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.
  • Depression is a whole-body illness.
    This means that it involves the body, mood, and thoughts. It is not the same as being
    unhappy or in a “blue” mood. Treatment is often needed.
  • There is no clear cause of depression,
    but healthcare providers think it’s a result of chemical problems in the brain. 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 play a role in the increased rate of
    depression in women.
  • Depression may be diagnosed after a
    careful mental health exam by a a psychiatrist or other mental health provider.
  • Depression is most often treated with
    medicine, psychotherapy, or cognitive behavioral therapy. It can also be a
    combination of medicine and therapy.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.