Depression

During any six-month period, 9 million American adults suffer from a depressive illness.  Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them.  Unfortunately, people with depression often do not seek treatment, although the great majority can be helped.  One reason may be that many people do not recognize that they have a treatable illness.  The following fact sheet provides information on depression and may help you take the steps that may save your own or someone else’s life.

What Is a Depressive Disorder?

A depressive disorder is an illness involving your body, mood, and thoughts.  It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things.  A depressive disorder is not the same as a passing blue mood.  People with a depressive illness cannot merely “pull themselves together” and get better.  Without treatment, symptoms can last for weeks, months, or years.

Types of Depression

Depressive disorders come in different forms, just as do other illnesses, such as heart disease.  Three of the most prevalent types of depressive disorders are major depression, dysthymia and bipolar.  The number of symptoms, their severity, and persistence vary with each type of depression. 

• Major depression is manifested by a combination of symptoms that interfere with the ability to work, sleep, eat, and enjoy once pleasurable activities.  These disabling episodes of depression can occur once, twice, or several times in a lifetime.

• Dysthymia is a less severe type of depression and involves long-term, chronic symptoms that do not disable, but keep one from functioning at “full steam” or from feeling good.  Sometimes people with dysthymia also experience major depressive episodes.

• Bipolar disorder, formerly called manic-depressive illness is not nearly as prevalent as other forms of depressive disorders.  Bipolar disorder involves cycles of depression and elation or mania.  Sometimes the mood switches are dramatic and rapid, but most often they are gradual.   Mania often affects thinking, judgment, and social behavior in ways that cause serious problems.  Bipolar disorder is often a chronic recurring condition.

Symptoms

Not everyone who is depressed or manic experiences every symptom.  Some people experience a few symptoms, some many.  Also, severity of symptoms varies with each individual. 

Depression

• Thoughts of death or suicide; suicide attempts

• Persistent sad, anxious, or “empty” mood

• Feelings of hopelessness

• Feelings of guilt, worthlessness, helplessness

• Decreased energy, fatigue

• Restlessness, irritability

• Loss of interest or pleasure in hobbies and activities that were once enjoyed

• Insomnia, early-morning awakening, or oversleeping     

• Appetite and/or weight loss or overeating and weight gain

Mania

Evaluation and Treatment

The first step to getting appropriate treatment is a complete physical and psychological evaluation to determine whether an individual has a depressive illness. Certain medications as well as some medical conditions can cause symptoms of depression and the examining physician should rule out these possibilities through examination, interview and lab tests.  A good diagnostic evaluation also includes a complete history of symptoms.  The doctor should ask about alcohol and drug use, and if thoughts about death or suicide are present.  

Helping Yourself

Depressive disorders make one feel exhausted, worthless, helpless, and hopeless.  Such negative thoughts and feelings make some people feel like giving up.  It is important to realize that these negative views are part of the depression and typically do not accurately reflect your situation.  Negative thinking fades as treatment begins to take effect.  

• Do not set difficult goals or take on a great deal of responsibility.

• Break large tasks into small ones and set some priorities.

• Do not expect too much from yourself too soon.

• Try to be with other people.

• Don’t overdo it or get upset if your mood is not greatly improved right away.  Feeling better takes time.

• Don’t make major life decisions, such as changing jobs, or getting married without consulting others.

• Negative thinking is part of the illness and will disappear as your depression responds to treatment.

Helping a Depressed Person

The most important thing anyone can do for an individual with depression is to help him/her get appropriate diagnosis and treatment.  This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks).  On occasion, it may require making an appointment and accompanying the individual to the doctor.  It may also mean monitoring whether the depressed person is taking medication.

The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Listen carefully to feelings expressed, point out realities and offer hope. Do not ignore remarks about suicide. Always report them to a therapist.