Depression
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10 Signs It's Time to Get Help for Depression
When you suffer from symptoms of depression it can be easy to dismiss what is happening as temporary or just a minor setback. Some people might be afraid to seek help due to anxiety in acknowledging that there may be a problem. Others may fear stigma of what their family or friends may think or even perceive depression as some sort of weakness. Still others may worry that they do not have the time or money to devote to therapy or they may be afraid that a doctor will push medications on them that they do not want. For whatever reason, some people who suffer from depression often do not get help or treatment. But, in many circumstances it is more of a risk to not get help. www.healthcentral.com/slideshow/10-signs-it-s-time-to-get-help-for-depression
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10 Signs of a Depression Relapse
www.healthcentral.com/slideshow/10-signs-depression-relapse Many people with depression will experience symptoms only once in their lives, but for others, major depression can be an ongoing battle with relapses occurring throughout their lives. Here are warning signs that could help a person avoid a major depressive episode by seeking help early.
The Effects of Depression on your Body
Clinical depression, especially left untreated, can interrupt your day-to-day life and cause a ripple effect of additional symptoms. Read more the_effects_of_depression_in_your_body.docx |
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What NOT to say to someone with depression
Click here for the full article: lifeeffects.teva/articles/what-not-to-say-to-someone-with-depression The don’ts Don’t say: “It’s just in your head” Don’t say: “I was depressed this one time” Don’t say: “There are a lot of people worse off than you” or “You have many reasons to be grateful” Don’t say: “It’s beautiful day” Don’t say: “Happiness is a choice” Don’t say: “You should/You need to… ” Don’t say: “I thought you were stronger” Don’t say: “You don’t look depressed” or “You’re not one of those people” The do’s: You’re not alone. You matter. You’re important. I care. I’m glad you’re here. I’m not giving up on you. You’re never a burden. |
How do I know if my depression is better?
Click here for the full article: lifeeffects.teva/articles/how-do-i-know-if-my-depression-is-‘better’ You catch yourself humming or singing. You aren’t annoyed by people who usually bother you. You erupt in spontaneous laughter. You briefly forget about the depression. You find yourself so immersed in an activity (a movie, a conversation) that you lose track of time for several hours. You have a desire to put on upbeat music — and listen to it. You notice a slight swagger in your step when you walk. You look at yourself in the mirror and feel OK about what you see. You are looking forward to exercise. You are thinking about sex, and are interested in being intimate. You start to be able to plan for the future, without feeling like this is an idle exercise. You feel a sense of calm in your mind. You want to go out with friends. You find pleasures in small things, like the smell of blooming flowers or a good cup of coffee. You notice that you are talking more and more, and at a louder volume. |
Seeing Beyond Depression
There's new evidence that depression is not just a disorder of the mind—and blood tests for signs of inflammation promise treatment options precisely tailored to each patient's needs. Establishing that depression can be caused by inflammation somewhere —anywhere—in the body demands much evidence. But it also requires more: a radical shift in mindset, because it overrides one of the distinguishing features of Western thinking—the deep fault line that separates ideas about the workings of the body from those about the workings of the mind.
Read more here: seeing_beyond_depression_-_psychology_today.pdf
There's new evidence that depression is not just a disorder of the mind—and blood tests for signs of inflammation promise treatment options precisely tailored to each patient's needs. Establishing that depression can be caused by inflammation somewhere —anywhere—in the body demands much evidence. But it also requires more: a radical shift in mindset, because it overrides one of the distinguishing features of Western thinking—the deep fault line that separates ideas about the workings of the body from those about the workings of the mind.
Read more here: seeing_beyond_depression_-_psychology_today.pdf
When researchers showed in 2006 that the anesthetic ketamine— also known as the club drug Special K—was a rapid and potent antidepressant, big pharmaceutical companies quickly jumped into the game. Extensive efforts to improve on decades-old antidepressants had floundered, but ketamine finally promised a novel mechanism of action and the potential to help treatment- resistant patients.
