Depression

Depression is a serious medical illness. In contrast to the normal emotional experiences of sadness, loss, or passing mood states, clinical depression is persistent and can interfere significantly with an individual's ability to function.

There are two schools of thought governing depression. One maintains that depression is indogenous [That you are born with a propensity to be depressed] requiring medication to reinstate a balance in body chemistry. The other maintains that Depression has to do with certain repressed feelings that are learned, and with the proper insight and implementation changes are made to rid one of the Depression. When the symptoms are pronounced, a combination of psychotherapy and medications may be indicated.

Depression can be devastating to all areas of a person's everyday life, including family relationships, friendships, and the ability to work or go to school. Many people still believe that the emotional symptoms caused by depression are "not real," and that a person should be able to shake off the symptoms if only he or she were trying hard enough. Because of these inaccurate beliefs, people with depression either may not recognize that they have a treatable disorder or may be discouraged from seeking or staying on treatment because of feelings of shame and stigma. Too often, untreated or inadequately treated depression leads to suicide.

Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive illness each year. Evidence from studies of twins supports the existence of a genetic component to risk of depression. Research has shown that stress in the form of loss, especially death of close family members or friends, may trigger major depression in vulnerable individuals.

ARE YOU DEPRESSED???
This quick, simple self-test can help distinguish between clinical depression and normal feelings of being "down in the dumps." It's common to get "the blues" from time to time. Many people experience difficulties over job lay-offs, divorce, the death of a loved one, or other major losses. Sadness is a normal part of life. But when sadness never returns to gladness, it becomes what mental health authorities call the nation's leading psychological problem: clinical depression, also known as major depression.

1) Much of the time, do you feel:

Sad? Lethargic? Pessimistic? Hopeless? Worthless? Helpless?

2) Much of the time, do you:

Have difficulty making decisions? Have trouble concentrating? Have memory problems?

3) Lately, have you:

Lost interest in things that used to give you pleasure? Had problems at work or in school? Had problems with your family or friends? Isolated yourself from others, or wanted to?

4) Lately, have you:

Felt low energy? Felt restless and irritable? Had trouble falling asleep, staying asleep, or getting up in the morning? Lost your appetite, or gained weight? Been bothered by persistent headaches, stomach aches, or back aches? Muscle or joint pains?

5) Lately, have you:

Been drinking more alcohol than you used to? Been taking more mood-altering drugs than you used to? Engaged in risky behavior -- not wearing a seat belt? Crossing streets without looking?

6) Lately, have you been thinking about:

Death? Hurting yourself? Your funeral? Killing yourself?

If you answered "yes" to more than two of the preceding questions, you may well be depressed. Consult your physician or a mental health professional.

Symptoms of depression include:

• sad mood
• loss of interest or pleasure in activities that were once enjoyed
• change in appetite or weight
• difficulty sleeping or oversleeping
• physical slowing or agitation
• energy loss
• feelings of worthlessness or inappropriate guilt
• difficulty thinking or concentrating
• recurrent thoughts of death or suicide.

A diagnosis of depression is made if a person has five or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period.

Episodes typically recur. Some people have a chronic but less severe form of depression, called dysthymia (or dysthymic disorder), that is diagnosed when depressed mood persists for at least two years and is accompanied by at least two other symptoms of depression. Many people with dysthymia also have major depressive episodes. While unipolar major depression and dysthymia are the primary forms of depression, a variety of other subtypes exist.

Treatment
Antidepressant medications are widely used, effective treatments for depression. Existing antidepressant drugs are known to influence the functioning of certain neurotransmitters (chemicals used by brain cells to communicate), primarily serotonin, norepinephrine, and dopamine, known as monoamines.

Some people will respond to one type of drug, but not another. Medications that take entirely different approaches to treating depression are now in development.

Electroconvulsive therapy (ECT), although not generally used as a first-line treatment, is one of the effective treatments for severe depression.

Psychotherapy is also effective for treating depression. Certain types of psychotherapy, cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been shown to be particularly useful. More than 80 percent of people with depression improve when they receive appropriate treatment with medication, psychotherapy, or the combination. Recently there has been enormous interest in herbal remedies for various medical conditions including depression. One herbal supplement, hypericum or St. John's Wort, has been promoted as having antidepressant properties. However, no carefully designed studies have determined the antidepressant efficacy of the supplement.