Depression

What Is Depression?
Depression is an illness that involves feelings of sadness lasting for two weeks or longer, often accompanied by a loss of interest in life, hopelessness, and decreased energy. Such distressing feelings can affect one's ability to perform the usual tasks and activities of daily living.
This is considered to be clinical depression. It is very different from a temporary case of "the blues" triggered by an unhappy event or stressful situation.
Depression affects the mind, but this doesn't mean "it's all in your head." Depression is a medical illness linked to changes in the biochemistry of the brain.
Depression is not a weakness of character. Being depressed doesn't mean a person is inadequate. It means the person has a medical illness that is just as real as diabetes or ulcers. Like other medical disorders, clinical depression should not be ignored or dismissed. A clinically depressed person cannot simply "snap out of it" any more than a person with an ulcer could simply will it away.
But depression is highly treatable in the vast majority of cases. Up to 90 per cent of depressed people respond positively to treatment. Sometimes psychotherapy or counseling is all that is needed, but there is also a wide array of effective antidepressant medications and alternatives available.
Clinical depression is an umbrella term used to describe the most common forms of depression, which include:
Major depression, also known as melancholia or unipolar depression, can last up to a year if not treated. A person experiencing an episode of major depression will experience some physical problems, such as headaches or digestive upset, in addition to emotional difficulties.
Bipolar disorder, once called manic depression, causes mood swings that soar to unusual elation, and then plummet to depression. A person with severe bipolar disorder may also see or hear things that are not there and experience paranoia (a feeling that they are in danger).
Dysthymia is a chronic (ongoing), low-grade depression. It often begins in childhood or adolescence and may last for many years in adulthood if not treated. It is a less severe form of clinical depression, but at times it can be almost as disabling as major depression.
Seasonal affective disorder (SAD) is a form of depression thought to be triggered by a decrease in exposure to sunlight. In the Northern Hemisphere, the condition usually occurs in late fall and winter, when daylight hours are short, and it is more common in geographical areas that have four clearly defined seasons.
Nice To Know:
Perhaps nowhere is the connection between mind, body, wellness, and illness more striking than in depression. It is now believed that human emotions, including sadness, elation, and anxiousness, are governed to some extent by chemical reactions in the brain. That is only the beginning. Scientists have only recently begun to unravel the complex interplay between factors that contribute to depression. Illness, heredity, psychological traits, and social environment are all believed to play a role.
Facts about Depression
Depression affects nearly 17 million Americans.
It is the most common mental illness, yet fewer than half of depressed people seek help.
Depression affects one in five people at some point in their life.
It is the leading cause of suicide.
It reportedly afflicts twice as many women as men (although some observers speculate that this could be because fewer men admit they need treatment).
Depression affects four times as many people over age 65 as those in other age groups.
Depression has affected countless accomplished people throughout history, including Abraham Lincoln, Ernest Hemingway, Peter Tchaikovsky, Charles Dickens, Virginia Woolf, and Mary Shelley.
The number of people who experience depression has increased with every generation since World War II.
Nice To Know
Facts about The Form of Depression Known as Bipolar Disorder:
- Bipolar disorder occurs in about one in 10 people with clinical depression.
- It usually begins before the age of 30.
- It strikes men and women equally.
- It is twice as likely as major depression to run in families.
- Bipolar disorder triggers more frequent and severe episodes of illness than does major depression.
- Seasonal Affective Disorder (SAD)
Definition
A form of depression that recurs with a fall-winter onset and a spring-summer remission (also known as SAD).
Causes, Incidence, and Risk Factors
The cause of seasonal affective disorder (SAD) is not known, but is thought to be related to the body's temperature and hormone regulation. The disorder is rare, and most people with the "winter blahs" or cabin fever do not have SAD. The disorder may have its onset in adolescence or early adulthood, and it occurs more frequently in women than in men.
Symptoms
- depression with a fall or winter onset
- lack of energy
- decreased interest in work or significant activities
- increased appetite with weight gain
- carbohydrate cravings
- increased sleep, excessive daytime sleepines
- social withdrawal
- afternoon slumps with decreased energy and concentration
- slow, sluggish, lethargic movement
Signs and tests
A psychological evaluation rules out other causes for the symptoms and confirms the diagnosis.
Treatment
Light therapy for varying periods of time under special bright light seems to make the symptoms subside. However, the symptoms usually reappear when the therapy is discontinued. Full-spectrum fluorescent light is being investigated as a treatment.
Expectations (prognosis)
The outcome is expected to be good with continuous treatment. Some people may be affected with this disorder throughout their lives.
Complications
The disorder can sometimes progress to a full major depressive syndrome, but spontaneous remission (especially with the change of seasons) is common.
Calling Your Health Care Provider
Call for an appointment with your health care provider if you experience symptoms of seasonal affective disorder and it is affecting your lifestyle or work.
Prevention
Unknown
How Is Depression Treated?
Depending on The Type And Severity of Depression, Treatment May Involve:
- Psychotherapy (counseling), which is the treatment of mental and emotional disorders by psychologic techniques and counseling
- Antidepressant medications which can restore proper chemical balance in the brain
- Other treatments such as light therapy and electroconvulsive therapy
- Treatment is successful in 80per cent to 90per cent of clinically depressed people.
- In mild to moderate depression, psychotherapy may be all that is needed.
- Regular exercise is also beneficial for helping to uplift mood in milder forms of depression.
- If symptoms don't improve in a couple of months, and certainly in more severe cases of depression, medication may be recommended.
- If there is a risk of suicide, medication or hospitalization may be necessary right away
- For some people, the best and most lasting results are obtained with a combination of psychotherapy and antidepressant medication
- To be considered recovered, one must be in remission - that is, symptoms must not be present - for four to six months. The person should have returned to his or her usual ways of thinking, feeling, and behaving
Submitted By
Christos Ballas Md.
Author is Christos Ballas, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA.
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