Because ketamine is an old drug and difficult to commercialize for a new indication, early entrants into this space set out to build ketamine mimetics that could replicate the anesthetic’s effect, ideally without its hallucinatory side effects. A few of these ketamine-inspired drugs are now nearing the finish line. In September, Johnson & Johnson (J&J) filed for FDA approval of a nasal spray containing esketamine—an isomer of ketamine that the company has patented. Despite some lingering questions about its efficacy compared with ketamine, experts in the field expect the drug will be approved, providing the first antidepressant breakthrough in decades.
Full Article: scientific_american_mind_–_08 _ 09_2017.pdf
Because ketamine is an old drug and difficult to commercialize for a new indication, early entrants into this space set out to build ketamine mimetics that could replicate the anesthetic’s effect, ideally without its hallucinatory side effects. A few of these ketamine-inspired drugs are now nearing the finish line. In September, Johnson & Johnson (J&J) filed for FDA approval of a nasal spray containing esketamine—an isomer of ketamine that the company has patented. Despite some lingering questions about its efficacy compared with ketamine, experts in the field expect the drug will be approved, providing the first antidepressant breakthrough in decades.
Full Article: scientific_american_mind_–_08 _ 09_2017.pdf
The Recovery Letters
The Recovery Letters are all written with the intention to try and allieviate some of the pain of depression, to make the loneliness slightly more bearable and above all to give hope that you can recover. We see recovery as self defined but can include living alongside symptoms or being symptom free, being stable on medication or medication free but most of all living a life with some meaning.
The letters are written from people recovering from depression, addressed to those currently suffering. At the moment the letter writers have experienced different types of depression including clinical/major depression, bi-polar and post partum depression. therecoveryletters.com
The Recovery Letters are all written with the intention to try and allieviate some of the pain of depression, to make the loneliness slightly more bearable and above all to give hope that you can recover. We see recovery as self defined but can include living alongside symptoms or being symptom free, being stable on medication or medication free but most of all living a life with some meaning.
The letters are written from people recovering from depression, addressed to those currently suffering. At the moment the letter writers have experienced different types of depression including clinical/major depression, bi-polar and post partum depression. therecoveryletters.com
A Key To Depression: Sensing The Slip
The slip is what happens when small signs of your regular depression symptoms come back. It’s a mental process that, to me, feels like something close to quicksand. When you’re slipping, it may feel harder to get out with each moment. Like quicksand, it may pull you down faster than you’d think, and it’s hard to recognize at first.
Read more here: lifeeffects.teva/us/articles/a-key-to-depression-sensing-the-slip
The slip is what happens when small signs of your regular depression symptoms come back. It’s a mental process that, to me, feels like something close to quicksand. When you’re slipping, it may feel harder to get out with each moment. Like quicksand, it may pull you down faster than you’d think, and it’s hard to recognize at first.
Read more here: lifeeffects.teva/us/articles/a-key-to-depression-sensing-the-slip
The Link Between Dehydration and Depression
New studies show that dehydration could be to blame for your sagging mood. Learn more here.
New studies show that dehydration could be to blame for your sagging mood. Learn more here.
Herpes Virus may lead to Bipolar disorder and Depression
Scientists have discovered the human herpesvirus HHV-6 in the neurons of people who lived with bipolar or severe depression. www.medicalnewstoday.com/articles/322752.php
Scientists have discovered the human herpesvirus HHV-6 in the neurons of people who lived with bipolar or severe depression. www.medicalnewstoday.com/articles/322752.php
Depression in Teens: The Warning Signs and How to Help Them Through
During adolescence, the rates of depression skyrocket. According to the World Health Organization, depression is the number one cause of illness and disability in adolescents. But there’s something else. Research shows that in half of all adults who have problems with their mental health, their symptoms showed up before age 14. Three-quarters had symptoms by age 24. This puts flashing lights around the importance of noticing when our teens are struggling and making sure they get the support they need. The earlier symptoms are caught, the easier it will be to stop those symptoms expanding into something bigger and more difficult to shift.
