Depression

Definition

Everybody feels sad once in a while. Depression, on the other hand, is a complex condition characterized by profound sadness, lethargy, feelings of worthlessness, and a loss of interest in social activities. About 15 million people in the U.S. are diagnosed with clinical depression each year.

Depression affects all ages, although its onset is most often in the late 20s and early 30s.

Women experience depression at twice the rate of men.

Depression can last for weeks, months, or years (often with stretches of well-being in between)

The triggers can be biological or emotional, or a combination of the two.

Depression is the cause of two-thirds of all reported suicides in the U.S. each year. The rate is higher among older adults.

The positive news is that roughly 80% of depressed people respond positively to medication and/or talk therapy within four to six months of starting treatment. Half of the unsuccessful individuals have ceased taking medication because of side effects or other reasons.

Depression is divided into several subcategories:

Major depression: Also called unipolar depression (as opposed to bipolar), this condition involves a profound mood drop lasting for two weeks or more.

Bipolar disorder: Once called manic depressive illness, this disorder is not actually considered to be depression; it is a mood disorder. It can involve extreme mood swings over weeks or years. The manic phase can be out of control and potentially dangerous to the person and others.

Dysthymia: A chronic and usually long-lasting low-grade depression. It typically starts in childhood or adolescence and may last for many years into adulthood if not treated. It can worsen if untreated.

Seasonal affective disorder (SAD): A type of depression believed to be triggered by inadequate exposure to direct sunlight. It is most evident in places that have long autumns and winters. SAD is commonly treated with “light therapy,” during which you sit in front of a high-intensity fluorescent lamp for a specified time.
Alternate Names

Clinical Depression

Major Depressive Disorder

Dysthymia

Unipolar Depression

Bipolar Disorder
Symptoms

Depression is a complex condition characterized by profound sadness, lethargy, feelings of worthlessness, and a loss of interest in social activities. These feelings can last for two weeks or go on for decades. The difference between the blues and clinical depression is one of duration and severity of symptoms.

Other Major Symptoms:

Irritability

Some 67% to 69% of people who receive a diagnosis of major depression also have muscle and joint pain, headaches, and fatigue.

Difficulty concentrating and remembering

Sluggishness, confusion

Indifference to daily activities

Despair—believing there is no way out

Sleeping too little or too much

Diminished sex drive

Suicidal thoughts

Causes

An imbalance of brain chemicals called neurotransmitters (among them norepinephrine, serotonin, and dopamine) play a role in depression and other mood disorders.

Heredity is another cause. Upwards of 90% of people with depression (or bipolar depression) have a blood relative who has suffered from this disease. Children with one parent who has experienced depression are more likely to get it themselves.

A thyroid imbalance—particularly on the low side—can set the stage for depression.

Severe emotional stress—loss of a loved one, losing a job, moving—can affect brain chemistry.

Regular substance abuse modifies brain chemistry.

New mothers are vulnerable to “postpartum depression,” a depression [http://www.health.com/health/condition-section/0,,20187827,00.html] that generally lasts no longer than two weeks, although in some cases it drags on longer.
Tests

It's fairly easy to ascertain whether you are merely going through the blues or are depressed. The first step may be a thorough physical exam to rule out ailments such as a stroke, brain tumor, or thyroid imbalance.

A detailed interview by your doctor or a mental health professional is crucial to identifying symptoms. Among other things they investigate: frequency of episodes, length of episodes, seriousness of symptoms, effects on cognitive functions, mood, and suicidal thoughts.

A family medical history is assembled, with particular attention to relatives who have suffered from depression or other mood disorders. You may be referred to a psychiatrist or psychologist, who can better evaluate mental health issues than a primary-care physician.

Therapy

So-called “talk therapy” can be extremely effective in uncovering emotional issues underlying depression. Studies show that a combination of psychotherapy and medication is more effective than either alone There are several kinds of talk therapy:.

