sleeping aids, blood pressure medication)
  • Major life changes, trauma, or stress (physical/sexual abuse, death of a loved one, financial problems)
  • Certain physical illnesses and medications

No mater the treatment methods chosen, it is important to have a healthy diet and regular sleep. They vast majority of people with depression who seek treatment find a cure, with a success rate of 80-90%. However, it is not always an easy process. Finding the right approach takes work, even as the options expand and become more targeted to each patient’s particular needs. No two people are affected the same way by depression and there is no “one-size-fits-all” for treatment. It may take some trial and error to find the right treatment that works best. 

There are several treatment methods for depression ranging from psychological counseling to medication and exercise. Some treatments include:

  • Studies suggest different types of talk therapy can fight mild to moderate depression. Patients find that a few months of therapy is all they need, while other may continue treatment long term.
    • Cognitive Behavioral Therapy (CBT) – change thoughts and behaviors that contribute to depression
    • Interpersonal Therapy – identifies how your relationships impact your mood
    • Psychodynamic Psychotherapy – helps people understand how their behavior and mood are affected by unresolved issues and unconscious feelings
  • Antidepressants are depression medication that affect the levels of brain chemicals, such as serotonin and norepinephrine. Antidepressants take a few weeks of use to take effect. Follow up with a doctor is very important to make sure the medication is working effectively and is the correct dosage. If the medication tried does not help, there’s a good chance another will. The American Psychiatric Association suggests that a combination of both antidepressants and psychological counseling is, on average, more effective.
  • Phototherapy (Light Therapy) has shown promise at being an effective treatment for people with SAD, among other depression disorders. It involves sitting in front of a specially designed light box that provides either a bright or dim light for a prescribed amount of time each day. It is can be used in conjunction with other treatments.
  • Research suggests exercise is very effective against mild to moderate depression. Physical activity releases endorphins that can help boost mood. Regular exercise is also linked to higher self-esteem, better sleep, less stress, and more energy. Any type of moderate activity, from swimming to housework, can help. Choose something you enjoy and aim for 20-30 minutes four or five times a week.
  • Electroconvulsive Therapy (ECT) is a brain stimulation therapy and an option for patients with treatment-resistant or severe melancholic depression. This treatment uses electric charges to create a controlled seizure. Patients are not conscious for the procedure. ECT helps 80-90% of patients who receive it. 

Prolonged or chronic depression can have a devastating inpact on your emotional and physical health. Mental Health America reports that 30-70% of those who died by suicide have depression or bipolar disorder. 

Other complications of depression can lead to:

  • Alcohol or substance abuse
  • Headaches and other chronic aches and pains
  • Phobias, panic disorders, and anxiety attacks
  • Trouble with school or work
  • Family and relationship problems
  • Social Isolation
  • Excess weight or obesity due to eating disorders, raising the risk for heart disease and type 2 diabetes
  • Self-mutilation
  • Attempted suicide or suicide

Suicide Prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 9-1-1 or your local emergency number
  • Stay with the person until help arrives
  • Remove any guns, knives, medication , or other things that may cause harm
  • Listen, but don’t judge, argue, threaten, or yell

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. You can call the National Suicide Prevention Lifeline at 1-800-273-8255.

Source: MedlinePlus.gov

Resources

Links to various resources on the topics discuss on this page.