www.heysigmund.com/depression-teens-warning-signs-help/
During adolescence, the rates of depression skyrocket. According to the World Health Organization, depression is the number one cause of illness and disability in adolescents. But there’s something else. Research shows that in half of all adults who have problems with their mental health, their symptoms showed up before age 14. Three-quarters had symptoms by age 24. This puts flashing lights around the importance of noticing when our teens are struggling and making sure they get the support they need. The earlier symptoms are caught, the easier it will be to stop those symptoms expanding into something bigger and more difficult to shift.
www.heysigmund.com/depression-teens-warning-signs-help/
The Link Between Dehydration and Depression
New studies show that dehydration could be to blame for your sagging mood.
www.hopetocope.com/the-link-between-dehydration-and-depression/
Water for wellnessResearchers now believe that even mild dehydration will have an effect on your moods. Two studies from the Human Performance Laboratory at the University of Connecticut show that it doesn’t take much dehydration (they describe this as 1.5 percent loss in normal water volume in the body) to alter your energy level, mood, and ability to think clearly. Female subjects in one of the studies also perceived tasks as more difficult when slightly dehydrated.
Dehydration, the body and the mindThe University of Connecticut study found that drinking water has a “significant impact” on alleviating depression and helping with concentration. It can also help with sleep disorders. In one of the studies, lead scientist Lawrence E. Armstrong, a professor of physiology in UConn’s Department of Kinesiology found that when dehydrated, the subjects were more cranky and fatigued. Not drinking enough water can also cause headaches, sleepiness, and confusion, said Armstrong.
How much is enough?First off, waiting until you’re thirsty to hydrate is too late, as our thirst sensation doesn’t appear until we are 1 or 2 percent dehydrated, explained Armstrong. “By then, dehydration is already setting in and starting to impact how our mind and body perform.” So how much should we be drinking? According to the U.D. Institute of Medicine (IOM), women should drink six pints of water per day and men should drink eight pints of water per day. Remember that even if you think you drink enough water, your fluids will be reduced by heat, exercising or drinking too much caffeine.
New studies show that dehydration could be to blame for your sagging mood.
www.hopetocope.com/the-link-between-dehydration-and-depression/
Water for wellnessResearchers now believe that even mild dehydration will have an effect on your moods. Two studies from the Human Performance Laboratory at the University of Connecticut show that it doesn’t take much dehydration (they describe this as 1.5 percent loss in normal water volume in the body) to alter your energy level, mood, and ability to think clearly. Female subjects in one of the studies also perceived tasks as more difficult when slightly dehydrated.
Dehydration, the body and the mindThe University of Connecticut study found that drinking water has a “significant impact” on alleviating depression and helping with concentration. It can also help with sleep disorders. In one of the studies, lead scientist Lawrence E. Armstrong, a professor of physiology in UConn’s Department of Kinesiology found that when dehydrated, the subjects were more cranky and fatigued. Not drinking enough water can also cause headaches, sleepiness, and confusion, said Armstrong.
How much is enough?First off, waiting until you’re thirsty to hydrate is too late, as our thirst sensation doesn’t appear until we are 1 or 2 percent dehydrated, explained Armstrong. “By then, dehydration is already setting in and starting to impact how our mind and body perform.” So how much should we be drinking? According to the U.D. Institute of Medicine (IOM), women should drink six pints of water per day and men should drink eight pints of water per day. Remember that even if you think you drink enough water, your fluids will be reduced by heat, exercising or drinking too much caffeine.
Depression After Surgery
The interaction of depression and anesthesia and surgery may result in significant increases in morbidity and mortality of patients. Major depressive disorder is a frequent complication of surgery.