Traditional psychotherapy: This helps you make cathartic connections with troublesome issues in the past, some of which are entirely sublimated. Psychotherapy also addresses harmful and negative thought patterns and behaviors. Psychotherapy by itself can relieve depression, although it can take months or years. For this reason it is best to seek immediate relief from medication at the same time therapy commences.

Cognitive behavioral therapy:This talk therapy is based on the concept that your problems are rooted in the present and not necessarily in the distant past. It entails recognizing your distorted thoughts and beliefs and acting to change them.

Family-focused therapy: Family members participate in discussions to help them understand the psychodynamics of bipolar illness and to learn how to cope and recognize danger signs.

Interpersonal and social rhythm therapy: This therapy helps bipolar individuals improve interpersonal relationships and structure their often-chaotic daily routines (meals, sleep, study).
Medication

Individuals respond to medications in different ways. If one doesn't work there are many more to try, likely in combination. Antidepressants aim to stabilize and facilitate brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists investigating depression have found that these chemicals are central in regulating mood, but they are unsure of the precise reason.

Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressant medications, going by the names fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), and others.

Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) act similarly to SSRIs and may prove effective when others are not. These include venlafaxine (Effexor) and duloxetine (Cymbalta).

Monoamine oxidase inhibitors (MAOIs) are one of the earliest antidepressants; they sometimes works when all others fail. The MAOI Phenelzine (Nardil) also treats phobias mixed with depression. It works by reducing the amount of monoamine oxidase, an enzyme that breaks down certain neurotransmitters that are important for regulating mood. By inhibiting MAO, Nardil helps restore more normal mood states.

Mood stabilizers are highly effective in providing stability to those on the roller coaster of bipolar illness and are standard treatment for unipolar depression as well. The most common is lithium (Eskalith and Lithobid). Others are valproic acid (Depakene) and divalproex sodium (Depakote).

Anticonvulsants, a category of drugs developed to prevent seizures, have also proven effective with depression. They are often prescribed along with lithium and include: lamotrigine (Lamictal), gabapentin (Neurontin), topiramate (Topamax), and oxcarbazepine (Trileptal).

Antipsychotics, like anticonvulsants, are prescribed for severe cases of mental illness; at the same time they have the ancillary benefit of relieving depression, and with few or no harmful effects. Some of the most widely prescribed are: olanzapine (Zyprexa), aripiprazole (Abilify), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon).
Other Treatments

Electroconvulsive therapy (ECT): When medication and/or talk therapy prove ineffective, this treatment can serve as a last resort. It's highly successful; 75% of patients get relief after several weeks of treatments (typically two to three sessions a week). Most patients relapse within six months, but antidepressants and therapy can help prevent recurrence.; MayoClinic.com
Resources

Research scientists rarely agree on the best treatment for depression, bipolar disorder, and other similar conditions. But there is one area where something like consensus is emerging: the benefits of support groups for people suffering from mental disorders, either as an adjunct to therapy or alone.

The results of studies of such programs consistently show reduced symptoms and substance abuse, reduction in hospitalizations, improved social skills, and increased self-esteem and healthy behavior in people who participate.

Online support groups are also valuable, and are the preferred choice for many sufferers. In one study, 47% of chronically depressed, socially isolated people who participated regularly in online groups reported a reduction in symptoms. Notably, nearly 40% of the participants said they preferred the online support groups to face-to-face counseling.
Coping

For people with a history of depression or bipolar disorder, the risk of relapse looms like a cloud over their lives, threatening to separate them from their work, relationships, even their children. Stress, sleep deprivation, hormonal shifts, and stopping treatment are among the most common relapse triggers.

The National Mental Health Information Center at the U.S. Department of Health and Human Services lists numerous triggers. Here are five:

• Interpersonal friction

• Feeling overwhelmed or having too much to do

• Being judged or criticized

• Ending a relationship

• Physical illness

The temptation to stop treatment on your own is another trigger, one that can lead to a downward spiral. If you are in the midst of a relapse, it's critical to realize that your outlook on everything is altered, and it's unlikely that you will be aware of your lack of perspective. To the extent possible, important decisions should be delayed, say experts.
Definition

Everybody feels sad once in a while. Depression, on the other hand, is a complex condition characterized by profound sadness, lethargy, feelings of worthlessness, and a loss of interest in social activities. About 15 million people in the U.S. are diagnosed with clinical depression each year.

