What is depression?

What is depression?

Depression is a mental health condition where a person has a long lasting low mood, and/or may lose pleasure or interest in activities.

Other symptoms of depression include:

• A depressed mood during most of the day, particularly in the morning
• Fatigue or loss of energy almost every day
• Feelings of worthlessness or guilt almost every day
• Impaired concentration, indecisiveness
• Insomnia or hypersomnia (excessive sleeping) almost every day
• Markedly diminished interest or pleasure in almost all activities nearly every day, a condition called anhedonia that can be indicated by a subjective account or by observations of significant others
• Recurring thoughts of death or suicide (not just fearing death)
• A sense of restlessness known as psychomotor agitation, or being slowed down, retardation
• Significant weight loss or gain

How long do these signs have to be present before they are diagnosed as depression?

With major or clinical depression, one of the key signs is either depressed mood or loss of interest. For a diagnosis of depression, at least one of these signs should be present most of the day either daily or nearly daily for at least two weeks. In addition, the depressive symptoms need to cause clinically significant distress or impairment. They cannot be due to the direct effects of a substance, for example, a drug or medication. Nor can they be the result of a medical condition such as hypothyroidism.

What are some common feelings associated with depression?

People with depressive illnesses do not all experience the same symptoms. How severe they are, how frequent, and how long they last will vary. It depends on the individual and their particular illness. Here are common symptoms people with depression experience:

• Difficulty concentrating, remembering details, and making decisions
• Fatigue and decreased energy
• Feelings of guilt, worthlessness, and/or helplessness
• Feelings of hopelessness and/or pessimism
• Insomnia, early morning wakefulness or excessive sleeping
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable, including sex
• No pleasure left in life any more
• Overeating or appetite loss
• Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• Persistent sad, anxious, or "empty" feelings
• Thoughts of suicide, suicide attempts

While these are common symptoms of depression, they may also occur in patterns. For example, a person may experience depression with mania or hypomania, a condition known as bipolar disorder. Or the symptoms may be seasonal as in the case of seasonal affective disorder (SAD).

Is childhood depression common?

Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. If your child is sad, this does not necessarily mean they have significant depression. It's when the sadness becomes persistent, day after day, that depression may be an issue. Or, if your child has disruptive behaviour that interferes with normal social activities, interests, schoolwork, or family life, it may indicate that they have a depressive illness. The NHS estimates that 4% of children aged between 5 and 16 years old has depression. Bear in mind that while depression is a serious illness, it is also a treatable one.

What about depression in teenagers?

It is common for teenagers to occasionally feel unhappy. However, when the unhappiness lasts for more than two weeks and the teenager experiences other symptoms of depression, then they may be suffering from adolescent depression. Seek medical advice to find out if your teenager may be depressed. There is effective treatment available to help teenagers move beyond depression as they grow older.

Is depression difficult to diagnose?

It is estimated that, by the year 2020, major depression will be second only to ischaemic heart disease in terms of the leading causes of illness in the world. Patients with depression sometimes fail to realise (or accept) that there is a physical cause to their depressed moods. As a result, they may search endlessly for external causes.
In the UK, about 15% of people will suffer from at least one episode of major depression, according to the NHS. The suicide risk in people with this type of depression is the highest rate for any psychiatric state. Unfortunately, most people with clinical depression never seek treatment. Left undiagnosed and untreated, depression can worsen, lasting for years and causing untold suffering, and possibly suicide.

What are the warning signs of suicide?

Depression carries a high risk of suicide. Anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call a helpline, such as the Samaritans (on 08457 90 90 90, open 24 hours a day, 365 days a year) or the mental health charity, SANE (on 0845 767 8000, open from 1pm to 11pm every day). Or contact your GP or a mental health professional immediately.
Warning signs of suicide include:

• Thoughts or talk of death or suicide
• Thoughts or talk of self-harm or harm to others
• Aggressive behaviour or impulsiveness

Previous suicide attempts increase the risk of future suicide attempts and completed suicide. All mention of suicide or violence must be taken seriously. If you intend or have a plan to commit suicide, call 999 or go to hospital for immediate treatment.

