What is depression?
Depression refers to feeling sad, "blue," and uninterested in the things that are normally a source of pleasure. It also refers to having negative or pessimistic thoughts. A depression becomes more severe when physiological symptoms also occur, such as changes in sleep, appetite, or sexual function. Also, the symptoms of depression can make it difficult for you to function normally.
How does it occur?
The exact cause of depression is not known. In more serious cases heredity appears to be involved.
Some people have a greater risk of depression, such as those who:
- have a family history of anxiety or depression
- are anxious
- are alcoholics
- are drug addicts
- have a perfectionist personality.
What are the symptoms?
- feeling sad or blue (may include crying spells, anxiety, agitation, irritability)
- loss of interest or pleasure in usual activities.
- poor appetite and significant weight loss, or increased appetite and significant weight gain
- inability to sleep (insomnia), increase in time spent sleeping (hypersomnia), or difficulty sleeping soundly
- fatigue, loss of energy
- increased physical activity (agitation) and restlessness
- decreased sex drive
- feelings of self-reproach or inappropriate guilt
- difficulty in thinking clearly or concentrating
- memory difficulties
- thoughts of death or suicide.
How is it diagnosed?
To diagnose depression, your doctor reviews your symptoms with you and with someone close to you. A physical exam may also be part of the evaluation. In addition to checking your overall physical condition, the doctor will try to determine whether alcohol abuse, overeating, hypothyroidism, some cancers, anemia, or an infection such as hepatitis or mononucleosis may be contributing to your depression.
How is it treated?
It is unwise to try to overcome depression by yourself. When symptoms are relatively mild, psychotherapy or counseling is the most common way to treat depression. If your symptoms are more serious (for example, involving sleep changes or difficulties with day-to-day functioning), you may need medication and psychotherapy.
If you start taking antidepressant medication, it will probably be 3 to 6 weeks before the medication relieves the symptoms of depression. After that, you should continue to take the medication for 9 to 12 months to prevent a recurrence of the depression. It is important to keep taking your medication at the prescribed dose, even after symptoms go away, and not to stop until told to by your doctor. When it is time to stop taking the medication, it is usually necessary to reduce the dosage gradually, rather than suddenly stopping the medication, to avoid adverse effects. If you have recurrent depressions or chronic depression, you may need to continue to take antidepressant medication indefinitely.
How long will the effects last?
Without treatment, most episodes of depression end within 6 to 12 months. However, these episodes often recur and some episodes may last much longer. Psychotherapy and antidepressant medication should help you feel better in a few weeks. Depression often recurs, however, even with treatment. If the symptoms of depression return, call your therapist or doctor immediately.
You may experience some side effects from antidepressant medication, depending on the medication and dosage you are taking. Notify your doctor of any side effects so he or she can work with you to keep them to a minimum.
How can I take care of myself?
Follow the treatment recommended by your doctor, including antidepressant medication (if prescribed) and counseling. In addition, you can:
- Identify the activities that make you feel somewhat better and try to focus on them. Do things for yourself. Take up hobbies. Listen to music. Participate in activities even when you may not want to.
- Do not withdraw from others. Join a support group and talk to your friends. Call on your support group or therapist for help when you need it. Ask for assistance at home and work if the load is too great to handle.
- Eat nutritious, well-balanced meals. Avoid drinking alcohol and coffee.
- Exercise on a regular basis, several times a week.
- Get adequate rest and keep your sleep cycle as regular as possible.
- Concentrate on good grooming and cleanliness.
- Learn new, positive problem-solving techniques.
- Call your doctor or therapist if you feel suicidal.