Understanding Depression
What is Depression?
A depressive disorder is not a passing blue mood but rather persistent feelings of sadness and worthlessness and a lack of desire to engage in formerly pleasurable activities. A complex mind/body illness, depression can be treated with drugs and/or therapy.
Symptoms of Depression
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Persistent sad, anxious, or empty mood
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Feelings of hopelessness or pessimism
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Feelings of guilt, worthlessness, or helplessness
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Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
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Decreased energy, fatigue, being "slowed down"
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Difficulty concentrating, remembering, or making decisions
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Insomnia, early morning awakening or oversleeping
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Appetite and/or weight loss, or overeating and weight gain
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Thoughts of death or suicide, suicide attempts
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Restlessness, irritability
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Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain
There is no single known cause of depression. Rather, it likely results from a combination of genetic, biochemical, environmental, and psychological factors.
Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite, and behavior appear to function abnormally. In addition, important neurotransmitters—chemicals that brain cells use to communicate—appear to be out of balance. But these images do not reveal why the depression has occurred.
Some types of depression tend to run in families, suggesting a genetic link. However, depression can occur in people without family histories of it as well. Genetics research indicates that risk for depression results from the influence of multiple genes acting together with environmental or other factors.
In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Subsequent depressive episodes may occur with or without an obvious trigger.
Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.
Appropriate treatment for depression starts with a physical examination by a physician. Certain medications, as well as some medical conditions such as viral infections or a thyroid disorder, can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation that includes a mental status exam should be done either by the physician or by referral to a mental health professional.
He or she should discuss any family history of depression including their treatment, and get a complete history of symptoms, such as when they started, how long they have lasted, how severe they are, whether the patient had them before. And if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide.
Once diagnosed, a person with depression can be treated with a number of methods. The most common treatments are medication and psychotherapy.
Causes
Treatment