Depression

Depression is mental illness in which a person experiences deep, unshakable sadness and diminished interest in nearly all activities. The term depression is also used to describe the temporary sadness, loneliness, or blues that everyone feels from time to time. In contrast to normal sadness, severe depression, also called major depression, can dramatically impair a person’s ability to function in social situations and at work. People with major depression often have feelings of despair, hopelessness, and worthlessness, as well as thoughts of committing suicide.

Anyone, regardless of age, gender, race, or socioeconomic status, can suffer from depression. Depression is not a weakness or a character flaw; it is a true medical illness. The good news is that with proper treatment, 4 out of 5 patients will improve in time.People who have depression are not just moody or having "the blues" for a few days. They have long periods of feeling very sad and lose interest in social and daily activities. Depression changes the way a person feels, thinks, and behaves.

The causes of depression are not always clear. It may be caused by an event or for no apparent reason at all. Genes may also play a role by not providing your brain with enough serotonin. The symptoms of depression may differ from person to person. Some symptoms may include a persistent sad mood, lack of pleasure in activities, change in sleep or eating habits, or a feeling of worthlessness.

Depression can take several other forms. In bipolar disorder (manic-depressive illness) a person’s mood swings back and forth between depression and mania. People with seasonal affective disorder typically suffer from depression only during autumn and winter, when there are fewer hours of daylight. In dysthymia people feel depressed, have low self-esteem, and concentrate poorly most of the time—often for a period of years—but their symptoms are milder than in major depression. Some people with dysthymia experience occasional episodes of major depression.

If left untreated, an episode of major depression typically lasts eight or nine months. About 85 percent of people who experience one bout of depression will experience future episodes.

Depression usually alters a person’s appetite, sometimes increasing it, but usually reducing it. Sleep habits often change as well. People with depression may oversleep or, more commonly, sleep for fewer hours. A depressed person might go to sleep at midnight, sleep restlessly, then wake up at 5 am feeling tired and blue. For many depressed people, early morning is the saddest time of the day.

Depression also changes one’s energy level. Some depressed people may be restless and agitated, engaging in fidgety movements and pacing. Others may feel sluggish and inactive, experiencing great fatigue, lack of energy, and a feeling of being worn out or carrying a heavy burden. Depressed people may also have difficulty thinking, poor concentration, and problems with memory.People with depression often experience feelings of worthlessness, helplessness, guilt, and self-blame. They may interpret a minor failing on their part as a sign of incompetence or interpret minor criticism as condemnation. Some depressed people complain of being spiritually or morally dead. Their mirror seems to reflect someone ugly and repulsive. Even a competent and decent person may feel deficient, cruel, stupid, phony, or guilty of having deceived others. People with major depression may experience such extreme emotional pain that they consider or attempt suicide.

At least 15 percent of seriously depressed people commit suicide, and many more attempt it.In some cases, people with depression may experience psychotic symptoms, such as delusions (false beliefs) and hallucinations (false sensory perceptions). Psychotic symptoms indicate an especially severe illness. Compared to other depressed people, those with psychotic symptoms have longer hospital stays, and after leaving, they are more likely to be moody and unhappy. They are also more likely to commit suicide.

Treatment

Commonly used antidepressant drugs fall into three major classes: tricyclics, monoamine oxidase inhibitors (MAO inhibitors), and selective serotonin re-uptake inhibitors (SSRIs).

Studies have shown that short-term psychotherapy can relieve mild to moderate depression as effectively as antidepressant drugs. Unlike medication, psychotherapy produces no physiological side effects. In addition, depressed people treated with psychotherapy appear less likely to experience a relapse than those treated only with antidepressant medication. However, psychotherapy usually takes longer to produce benefits.There are many kinds of psychotherapy. Cognitive-behavioral therapy assumes that depression stems from negative, often irrational thinking about oneself and one’s future. In this type of therapy, a person learns to understand and eventually eliminate those habits of negative thinking. In interpersonal therapy, the therapist helps a person resolve problems in relationships with others that may have caused the depression. The subsequent improvement in social relationships and support helps alleviate the depression. Psychodynamics therapy views depression as the result of internal, unconscious conflicts. Psychodynamics therapists focus on a person’s past experiences and the resolution of childhood conflicts. Psychoanalysis is an example of this type of therapy. Critics of long-term psychodynamics therapy argue that its effectiveness is scientifically unproven.

Electro convulsive therapy (ECT) can often relieve severe depression in people who fail to respond to antidepressant medication and psychotherapy.

For milder cases of depression, regular aerobic exercise may improve mood as effectively as psychotherapy or medication. In addition, some research indicates that dietary modifications can influence one’s mood by changing the level of serotonin in the brain.

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