Depression

What is depression?

A depressive disorder is a whole-body illness, involving the body, mood, and thoughts, and affects the way a person eats and sleeps, feels about himself or herself, and thinks about things. It is not the same as being unhappy or in a blue mood. Nor is it a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better.

Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression. During any one year period, 19 million American adults suffer from depressive illness. Yet, treatment can alleviate symptoms in nearly 80 percent of cases.

What are the different types of depression?

Depressive disorders come in different forms, just as do other illnesses, such as heart disease. Three of the most prevalent types of depressive disorders are:

• major depression
  a combination of symptoms (see symptom list) that interfere with the ability to work, sleep, eat, and enjoy once pleasurable activities. These disabling episodes of depression can occur once, twice, or several times in a lifetime.
• dysthymia
  long-term, chronic symptoms that do not disable, but keep people from functioning at "full steam" or from feeling good. Sometimes people with dysthymia also experience major depressive episodes.
• bipolar disorder (manic-depression)
  a chronic recurring condition that includes cycles of depression and elation or mania.

Within these types there are variations in the number of symptoms, their severity, and persistence.

What are the symptoms and signs of depression?

The following are the most common symptoms of depression. However, each individual may experience symptoms differently. In general, nearly everyone suffering from depression has ongoing feelings of sadness, and may feel helpless, hopeless, and irritable.

The American Psychiatric Association suggests that professional help is advisable for those who have four or more of the following symptoms continually for more than two weeks:

• noticeable change of appetite, with either significant weight loss not attributable to dieting or weight gain
• noticeable change in sleeping patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much
• loss of interest and pleasure in activities formerly enjoyed
• persistent sad, anxious, or "empty" mood
• feelings of hopelessness, pessimism
• restlessness, irritability
• decreased energy, fatigue, being "slowed down"
• feelings of worthlessness
• persistent feelings of hopelessness
• feelings of inappropriate guilt
• inability to concentrate or think, indecisiveness
• recurring thoughts of death or suicide, wishing to die, or attempting suicide (Note: Individuals with this symptom should receive treatment immediately!)
• melancholia (defined as overwhelming feelings of sadness and grief), accompanied by waking at least two hours earlier than normal in the morning
• feeling more depressed in the morning
• moving significantly more slowly
• disturbed thinking -- for example, severely depressed people sometimes have beliefs not based in reality about physical disease, sinfulness, or poverty
• physical symptoms, such as headaches, digestive disorders, and chronic pain

Treatment for depression:

Specific treatment for depression will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the depression
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disorder
• your opinion or preference

Generally, based on the outcome of evaluations, treatment for depressive disorders includes medication or psychotherapy, or a combination of the two.