DEPRESSION? IT'S NOT JUST A "FUNK"

Clinical Depression is a serious medical illness. There are times when you can feel down, or a little sad, disappointed, or irritable; but in contrast to the normal passing of emotional mood states, depression is persistent and can interfere significantly with your ability to function.


SYMTOMS OF DEPRESSION INCLUDE:

* sad mood
* loss of interest or pleasure in activities that were once enjoyed
* change in appetite or weight
* difficulty sleeping or oversleeping
* physical showing of agitation
* physical symtoms like aches and pains
* energy loss
* feelings of worthlessness or inappropriate guilt
* difficulty thinking or concentrating
* recurrent thoughts of death or suicide


A diagnosis of unipolar major depression (or major depressive disorder)is made if a person has five or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15-30 or even earlier. Episodes typically recur.


TYPES OF DEPRESSION

Depressive disorders come in different forms, just like other illnesses, for example, heart disease and cancer. This is a brief discussion of three of the most common types of depressive disorders. Within these types there are variations in the number of symptoms, their severity, and persistence.


Major Depression is a group of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy life. 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 depressive disorders, 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 have a great deal of energy. They may also be agitated, aggressive and explosive.

Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.


Depression can be devastating to all areas of a person's everyday life, including family relationships, friendships, and the ability to work or go to school. Many people still believe that the emotional symptoms caused by depression are "not real", and that a person should be able to shake off the symptoms if only he or she were trying hard enough.

Because of these inaccurate beliefs, people with depression either may not recognize that they have a treatable disorder or may be discouraged from seeking or staying in treatment because of feelings of shame and stigma. Too often, untreated or inadequately treated depression leads to suicide.


Depression affects nearly 10 percent of adult Americans age 18 and over in a given year (more than 19 million people per year).

Major Depression is the leading cause of disability in the United States and worldwide.

Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive illness each year.

Evidence from studies of twins support the existence of a genetic component to risk for depression.

Research has shown that stress in the form of loss, especially death of a close family member or friend, may trigger major depression in vulnerable individuals.



Treatment

Antidepressant medications are widely used effective treatments for depression. Existing antidepressant drugs are known to influence the functioning of certain neurotransmitters (chemicals used by the brain cells to communicate), primarily serotonin, norepinephrine, and dopamine, known as monoamines. Older medications - tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAIOs) affect the activity of both of these neurotransmitters simultaneously. Their disadvantage is that they can be difficult to tolerate due to side effects or, in the case of MAOIs, dietary and medication restrictions.

Newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), have fewer side effects than the older drugs, making it easier for patients to adhere to treatment. Both generations of medications are effective in relieving depression, although some people will respond to one type of drug, but not another. Medications that take entirely different approaches to treating depression are now in development.


Psychotherapy is also effective in treating depression. Certain types of psychotherapy, cognitive-behavioral therapy and interpersonal therapy have been shown to be particularly useful. More than 80 percent of people with depression improve when they receive appropriate treatment with medication, psychotherapy, or the combination.

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