Depression

What is depression?

When doctors talk about depression, they mean the medical illness called major depression. Someone who has major depression has symptoms nearly every day, all day, for 2 weeks or longer. There is also a minor form of depression that causes less severe symptoms. Both kinds of depression have the same causes and treatment.

Depression can affect people of all ages and is different for every person. A person who has depression can’t control his or her feelings. If you or your child, teen, or older relative is depressed, it’s not his or her fault. Left untreated, depression can last for weeks, months, or even years.

Is depression more common in women than in men?

Yes. Women are twice as likely as men to experience depression. The reason for this is unknown. Changes in a woman’s hormone levels may be related to depression.

What are the symptoms of depression?

The symptoms of depression are different for every person. You may have one or many of the symptoms listed below. Your symptoms may include only emotional or only physical symptoms, or both. The symptoms of depression may be different for children, teens, and seniors.

Emotional symptoms

  • Crying easily or for no reason.
  • Feeling guilty or worthless.
  • Feeling restless, irritated, and easily annoyed.
  • Feeling sad, numb, or hopeless.
  • Losing interest or pleasure in things you used to enjoy (including sex).
  • Thinking about death or suicide.

Physical symptoms

  • Changes in appetite (eating more than usual, or eating less than usual).
  • Feeling very tired all the time.
  • Having other aches and pains that don’t get better with treatment.
  • Having trouble paying attention, recalling things, concentrating, and making decisions.
  • Headaches, backaches, or digestive problems.
  • Sleeping too much, or having problems sleeping.
  • Unintended weight loss or gain.

What causes depression?

Depression may be caused by an imbalance of chemicals in the brain. Sometimes there aren’t enough chemical messengers (called neurotransmitters) in the brain. Examples of neurotransmitters that affect your mood are serotonin, norepinephrine, and dopamine. A chemical imbalance in the brain may be caused by one or more of the following:

  • Your genes. Sometimes depression is hereditary, meaning it runs in your family. You may be more at risk for having depression if you have a parent or sibling who has depression
  • A medical condition. Problems with your thyroid or nutrient deficiencies can cause depression. So can chronic diseases such as heart disease, diabetes, or cancer.
  • Events in your life. Depression can be triggered by stressful events in your life. These can include the death of someone you love, a divorce, chronic illness, or loss of a job.
  • Medicines, drugs, or alcohol. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also lead to depression.

Depression is not caused by personal weakness, laziness, or lack of willpower.

Can giving birth cause depression?

In the days following the birth of a baby, it is common for some mothers to have mood swings. They may feel a little depressed or have a hard time concentrating. They may lose their appetite or find that they can’t sleep well even when the baby is asleep. This is called the baby blues and goes away within 10 days after delivery. However, some women have worse symptoms or symptoms that last longer. This is called postpartum depression.

How is depression diagnosed?

You need to tell your doctor about your symptoms. Don’t expect your doctor to be able to guess that you’re depressed just by looking at you. You may feel embarrassed. It may be hard for you to imagine treatment will actually help you feel better. But don’t wait to talk to your doctor. The sooner you seek treatment, the sooner the depression will lift.

Once you tell your doctor how you’re feeling, he or she may ask you some questions about your symptoms, your health, and your family history. Your doctor may also give you a physical exam and do some tests. It is important to tell your doctor about any medicines that you are taking.

Reasons to get help for depression

  • Early diagnosis and treatment helps keep depression from getting worse or lasting a long time.
  • Diagnosis and treatment can help you return to your “normal” self and enjoy life.
  • After you’re diagnosed, treatment can help prevent depression from coming back.
  • Thoughts of suicide are common in people with depression. The risk of suicide is higher if you don’t get help for your depression. When depression is successfully treated, the thoughts of suicide will go away.

Can depression be prevented or avoided?

Generally, depression is a condition that cannot be prevented. There are lifestyle changes you can make that can boost your mood and minimize symptoms of depression.

Depression treatment

Depression can be treated with medicines, with counseling, or with both. A nutritious diet, exercising regularly, and avoiding alcohol, drugs, and too much caffeine can also help.

Depression usually can be treated through visits to your doctor. You may need in-hospital treatment if you have other medical conditions that could affect your treatment. In-hospital treatment is required if you’re at high risk of suicide.

Medicine

Your doctor may prescribe medicine to treat your depression. These are called antidepressants. They help increase the number of chemical messengers (serotonin, norepinephrine, dopamine) in your brain.

