Sunday, April 5, 2015

Wednesday, February 2, 2011

What is depression?

Depression is a disorder that involves feelings of sadness lasting for two weeks or longer, often accompanied by a loss of interest in life, hopelessness, and decreased energy. Such distressing feelings can affect one's ability to perform the usual tasks and activities of daily living.

Depression is not a weakness of character. Being depressed does not mean that a person is inadequate. It means the person has a medical illness that is just as real as diabetes or ulcers. Like other medical disorders, clinical depression should not be ignored or dismissed. A clinically depressed person cannot simply "snap out of it" any more than a person with an ulcer could simply will it away.


But depression is highly treatable in the vast majority of cases. Up to 90% of depressed people respond positively to one treatment or another. Sometimes psychotherapy or counseling is all that is needed, but there is also a wide array of effective antidepressant medications and other alternatives. Sometimes, the first treatment will work well. At other times, a second or even a third treatment trial is required to find the best (most effective, most easily tolerated) treatment for the individual patient.




Clinical depression, is an umbrella term used to describe the most common forms of depression, which include:


Major depression, also known as melancholia or unipolar depression, can last up to a year if not treated. A person experiencing an episode of major depression will experience some physical problems, such as headaches, other aches and pains, or digestive upset, for example, in addition to emotional difficulties.


Bipolar disorder,  once called manic depressive illness, causes mood swings that soar to unusual elation, and then plummet to depression. A person with severe bipolar disorder may also see or hear things that are not there or experience paranoia (an incorrect feeling that they are in danger from others).

Dysthymia, is a chronic (ongoing), low-grade depression. It often begins in childhood or adolescence and may last for many years in adulthood if not treated. It is a less severe form of clinical depression, but at times it can be almost as disabling as major depression.

Seasonal affective disorder, (SAD) is a form of depression thought to be triggered by a decrease in exposure to sunlight. In the Northern Hemisphere, the condition usually occurs in late fall and winter, when daylight hours are short, and it is more common in geographical areas that have four clearly defined seasons.

Depression Types

According to the National Institute of Mental Health, major depressive disorder is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities.


There are times you may feel sad, lonely, or hopeless for a few days. But major depression -- clinical depression -- is disabling. It can prevent you from functioning normally. An episode of clinical depression may occur only once in a person's lifetime. More often, though, it recurs throughout a person's life.
In addition, with major depression, one of the symptoms must be either depressed mood or loss of interest. The symptoms should be present daily or for most of the day or nearly daily for at least two weeks. Also, the depressive symptoms must cause clinically significant distress or impairment in functioning. The symptoms cannot be due to the direct effects of a substance -- drug abuse, medications  or a medical condition, such as hypothyroidism, nor occur within two months of the loss of a loved one.

What Is Chronic Depression or Dysthymia?

Chronic depression, or dysthymia, is characterized by a long-term (two years or more) depressed mood. Chronic depression is less severe than major depression and typically does not disable the person. If you have dysthymia or chronic depression, you may also experience one or more episodes of major depression during your lifetime.

What Is Atypical Depression?

The key symptoms of atypical depression include:
  • Overeating
  • Oversleeping
  • Fatigue
  • Extreme sensitivity to rejection
  • Moods that worsen or improve in direct response to events
Regular depression, on the other hand, tends to be marked by pervasive sadness

What Is Bipolar Depression or Manic Depression?

Bipolar disorder -- sometimes referred to as manic depression -- is a complex mood disorder that alternates between periods of clinical depression and times of extreme elation or mania. There are two subtypes of bipolar disorder: bipolar I and bipolar II.
With bipolar I disorder, patients have a history of at least one manic episode with or without major depressive episodes.
With bipolar II disorder, patients have a history of at least one episode of major depression and at least one hypomanic (mildly elated) episode.
For in-depth information, see WebMD's Bipolar Disorder (Manic Depression).

How Is Seasonal Depression (SAD) Different From Other Types of Depression?

Seasonal depression, often called seasonal affective disorder or SAD, is a depression that occurs each year at the same time. It usually starts in the fall or winter and ends in spring or early summer. It is more than just "the winter blues" or "cabin fever." A rare form of SAD, known as "summer depression," begins in late spring or early summer and ends in fall.

Recognizing the Symptoms of Depression

Many women report mood changes linked to their monthly menstrual cycles. Between 3% and 9% of women of reproductive age experience premenstrual dysphoric disorder (PMDD), often with severe depression symptoms.

Whether these cyclic changes are enough to bring on or worsen mood changes or PMDD symptoms probably depends on the individual woman, and how sensitive she is to estrogen and progesterone.
Before you conclude that your mood changes or depression are definitely linked to your menstrual cycle, try keeping a diary for three months, suggests Nada Stotland, MD, MPH, professor of psychiatry and obstetrics and gynecology at Rush Medical College in Chicago.


Many women who think they have PMS [actually] have symptoms that have nothing to do with their cycles at all," she says. "We tend to blame everything on that."


Buy a calendar and chart your daily moods -- up, down, happy, sad, tired, euphoric, angry, irritable, or fatigued. But make sure it's a page-a-day calendar, not a monthly one.


"If you're looking at a monthly calendar, you anticipate your period and are thinking, 'That's when I'm going to feel bad,'" Stotland says. "In order not to prejudice yourself, find a way to keep track of your moods day by day and not pay attention to where you are in your cycle. You can put that together later."

Do You Need Treatment?

If your diary does indeed reveal that your ups and downs are linked to your cycle, how do you know if you should seek treatment? Consider some of these questions:
  • Are you not just irritable at these times, but having the worst fights ever with your partner or children?
  • Do you find yourself unable to enjoy work or family life at these times?
  • Do you experience major disruptions in your ability to function, your eating habits, or your sleep patterns?
  • Do you have extreme levels of anxiety and self-criticism?
  • Do you have morbid thoughts about death, dying, or wanting to die?
        If you answer yes to several of these questions (especially the last one), call your doctor. "If your cyclic symptoms really start to impair your work or personal life significantly, it's time to seek professional help