Symptoms Of Depression
Everyone gets blue now and then in response to life's
disappointments, but when feelings such as sadness, loneliness,
exhaustion, hopelessness, and irritability persist and prevent a
person from functioning normally, they may be suffering from
Depression can be devastating to all areas of a person's
everyday life, affecting their relationships with family and
friends, impeding their ability to work or go to school, and
even disrupting their normal eating and sleeping patterns.
Depression is not a sign of personal weakness; people with a
depressive illness cannot merely "pull themselves together" and
get better. If left untreated, symptoms can last for weeks,
months, or even years, causing needless pain and suffering, not
only to the person who is depressed, but also to those who care
about them. Untreated, depression can even lead to suicide.
Depression can afflict anyone, regardless of age, race, class,
or gender. Nearly 20 million Americans suffer from depression
each year, but only one out of ten seeks out and receives
adequate treatment, even though the great majority of people
with depression--including those whose illness is extremely
severe--can be helped to full recovery.
Types of Depression
Depressive disorders come in different forms, just as in the
case of many other illnesses. Two of the most common depressive
disorders--major depressive disorder and dysthymia-are detailed
- Major Depressive
Disorder (often referred to as clinical depression) is
manifested by a combination of symptoms that severely
interfere with the ability to work, sleep, eat, and enjoy once
pleasurable activities. A diagnosis of major depressive
disorder is made if an individual has five or more of the
depression symptoms listed below, and at least one of the
first two, during the same two-week period. Disabling episodes
of major depression affect 15% of Americans and can occur one
or more times in a person's lifetime.
(sometimes called minor or chronic depression) does not strike
in episodes like major depression; rather it is characterized
by less intense, more persistent symptoms that may last for
years (at least two years in adults, and at least one year in
children or adolescents). Typically, there are no disturbances
in appetite or sexual drive. Severe agitation, sedentary
behavior, and suicidal thoughts are also not usually present
in dysthymia. While the symptoms of dysthymia are not as
disabling as those for major depression, people who suffer
from this depressive disorder do experience decreased energy,
general negativity, and an overall sense of dissatisfaction
and hopelessness that pervades most, if not all, areas of
their life. Many people with dysthymia also experience major
depressive episodes; in such cases, the condition is known as
double depression. Almost 10 million Americans suffer from
dysthymia each year.
Persistent sad, anxious, or
While major depressive disorder and dysthymia are considered the
two most common depressive disorders, there are other types of
depression, including adjustment disorder, complicated grief,
and seasonal affective disorder.
Symptoms of Depression
Not everyone who is depressed experiences every symptom listed
below. The severity of symptoms also varies with individuals. A
person's diagnosis depends on the number of symptoms they have,
how strong those symptoms are, and how long they last.
Loss of interest or pleasure
in hobbies and activities that were once enjoyed, even sex.
Feelings of hopelessness,
Feelings of guilt,
awakening, or oversleeping.
Significant change in
appetite or body weight.
Decreased energy, fatigue,
feeling "slowed down."
Recurrent thoughts of death
or suicide; suicide attempts.
remembering, making decisions.
Persistent physical symptoms
that do not respond to treatment, such as headaches, digestive
disorders, and chronic pain.
For a child or adolescent, symptoms of depression also include
such youth-specific considerations as performance in school and
interaction with classmates.
Causes of Depression
There are many possible factors that can contribute to
depression. For some people, depression is the result of a
combination of factors, while for others, a single cause can be
responsible for the onset of depression. Common contributing
factors include the following:
Catastrophic illness or death of a close family member or
friend, divorce, career crisis, moving to a new place, financial
problems, or any unwelcome change in life patterns can be risk
factors for depression. Research also indicates that stressors
in the form of social isolation or early-life deprivation can
lead to permanent changes in brain function that increase
susceptibility to depressive symptoms. For some individuals,
stressful life events can contribute to recurrent episodes of
Severe or long-term illness can bring on or aggravate
depression. Up to 60% of chronic pain patients suffer from some
degree of clinical depression. There are also illnesses that may
be directly related to depressive disorders, such as strokes,
heart disease, certain types of cancer, thyroid disease,
diabetes, Parkinson's disease, Alzheimer's disease, and hormonal
abnormalities. When it occurs with other illnesses, depression
is frequently unrecognized and goes untreated. This can lead to
unnecessary suffering since depression is highly treatable, even
when it occurs with other disorders. Individuals or family
members with concerns about the occurrence of depression with
another illness should discuss this issue with their physician.
Some medications cause depressive symptoms as side effects;
among them are pain relievers for arthritis,
cholesterol-lowering drugs, certain medications for high blood
pressure and heart problems, and bronchodilators used for asthma
and other lung disorders. In addition, different drugs can
interact in unforeseen ways when taken together. It is important
that each physician and pharmacist knows all the different types
and dosages of medicine being taken and discusses the possible
side effects with the patient.
Genetics research indicates that vulnerability to depression
results from the influence of brain chemistry imbalance acting
together with environmental factors. Modern brain imaging
technologies are revealing that in depression, neural circuits
responsible for the regulation of moods, thinking, sleep,
appetite, and behavior fail to function properly, and that
critical neurotransmitters-chemicals used by nerve cells to
communicate-are out of balance.
Co-Occurrence of Depression and Anxiety
Research has revealed that depression can co-exist with anxiety
disorders (e.g., panic disorder, obsessive-compulsive disorder,
post-traumatic stress disorder, social phobia, or generalized
anxiety disorder). Studies have shown an increased risk of
suicide attempts in people with co-occurring depression and
panic disorder, the anxiety disorder characterized by unexpected
and repeated episodes of intense fear and physical symptoms,
including chest pain, dizziness, and shortness of breath. Rates
of depression are especially high in people with post-traumatic
stress disorder, a debilitating condition that can occur after
exposure to a terrifying event or ordeal in which grave physical
harm occurred or was threatened.
Abuse and Addictions
It is estimated that 25% of people with substance abuse suffer
from major depression.
Evidence suggests that depression runs in families. Still, just
because a person has family members with depression does not
guarantee that he or she will develop it. Similarly, a person
may get depression even if no one else in their family has
The sooner depression is treated, the sooner recovery can begin.
The American Psychiatric Association reports that "80% to 90% of
all people with depression-even those with the severest
cases-improve once they receive appropriate treatment." Basic
ways to treat depression include therapy, medication, and a
combination of the two.
There are therapists who are especially skilled at helping
people who are suffering from depression. Therapy provides a
safe, comforting, and confidential setting in which to receive
the kind of help and understanding that can best assist in first
relieving, then understanding, and finally recovering from the
effects of depression. It can take as few as one to two weeks
for people to begin to receive noticeable relief from their
symptoms with therapy.
Antidepressant medication is often the first step in treating
cases of depression because of the relatively quick relief it
can bring to physical symptoms. Once medication treatment
begins, minor improvement is usually seen in one to two weeks
and the full effect of relief becomes evident approximately
three to four weeks later.
Combination of Therapy and Medication
In some cases, neither therapy alone nor medication alone may
treat depression as quickly or thoroughly as the patient or the
therapist would like. For these cases, both types of treatment
used together can have very successful results. For those who
suffer from chronic depression, combination therapy is
especially helpful in dealing with the condition and how it
affects their lives.