Depression is commonly associated with cognitive impairment, which may be exacerbated postoperatively. There is evidence that acute postoperative pain causes depression and depression lowers the threshold for pain. Depression is also a strong predictor and correlate of chronic post-surgical pain. Many studies have identified depression as an independent risk factor for development of postoperative delirium, which may be a cause for a long and incomplete recovery after surgery. Depression is also frequent in intensive care unit patients and is associated with a lower health-related quality of life and increased mortality. Depression and anxiety have been widely reported soon after coronary artery bypass surgery and remain evident one year after surgery. They may increase the likelihood for new coronary artery events, further hospitalizations and increased mortality. Morbidly obese patients who undergo bariatric surgery have an increased risk of depression. Postoperative depression may also be associated with less weight loss at one year and longer. The extent of preoperative depression in patients scheduled for lumbar discectomy is a predictor of functional outcome and patient’s dissatisfaction, especially after revision surgery. General postoperative mortality is increased.
FULL ARTICLE: depression_and_post_surgery_complications.pdf
The interaction of depression and anesthesia and surgery may result in significant increases in morbidity and mortality of patients. Major depressive disorder is a frequent complication of surgery.
Depression is commonly associated with cognitive impairment, which may be exacerbated postoperatively. There is evidence that acute postoperative pain causes depression and depression lowers the threshold for pain. Depression is also a strong predictor and correlate of chronic post-surgical pain. Many studies have identified depression as an independent risk factor for development of postoperative delirium, which may be a cause for a long and incomplete recovery after surgery. Depression is also frequent in intensive care unit patients and is associated with a lower health-related quality of life and increased mortality. Depression and anxiety have been widely reported soon after coronary artery bypass surgery and remain evident one year after surgery. They may increase the likelihood for new coronary artery events, further hospitalizations and increased mortality. Morbidly obese patients who undergo bariatric surgery have an increased risk of depression. Postoperative depression may also be associated with less weight loss at one year and longer. The extent of preoperative depression in patients scheduled for lumbar discectomy is a predictor of functional outcome and patient’s dissatisfaction, especially after revision surgery. General postoperative mortality is increased.
FULL ARTICLE: depression_and_post_surgery_complications.pdf
This Artist Battles Depression (And Metro Delays) With Roller Coaster Doodles
Mid-drawing, Brody Rose fixated on an image in the Washington Post Express, trapped in the trance of creating. He did not want to leave the Metro. “I’m probably the only person on the train who doesn’t have a problem when there’s a delay,” he says.
An associate creative director at HDZG, Rose started drawing in 2010 to fight the nervous knots in his stomach that came when he began the high-pressure creative job. He was diagnosed with depression in 2000, and he wanted to do something productive on his 30-minute commute from Dupont to Rockville.
“When you’re in a depression, everything is sort of glossed over,” he said. “There’s no spark that kind of ignites the creativity.”
So Rose embraced a new puzzle: Fitting a roller coaster into an image from the Washington Post Express.
Click here for the full article.
Click here to listen to 91.1FM WGTD interview of Brody Rose, son of local NAMI president Jack Rose. Brody discusses his experiences in living with depression.
Mid-drawing, Brody Rose fixated on an image in the Washington Post Express, trapped in the trance of creating. He did not want to leave the Metro. “I’m probably the only person on the train who doesn’t have a problem when there’s a delay,” he says.
An associate creative director at HDZG, Rose started drawing in 2010 to fight the nervous knots in his stomach that came when he began the high-pressure creative job. He was diagnosed with depression in 2000, and he wanted to do something productive on his 30-minute commute from Dupont to Rockville.
“When you’re in a depression, everything is sort of glossed over,” he said. “There’s no spark that kind of ignites the creativity.”
So Rose embraced a new puzzle: Fitting a roller coaster into an image from the Washington Post Express.
Click here for the full article.
Click here to listen to 91.1FM WGTD interview of Brody Rose, son of local NAMI president Jack Rose. Brody discusses his experiences in living with depression.
Depression is more than just feeling sad or going through a rough patch.
