Depression / Major Depressive Disorder
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.
More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both. Causes
It's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:
Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.
Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.
Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.
Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.
Risk Factors Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.
Factors that seem to increase the risk of developing or triggering depression include:
Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic
Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation
History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
Abuse of alcohol or recreational drugs
Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)
Complications Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.
Examples of complications associated with depression include:
Excess weight or obesity, which can lead to heart disease and diabetes
Pain or physical illness
Alcohol or drug misuse
Anxiety, panic disorder or social phobia
Family conflicts, relationship difficulties, and work or school problems
Social isolation
Suicidal feelings, suicide attempts or suicide
Self-mutilation, such as cutting
Premature death from medical conditions
Symptoms
Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.
----Depression symptoms in children and teens----
Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.
In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.
----Depression symptoms in older adults----
Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:
- Memory difficulties or personality changes
- Physical aches or pain
- Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
- Often wanting to stay at home, rather than going out to socialize or doing new things
- Suicidal thinking or feelings, especially in older men
If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.
!!!!-!-!-!-WHEN TO GET EMERGENCY HELP-!-!-!-!!!!
If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.
Also consider these options if you're having suicidal thoughts:
https://988lifeline.org
- Call your doctor or mental health professional.
- Contact a suicide hotline.
- In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
- U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
- The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader or someone else in your faith community.
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Treatment Options
Depression is treated with psychotherapy, medication, or a combination of both. The best treatment depends on the person's needs, preferences, and medical situation.
----Psychotherapy----
- Cognitive behavioral therapy (CBT): A common psychological therapy that helps people identify and change negative thought patterns
- Interpersonal psychotherapy: A psychological treatment for depression
- Problem-solving therapy: A psychological treatment for depression
- Behavioral activation: A psychological treatment for depression
- Talk therapy: Can be done in person or online with a professional or lay therapist
----Medication----
- Antidepressants: The main medical treatment for depression
- Mood stabilizers: Used to treat more severe forms of depression, like bipolar disorder
- Antipsychotic drugs: Used to treat more severe forms of depression, like psychosis
----Brain stimulation therapy----
- Electroconvulsive therapy (ECT): A type of brain stimulation therapy
- Transcranial magnetic stimulation (TMS): A type of brain stimulation therapy
- Vagus nerve stimulation (VNS): A type of brain stimulation therapy
With treatment, you should start to feel better within a few weeks, but it can take longer. Stay connected with your healthcare provider and let them know if you are not starting to feel better. Without treatment, symptoms can last for weeks, months, or even years. Continued treatment may help to prevent depression from appearing again.
Depression can make you feel exhausted, worthless, helpless, and hopeless. It’s important to realize that these negative views are part of the depression and don't reflect reality. Negative thinking fades as treatment starts to take effect. Meanwhile, consider the following:
* Get help. Being depressed is miserable and impacts all aspects of life, including your relationships and long-term health. If you think you may be depressed, see a healthcare provider as soon as possible.
* Set realistic goals in light of the depression and don’t take on too much.
* Break large tasks into small ones. Set priorities, and do what you can as you can.
* Try to be with other people and confide in someone. It’s usually better than being alone and secretive.
* Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
* Get regular exercise. Studies show exercise can improve mood.
* Expect your mood to get better slowly, not right away. Feeling better takes time.
* Eat healthy, well-balanced meals.
* Stay away from alcohol and drugs. These can often make depression worse.
* It's best to delay important decisions until the depression has lifted. Before deciding to make a big change—such as changing jobs or getting married or divorced—discuss it with others who know you well and have a more objective view of your situation.
* Remember: People don’t "snap out of" a depression. But they can feel a little better day-by-day.
* Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression. The negative thoughts will fade as your depression responds to treatment.
* Let your family and friends help you.