Depression

Summary

Depression is a mood disorder that can affect adults, adolescents, and children.  Depression causes a persistent feeling of sadness and loss of interest.  It affects how you feel, think, and behave and it can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.  More than just a bout of the blues, depression isn’t a weakness and you can’t simply “snap out” of it. Depression may require long-term treatment, but don’t get discouraged—most people with depression feel better with psychotherapy, medication, or both.

Symptoms

  • Feelings of sadness, tearfulness, emptiness, or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and low energy
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation, or restlessness
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble concentrating, making decisions, and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
  • Unexplained physical problems, such as back pain or headaches

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences:

  • In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches, and pains, refusing to go to school or being underweight.
  • In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

  • Memory difficulties or personality changes
  • Physical aches or pain
  • Fatigue, loss of appetite, sleep problems, or loss of interest in sex — not caused by a medical condition or medication
  • Often wanting to stay at home, rather than going out to socialize or doing new things
  • Suicidal thinking or feelings, especially in older men

Causes

The medical community does not fully understand the causes of depression. There are many possible causes, and sometimes, various factors combine to trigger symptoms. Factors that are likely to play a role include:

  • Genetic features
  • Changes in the brain’s neurotransmitter levels
  • Environmental factors
  • Psychological and social factors

Risk factors

Some people have a higher risk of depression than others.  These risk factors include:

  • Experiencing certain life events, such as bereavement, work issues, changes in relationships, financial problems, and medical concerns
  • Experiencing acute stress
  • Lacking successful coping strategies
  • Family history of depression or other mood disorders
  • Using some prescription drugs, such as corticosteroids, some beta-blockers, and interferon
  • Using recreational drugs,such as alcohol or amphetamines
  • Having sustained a head injury
  • Having had a previous episode of major depression
  • Having a chronic condition, such as diabetes, chronic obstructive pulmonary disease (COPD), or cardiovascular disease
  • Living with persistent pain

Types of Depression

There are several forms of depression. Below are some of the most common types.

Major Depression – A person with major depression experiences a constant state of sadness and typically have lost interest in activities that they used to enjoy. Treatment usually involves a combination of medication and psychotherapy.

Dysthymia/Persistent Depressive Disorder – Individuals who suffer from this form of depression have experienced the symptoms for a minimum of 2 years. A person with this disorder may have episodes of major depression as well as milder symptoms.

Bipolar Disorder – Depression is a common symptom of bipolar disorder, and research shows that people with this disorder may have these symptoms half of the time. This can make bipolar disorder hard to distinguish from depression.  A person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” ora less severe form called “hypomania.”

Major Depressive Disorder with Seasonal Pattern – Previously called Seasonal Affective Disorder, or SAD, this type of depression is related to the reduction in daylight during the fall and winter months.  It lifts during the rest of the year due to a response to light therapy. People who live in countries with long or severe winters seem to be affected more by this condition.

How is Depression different from sadness or grief/bereavement?

The death of a loved one, the loss of a job, or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being “depressed” but being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression, but it’s necessary to differentiate between the two. Grief and depression may involve intense sadness and withdrawal from usual activities, but here’s how they differ:

In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood, and/or interest (pleasure) are decreased for two weeks or more. In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common. When grief and depression coexist, the grief is more severe and lasts longer than grief without depression. Despite some overlap between grief and depression, they are different and distinguishing between them can help people get the help, support, and treatment they need.

Treatment

Support: This can range from discussing practical solutions and possible causes to educating family members about your depression symptoms. Psychotherapy: This includes one-to-one counseling, and cognitive behavioral therapy (CBT), Interpersonal therapy, or Dialectical Behavioral Therapy (DBT).  All approaches aim to help people identify:

  • Emotional problems that affect relationships and communication
  • How these issues also affect their mood
  • Recognize distorted thinking by addressing the negative thinking patterns,feelings and behaviors.

Medication: Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify and balance out one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers and they are not habit-forming.   Antidepressants may produce some improvement within the first week or two of use, but full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant. In some situations, other psychotropic medications may be helpful. It is important to let your doctor know if a medication does not work or if you experience side effects. Self-Help and Coping:  There are a number of things people can do to help reduce the symptoms of depression. For men, exercise helps create positive feelings and improve mood. Getting enough quality sleep on a regular basis, eating a healthy diet, and avoiding alcohol (a depressant) can also help reduce symptoms of depression.  Avoiding isolating yourself and spending time with other people will help you stay connected and gain support through your treatment. 

Overview

If a person suspects that they have symptoms of depression, they should seek professional help from a doctor or mental health specialist.  A qualified health professional can rule out various causes, ensure an accurate diagnosis, and provide safe and effective treatment. They will accurately assess your symptoms by asking questions pertaining to the level of severity and how long they have been present. A doctor may also conduct an examination to check for physical causes and order a blood test to rule out other health conditions.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately. Also consider these options if you’re having suicidal thoughts:

  • Call your doctor or mental health professional.·
  • Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Use
    that same number and press “1” to reach the Veterans Crisis Line.
  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader, or someone else in your faith community.
  • If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.


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