It’s a serious mental health condition that requires understanding, treatment and a good recovery plan. With early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and lifestyle choices, many people get better. But left untreated, depression can be devastating, both for the people who have it and for their families.
Some people have only one episode in a lifetime, but for most people depression recurs. Without treatment, episodes may last a few months to several years. People with severe depression can feel so hopeless that they become a risk for suicide.
An estimated 16 million American adults—almost 7% of the population—had at least 1 major depressive episode last year. People of all ages and all racial, ethnic and socioeconomic backgrounds can experience depression, but it does affect some groups of people more than others. Women are 70% more likely than men to experience depression, and young adults aged 18–25 are 60% more likely to have depression than people aged 50 or older.
Getting a comprehensive evaluation is important. Underlying medical issues that can mimic a major depressive episode, side effects of other medications (like beta blockers or antihypertensives) or any other medical causes need to be ruled out. Understanding life stressors and prior responses to treatment effort can help shape a good treatment plan. Understanding how any co-occurring conditions fit into the diagnostic picture also informs treatment options.
Symptoms
Just like with any mental health condition, people with depression or who are going through a depressive episode (also known as major or clinical depression) experience symptoms differently. But for most people, depression changes how they function day-to-day.
Changes in sleep. Many people have trouble falling asleep, staying asleep or sleeping much longer than they used to. Waking up early in the morning is common for people with major depression.
Changes in appetite. Depression can lead to serious weight loss or gain when a person stops eating or uses food as a coping mechanism.
Lack of concentration. A person may be unable to focus during severe depression. Even reading the newspaper or following the plot of a TV show can be difficult. It becomes harder to make decisions, big or small.
Loss of energy. People with depression may feel profound fatigue, think slowly or be unable to perform normal daily routines.
Lack of interest. People may lose interest in their usual activities or lose the capacity to experience pleasure. A person may have no desire to eat or have sex.
Low self esteem. During periods of depression, people dwell on losses or failures and feel excessive guilt and helplessness. Thoughts like “I am a loser” or “the world is a terrible place” or “I don’t want to be alive” can take over.
Hopelessness. Depression can make a person feel that nothing good will ever happen. Suicidal thoughts often follow these kinds of negative thoughts—and need to be taken seriously.
Changes in movement. People with depression may look physically depleted or they may be agitated. For example, a person may wake early in the morning and pace the floor for hours.
Physical aches and pains. Instead of talking about their emotions or sadness, some people may complain about a headache or an upset stomach.
How a person describes the symptoms of depression often depends on the cultural lens she is looking through. In Western cultures, people generally talk about their moods or feelings, whereas in many Eastern cultures, people refer to physical pain.
Causes
Depression does not have a single cause. It can be triggered, or it may occur spontaneously without being associated with a life crisis, physical illness or other risk. Scientists believe several factors contribute to cause depression:
Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These brain changes may explain why people who have a history of childhood trauma are more likely to experience depression.
Genetics. Mood disorders and risk of suicide tend to run in families, but genetic inheritance is only one factor. Identical twins share 100% of the same genes, but will both develop depression only about 30% of the time. People who have a genetic tendency to develop depression are more likely to show signs at a younger age. While a person may have a genetic tendency, life factors and events seem to influence whether he or she will ever actually experience an episode.
Life circumstances. Marital status, financial standing and where a person lives have an effect on whether a person develops depression, but it can be a case of “the chicken or the egg.” For example, depression is more common in people who are homeless, but the depression itself may be the reason a person becomes homeless.
Brain structure. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Brain patterns during sleep change in a characteristic way. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety, and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression.
Drug and alcohol abuse. Approximately 30% of people with substance abuse problems also have depression.
Who Gets Depression
Depression affects people of all ages and all racial, ethnic and socioeconomic groups. But different groups of people do experience depression in different ways.
Men. For cultural reasons, men may feel more shame about their depression and simply try to tough it out or use alcohol or drugs to self-medicate. Untreated depression in men can have devastating consequences, as men are about four times more likely to die by suicide than women.
