Depression
Introduction
Depression is when feelings of loss, anger, sadness, or frustration make it hard for you to do the things you enjoy in everyday life. Although everyone feels sad sometimes, depression lasts longer and interferes with your daily life.Depression is one of the most common illnesses, affecting about 18 million Americans each year. It can be mild, moderate, or severe. You can have a single episode of depression, or depression that comes back or lasts a long time (more than 2 years). Many experts think that depression is a chronic illness that needs long-term treatment.
The primary types of depression include:
- Major depression -- A person must be depressed for at least 2 weeks but often for as long as 20 weeks.
- Dysthymia -- a long-lasting, less severe form of depression. Symptoms are like those of major depression but more mild. People with dysthymia have an greater risk of major depression.
- Atypical depression -- Unlike those with major depression, people with atypical depression can feel better for a while when something good happens. In addition, people with atypical depression have different symptoms than those with major depression. Despite its name, atypical depression may be the most common type of depression.
- Adjustment disorder -- happens when someone's response to a major life event, such as the death of a loved one, causes symptoms of depression.
- Postpartum depression -- about 10% of mothers may have depression after giving birth
- Premenstrual dysphoric disorder (PDD) -- Women with PDD have symptoms 1 week before getting their period. Symptoms go away after their period.
- Seasonal affective disorder (SAD) -- a kind of depression that is seasonal and happens when there is less sunlight. It starts during fall-winter and disappears during spring-summer .
- Bipolar disorder -- People with bipolar disorder have moods that swing from depression to mania. Also called manic-depressive disorder.
Signs and Symptoms
While it is normal to feel "down in the dumps" sometimes, people with major depression feel significantly depressed for a long period of time. They have trouble enjoying things that they used to love to do. Symptoms include:- Sleep problems -- at least 90% of people with depression have either insomnia or hypersomnia, meaning they sleep too much.
- Big change in appetite, often causing either weight loss or weight gain
- Fatigue and loss of energy
- Feelings of worthlessness, self-hate, and guilt
- Trouble concentrating
- Agitation, restlessness, and irritability or inactivity and withdrawal
- Recurring thoughts of death or suicide
- Feelings of hopelessness
- Not being interested in sex
Causes
No one knows exactly what causes depression. Probably a combination of physical, genetic, and environmental factors are involved. People with depression may have abnormal levels of brain chemicals called neurotransmitters, including serotonin, dopamine, and norepinephrine. These things may contribute to having depression:- Heredity -- a gene called SERT that controls the brain chemical serotonin has been linked to depression. In addition, some studies show that people with depressed family members are more likely to be depressed.
- Changes in the brain -- some imaging studies suggest that people with depression may have physical changes in their brains.
- Long-term stress, such as from loss, abuse, or being deprived as a child
- Being exposed to low levels of light, in SAD
- Sleep problems
- Social isolation
- Not getting enough of some vitamins and minerals
- Serious medical conditions, such as heart attack or cancer
- Certain medications, including those for high blood pressure, high cholesterol, or irregular heartbeat
Risk Factors
Although depression can happen to anyone, no matter what age, race, or gender, the following things may increase your risk for depression:- Having had depression
- Family history of depression
- Suicide attempt -- having made a suicide attempt while depressed raises the risk of another episode of depression
- Being a woman -- more women than men seem to have depression. This may be because women tell their doctors about their symptoms more often than men. Or hormone changes may make women more likely to have depression.
- Stressful life events, such as the death of a loved one
- Just having given birth to a baby (postpartum)
- Having a long-lasting illness, including autoimmune diseases (such as lupus), cancer, heart disease, chronic headaches, chronic pain, anxiety, obsessive-compulsive disorder, and borderline personality disorder. Medical conditions that cause shifts in hormones, such as thyroid disorders or menopause, may also contribute to depression.
- History of abuse, such as mental, physical, or sexual
- Lack of a support system, such as a network of close friends or family
- Alcohol or drug abuse -- 25% of people with addictions have depression.
Diagnosis
If you feel depressed or have symptoms of depression, it's important to tell your doctor. Depression usually doesn't go away on its own. Telling your doctor is the first step toward treatment. Talk to your primary care doctor or a mental health provider.If you have thoughts of suicide, call 911 or a local emergency hotline. It's important to talk to someone immediately. You can also call a family member or friend, your minister, or someone in your faith community.
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