Depression affects all ages, although its onset is most often in the late 20s and early 30s.

Women experience depression at twice the rate of men.

Depression can last for weeks, months, or years (often with stretches of well-being in between)

The triggers can be biological or emotional, or a combination of the two.

Depression is the cause of two-thirds of all reported suicides in the U.S. each year. The rate is higher among older adults.

The positive news is that roughly 80% of depressed people respond positively to medication and/or talk therapy within four to six months of starting treatment. Half of the unsuccessful individuals have ceased taking medication because of side effects or other reasons.

Depression is divided into several subcategories:

Major depression: Also called unipolar depression (as opposed to bipolar), this condition involves a profound mood drop lasting for two weeks or more.

Bipolar disorder: Once called manic depressive illness, this disorder is not actually considered to be depression; it is a mood disorder. It can involve extreme mood swings over weeks or years. The manic phase can be out of control and potentially dangerous to the person and others.

Dysthymia: A chronic and usually long-lasting low-grade depression. It typically starts in childhood or adolescence and may last for many years into adulthood if not treated. It can worsen if untreated.

Seasonal affective disorder (SAD): A type of depression believed to be triggered by inadequate exposure to direct sunlight. It is most evident in places that have long autumns and winters. SAD is commonly treated with “light therapy,” during which you sit in front of a high-intensity fluorescent lamp for a specified time.
Alternate Names

Clinical Depression

Major Depressive Disorder

Dysthymia

Unipolar Depression

Bipolar Disorder
Symptoms

Depression is a complex condition characterized by profound sadness, lethargy, feelings of worthlessness, and a loss of interest in social activities. These feelings can last for two weeks or go on for decades. The difference between the blues and clinical depression is one of duration and severity of symptoms.

Other Major Symptoms:

Irritability

Some 67% to 69% of people who receive a diagnosis of major depression also have muscle and joint pain, headaches, and fatigue.

Difficulty concentrating and remembering

Sluggishness, confusion

Indifference to daily activities

Despair—believing there is no way out

Sleeping too little or too much

Diminished sex drive

Suicidal thoughts

Causes

An imbalance of brain chemicals called neurotransmitters (among them norepinephrine, serotonin, and dopamine) play a role in depression and other mood disorders.

Heredity is another cause. Upwards of 90% of people with depression (or bipolar depression) have a blood relative who has suffered from this disease. Children with one parent who has experienced depression are more likely to get it themselves.

A thyroid imbalance—particularly on the low side—can set the stage for depression.

Severe emotional stress—loss of a loved one, losing a job, moving—can affect brain chemistry.

Regular substance abuse modifies brain chemistry.

New mothers are vulnerable to “postpartum depression,” a depression [http://www.health.com/health/condition-section/0,,20187827,00.html] that generally lasts no longer than two weeks, although in some cases it drags on longer.
Tests

It's fairly easy to ascertain whether you are merely going through the blues or are depressed. The first step may be a thorough physical exam to rule out ailments such as a stroke, brain tumor, or thyroid imbalance.

A detailed interview by your doctor or a mental health professional is crucial to identifying symptoms. Among other things they investigate: frequency of episodes, length of episodes, seriousness of symptoms, effects on cognitive functions, mood, and suicidal thoughts.

A family medical history is assembled, with particular attention to relatives who have suffered from depression or other mood disorders. You may be referred to a psychiatrist or psychologist, who can better evaluate mental health issues than a primary-care physician.

Therapy

So-called “talk therapy” can be extremely effective in uncovering emotional issues underlying depression. Studies show that a combination of psychotherapy and medication is more effective than either alone There are several kinds of talk therapy:.

Traditional psychotherapy: This helps you make cathartic connections with troublesome issues in the past, some of which are entirely sublimated. Psychotherapy also addresses harmful and negative thought patterns and behaviors. Psychotherapy by itself can relieve depression, although it can take months or years. For this reason it is best to seek immediate relief from medication at the same time therapy commences.