Are there different types of depression?

There are a number of different types of depression including:

• Major depression
• Chronic depression (dysthymia)
• Bipolar depression
• Seasonal depression (SAD or seasonal affective disorder)
• Psychotic depression
• Postnatal depression

Are there other types of depression?

Other types of depression that can occur include:

• Double depression, a condition that happens when a person with chronic depression (dysthymia) experiences an episode of major depression
• Secondary depression, a depression that develops after the development of a medical condition such as hypothyroidism, stroke, Parkinson's disease, or AIDS, or after a psychiatric problem such as schizophrenia, panic disorder, or bulimia
• Chronic treatment-resistant depression, a condition that lasts over a year and is extremely difficult to treat with antidepressants and other psychopharmacologic drugs and psychotherapies
• Masked depression, a depression that is hidden behind physical complaints for which no organic cause can be found.

For chronic treatment-resistant depression, electroconvulsive therapy (ECT) is usually the treatment of choice.

Can depression occur with other mental illnesses?

Depression commonly occurs with other illnesses such as anxiety, obsessive compulsive disorder, panic disorder, phobias and eating disorders. If you or a loved one has symptoms of depression and/or these other mental illnesses, seek medical advice. Treatment is available to lift the depression so you or a loved one can regain your meaningful life.

Can depression have physical symptoms?

Because certain brain chemicals or neurotransmitters, specifically serotonin and norepinephrine, influence both mood and pain, it's not uncommon for depressed individuals to have physical symptoms. These symptoms may include joint pain, back pain, gastrointestinal problems, sleep disturbances, and appetite changes. The symptoms may also be accompanied by slowed speech and physical retardation. Many patients go from doctor to doctor seeking treatment for their physical symptoms when, in fact, they are clinically depressed.

Where can I get help for depression?

If you or someone you know is experiencing symptoms of depression, seek medical advice for treatment or referral to a mental health professional.
Source:  http://www.webmd.boots.com/depression/guide/what-is-depression

Move over Prozac: New drug offers hope for depression

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The brain chemistry that underlies depression is incompletely understood, but research suggests that aberrant signaling by a chemical called Brain-Derived Neurotrophic Factor through its receptor TrkB, may contribute to anxiety and depression. Here, researchers describe a screen for stable small molecules that could specifically inhibit TrkB action. They identified one they dubbed ANA-12, which had potent behavioral effects when administered to mice that suggest it will have antidepressant and anti-anxiety activity in humans.

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An estimated 19 million Americans suffer from depression, and though the symptoms might be recognizable, the brain chemistry that underlies them is incompletely understood. Research suggests that aberrant signaling by a chemical called Brain-Derived Neurotrophic Factor (BDNF) through its receptor TrkB, may contribute to anxiety and depression, and inhibiting this pathway in mice can reduce anxiety and depression-related behaviors. However, translating these findings to clinical studies will require the development of small molecule inhibitors of the BDNF/TrkB pathway that could be used pharmacologically.
In this paper, researchers led by Maxime Cazorla, of Columbia University in New York, and Didier Rognan, of the Université de Strasbourg in France, describe a screen for stable small molecules that could specifically inhibit TrkB action. They identified one they dubbed ANA-12, which had potent behavioral effects when administered to mice that suggest it will have antidepressant and anti-anxiety activity in humans. The researchers are hopeful that this new compound could be used to develop a new class of psychiatric drugs.

Source: http://www.sciencedaily.com/releases/2011/04/110418122314.htm

How to Get Rid of Depression

Depression is a clinical condition, a disease just as real as a cold or flu. Treatment for depression varies widely from person to person, but there are some approaches that seem to work more often than others. Read this guide to learn about them and consider which ones are worth trying yourself.