Women. Many factors unique to women’s lives play a role in whether they develop depression, including genetics, biology, reproduction, hormonal changes and interpersonal relationships.
During their menstrual cycles, many women experience behavioral and physical changes. These changes can include depressed feelings, irritability and other emotional and physical changes. Many women with depression experience worse symptoms before their periods. Women who have premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) will experience gradually worsening symptoms until menstruation starts. Researchers are exploring how the cyclical change in hormones may affect the brain chemistry associated with depression.
Many women experience a temporary mood disturbance after childbirth. But an estimated 9-16% of American women will experience postpartum depression, a disorder that occurs after pregnancy. Women with postpartum depression may find it difficult to function day-to-day because the illness can cause anxiety, insomnia, bouts of crying and thoughts of hurting themselves or the child.
Seniors. Depression in elderly people often goes untreated because many people think that depression is a normal part of aging and a natural reaction to chronic illness, loss and social transition. Depression symptoms in older people may differ from younger people’s symptoms. Depression in seniors can be characterized by memory problems, vague complaints of pain and delusions. Depression can be a side effect of some medications commonly prescribed to older persons, such as medications to treat hypertension, and conditions such as heart attack, stroke, hip fracture or macular degeneration are known to be associated with the development of depression.
LGBTQ. Lesbian, gay, bisexual, transgender and questioning (LGBTQ) people are at higher risk for depression because they regularly face discrimination from society at large and sometimes from family, co-workers or classmates. The stigma experienced by some LGBTQ people can make them more vulnerable to mental health conditions like depression.
Children and teens. All children experience ups and downs while growing up, but for some, the downs aren’t commonplace—they are symptoms of depression. Children and teens at higher risk for depression include those who have attention deficit/hyperactivity disorder, learning or anxiety disorders and oppositional defiance disorder. A young person who has experienced considerable stress or trauma, faced a significant loss or has a family history of mood disorders is at increased risk for depression.
Children with depression are more likely to complain of aches and pains than to say they are depressed. Teens with depression may become aggressive, engage in risky behavior, abuse drugs or alcohol, do poorly in school or run away. When experiencing an episode, teens have an increased risk for suicide. In fact, suicide is the third-leading cause of death among children aged 15-19.
Diagnosis
To be diagnosed with depression, a person must have experienced a major depressive episode that has lasted longer than two weeks. The symptoms of a major depressive episode include:
Loss of interest or loss of pleasure in all activities
Change in appetite or weight
Sleep disturbances
Feeling agitated or feeling slowed down
Fatigue
Feelings of low self worth, guilt or shortcomings
Difficulty concentrating or making decisions
Suicidal thoughts or intentions
Diagnosing depression can be complicated because a depressive episode can be part of bipolar disorder or another mental illness. How a person describes symptoms often depends on the cultural lens she is looking through. Research has shown that African Americans and Latinos are more likely to be misdiagnosed, so people who have been diagnosed with depression should look for a health care professional who understands their background and shares their expectations for treatment.
Treatment
Although depression can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and a treatment plan. Today, there are a variety of treatment options available for people with depression.
Medications including antidepressants, mood stabilizers and antipsychotic medications
Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy
Brain stimulation therapies including electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS)
Light therapy, which uses a light box to expose a person to full spectrum light and regulate the hormone melatonin
Exercise
Alternative therapies including acupuncture, meditation and nutrition
Self-management strategies and education
Mind/body/spirit approaches such as meditation, faith and prayer
Though depression cannot be cured, it can be treated effectively.
Related Conditions
A person with depression may have additional conditions:
Anxiety disorders, including posttraumatic stress disorder (PTSD)
Attention-deficit hyperactivity disorder (ADHD)
Substance abuse
These other illnesses can make it hard to treat depression, but successfully treating depression almost always improves these related illnesses. Successful treatment of PTSD, ADHD or substance abuse usually improves the symptoms of depression.
