Depression is a mood disorder that reduces the ability to think clearly, feel pleasure, express love, perform on the job and maintain good health. Although this disorder begins in the mind, the consequences of depressed mood radiate outward, affecting all areas of mental, physical and social life.
Although all of us feel down sometimes, for most of us, these feelings tend to pass relatively quickly. People with depression feel down for most of each day, for weeks, months or even years on end.
Millions of Americans suffer with one of many forms of depression. Some get effective treatment and recover quickly; many never receive a diagnosis or treatment, and so struggle with depressive symptoms for years.
Different Types of Depression
While many people know about "major depression" there are actually a number of depressive illnesses, such as:
- Major Depression – A serious form of depression that causes pervasive depressive symptoms for most of each day, for 2 or more consecutive weeks.
- Atypical Depression – Similar to major depression with one distinction; people with atypical depression can enjoy transient pleasurable activities (such as going out socially with friends), while people with major depression generally cannot.
- Dysthymia - A long lasting chronic form of milder depression. Many people experience this vastly under-diagnosed condition for years or even decades.
- Postpartum Depression – A period of depression that occurs after giving birth (not the very commonly experienced, "baby blues").
- Seasonal Affective Disorder (SAD) – A cyclical form of depression that emerges with the changing of the seasons, most commonly beginning in late fall and ending in spring. Many believe that SAD is caused by variable sunlight levels over the course of a year.
- Bipolar Disorder – Characterized by a cycling between states of depression and states of mania.
Although people may rarely speak of mental illness in the family, depression affects many of us.
Between 16 and 20 million Americans experience major depression during any given year, 3.3 million experience dysthymia and 5.7 million experience bipolar disorder.
Although first line treatments for depression can cause symptoms betterment in about two thirds of people, only a fraction of people with depressive illnesses receive appropriate care.
What Are the Symptoms of Depression?
Depression Symptoms - the difference between normal feelings of sadness and different types of depression:
All of us experience many of the symptoms of depression at times in life, but for a diagnosis of depression, symptoms must last for 2 weeks or longer, for most of every day.
The two most commonly experienced symptoms of major depression are:
- Feeling sad, or down for most of every day for two weeks or longer
- An inability to feel pleasure from previously enjoyable activities
Other symptoms include:
- Fatigue or lethargy
- Insomnia or oversleeping
- Frequent weeping or crying
- Low self esteem or self confidence
- An inability to make decisions, or concentrate
- Feelings of worthlessness
- Unexplained guilt
- Changes in eating habits and weight
- Headaches, stomachaches without cause or reason
- Social isolation
- Suicidal ideation
Few people will experience all of these symptoms.
Who Gets Depression?
Depression can affect children, teens, young and older adults and seniors. The most common period of onset ranges from 18 to 45 years of age, with a median age of 32. Women are about twice as likely as men to experience depression, although this statistic may reflect a male reluctance to admit to emotional problems. Although men are less often diagnosed with depression, depressed men are many times more likely to commit suicide than depressed women.
What Causes Depression?
Certain environmental and genetic factors interact to increase a person's susceptibility to depression. Although depression has a strong genetic component, many people with a strong familial history of the disorder escape it, and many people without a family history of depression succumb. Genetics tells only part of the story.
Factors that increase the risks of depression include:
- Drug or alcohol abuse
- Childhood trauma
- Chronic stress
- Extreme acute stress (bereavement or a job loss, for example)
- A negative personality
- Social isolation
- Being a woman
- Being in a difficult or unsatisfactory love relationship
- Serious medical illness
- Giving birth
Common Treatments for Depression
Depression is a treatable disease. In most cases, people who receive medication, talk therapy or a combination of psychotherapy and medication will start to feel much better.
Antidepressant medications and psychotherapy are the 2 most commonly recommended treatments for major depression.
Many studies indicate that for mild to moderate depression, certain forms of talk therapy, such as cognitive behavioral therapy, will work as well as medication to control depressive symptoms.
Anti depressant medications, such as SSRIs, MAOIs and tricyclic anti depressants work very well for about two thirds of people. Medication treatment is almost always indicated for severe major depression and often recommended for mild and moderate depression as well. Doctors will often recommend a combined treatment of psychotherapy and medication, to maximize the likelihood of efficacy.
Because most people tolerate the SSRIs (Prozac, Zoloft, etc.) best, medications from this class are the most commonly prescribed form of anti depressant. Although most people tolerate the SSRIs better than other varieties of anti depressant medications, SSRIs do produce side effects, cause a physical dependency and are associated with an increased risk of suicide for those under 25.
The herbal medication, St. John's Wort, has shown efficacy in several clinical trials, particularly for mild to moderate depression. European mental health professionals recommend the use of this complimentary therapy with far greater frequency than their American counterparts.
Electroconvulsive therapy (ECT) is sometimes used when medication does not help to control the symptoms of severe depression or when suicidal thoughts require an immediate treatment response. Today's ECT bears little resemblance to the ECT treatments of the 1950's. Today, patients are given very small and focused electro stimulation while under general anesthesia. Side effects can include memory problems, but most people find that ECT provides immediate relief from depressive symptoms.
A newer form of therapy, transcranial magnetic stimulation, may provide many of the benefits of ECT with fewer side effects, although this treatment remains experimental.
(Bipolar disorder treatments are somewhat different)
What Lifestyle Changes Can Help?
Although lifestyle changes are rarely an effective substitute for clinical treatment and or medication, making a few easy changes can help to prevent depression, or shorten/reduce the severity of experienced symptoms.
Improving eating habits can have a substantial impact, and in some cases, depressive symptoms result from vitamin and mineral deficiencies. Ensure adequate consumption of vitamin B (complex) vitamin C, folate, calcium, zinc, manganese, magnesium, iron and potassium; and increase consumption of omega 3 fatty acids and whole grain carbohydrates. Avoid alcohol, caffeine, aspartame, white sugar and highly processed carbohydrates; and eat on a regular schedule, 3 or more times daily. You are what you eat and the way you eat affects the way you feel!
Getting enough sunshine can help people with certain forms of depression and regular moderate exercise is a must for anyone with the disorder. Get out for a brisk half hour walk at lunch-time each day and get your sun and exercise at the same time!
Sleep as well as you can, ensuring 8 hours of sleep per night, force yourself to get out of the house and spend time with friends and family and give yourself a break from stress, by limiting your work commitments during a time of depression.
Supporting a Loved One with Depression
It can be painful to watch a loved one experience a clinical depression. Thankfully, friends and family can help to ease the burdens caused by depression.
- Getting educated
- Encouraging treatment and treatment compliance
- Being there to listen
- Getting him or her out of the house (plan social and fun activities)
- Help to reduce stress by helping around the house, on the job or with the kids
Page last updated 07/07/2015