Depression: What Is It?
It's natural
to feel down sometimes, but if that low mood lingers day after day, it could
signal depression. Major depression is an episode of sadness or apathy along
with other symptoms that lasts at least two consecutive weeks and is severe
enough to interrupt daily activities. Depression is not a sign of weakness or a
negative personality. It is a major public health problem and a treatable
medical condition. The primary symptoms of depression are a sad mood and/or
loss of interest in life. Activities that were once pleasurable lose their
appeal. Patients may also be haunted by a sense of guilt or worthlessness, lack
of hope, and recurring thoughts of death or suicide. Depression
is sometimes linked to physical symptoms. These include:
•Fatigue and decreased energy
•Insomnia, especially early-morning waking
•Excessive sleep
•Persistent aches or pains, headaches, cramps, or
digestive problems that do not ease even with treatment
Depression
can make other health problems feel worse, particularly chronic pain. Key brain
chemicals influence both mood and pain. Treating depression has been shown to
improve co-existing illnesses. Changes in appetite or weight are another
hallmark of depression. Some patients develop increased appetite, while others
lose their appetite altogether. Depressed people may experience serious weight
loss or weight gain. Without treatment, the physical and emotional
turmoil brought on by depression can derail careers, hobbies, and
relationships. Depressed people often find it difficult to concentrate and make
decisions. They turn away from previously enjoyable activities, including sex.
In severe cases, depression can become life-threatening. People
who are depressed are more likely to attempt suicide. Warning signs include
talking about death or suicide, threatening to hurt people, or engaging in
aggressive or risky behavior. Anyone who appears suicidal should be taken very
seriously. Do not hesitate to call one of the suicide hotlines.
Anyone can become depressed, but many experts
believe genetics play a role. Having a parent or sibling with depression
increases your risk of developing the disorder. Women are twice as likely as
men to become depressed. Doctors aren't sure what causes depression, but a
prominent theory is altered brain structure and chemical function. Brain
circuits that regulate mood may work less efficiently during depression. Drugs
that treat depression are believed to improve communication between nerve
cells, making them run more normally. Experts also think that while stress --
such as losing a loved one -- can trigger depression, one must first be
biologically prone to develop the disorder. Other triggers could include
certain medications, alcohol or substance abuse, hormonal changes, or even the
season.
If your mood matches the season -- sunny in
the summer, gloomy in the winter -- you may have a form of depression called
seasonal affective disorder (SAD). The onset of SAD usually occurs in the late
fall and early winter, as the daylight hours grow shorter. Experts say SAD
affects from 3% to 20% of all people, depending upon where they live.
The
"baby blues" strikes as many as three out of four new mothers. But
nearly 12% develop a more intense dark mood that lingers even as their baby
thrives. This is known as postpartum depression, and the symptoms are the same
as those of major depression. An important difference is that the baby's
well-being is also at stake. A depressed mother may have trouble enjoying and
bonding with her infant. In the UK, depression affects 2% of grade
school kids and about one in 10 teenagers. It interferes with the ability to
play, make friends, and complete schoolwork. Symptoms are similar to depression
in adults, but some children may appear angry or engage in risky behavior,
called "acting out." Depression can be difficult to diagnose in
children.
As of
yet, there is no lab test for depression. To make an accurate diagnosis,
doctors rely on a patient's description of the symptoms. You'll be asked about
your medical history and medication use since these may contribute to symptoms
of depression. Discussing moods, behaviors, and daily activities can help
reveal the severity and type of depression. This is a critical step in determining
the most effective treatment.
Studies
suggest different types of talk therapy can fight mild to moderate depression.
Cognitive behavioral therapy aims to change thoughts and behaviors that
contribute to depression. Interpersonal therapy identifies how your
relationships impact your mood. Psychodynamic psychotherapy helps people
understand how their behavior and mood are affected by unresolved issues and
unconscious feelings. Some patients find a few months of therapy are all they
need, while others continue long term. Antidepressants affect the levels of
brain chemicals, such as serotonin and norepinephrine. There are many options.
Give antidepressants a few weeks of use to take effect. Good follow-up with
your doctor is important to evaluate their effectiveness and make dosage
adjustments. If the first medication tried doesn't help, there's a good chance
another will. The combination of talk therapy and medication appears
particularly effective.
Research
suggests exercise is a potent weapon against mild to moderate depression.
Physical activity releases endorphins that can help boost mood. Regular
exercise is also linked to higher self-esteem, better sleep, less stress, and
more energy. Any type of moderate activity, from swimming to housework, can
help. Choose something you enjoy and aim for 20 to 30 minutes four or five
times a week.
A playful
puppy or wise-mouthed parrot is no substitute for medication or talk therapy.
But researchers say pets can ease the symptoms of mild to moderate depression
in many people. Pets provide unconditional love, relieve loneliness, and give
patients a sense of purpose. Studies have found pet owners have less trouble
sleeping and better overall health.
Because
loneliness goes hand-in-hand with depression, developing a social support
network can be an important part of treatment. This may include joining a
support group, finding an online support community, or making a genuine effort
to see friends and family more often. Even joining a book club or taking
classes at your gym can help you connect with people on a regular basis
In the midst
of major depression, you may feel hopeless and helpless. But the fact is, this
condition is highly treatable. More than 80% of people get better with
medication, talk therapy, or a combination of the two. Even when these
therapies fail to help, there are cutting-edge treatments that pick up the
slack. Most importantly seek help. Even if you start by just talking to a
friend.
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