Cognitive behavioral therapy:This talk therapy is based on the concept that your problems are rooted in the present and not necessarily in the distant past. It entails recognizing your distorted thoughts and beliefs and acting to change them.

Family-focused therapy: Family members participate in discussions to help them understand the psychodynamics of bipolar illness and to learn how to cope and recognize danger signs.

Interpersonal and social rhythm therapy: This therapy helps bipolar individuals improve interpersonal relationships and structure their often-chaotic daily routines (meals, sleep, study).
Medication

Individuals respond to medications in different ways. If one doesn't work there are many more to try, likely in combination. Antidepressants aim to stabilize and facilitate brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists investigating depression have found that these chemicals are central in regulating mood, but they are unsure of the precise reason.

Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressant medications, going by the names fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), and others.

Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) act similarly to SSRIs and may prove effective when others are not. These include venlafaxine (Effexor) and duloxetine (Cymbalta).

Monoamine oxidase inhibitors (MAOIs) are one of the earliest antidepressants; they sometimes works when all others fail. The MAOI Phenelzine (Nardil) also treats phobias mixed with depression. It works by reducing the amount of monoamine oxidase, an enzyme that breaks down certain neurotransmitters that are important for regulating mood. By inhibiting MAO, Nardil helps restore more normal mood states.

Mood stabilizers are highly effective in providing stability to those on the roller coaster of bipolar illness and are standard treatment for unipolar depression as well. The most common is lithium (Eskalith and Lithobid). Others are valproic acid (Depakene) and divalproex sodium (Depakote).

Anticonvulsants, a category of drugs developed to prevent seizures, have also proven effective with depression. They are often prescribed along with lithium and include: lamotrigine (Lamictal), gabapentin (Neurontin), topiramate (Topamax), and oxcarbazepine (Trileptal).

Antipsychotics, like anticonvulsants, are prescribed for severe cases of mental illness; at the same time they have the ancillary benefit of relieving depression, and with few or no harmful effects. Some of the most widely prescribed are: olanzapine (Zyprexa), aripiprazole (Abilify), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon).
Other Treatments

Electroconvulsive therapy (ECT): When medication and/or talk therapy prove ineffective, this treatment can serve as a last resort. It's highly successful; 75% of patients get relief after several weeks of treatments (typically two to three sessions a week). Most patients relapse within six months, but antidepressants and therapy can help prevent recurrence.; MayoClinic.com
Resources

Research scientists rarely agree on the best treatment for depression, bipolar disorder, and other similar conditions. But there is one area where something like consensus is emerging: the benefits of support groups for people suffering from mental disorders, either as an adjunct to therapy or alone.

The results of studies of such programs consistently show reduced symptoms and substance abuse, reduction in hospitalizations, improved social skills, and increased self-esteem and healthy behavior in people who participate.

Online support groups are also valuable, and are the preferred choice for many sufferers. In one study, 47% of chronically depressed, socially isolated people who participated regularly in online groups reported a reduction in symptoms. Notably, nearly 40% of the participants said they preferred the online support groups to face-to-face counseling.
Coping

For people with a history of depression or bipolar disorder, the risk of relapse looms like a cloud over their lives, threatening to separate them from their work, relationships, even their children. Stress, sleep deprivation, hormonal shifts, and stopping treatment are among the most common relapse triggers.

The National Mental Health Information Center at the U.S. Department of Health and Human Services lists numerous triggers. Here are five:

• Interpersonal friction

• Feeling overwhelmed or having too much to do

• Being judged or criticized

• Ending a relationship

• Physical illness

The temptation to stop treatment on your own is another trigger, one that can lead to a downward spiral. If you are in the midst of a relapse, it's critical to realize that your outlook on everything is altered, and it's unlikely that you will be aware of your lack of perspective. To the extent possible, important decisions should be delayed, say experts.

Read more: http://www.righthealth.com/topic/depression/overview/healthcomunique#ixzz1FOcFgoNT