Healthinmind/Mental Health Disorders/Mood Disorders

Depression

Depression is the most common mental health problem. During the course of their  lifetimes, about 1 in every 4 people will experience symptoms that qualify for a diagnosis of depression.

Depression may be a temporary state. Someone can go into a depression for a short time  (maybe 6 months) and then recover and never suffer the constellation of symptoms again. Others have recurrent episodes.

Symptoms of depression (should be present for at least 2 weeks or cause impairment in daily functioning):

	depressed mood for most of the day, on most days. Depressed children and adolescents  may appear irritable instead of depressed.
	less or no interest in activities that used to be enjoyable
	changes in weight, either loss or gain, related to increase in eating or loss of appetite
	changes in sleep, either sleeping much more than usual or having trouble sleeping
	changes in energy level, which can be slowing down (lethargy, psychomotor retardation) or speeding up (psychomotor agitation)
	feeling tired for no reason
	feeling guilty (not necessarily about being sick) or feeling worthless
	problems with concentration, forgetting, having trouble making decisions, etc.
	thoughts of death, maybe comments regarding suicide
	symptoms are not caused by substance abuse (such as alcohol), a medical condition, or bereavement (death of a loved one).

	they know someone who has depression and they don’t think they have the same symptoms. Usually, people don’t experience all of the symptoms. In fact, the symptoms are so varied that two depressed persons may have few symptoms in common, except for the depressed mood.
	there is an obvious reason for the feelings, so they think it is not depression. For example, after the death of a loved one, or the loss of a job, or even after a disagreement with a close friend, these symptoms may appear and seem to be perfectly understandable. However, if the symptoms are making life difficult, and the person can’t seem to "shake them," it’s time to seek help.
	even though it is common for depression to be triggered by life stressors, sometimes it just happens, without any apparent cause. If you recognize the symptoms above, it may be depression, no matter how it started or what caused it. A fascinating new theory about depression is presented in the July-August 2000 issue of American Scientist. The theory is that brain cells are not being produced fast enough in a brain area called the hippocampus, and that the reason certain drugs and electro convulsive shock work is that they stimulate cell production.
	they feel so helpless and hopeless that they can’t seek help. In these cases, family members may try to convince them to get help. If someone you love refuses to seek help, talk to them and try to encourage them. Provide support and try to calm their fears.

If you or someone you love experiences enough symptoms of depression to feel upset about it, you need to consult a mental health professional (clinician, therapist). A mental health professional  will conduct a thorough evaluation  to first understand what is happening and then will discuss treatment options (discussed below).

There are many ways family members or loved ones can help individuals who are depressed to deal with the illness better.   

Other disorders that are related to depression are  Dysthymia  and Bipolar Disorder (or manic depressive illness) Self-help Books: Feeling Good : The New Mood Therapy by David Burns (plus check out the workbook)

Treatment Options:

There are effective treatment options for depression, many of which provide relief within weeks. A recent study indicated that 85% of patients improved when treated with a combination of drugs and psychotherapy. There is no reason to put up with these feelings. Seeking help is a sign of strength, not weakness. Depression is an illness, not a defect of personality.

Psychological Therapies:  There are various types of therapies that can effectively work alone or in conjunction with medication to treat depression. Which therapy will be used depends on:

	The clinician you are working with: some use a variety of techniques; others stick to one technique they have found effective.
	Your specific circumstances, such as the type of depression you have, your personality, your interests, your time limitations, etc.

To get general information on the most common types of therapies used by clinicians today, go to psychotherapies. Be aware that in that page, the therapies are presented individually. It is very common for practitioners to take from various therapies to work with clients. Because of this, you may find that what you read does not exactly match the work you are doing with your therapist.

Read a study (web site) comparing psychotherapy with medication therapy for depression.

Medication Therapy:  There are three major types of medication used effectively to treat depression, they are:

	Reuptake Inhibitors (SSRIs, SATCAs, SNRI, SRIs)
	Tricyclics (TCAs)
	MAO Inhibitors

SSRIs are the newest, with the least side effects; they work by increasing the amount of serotonin in the brain.

It takes about 2 weeks of medication use to start feeling better. Just because you start feeling better doesn’t mean you can stop taking your medication.

Which medication works for you will depend on your specific circumstances. People often go through several different medications, even within the same type, to find the one that works best for them.

Visit our medications page to learn more about psychiatric medications in general and important factors to consider when taking these medications.  That page will lead you to a more detailed description of antidepressant medication and to a table comparing the various antidepressant medications on the market.

Read a case study of a depressed person

Read a book on the subject:

Self-help books:

The Depression Workbook: A Guide for Living With Depression and Manic Depression, by Mary Ellen Copeland, Mary Liz Riddle (Preface), Matthew McKay (Contributor)

Undoing Depression : What Therapy Doesn't Teach You and Medication Can't Give You, by Richard O'Connor

Writers describing their depression:

Darkness Visible : A Memoir of Madness
by William Styron

The Beast : A Journey Through Depression by Tracy Thompson

Books by professionals:

Mind Over Mood: A Cognitive Therapy Treatment for Clients by Dennis Greenberger and Christine Padesky

How to Cope With Depression : A Complete guide for you and your family, by Raymond DePaulo and Keith Ablow (1992) (discusses medication treatments)

Other Resources on the Web:

Wings of Madness
National Institute of Mental Health
National Mental Health Association
National Alliance for the Mentally Ill
Depression Fallout (for families)

                                                                                                                                Last updated  12/19/03