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Depression

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What is depression?

It is a medical illness that involves the mind and body.
It is more than feeling blue, down in the dumps, or sad about a particular issue or situation.
It interferes with a person’s function in daily living, relationship, and work life.
It is a condition that requires diagnosis and treatment by a trained healthcare provider.

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What is NOT depression?

It is NOT a normal part of aging
It is NOT something to be a shamed of
It is NOT a character flaw or sign of weakness
It is NOT something you can just “snap out of”

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Who suffers from depression?

EVERYONE.

Depression is a common condition that affects

about 19 million American adults every year.

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What are the symptoms of depression?

Emotional Symptoms Include:
Sadness
Loss of interest or pleasure
Overwhelmed
Anxiety
Diminished ability to think or concentrate, indecisiveness
Excessive or inappropriate guilt

Physical Symptoms Include:
Vague aches and pains
Headache
Sleep disturbances
Fatigue
Back pain
Significant change in appetite resulting in weight loss or gain

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Why do people get depression?

There is no one single cause.

Depression happens because of a combination of things:

Genes
Brain chemistry
Environment and psychological factors
Medical conditions / medications - Must rule out!

Genes - some types of depression tend to run in families. Genes are the "blueprints" for who we are, and we inherit them from our parents. Scientists are looking for the specific genes that may be involved in depression.

Brain chemistry and structure - when chemicals in the brain are not at the right levels, depression can occur. These chemicals, called neurotransmitters, help cells in the brain communicate with each other. By looking at pictures of the brain, scientists can also see that the structure of the brain in people who have depression looks different than in people who do not have depression. Scientists are working to figure out why these differences occur.

Environmental and psychological factors - trauma, loss of a loved one, a difficult relationship, and other stressors can trigger depression. Scientists are working to figure out why depression occurs in some people but not in others with the same or similar experiences. They are also studying why some people recover quickly from depression and others do not.

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Two neurotransmitters involved in depression

Sex

Appetite

Aggression

Concentration

Interest

Motivation

Depressed Mood

Anxiety

Irritability

Thought process

Norepinephrine

Serotonin

Vague Aches and pain

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�Can a person have depression and another illness at the same time?

Anxiety disorders, including

post-traumatic stress disorder (PTSD),
obsessive-compulsive disorder (OCD),
panic disorder,
social phobia,
generalized anxiety disorder (GAD);

Alcohol and other substance abuse or dependence;
Medical problems, including

heart disease,
stroke, cancer,
HIV/AIDS,
diabetes,
Parkinson's disease.

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Different forms of depression

Major Depressive Disorder

Melancholic
Atypical
Catatonic
Psychotic

Dysthymic Disorder
Double Depression
Postpartum Depression
Seasonal Affective Disorder

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What are my treatment options?

Psychotherapy
Medication
Electroconvulsive therapy

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Psychotherapy, aka “talk therapy”

Best treatment for mild to moderate depression
2 main types:

Cognitive-behavorial therapy
Interpersonal therapy

for major depression or for certain people, psychotherapy may not be enough. For teens, a combination of medication and psychotherapy may work the best to treat major depression and help keep the depression from happening again. Also, a study about treating depression in older adults found that those who got better with medication and IPT were less likely to have depression again if they continued their combination treatment for at least two years.

There are two main types of psychotherapy commonly used to treat depression: cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT teaches people to change negative styles of thinking and behaving that may contribute to their depression. IPT helps people understand and work through troubled personal relationships that may cause their depression or make it worse.

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Medications

Selective serotonin reuptake inhibitors (SSRIs)
Serotonin & norepinephrine reuptake inhibitors (SNRIs)
Monoamine oxidase inhibitors (MAOIs)
Tricyclics

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Electroconvulsive therapy (ECT)

For severe cases in which therapy and/or medication does not treat depression
Used to have a bad reputation and was known as “shock therapy”
Today, ECT has greatly improved and has shown to help those who cannot feel better with other treatments

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How can I find help?

Talk to your family doctor
Others who can help: Psychiatrists, psychologists, licensed social workers, or licensed mental health counselors, Health maintenance organizations, Community mental health centers, Hospital psychiatry departments and outpatient clinics, Mental health programs at universities or medical schools, State hospital outpatient clinics, Family services, social agencies or clergy, Peer support groups, Private clinics and facilities, Employee assistance programs, Local medical and/or psychiatric societies.

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How can I afford treatment?

Insurance
Low-fee / sliding scales at some clinics or health centers
Medicaid

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�What if I or someone I know is in crisis?

Call your doctor.
Call 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.
Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor.
Make sure you or the suicidal person is not left alone.

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References

National Institute of Mental Health http://www.nimh.nih.gov/
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. �Fourth Edition,Text Revision. Washington, DC; American Psychiatric Association. 2000:345-356,489.