Symptoms and Types of Depression
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, and recurrent thoughts of death or 0119. A diagnosis of major depressive disorder is made if a person has 5 or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15 to 30 but also can appear in children. Episodes typically recur.
Some people have a chronic but less severe form of depression, called dysthymic disorder, which is diagnosed when depressed mood persists for at least 2 years (1 year in children) and is accompanied by at least 2 other symptoms of depression. Many people with dysthymia develop major depressive episodes.
Episodes of depression also occur in people with bipolar disorder. In this disorder, depression alternates with mania, which is characterized by abnormally and persistently elevated mood or irritability and symptoms including overly-inflated self-esteem, decreased need for sleep, increased talkativeness, racing thoughts, distractibility, physical agitation, and excessive risk taking. Because bipolar disorder requires different treatment than major depressive disorder or dysthymia, obtaining an accurate diagnosis is extremely important.
Facts About Depression
* Major depression is the leading cause of disability in the U.S. and worldwide.
* Depressive disorders affect an estimated 9.5 percent of adult Americans ages 18 and over in a given year or about 18.8 million people in 1998.
* Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive disorder each year.
Depression can be devastating to 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. 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 due to feelings of shame and stigma. Too often, untreated or inadequately treated depression is associated with 0119.
Treatments
Antidepressant medications are widely used, effective treatments for depression. Existing antidepressants influence the functioning of certain chemicals in the brain called neurotransmitters. The newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), tend to have fewer side effects than the older drugs, which include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). Although both generations of medications are effective in relieving depression, some people will respond to one type of drug, but not another. Other types of antidepressants are now in development.
Certain types of psychotherapy, specifically cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been found helpful for depression. Research indicates that mild to moderate depression often can be treated successfully with either therapy alone; however, severe depression appears more likely to respond to a combination of psychotherapy and medication. More than 80 percent of people with depressive disorders improve when they receive appropriate treatment.
In situations where medication, psychotherapy, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms such as psychosis (e.g., hallucinations, delusional thinking) or suicidality, electroconvulsive therapy (ECT) may be considered. ECT is a highly effective treatment for severe depressive episodes. The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.
One herbal supplement, hypericum or St. John's wort, has been promoted as having antidepressant properties. Results from the first large-scale, controlled study of St. John's wort for major depression, which was funded in part by NIMH, are expected in 2001. Note: There is evidence that St. John's wort can reduce the effectiveness of certain medications. Use of any herbal or natural supplements should always be discussed with your doctor before they are tried.
Research Findings
* Brain imaging research is revealing that in depression, neural circuits responsible for moods, thinking, sleep, appetite, and behavior fail to function properly, and that the regulation of critical neurotransmitters is impaired.
* Genetics research, including studies of twins, indicates that genes play a role in depression. Vulnerability to depression appears to result from the influence of multiple genes acting together with environmental factors.
* Other research has shown that stressful life events, particularly in the form of loss such as the death of a close family member, may trigger major depression in susceptible individuals.
* The hypothalamic-pituitary-adrenal (HPA) axis, the hormonal system that regulates the body's response to stress, is overactive in many people with depression. Research findings suggest that persistent overactivation of this system may lay the groundwork for depression.
* Studies of brain chemistry, mechanisms of action of antidepressant medications, and the cognitive distortions and disturbed interpersonal relationships commonly associated with depression, continue to inform the development of new and better treatments.
Further reading...Download a fact sheet that describes the symptoms of depression and the reasons why women are more likely than men to suffer depression...(Depression: What Every Woman Should Know)
http://www.anxietyzone.com/NIMHdepwomenknows.pdfDownload a brochure for men about dealing with depression...(Real Men. Real Depression)
http://www.anxietyzone.com/MENANDDE-coverpage(1).pdfDownload a fact sheet that describes the symptoms and types of depression and effective treatments...(Depression: A Treatable Illness)
http://www.anxietyzone.com/NIMH317.406_F_TSH_treatable.pdfDownload an easy-to-read booklet with a personal story of bipolar disorder -- includes a checklist of symptoms and tips on getting help...(A story of bipolar disorder (manic-depressive illness): Does this sound like you?)
http://www.anxietyzone.com/NIMHstorybipolar.pdfDownload a brief overview of the relationship between depression and heart disease...(Depression Can Break Your Heart)
http://www.anxietyzone.com/NIMHheartbreak.pdfDownload a detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping...(Depression)
http://www.anxietyzone.com/nimhdepression.pdfDownload a fact sheet that describes how to spot depression in friends and get them help...(What to do when a friend is depressed)
http://www.anxietyzone.com/NIMHfriend.pdfDownload a booklet that describes how the stresses of college can lead to depression, with information on symptoms, causes, treatments, and getting help...(What do These Students Have in Common?)
http://www.anxietyzone.com/NIMHstudents.pdf- Source: National Institute of Mental Health (NIMH)
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Topic: About Clinical Depression (Symptoms, Treatments, etc) (Read 7393 times)
December 30, 2008, 05:57:09 PM
