Depression: Signs, Symptoms, Treatment
Synopsis: Introduction to depression including common causes of feeling depressed, medications available and treatment options. There are several types of antidepressant medications that a physician may prescribe to treat depression. Antidepressant medications can also be used to treat diseases that have depression as a component of them, such as Bipolar disorder. Despite the form of treatment a doctor prescribes to treat the form of depression a person has, there are no immediate solutions. People often find that they have to try different antidepressant medications before finding the one that works for them, making patients with the process of treatment a crucial part.
Depression is defined as a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings, and sense of well-being. People with depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed or restless. They may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present.
The DSM-IV is a manual that is used to diagnose mental health disorders; it describes depression as occurring when a person has at least five out of nine of the following symptoms at the same time. Symptoms the persons may experience include:
- Experiencing significant weight gain or loss
- Having recurring thoughts of death or suicide
- Experiencing fatigue or loss of energy nearly every day
- Having feelings of worthlessness or guilt almost every day
- Feeling a sense of restlessness, or of being slowed down
- Experiencing impaired concentration, or indecisiveness
- Experiencing insomnia or sleeping excessively nearly every day
- Feeling depressed during most of the day, particularly in the morning
- Markedly diminished interest or pleasure in almost all activities, nearly every day
In persons who may have either clinical or major depression, one of the signs is either loss of interest in things that used to interest the person greatly, or depressed mood. In order for a diagnosis of depression to be made, these signs need to be present throughout most of the person's day on either a daily, or nearly daily basis for at least two weeks. The symptoms the persons are experiencing related to depression also need to be causing them clinically significant distress or impairment. The symptoms cannot be caused by something like a substance; medications or illegal drugs, for example. The symptoms the person is also experiencing cannot be the result of something such as hypothyroidism or another medical condition. If the symptoms the person is experiencing happen within two months of the time they have lost someone they love, they will also not be diagnosed with depression.
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Feelings Associated with Depression
The National Institute of Mental Health states that not everyone with a depressive illness will experience the same symptoms. The frequency, severity, and length of the feelings an individual will experience varies from person to person, as well as the particular illness they have. Common symptoms that people experience relating to depression include:
- Feeling fatigue and decreased energy
- Experiencing restlessness or irritability
- Finding no pleasure left in life anymore
- Experiencing appetite loss, or overeating
- Having persistent sad, anxious, or "empty" feelings
- Having feelings of pessimism or hopelessness
- Having thoughts of suicide, or making suicide attempts
- Experiencing feelings of worthlessness, guilt, or helplessness
- Experiencing insomnia, early morning wakefulness, or excessive sleeping
- Having difficulty concentrating, remembering details, and making decisions
- Having a loss of interest in activities or hobbies once pleasurable, including sex
- Experiencing persistent aches or pains, headaches, cramps, or digestive problems
The symptoms of depression may also occur in patterns. A person might also be diagnosed with either mania or hypomania, or a condition referred to as, 'Manic-Depressive Illness.' The symptoms that a person experiences may also be seasonal; something that is referred to as, 'Seasonal Affective Disorder (SAD).'
There are different forms of Manic-Depressive Illness. Persons with Bipolar II disorder are currently believed to have experienced a minimum of one major depression and one hypomanic episode. Persons with Bipolar I disorder are currently believed to have experienced at least one manic episode, yet may or may not have experienced a major depression. Persons with Unipolar disorder are currently believed to experience major depression only, and do not experience either mania or hypomania.
Depression Facts and Statistics
According to the World Health Organization (WHO; 2010), major depression also carries the heaviest burden of disability among mental and behavioral disorders. Specifically, major depression accounts for:
- 8.3 percent of all U.S. years lived with disability(YLDs)
- 3.7 percent of all U.S. disability-adjusted life years(DALYs)
- Major depressive disorder is more prevalent in women than in men.
- As many as one in 33 children and one in eight adolescents have clinical depression.
- While major depressive disorder can develop at any age, the median age at onset is 32.
- In 2012, an estimated 16 million adults aged 18 or older in the U.S. had at least one major depressive episode in the past year. This represented 6.9 percent of all U.S. adults.
- People with depression are four times as likely to develop a heart attack than those without a history of the illness. After a heart attack, they are at a significantly increased risk of death or second heart attack.
Home Remedies: Some people experience depression that they prefer natural therapy treatments for. There is currently no evidence that any form of alternative therapy treatments or home remedies are effective in the treatment of moderate to severe depression. Persons with mild depression may find some benefit through use of home remedies and alternative therapies due to increased relaxation, which can provide relief from depressive symptoms. They may also assist people in coping with causes of depression, or even physical pain. It is always wise to consult a health care professional before beginning alternative or natural therapy.
Alternative Therapy: Health treatments that are not classified as being, 'standard,' according to Western medicine, are referred to as, 'alternative.' Alternative therapies pursue several approaches, which may include things such as exercise, diet, mental conditioning, and lifestyle changes. The following are some examples of alternative therapies:
- Guided imagery
- Herbal remedies
- Massage therapy
- Chiropractic treatments
Herbal Remedies - There are two herbal therapies that some people believe are useful in association with depression; St. John's Wort and Ginko Biloba. St. John's Wort is a herb that has been used for medical purposes in parts of the world for thousands of years. Still; it has not been scientifically proven to be effective in treatment of moderate depression. Ginko Biloba is a herb that some people believe is useful for improving both memory and intellectual functioning; it also has yet to be proven. Always consult a doctor before starting to take a herbal supplement. Herbal supplements should be treated exactly like medications.
There are several types of antidepressant medications that a physician may prescribe to treat depression. Antidepressant medications can also be used to treat diseases that have depression as a component of them, such as Bipolar disorder. Antidepressants improve the symptoms of depression, and belong to the following types:
- Tricyclic antidepressants (TCAs):
TCAs primarily affect the levels of two chemical messengers in the brain, norepinephrine, and serotonin. Although these drugs are effective in treating depression, they can have more side effects than other drugs. So, they typically aren't the first drugs used.
- Monoamine oxidase inhibitors (MAOIs):
MAOIs are most effective in people with depression who do not respond to other treatments. They are also effective for treating other mental illnesses. Substances in certain foods like cheese, beverages like wine, and medications can interact with an MAOI. So people taking this medication must adhere to strict dietary restrictions. For this reason, these antidepressants also aren't usually the first drugs used.
- Selective serotonin reuptake inhibitors (SSRIs):
SSRIs are a newer form of antidepressant. These drugs work by altering the amount of a chemical in the brain called serotonin.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs):
SNRIs are another newer form of antidepressant medicine. They treat depression by increasing availability of the brain chemicals serotonin and norepinephrine.
Once a diagnosis of depression has been reached, a doctor discusses potential treatment options with the person who has been diagnosed. The kind of treatment options that are pursued depend on the form of depression the person is experiencing. Some people who are experiencing clinical depression are prescribed antidepressant medications, others are prescribed both antidepressant medications and psychotherapy. Persons who are experiencing depression that is not responding to these forms of treatments may undergo electroconvulsive therapy (ECT), also referred to as, 'electroshock therapy.'
Despite the form of treatment a doctor prescribes to treat the form of depression a person has, there are no immediate solutions. People often find that they have to try different antidepressant medications before finding the one that works for them, making patients with the process of treatment a crucial part. Many people with depression benefit by making lifestyle changes such as getting more exercise, cutting down on alcohol and eating more healthily. Self-help measures such as reading a self-help book or joining a support group are also worthwhile.
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