Method 1 of 3: Focus on Health and Fitness

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   Exercise. Physical exercise releases chemicals in the brain that help boost your mood. It's long been known that vigorous, regular exercise can serve to lessen and in some cases even cure depression in many patients. The best part of exercise as a treatment for depression is that it's basically free. On the other hand, some people suffering from depression find it almost impossible to get motivated enough to start a regular exercise routine.
   • Cardiovascular exercise is an ideal core exercise for treating depression, as the body can sustain cardio activity for a much longer period of time than resistance exercise, without any ill effects. Choose cardio exercise that's easy on your joints, such as swimming laps or cycling, if you possibly can.
     
   • If you'd like to try exercise a s a means of fighting your depression, but just can't seem to work up the will to do it, talk to a trusted friend or loved one and ask them to help you get out and start doing it. Explain that it won't be easy to motivate you, but that any help they can give will be sincerely appreciated.
     
   • Exercise for at least 30 minutes a day, 3 times a week to begin to feel a sustained effect on your mood. It may take a few weeks to really notice a change.
     • If you're exercising a lot and still feel just as depressed as before, you should try something else instead. However, for purely physical reasons, you should also continue with your fitness regimen as long as you're able to make yourself do so.
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   Control your diet. There's some research that suggests certain dietary guidelines can help people suffering from depression, by providing the body the correct chemical tools it needs to heal the chemical imbalances that often cause depression. The dietary approach doesn't work for everybody, but like exercise, it's a relatively inexpensive treatment that has no negative side effects to speak of.
   • Eat foods rich in depression-fighting nutrients. Studies have shown links between lowered rates of depression and the nutrients folate, vitamin B12, vitamin D, selenium, and Omega-3. Start by focusing on foods that are rich in some or all of these nutrients, such as dark green vegetables, legumes (beans), nuts, extra-lean meat, whole fruit, and yogurt.
   • Get plenty of antioxidants. Antioxidants seem to help the brain (and the rest of the body) stay in better shape overall by neutralizing free radicals, damaging particles that are seen as a leading cause of cellular degeneration over time. Although antioxidants aren't strictly indicated as a treatment for depression, they do allow your brain to function more smoothly overall. Look for foods high in beta carotene, vitamin C, and vitamin E, such as carrots, squash, citrus fruit, and nuts.
   • Eat complex carbohydrates to relax. Carbohydrates have a well-known stress-reduction effect when eaten, but some carbs are better for you than others. Avoid simple carbs like sugar and milled grain; opt for brown rice, whole grains, and legumes instead.
   • Get plenty of protein. Protein in foods like turkey and fish helps boost energy and alertness levels, improving overall mood.
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   Get some sunshine. Your body naturally produces vitamin D, which is known to help combat depression and mood swings, when your skin is exposed to the sun. This is why some counselors prescribe sunlight lamps for depression patients who live in areas with low winter sunlight: it stimulates the same effect as going outside and standing under bright sunlight. Make a commitment to do the real thing yourself, for at least 15 or 20 minutes, whenever you have the chance.
   • If you're going to be out in the sun for more than a few minutes, take sensible precautions by applying sunscreen to your bare skin and wearing sunglasses. Your skin will still manufacture vitamin D even if you wear sunscreen.
   • You don't necessarily have to do anything while you're outside. Just find a bench and sit for a while, or take a leisurely walk around your neighborhood.

