Provided by the National Institute of Mental Health
Depression is a serious medical condition that
involves the body, mood, and thoughts. It affects the way a person eats and
sleeps, the way one feels about oneself, and the way one thinks about things. A
depressive disorder is not the same as a passing blue mood. It is not a sign of
personal weakness or a condition that can be willed or wished away. People with
a depressive illness cannot merely "pull themselves together" and get better.
Without treatment, symptoms can last for weeks, months, or years. Appropriate
treatment, however, can help most people who have depression.
Types of Depression
Depression comes in different forms, just as is the case with other illnesses
such as heart disease. The three main depressive disorders are: major depressive
disorder, dysthymic disorder, and bipolar disorder.
Major depression (or major depressive disorder) is manifested by a combination
of symptoms (see symptom list below) that interfere with the ability to work,
study, sleep, eat, and enjoy once pleasurable activities. A major depressive
episode may occur only once, but more commonly, several episodes may occur in a
lifetime. Chronic major depression may require a person to continue treatment
indefinitely.
A less severe type of depression, dysthymia (or dysthymic disorder), involves
long-lasting symptoms that do not seriously disable, but keep one from
functioning well or feeling good. Many people with dysthymia also experience
major depressive episodes during their lives.
Another type of depressive illness is bipolar disorder (or manic-depressive
illness). Bipolar disorder is characterized by cycling mood changes: severe
highs (mania) and lows (depression), often with periods of normal mood in
between. When in the depressed cycle, an individual can have any or all of the
symptoms of depression. When in the manic cycle, the person may be overactive,
over-talkative, and have a great deal of energy. Mania often affects thinking,
judgment, and social behavior in ways that cause serious problems and
embarrassment. For example, an individual in a manic phase may feel elated and
full of grand schemes that might range from unwise business decisions to
romantic sprees.
Symptoms of Depression
Not everyone with a depressive disorder experiences every symptom. The number
and severity of symptoms may vary among individuals and also over time. In
addition, men and women may experience depression differently. Symptoms of
depression include:
Persistent sad, anxious, or "empty" mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in hobbies and activities that were once enjoyed,
including sex
Decreased energy, fatigue, being "slowed down"
Difficulty concentrating, remembering, making decisions
Trouble sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
Restlessness, irritability
Persistent physical symptoms, such as headaches, digestive disorders, and
chronic pain, which do not respond to routine treatment
Some Facts About Depression
Depressive disorders are common: they affect an estimated 9.5 percent of adult
Americans in a given year, or about 19 million people.
Depressive disorders often begin between ages 15 and 30 but also can appear in
children.
The World Health Organization's World Health Report, 2001 states that in the
year 2000, depression (not including bipolar disorder) was the leading cause of
years lived with a disability among men and women of all ages in the U.S. and
worldwide.
Treatments
More than 80 percent of people with depressive disorders improve when they
receive appropriate treatment. The first step to getting treatment is a physical
examination by a physician to rule out other possible causes for the symptoms.
Next, the physician should conduct a diagnostic evaluation for depression or
refer the patient to a mental health professional for this evaluation.
Treatment choice will depend on the patient's diagnosis, severity of symptoms,
and preference. A variety of treatments, including medications and short-term
psychotherapies (i.e., "talking" therapies), have proven effective for
depression. In general, severe depressive illnesses, particularly those that are
recurrent, will require a combination of treatments for the best outcome. It
usually takes a few weeks of treatment before the full therapeutic effect
occurs. Once the person is feeling better, treatment may need to be continued
for several months-and in some cases, indefinitely-to prevent a relapse into
depression.
NIH Publication No. 03-5299
Printed March 2003
Department of Health & Human Services
National Institutes of Health
National Institute of Mental Health
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