Antidepressants work differently for different people. They also have different side effects. So, even if one medicine bothers you or doesn’t work for you, another may help. You may notice improvement as soon as 1 week after you start taking the medicine. But you probably won’t see the full effects for about 8 to 12 weeks. You may have side effects at first, but they tend to decrease after a couple of weeks. Don’t stop taking the medicine without checking with your doctor first.

Counseling

For mild to moderate depression, counseling may be a good treatment option. For major depression and for some people with minor depression, counseling may not be enough. A combination of medicine and talk therapy is usually the most effective way of treating more severe depression. If you continue the combination treatment for at least a year, you are less likely to have depression come back.

In psychotherapy, you talk with a trained therapist or counselor about things that are going on in your life. The focus may be on your thoughts and beliefs, on things that happened in your past, or on your relationships. Or the focus may be on your behavior, how it’s affecting you, and what you can do differently. Psychotherapy usually lasts for a limited time, such as 8 to 20 visits.

In more serious cases, your doctor may suggest the use of electroconvulsive therapy (also called ECT or electroshock therapy). This is a procedure used to help treat certain mental illnesses. Electric currents are passed through the brain in order to trigger a seizure (a short period of irregular brain activity), lasting about 40 seconds. Medicine is given during ECT to help prevent damage to muscles and bones.

Electroconvulsive therapy may help people who have the following conditions:

  • Severe depression that does not respond to antidepressants (medicines used to treat depression) or counseling.
  • Severe depression in patients who can’t take antidepressants.
  • Severe mania that does not respond to medication. Symptoms of severe mania may include agitation, confusion, hallucinations, or delusions.
  • Schizophrenia that does not respond to medication.

Living with depression

The most important part of living with depression is not giving up. If you stay focused and are consistent with treatment, your mood will improve over time. Consider these dos and don’ts as you work toward recovery.

DO:

  • Pace yourself.
  • Get involved in activities that make you feel good or feel like you’ve achieved something.
  • Avoid drugs and alcohol. Both make depression worse. Both can cause dangerous side effects with antidepressant medicines.
  • Exercise often to make yourself feel better. Physical activity seems to cause a chemical reaction in the body that can improve your mood. Exercising 4 to 6 times a week for at least 30 minutes each time is a good goal. But even less activity can be helpful.
  • Eat balanced meals and healthful foods.
  • Get enough sleep.
  • Take your medicine and/or go to counseling as often as your doctor recommends. Your medicine won’t work if you only take it once in a while.
  • Set small goals for yourself, because you may have less energy.
  • Encourage yourself.
  • Get as much information as you can about depression and how to treat it.
  • Call your doctor or the local suicide crisis center right away if you start thinking about suicide.

DON’T:

  • Don’t isolate yourself. Stay in touch with your loved ones and friends, your religious advisor, and your family doctor.
  • Don’t believe negative thoughts you may have, such as blaming yourself or expecting to fail. This thinking is part of depression. These thoughts will go away as your depression lifts.
  • Don’t blame yourself for your depression. You didn’t cause it.
  • Don’t make major life decisions (for example, about separation or divorce). You may not be thinking clearly while you are depressed, so the decisions you make at this time may not be the best ones for you. If you must make a big decision, ask someone you trust to help you.
  • Don’t expect to do everything you normally can. Set a realistic schedule.
  • Don’t get discouraged. It will take time for your depression to lift fully. Be patient with yourself.
  • Don’t give up.

Complications

People who have depression sometimes think about suicide. This thinking is a common part of the depression. If you have thoughts about hurting yourself, tell someone. You could tell your doctor, your friends, or your family. Or you could call your local suicide hotline, such as the National Suicide Prevention Lifeline at 1-800-273-8255.

Get help right away. There are people who can help you. Depression can be successfully treated.

Questions to ask your doctor

  • I’ve been feeling ______. Could I be depressed?
  • Do I need treatment? What are my treatment options?
  • Should I see a therapist?
  • Is there anything I can do at home to help myself?
  • Are there any support groups in my area?
  • What are the risks and benefits of taking antidepressants?
  • I’m pregnant. Should I take antidepressants?
  • I’m breastfeeding. Should I take antidepressants?
  • Will I have to take medicine the rest of my life?
  • I care for an older adult. How do I tell if he or she is depressed?
  • What kinds of treatment are safe for older adults who have other health problems, such as dementia?
  • What should I do if I am having or start having thoughts of suicide?