It’s a serious mental health condition that requires understanding, treatment and a good recovery plan. With early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and lifestyle choices, many people get better. But left untreated, depression can be devastating, both for the people who have it and for their families.
Some people have only one episode in a lifetime, but for most people depression recurs. Without treatment, episodes may last a few months to several years. People with severe depression can feel so hopeless that they become a risk for suicide.
An estimated 16 million American adults—almost 7% of the population—had at least 1 major depressive episode last year. People of all ages and all racial, ethnic and socioeconomic backgrounds can experience depression, but it does affect some groups of people more than others. Women are 70% more likely than men to experience depression, and young adults aged 18–25 are 60% more likely to have depression than people aged 50 or older.
Getting a comprehensive evaluation is important. Underlying medical issues that can mimic a major depressive episode, side effects of other medications (like beta blockers or antihypertensives) or any other medical causes need to be ruled out. Understanding life stressors and prior responses to treatment effort can help shape a good treatment plan. Understanding how any co-occurring conditions fit into the diagnostic picture also informs treatment options.
Symptoms
Just like with any mental health condition, people with depression or who are going through a depressive episode (also known as major or clinical depression) experience symptoms differently. But for most people, depression changes how they function day-to-day.
Changes in sleep. Many people have trouble falling asleep, staying asleep or sleeping much longer than they used to. Waking up early in the morning is common for people with major depression.
Changes in appetite. Depression can lead to serious weight loss or gain when a person stops eating or uses food as a coping mechanism.
Lack of concentration. A person may be unable to focus during severe depression. Even reading the newspaper or following the plot of a TV show can be difficult. It becomes harder to make decisions, big or small.
Loss of energy. People with depression may feel profound fatigue, think slowly or be unable to perform normal daily routines.
Lack of interest. People may lose interest in their usual activities or lose the capacity to experience pleasure. A person may have no desire to eat or have sex.
Low self esteem. During periods of depression, people dwell on losses or failures and feel excessive guilt and helplessness. Thoughts like “I am a loser” or “the world is a terrible place” or “I don’t want to be alive” can take over.
Hopelessness. Depression can make a person feel that nothing good will ever happen. Suicidal thoughts often follow these kinds of negative thoughts—and need to be taken seriously.
Changes in movement. People with depression may look physically depleted or they may be agitated. For example, a person may wake early in the morning and pace the floor for hours.
Physical aches and pains. Instead of talking about their emotions or sadness, some people may complain about a headache or an upset stomach.
How a person describes the symptoms of depression often depends on the cultural lens she is looking through. In Western cultures, people generally talk about their moods or feelings, whereas in many Eastern cultures, people refer to physical pain.
Causes
Depression does not have a single cause. It can be triggered, or it may occur spontaneously without being associated with a life crisis, physical illness or other risk. Scientists believe several factors contribute to cause depression:
Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These brain changes may explain why people who have a history of childhood trauma are more likely to experience depression.
Genetics. Mood disorders and risk of suicide tend to run in families, but genetic inheritance is only one factor. Identical twins share 100% of the same genes, but will both develop depression only about 30% of the time. People who have a genetic tendency to develop depression are more likely to show signs at a younger age. While a person may have a genetic tendency, life factors and events seem to influence whether he or she will ever actually experience an episode.
Life circumstances. Marital status, financial standing and where a person lives have an effect on whether a person develops depression, but it can be a case of “the chicken or the egg.” For example, depression is more common in people who are homeless, but the depression itself may be the reason a person becomes homeless.
Brain structure. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Brain patterns during sleep change in a characteristic way. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety, and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression.
Drug and alcohol abuse. Approximately 30% of people with substance abuse problems also have depression.
Who Gets Depression
Depression affects people of all ages and all racial, ethnic and socioeconomic groups. But different groups of people do experience depression in different ways.
Men. For cultural reasons, men may feel more shame about their depression and simply try to tough it out or use alcohol or drugs to self-medicate. Untreated depression in men can have devastating consequences, as men are about four times more likely to die by suicide than women.
