Depression is a serious medical illness that negatively affects how
you feel, the way you think and how you act. Depression has a variety
of symptoms, but the most common are a deep feeling of sadness or a
marked loss of interest or pleasure in activities. Other symptoms
include:
• Changes in appetite that result in weight losses or gains unrelated to dieting
• Insomnia or oversleeping
• Loss of energy or increased fatigue
• Restlessness or irritability
• Feelings of worthlessness or inappropriate guilt
• Difficulty thinking, concentrating, or making decisions
• Thoughts of death or suicide or attempts at suicide
Depression
is common. It affects nearly one in 10 adults each year—nearly twice as
many women as men. It’s also important to note that depression can
strike at any time, but on average, first appears during the late teens
to mid-20s. Depression is also common in older adults. Fortunately,
depression is very treatable.
How Depression and Sadness Are Different
The death of a loved one, loss of a job, or the ending of a
relationship are difficult experiences for a person to endure. It is
normal for feelings of sadness or grief to develop in response to such
stressful situations. Those experiencing trying times often might
describe themselves as being “depressed.” But sadness and depression are
not the same. While feelings of sadness will lessen with time, the
disorder of depression can continue for months, even years. Patients who
have experienced depression note marked differences between normal
sadness and the disabling weight of clinical depression.
Causes
Depression can affect anyone—even a person who
appears to live in relatively ideal circumstances. But several factors
can play a role in the onset of depression:
Biochemistry
Abnormalities in two chemicals in the brain, serotonin and
norepinephrine, might contribute to symptoms of depression, including
anxiety, irritability and fatigue. Other brain networks undoubtedly are
involved as well; scientists are actively seeking new knowledge in this
area.
Genetics
Depression can run in families.
Personality
People with low self-esteem, who are easily
overwhelmed by stress, or who are generally pessimistic appear to be
vulnerable to depression.
Environmental factors
Continuous exposure to violence, neglect, abuse or
poverty may make people who are already susceptible to depression all
the more vulnerable to the illness. Also, a medical condition (e.g., a
brain tumor or vitamin deficiency) can cause depression, so it is
important to be evaluated by a psychiatrist or other physician to rule
out general medical causes.
Treatment
For many people, depression cannot
always be controlled for any length of time simply by exercise, changing
diet, or taking a vacation. It is, however, among the most treatable of
mental disorders; the majority of people with depression eventually
respond well to treatment, and almost all patients gain some relief from
their symptoms.
Before a specific treatment is recommended, a psychiatrist
should conduct a thorough diagnostic evaluation, consisting of an
interview and possibly a physical examination. The purpose of the
evaluation is to reveal specific symptoms, medical and family history,
cultural settings and environmental factors to arrive at a proper
diagnosis and to determine the best treatment.
Medication
Antidepressants may be prescribed to correct
imbalances in the levels of chemicals in the brain. These medications
are not sedatives, “uppers” or tranquilizers. Neither are they
habit-forming. Generally antidepressant medications have no stimulating
effect on those not experiencing depression.
Antidepressants may produce some improvement within the
first week or two of treatment. Full benefits may not be realized for
two to three months. If a patient feels little or no improvement after
several weeks, his or her psychiatrist will alter the dose of the
medication or will add or substitute another antidepressant.
Psychiatrists usually recommend that patients continue to
take medication for six or more months after symptoms have improved.
After two or three episodes of major depression, long-term maintenance
treatment may be suggested to decrease the risk of future episodes.
Psychotherapy
Psychotherapy, or “talk therapy,” is sometimes used
alone for treatment of mild depression; for moderate to severe
depression, it is often used in combination with antidepressant
medications. Psychotherapy may involve only the individual patient, but
it can include others. For example, family or couples therapy can help
address specific issues arising within these close relationships. Group
therapy involves people with similar illnesses. Depending on the
severity of the depression, treatment can take a few weeks or
substantially longer. However, in many cases, significant improvement
can be made in 10 to 15 sessions.
Depression is never normal and always produces needless
suffering. With proper diagnosis and treatment, the vast majority of
people with depression will overcome it. If you are experiencing
symptoms of depression, see your family physician or psychiatrist,
describe your concerns and request a thorough evaluation.
Electroconvulsive therapy (ECT)
Electroconvulsive therapy is a medical treatment most commonly used in patients with severe major depression or bipolar disorder that has
not responded to other treatments. It involves a brief electrical
stimulation of the brain while the patient is under anesthesia.
Source:http://www.psychiatry.org/depression
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