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Depression: What You Need to Know


Updated December 01, 2008


What Is Depression?

Depression is an illness that can make you feel sad and hopeless over a period of time. It is different from the occasional feelings of sadness, grief, or low energy that many of us have from time to time. Depression is a common but serious illness that can interfere with your daily routines, such as your relationships with your family and friends, caring for your children, participating in school or work, or taking care of household tasks.

What Are the Symptoms of Depression?

The symptoms of depression may be different in different people. If you have some of these symptoms, talk to your doctor. These symptoms may indicate that you are depressed and need to be treated.

If you are depressed, you may:

  • have sad, anxious or empty feelings
  • feel that life is hopeless
  • feel irritable or restless
  • lose interest in activities that were once enjoyable, including sex
  • feel tired all the time
  • have difficulty making decisions, concentrating, or remembering details
  • have changes in your sleeping or eating habits
  • have thoughts of death or suicide
  • have physical symptoms such as aches and pains, headaches, or digestive problems

Who Gets Depression?

Although depression is most likely to start when a person is in their mid-twenties, the condition can affect men and women of all ages, including children and teenagers. Depression is more common in women than in men, in people who have a serious illness such as diabetes, and in people who are separated or divorced.

Depression can be different in different people or in the same person over time. Even if you have severe depression, treatment can help you get better.

How Is Depression Treated?

Depression is highly treatable and most people who have the condition get better with counseling, medication, or a combination of the two.

The first step is to visit your doctor, who can make sure that your symptoms are not being caused by another medical condition. Depending on your symptoms, your doctor may start you on an antidepressant medication and may refer you to a mental health professional for counseling (psychotherapy).

If you are having any thoughts about harming yourself or others, you may need to be hospitalized to start treatment and help you manage your thoughts about suicide.

Several types of psychotherapy -- or "talk therapy" -- are available to help people with depression.

For mild to moderate depression, psychotherapy may be the best treatment option. However, for some people, psychotherapy may not be enough. A combination of medication and psychotherapy may work the best to treat depression and help keep your depression from happening again.

Medications used to treat depression help balance chemicals in the brain called neurotransmitters. Although scientists are not sure exactly how these chemicals work, they do know they affect a person's mood.

Types (or classes) of antidepressant medications that help keep the neurotransmitters at the correct levels are:

Selective serotonin reuptake inhibitors (SSRIs) – examples include:

  • Celexa (citalopram)
  • Lexapro (escitalopram)
  • Luvox (fluvoxamine)
  • Prozac (fluoxetine)
  • Paxil (paroxetine)
  • Zoloft (sertraline)

Tricyclic antidepressants – examples include:

  • Aventyl (nortriptyline)
  • Elavil (amitriptyline)
  • Norpramin (desipramine)
  • Sinequan (doxepin)
  • Surmontil (trimipramine)
  • Tofranil (imipramine)
  • Vivactil (protriptyline)

Monoamine oxidase inhibitors (MAOIs) – examples include:

  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Parnate (tranylcypromine)

Atypical antidepressants (medications that do not fit well into the other antidepressant medication categories) – examples include:

  • Wellbutrin (bupropion)
  • Pristiq (desvenlafaxine)
  • Cymbalta (duloxetine)
  • Remeron (mirtazapine)
  • Desyrel (trazodone)
  • Effexor (venlafaxine)

Medications affect everyone differently. Sometimes several different types of antidepressants have to be tried before finding the one that works for you.

Medication side effects
If you are taking an antidepressant, tell your doctor about any side effects right away. Many of these side effects are temporary and go away with your continued use of the medication, although some side effects – such as constipation and sexual problems – may persist.

Depending on which type of medication your doctor prescribes, some possible side effects include:

  • headache
  • insomnia and nervousness
  • agitation or feeling jittery
  • sexual problems
  • dry mouth
  • constipation
  • blurred vision
  • drowsiness during the day

FDA warning on antidepressants
Although antidepressants are generally safe and reliable, some studies have shown that they may have serious side effects on some people, especially young people.

In 2005 the FDA required a "black box" warning label on all antidepressant medications to alert the public about the potential increased risk of suicidal thinking or attempts in children and teenagers taking antidepressants. In 2007, the FDA extended the black box warning to include young patients through age 24 who are taking medications for the treatment of depression.

A "black box" warning is the most serious type of warning on prescription drug labeling.

Electroconvulsive therapy
Electroconvulsive therapy (ECT) may be useful when medication and/or counseling do not help treat depression. ECT, once known as "shock therapy," formerly had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to get better with other treatments.

Why Do People Get Depression?

There is no single cause of depression. Experts believe that depression happens because of a combination of things including:

Genetic traits - some types of depression tend to run in families. Our genes are the "blueprints" for who we are, and we inherit them from our parents.

Brain chemistry and structure - when chemicals in the brain called neurotransmitters are not at the right levels, depression can occur. These chemicals help cells in our brain communicate with each other.

Stressful events - trauma, loss of a loved one, a difficult relationship, and other pressures can trigger depression. Certain medications and chronic illnesses such as diabetes and heart disease also can trigger depression.

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