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Depression is a serious mental illness. In contrast to the normal emotional experiences
of sadness, loss, or passing mood states, depression is persistent and can interfere
significantly with an individual's ability to function.
What Are the Symptoms of Depression?
Symptoms of depression include persistent sad mood, loss interest or pleasure in activities
that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping,
physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt,
difficulty thinking or concentrating, and recurrent thoughts of death or suicide. A diagnosis
of unipolar major depression (or major depressive disorder) is made if a person has five or
more of these symptoms and impairment in usual functioning nearly every day during the
same two-week period. Major depression often begins between ages 15-30 or even earlier.
Episodes typically recur. An estimated 5.3 percent of American adults ages 18 to 54 suffer
from unipolar major depression in a given year. Take a test for depression.
Some people have a chronic but less severe form of depression, called dysthymia (or dysthymic
disorder), that is diagnosed when depressed mood persists for at least two years and is
accompanied by at least two other symptoms of depression. An estimated 1.6 percent of
American adults ages 18 to 54 have dysthymia in a given year. Many people with dysthymia
also have major depressive episodes. While unipolar major depression and dysthymia are the
primary forms of depression, a variety of other subtypes exist.
Depression can be devastating to all areas of a person's everyday life, including family
relationships, friendships, and the ability to go to work or go to school. Many people still
believe that the emotional symptoms caused by depression are "not real," and that a person
should be able to shake off the symptoms if only he or she were trying hard enough.
Because of these inaccurate beliefs, people with depression either many not recognize
that they have a treatable disorder or may be discouraged from seeking or staying on
treatment because of feelings of shame and stigma. Too often, untreated or inadequately
treated depression leads to suicide.
Research has shown that stress in the form of loss, especially death of close family members
or friends, may trigger major depression in vulnerable individuals. In addition, research supports
existence of a genetic component to risk of depression.
What Treatments Are Available for Depression?
Antidepressant medications are widely used, effective treatments for depression. Antidepressant
drugs are known to influence the functioning of certain neurotransmitters (chemicals used by
brain cells to communicate), primarily serotonin, norepinephrine, and dopamine, known as
monoamines. Older medications tricyclic antidepressants (TCAs) and monoamine oxidase
inhibitors (MAOIs) affect the activity of all of these neurotransmitters simultaneously. Their
disadvantage is that they can be difficult to tolerate due to side effects or, in the case of
MAOIs, dietary and medication restrictions. Newer medications, such as the selective serotonin
reuptake inhibitors (SSRIs), have fewer side effects than the older drugs, making it easier for
patients to adhere to treatment. Both generations of medications are effective in relieving
depression, although some people will respond to one type of drug, but not another. Medications
that take entirely different approaches to treating depression are now in development.
Psychotherapy is also effective for treating depression. Certain types of psychotherapy,
cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been shown to be
particularly useful. More than 80 percent of people with depression improve when they receive
appropriate treatment with medication, psychotherapy, or the combination.
Recently there has been enormous interest in herbal remedies for various medical conditions
including depression. One herbal supplement, hypericum, or St. John's wort, has been promoted
as having antidepressant properties. However, no carefully designed studies have determined
the antidepressant efficacy of this supplement. NIMH is currently enrolling patients in a first
large-scale, multi-site, controlled study of St. John?s wort conducted in the U.S. as a potential
treatment for depression.
From: Mental Health: A Report by the Surgeon General Department of Health and Human Services
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