Method 2 of 3: Use Therapy and Medication

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   Visit a counselor. Counselors are the first line of treatment professionals in the world of mental health. They're somewhat less trained than psychiatrists and psychologists, but they still spend years in graduate school and are highly skilled and knowledgeable in treating depression and other mental illness with the power of speaking therapy. Counselors are usually cheaper to visit than psychiatrists or psychologists as well, making them a good first choice.
   • As a patient, you have the right to shop around and find a counselor who makes you feel welcome and at ease. A bad counseling experience can put you off the whole idea for years, which could deprive you of valuable therapy. Remember that not all counselors are alike; find one you like and stick with him or her.
   • Counselors will generally prompt you to speak with careful questions, and then listen to what you have to say. It can be nerve-wracking at first to open up to your counselor, but most people find it hard to stop talking after a few minutes have passed. The counselor will listen for significant ideas and phrases, and discuss them in greater detail with you to help you work out mental and emotional hangups that may be contributing to your depression.
   • The effects of counseling are gradual. Expect to attend regular sessions for at least a few months before noticing any permanent effect. Don't give up hope before you've given it time to work.
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   See a psychiatrist or clinical psychologist. The difference between these two professionals is in their doctorates: Psychiatrists hold a medical doctorate, while psychologists hold a Ph.D. or a Psy. D. (Doctorate in Psychology). Both are exceptionally well-trained, and both can tend to patients. Psychologists rely on psychotherapy, and cannot generally prescribe medication; psychiatrists combine therapy with medication.
   • Whichever type of professional you see, therapy sessions will be a significant part of your treatment. They may have less common psychotherapy methods that will work better for you than a counselor's standard approach; again, feel free to meet and discuss this until you find a doctor you're comfortable with.
   • As with all therapeutic treatments for depression, the typical treatments you receive from a psychologist or psychiatrist will take some time to have a lasting effect. In extreme cases, these professionals may recommend unorthodox or experimental treatments. If you've tried everything and are at the end of your rope, speak to them about such treatments.
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   Try antidepressant medication. Antidepressants can normally only be prescribed by a medical doctor. Psychiatrists are best qualified to prescribe them, but your regular family doctor may also have some power to judge your mental state and write you a prescription. Antidepressants comprise a wide field of many different types of drugs, all of which have some effect on your brain chemistry, which is generally seen as the source of most clinical depression. The most common types are SSRIs, SNRIs, MAOIs, and tricyclics.
   • Because there are so many different types of antidepressant, your psychiatrist may have you try a few different medications until one seems to work. Some antidepressants backfire on some people, so it's very important to stay in close contact with your practitioner and note any negative or unwelcome change in mood immediately. Usually, switching to a different class of drug will fix the problem.
   • Antidepressants take time to work, because they slowly and gently modify the brain's chemical balance. Generally speaking, it will take at least three months to see any lasting effect from an antidepressant.

Method 3 of 3: Try Uncommon Treatments

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   Shock your depression away with electroconvulsive therapy. Electroconvulsive therapy, or ECT, is commonly seen as a ghastly and barbaric treatment used in horror movies and soap opera plots more than anything else. The truth is, despite the treatment's checkered past, modern ECT is experiencing a recent surge in popularity as a last-ditch treatment for people with severe, major depressive disorder. The procedure is completely voluntary, and the shocks are administered under mild anesthesia so that the patient experiences no discomfort.
   • ECT treatments are not used except in extreme and recurring cases of depression. They're much safer than they were 60 years ago, but there are still risks associated with them, partly because their antidepressant effect on the brain isn't yet fully understood. If your doctor doesn't suggest ECT, it's unlikely he or she will sign off on it when you suggest it.
   • The treatment begins with a mild anesthetic, followed by several shocks delivered to the brain. The antidepressant effect is powerful and immediate; however, in most cases, more sessions are required to achieve a permanent cure. Sessions gradually get spaced farther apart, and last for a year at most (at which point they're typically administered just once per month).
   • Side effects of ECT include temporary short-term memory loss, confusion, and dizziness. However, studies have shown no long-term side effects whatsoever, including cognitive effects. Therefore, it's seen as a legitimately viable option for people who can't seem to recover from depression any other way.
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   Try herbal therapy if you want. Studies haven't shown any conclusive links between herbs like St. John's Wort, which is a common folk remedy for depression, and increased rates of recovery from major forms of the disease. However, comprehensive studies of its effects on mild and moderate depression aren't available yet, and many people swear by it.
   • If you buy herbal supplements, be sure to by from a reputable seller. Supplements are only very loosely patrolled by the FDA, and as such, levels of purity and quality vary wildly from manufacturer to manufacturer.
   • St. John's Wort in particular has been shown to interact negatively with clinical antidepressants. Ask your psychiatrist before taking it if you're already on a clinical drug.
   Source: http://www.wikihow.com/Image:Get-Rid-of-Depression-Step-8-Version-2.jpg