Depression

WHAT IS DEPRESSION?

Depression is a depressive disorder that involves a person’s body, mood, and thoughts. It can affect and disrupt eating, sleeping, or thinking patterns, and is not the same as being unhappy or in a “blue” mood, nor is it a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better. Treatment is often necessary and many times crucial to recovery.

TYPES OF DEPRESSION

Depressive disorders come in different forms, just as other illnesses such as heart disease do. Three of the most prevalent types of depressive disorders are:

Major Depression
A person who is badly depressed during a single, severe period is said to have had an episode of major depression. More severe symptoms mark the period as an episode of major depression. The key to judging this gradation lies in the amount of change a person undergoes in his or her normal patterns along with a loss of interest and a lack of pleasure.

Dysthymia
For people who suffer with recurrent or long-lasting depression, who almost always seem to have symptoms of a mild form of the illness, the diagnosis is dysthymia. These people may also have major depressive episodes, too, which causes double depression — a condition that demands careful treatment and close follow-up.

Bipolar Disorder
In bipolar depression, the lows alternate with terrible highs, which scientists now believe is the product of an imbalance in the brain chemistry. It can be treated successfully about 80 percent of the time with balance-restoring medications. Symptoms of the lows of bipolar disorder are much the same as for all depressive disorders. Symptoms of the highs of bipolar disorder include:

  • disconnected and racing thoughts grandiose notions inappropriate elation inappropriate irritability
  • inappropriate social behavior increased sexual desire increased talking markedly increased energy
  • poor judgment
  • severe insomnia

Within these types there are variations in the number of symptoms, their severity, and persistence.

CAUSES OF DEPRESSION

Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Some types of depression run in families, indicating that a biological vulnerability can be inherited. However, additional factors, possibly a stressful environment, are also involved.

What genetic factors are often associated with depression?
Major depression has been seen to occur, generation after generation, in some families. However, it can also occur in people whose family has no history of depression. Whether genetically-based or not, major depressive disorder is often associated with an imbalance (or having too little or too much) of certain neuro-chemicals in the body.

What psychological factors are often associated with depression?
Psychological makeup also plays a role in vulnerability to depression. People who have low self- esteem, who consistently view themselves and the world with pessimism, or who are readily overwhelmed by stress are more prone to depression than others.

What specific events are often associated with depression?
Any significant, unwelcome change in life pattern may trigger depression or a depressive episode. For example:

  • chronic illness
  • difficult relationships
  • financial problems
  • serious loss

TREATMENT FOR DEPRESSION

Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression. During any one year period, 17.6 million American adults or 10 percent of the population suffer from depressive illness.

Depression is one of the most treatable mental illnesses. The American Psychiatric Association reports that “between 80 and 90 percent of all depressed people respond to treatment and nearly all depressed people who receive treatment experience at least some relief from their symptoms.”

Along with the great strides made in understanding the causes of depression, scientists are closer to understanding how treatment of the illness works.

Medical/physical evaluation for treating depression
Depression is a complex illness, and many factors in a depressed person’s life may affect their condition. Therefore, a complete medical evaluation is essential. For example, some common illnesses and some commonly used medications can bring on depression. A medical evaluation will reveal the presence of these conditions or medicines.
The physician may also perform or order a physical exam for the patient to rule out an undiagnosed medical problem(s) that might lead to depressive illness.

A psychiatric history and a mental status examination will be performed to provide the patient’s emotional background and uncover changes in the patient’s mood, thoughts, patterns of speech, and memory.
Generally, based on the outcome of the evaluations, treatment for depressive disorders includes medication or psychotherapy, or a combination of the two treatment methods.

Medication as treatment for depression
Newer antidepressant medications have become available, and more are being developed for the treatment of depression. The effectiveness of these drugs depends on general health, weight, metabolism, and other characteristics unique to that patient.

Generally, antidepressant drugs become fully effective within three to six weeks after a person begins taking them. Physicians generally prescribe one of four major types of medication used to treat depression:

  • heterocyclics
  • lithium
  • MAO inhibitors
  • serotonin reuptake blockers

Consult your physician for more specific information concerning medication for the treatment of depression.