Depression

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Depression is a common illness worldwide, with an estimated 350 million people affected. Depression is a serious health condition, and differs from normal mood fluctuations and short-lived feelings of sadness. It can cause the affected person to suffer greatly and can affect how they perform at work, at school and in the family. At its worst, depression can lead to suicide, which accounts for an estimated 1 million deaths every year.

If you or a loved one is suffering from depression, understanding more about it can help you cope. In this section, you will find key details about the causes and symptoms of this condition.

As depression is a highly treatable condition, there is comprehensive information on the treatment options available to those with depression.

What is depression?

From time to time, nearly everyone feels depressed, sad or blue. These feelings are a normal reaction to some of life’s struggles, such as the loss of a loved one. But when feelings of intense sadness last for days or weeks on end and they interfere with your ability to function normally, it may be more than just a natural mood fluctuation.

Depression, also called major depression and major depressive disorder, is a common but serious medical illness that affects the way you feel, think and behave. It causes a persistent feeling of sadness and loss of interest, and can also trigger physical symptoms. In addition, it can make you feel as though life isn’t worth living.

Depression isn’t a weakness or something you can easily overcome, but rather a chronic illness that often requires long-term treatment. Medications, counseling and other forms of therapy prove to be very effective for treating depression. Despite this, many people with depression never seek treatment.

What causes depression?

Depression is most often caused by a combination of genetic, biological, environmental, and psychological factors. These include:

  • Family history of depressive disorders
  • Traumatic experiences
  • Physical health
  • High levels of stress
  • Life transition
  • Loss of a loved one
  • Alcohol and drug abuse
  • Certain medications
  • Serious physical and mental illness
  • Lack of social support
  • Lack of good coping skills
  • Difficult relationships and/or conflicts that have not been resolved
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Depressed man looking sadDepression affects each person in different ways, so symptoms caused by depression vary from person to person. Symptoms may include:

  • Persistent feelings of sadness, unhappiness or emptiness
  • Irritability, frustration or angry outbursts, even over small matters
  • Loss of interest in activities that were once pleasurable
  • Insomnia or excessive sleeping
  • Decreased appetite and weight loss, or conversely overeating and weight gain
  • Agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Fatigue, tiredness and loss of energy
  • Feelings of hopelessness, worthlessness or guilt
  • Reduced sex drive
  • Difficulty concentrating, making decisions and remembering things
  • Frequent thoughts of death, dying or suicide
  • Crying spells for no apparent reason
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • If you or a loved one is experiencing symptoms of depression that last for more than one or two weeks, see your health care provider for proper diagnosis and treatment.
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Depression Doctors Can HelpCertain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor will often ask some general questions and then conduct a physical exam and laboratory tests to rule out these possibilities. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation. The doctor may conduct the psychological evaluation or refer you to a mental health specialist.

  • Physical exam: This may include measuring your height and weight and checking your vital signs, such as heart rate, blood pressure and temperature. Your doctor may also listen to your heart and lungs and examine your abdomen.
  • Laboratory tests: Your doctor will typically do a blood test called a complete blood count (CBC) or test your thyroid to make sure it is functioning properly.
  • Psychological evaluation: To check for signs of depression, your doctor or mental health provider will discuss with you any family history of depression or other mental disorder, and get a complete history of your symptoms. Your doctor or mental health provider may also ask if you are using alcohol or drugs, and if you are thinking about death or suicide. 
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Depression Medicine can help treatmentOnce you have a depression diagnosis, your doctor will discuss various treatment options with you. The main treatments for major depression recommended by the World Health Organization are medication and psychotherapy. Usually, a combination of medication and psychotherapy is the most effective treatment for depression.

  • Medications: Several different types of antidepressant medications are available to treat depression. All antidepressants must be taken for at least 4 to 6 weeks before they have a full effect. These include:
    • Selective serotonin reuptake inhibitors (SSRIs): Many doctors start depression treatment by prescribing an SSRI as they tend to have fewer side effects than other types of antidepressants. The most common side effects include decreased sexual drive and delayed orgasm. The World Health Organization states that SSRIs can sometimes produce headaches, nausea, jitters, or insomnia when people first start to take them. However, these symptoms often fade with time.
    • Serotonin and norepinephrine reuptake inhibitors (SNRIs): These medications are similar to SSRIs. Side effects of SNRIs can cause increased sweating, dry mouth, fast heart rate and constipation.
    • Tricyclic antidepressants: Tricyclics are powerful, but are not used as often anymore because they tend to have more severe side effects than newer medications like SSRIs and SNRIs. Side effects include dizziness, dry mouth and weight gain.
    • Monoamine oxidase inhibitors (MAOIs): MAOIs are usually prescribed as a last resort, as MAOIs can have very serious and harmful side effects. They require a strict diet because of dangerous interactions with foods such as certain cheeses, pickles and wines. These medications also can't be combined with SSRIs.
    • Other medications: Your doctor may recommend other medications to treat your depression including stimulants, mood-stabilizing medications, anti-anxiety medications or antipsychotic medications.
  • Psychotherapy: Psychotherapy is a method of treating depression by talking about the condition and related issues with a mental health provider. Several types of psychotherapy are effective in treating depression, although two main types are used most commonly. These are cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT helps people with depression restructure negative thought patterns. Doing so helps them interpret their environment and interactions with others in a positive and realistic way, which in turn, can affect their moods. IPT helps people understand and resolve troubled relationships that may cause or worsen their depression. For mild to moderate depression, psychotherapy is sometimes considered the best option. However, for severe depression or for certain people, psychotherapy may not be enough.
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Exercise is Key in Managing DepressionAlthough depression is a highly treatable condition, there is no guaranteed way to prevent it.

However, the latest medical studies confirm that depression may often be alleviated and sometimes prevented with good health habits. Eating a healthy diet and getting regular exercise can go a long way in boosting your overall mood and reducing symptoms of depression. Taking steps to control stress, such as scheduling time every week for fun and relaxation, may also work together to prevent a depressed mood.

Strong social support, especially in times of crisis, is another identified way of getting through tough experiences and protecting against depression. Finally, seeking treatment at the earliest sign of a problem can stop depression from worsening.

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