About
Depression
Depression is an illness that involves the
body, mood, and thoughts. It affects the way a person
eats and sleeps, the way one feels about oneself, and the
way one thinks about things. Depression is not the same
as a passing blue mood.
It is not a sign of personal weakness or a
condition that can be willed or wished away. People with
depression cannot merely "pull themselves together" and
get better. Without treatment, symptoms can last for
weeks, months, or years. Appropriate treatment, however,
can help most people who suffer from
depression.
Types of
Depression
Major depression is manifested by a
combination of symptoms that interfere with the ability
to work, study, sleep, eat, and enjoy once pleasurable
activities. Such a disabling episode of depression may
occur only once but more commonly occurs several times in
a lifetime.
A less severe type of depression,
dysthymia, involves long-term, chronic symptoms that do
not disable, but keep one from functioning well or from
feeling good. Many people with dysthymia also experience
major depressive episodes at some time in their
lives.
Another type of depression is bipolar
disorder, also called manic-depressive illness. Not
nearly as prevalent as other forms of depression, bipolar
disorder is characterized by cycling mood changes: severe
highs (mania) and lows (depression).
Sometimes the mood switches are dramatic
and rapid, but most often they are gradual. When in the
depressed cycle, an individual can have any or all of the
symptoms of a depressive disorder. When in the manic
cycle, the individual may be overactive, overtalkative,
and have a great deal of energy.
Symptoms
Not everyone who is depressed experiences
every symptom. Some people experience a few symptoms,
some many. Severity of symptoms varies with individuals
and also varies over time.
The following are signs of
depression:
- Persistent sad, anxious, or "empty"
mood
- Feelings of hopelessness,
pessimism
- Feelings of guilt, worthlessness,
helplessness
- Loss of interest or pleasure in hobbies
and activities that were once enjoyed, including
sex
- Decreased energy,
fatigue, being "slowed
down"
- Difficulty
concentrating, remembering, making
decisions
- Insomnia, early-morning awakening,
or oversleeping
- Appetite and/or weight loss or
overeating and weight gain
- Thoughts of death or suicide; suicide
attempts
- Restlessness,
irritability
- Persistent physical symptoms that do
not respond to treatment, such as
headaches, digestive disorders,
and
chronic
pain
Causes
Some types of depression run in families,
suggesting that a biological vulnerability can be
inherited. This seems to be the case with bipolar
disorder.
Studies of families in which members of
each generation develop bipolar disorder found that those
with the illness have a somewhat different genetic makeup
than those who do not get ill. However, the reverse is
not true: Not everybody with the genetic makeup that
causes vulnerability to bipolar disorder will have the
illness.
In some families, major depression also
seems to occur generation after generation. However, it
can also occur in people who have no family history of
depression. Whether inherited or not, major depressive
disorder is often associated with changes
in brain structures or brain
function.
People who have low self-esteem, who consistently view themselves and the
world with pessimism or who are readily overwhelmed by
stress, are prone to depression. Whether this represents
a psychological predisposition or an early form of the
illness is not clear.
Treatment
The first step to getting appropriate
treatment for depression is a physical examination by a
physician. Certain medications as well as some medical
conditions such as a viral infection 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 should be done, by
the physician or by referral to a psychiatrist or
psychologist.
Treatment choice will depend on the outcome of
the evaluation. There are a variety of antidepressant
medications and psychotherapies that can be used to treat
depressive disorders.
Natural Remedies
St. John’s wort extract has been compared
to the prescription tricyclic
antidepressants imipramine (Tofranil), amitriptyline
(Elavil, fluoxetine (Prozac), and maprotiline (Ludiomil). The
improvement in symptoms of mild to moderate depression
was similar, with notably fewer side effects, in people
taking St. John’s wort.
In a double-blind trial using standard
amounts of fluoxetine (Prozac)-20 mg per day-St. John’s
wort extract in the amount of 400 mg twice daily was
equally effective at relieving depression in people aged
60-80 years.
References for
Depression Symptoms Article
-
90. Volz HP, Laux P. Potential
treatment for subthreshold and mild depression: a
comparison of St. John’s wort extracts and
fluoxetine. Compr
Psychiatry 2000;41(2 Suppl 1):133-7
[review].
-
Vorbach EU, Arnoldt KH, Hübner
WD. Efficacy and tolerability of St. John’s wort extract LI
160 versus imipramine in patients with severe depressive
episodes according to ICD-10. Pharmacopsychiatry
1997;30(suppl):81-5.
-
29. Levine J, Barak Y,
Gonzalves M, et al. Double-blind, controlled trial of
inositol treatment of depression.
Am J
Psychiatry 1995;152:792-4.
- National Institutes
of Health
|