Women. Many factors unique to women’s lives play a role in whether they develop depression, including genetics, biology, reproduction, hormonal changes and interpersonal relationships.
During their menstrual cycles, many women experience behavioral and physical changes. These changes can include depressed feelings, irritability and other emotional and physical changes. Many women with depression experience worse symptoms before their periods. Women who have premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) will experience gradually worsening symptoms until menstruation starts. Researchers are exploring how the cyclical change in hormones may affect the brain chemistry associated with depression.
Many women experience a temporary mood disturbance after childbirth. But an estimated 9-16% of American women will experience postpartum depression, a disorder that occurs after pregnancy. Women with postpartum depression may find it difficult to function day-to-day because the illness can cause anxiety, insomnia, bouts of crying and thoughts of hurting themselves or the child.
Seniors. Depression in elderly people often goes untreated because many people think that depression is a normal part of aging and a natural reaction to chronic illness, loss and social transition. Depression symptoms in older people may differ from younger people’s symptoms. Depression in seniors can be characterized by memory problems, vague complaints of pain and delusions. Depression can be a side effect of some medications commonly prescribed to older persons, such as medications to treat hypertension, and conditions such as heart attack, stroke, hip fracture or macular degeneration are known to be associated with the development of depression.
LGBTQ. Lesbian, gay, bisexual, transgender and questioning (LGBTQ) people are at higher risk for depression because they regularly face discrimination from society at large and sometimes from family, co-workers or classmates. The stigma experienced by some LGBTQ people can make them more vulnerable to mental health conditions like depression.
Children and teens. All children experience ups and downs while growing up, but for some, the downs aren’t commonplace—they are symptoms of depression. Children and teens at higher risk for depression include those who have attention deficit/hyperactivity disorder, learning or anxiety disorders and oppositional defiance disorder. A young person who has experienced considerable stress or trauma, faced a significant loss or has a family history of mood disorders is at increased risk for depression.
Children with depression are more likely to complain of aches and pains than to say they are depressed. Teens with depression may become aggressive, engage in risky behavior, abuse drugs or alcohol, do poorly in school or run away. When experiencing an episode, teens have an increased risk for suicide. In fact, suicide is the third-leading cause of death among children aged 15-19.
Diagnosis
To be diagnosed with depression, a person must have experienced a major depressive episode that has lasted longer than two weeks. The symptoms of a major depressive episode include:
Loss of interest or loss of pleasure in all activities
Change in appetite or weight
Sleep disturbances
Feeling agitated or feeling slowed down
Fatigue
Feelings of low self worth, guilt or shortcomings
Difficulty concentrating or making decisions
Suicidal thoughts or intentions
Diagnosing depression can be complicated because a depressive episode can be part of bipolar disorder or another mental illness. How a person describes symptoms often depends on the cultural lens she is looking through. Research has shown that African Americans and Latinos are more likely to be misdiagnosed, so people who have been diagnosed with depression should look for a health care professional who understands their background and shares their expectations for treatment.
Treatment
Although depression can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and a treatment plan. Today, there are a variety of treatment options available for people with depression.
Medications including antidepressants, mood stabilizers and antipsychotic medications
Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy
Brain stimulation therapies including electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS)
Light therapy, which uses a light box to expose a person to full spectrum light and regulate the hormone melatonin
Exercise
Alternative therapies including acupuncture, meditation and nutrition
Self-management strategies and education
Mind/body/spirit approaches such as meditation, faith and prayer
Though depression cannot be cured, it can be treated effectively.
Related Conditions
A person with depression may have additional conditions:
Anxiety disorders, including posttraumatic stress disorder (PTSD)
Attention-deficit hyperactivity disorder (ADHD)
Substance abuse
These other illnesses can make it hard to treat depression, but successfully treating depression almost always improves these related illnesses. Successful treatment of PTSD, ADHD or substance abuse usually improves the symptoms of depression.