Depression: When The Blues Don't Go Away

Everyone occasionally feels blue or sad, but these feelings usually pass within a couple of days. When a person has depression, it interferes with his or her daily life and routine, such as going to work or school, taking care of children, and relationships with family and friends. Depression causes pain for the person who has it and for those who care about him or her.

Depression can be very different in different people or in the same person over time. It is a common but serious illness. Treatment can help those with even the most severe depression get better.

What are the symptoms of depression?
Ongoing sad, anxious or empty feelings
Feelings of hopelessness
Feelings of guilt, worthlessness, or helplessness
Feeling irritable or restless
Loss of interest in activities or hobbies that were once enjoyable, including sex
Feeling tired all the time
Difficulty concentrating, remembering details, or difficulty making decisions
Not able to go to sleep or stay asleep (insomnia); may wake in the middle of the night, or sleep all the time
Overeating or loss of appetite
Thoughts of suicide or making suicide attempts
Ongoing aches and pains, headaches, cramps or digestive problems that do not go away.
Not everyone diagnosed with depression will have all of these symptoms. The signs and symptoms may be different in men, women, younger children and older adults.

Can a person have depression and another illness at the same time?
Often, people have other illnesses along with depression. Sometimes other illnesses come first, but other times the depression comes first. Each person and situation is different, but it is important not to ignore these illnesses and to get treatment for them and the depression. Some illnesses or disorders that may occur along with depression are:

Anxiety disorders, including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social phobia, and generalized anxiety disorder (GAD);
Alcohol and other substance abuse or dependence;
Heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson's disease.
Studies have found that treating depression can help in treating these other illnesses.

When does depression start?
Young children and teens can get depression but it can occur at other ages also. Depression is more common in women than in men, but men do get depression too. Loss of a loved one, stress and hormonal changes, or traumatic events may trigger depression at any age.

Is there help?

There is help for someone who has depression. Even in severe cases, depression is highly treatable. The first step is to visit a doctor. Your family doctor or a health clinic is a good place to start. A doctor can make sure that the symptoms of depression are not being caused by another medical condition. A doctor may refer you to a mental health professional.

The most common treatments of depression are psychotherapy and medication.

Psychotherapy

Several types of psychotherapy-or "talk therapy"-can help people with depression. There are two main types of psychotherapy commonly used to treat depression: cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT teaches people to change negative styles of thinking and behaving that may contribute to their depression. IPT helps people understand and work through troubled personal relationships that may cause their depression or make it worse.

For mild to moderate depression, psychotherapy may be the best treatment option. However, for major depression or for certain people, psychotherapy may not be enough. For teens, a combination of medication and psychotherapy may work the best to treat major depression and help keep the depression from happening again. Also, a study about treating depression in older adults found that those who got better with medication and IPT were less likely to have depression again if they continued their combination treatment for at least two years.

Medications

Medications 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 of antidepressant medications that help keep the neurotransmitters at the correct levels are:

SSRIs (selective serotonin reuptake inhibitors)
SNRIs (serotonin and norepinephrine reuptake inhibitors)
MAOIs (monoamine oxidase inhibitors)
Tricyclics.
These different types of medications affect different chemicals in the brain.

Medications affect everyone differently. Sometimes several different types have to be tried before finding the one that works. If you start taking medication, tell your doctor about any side effects right away. Depending on which type of medication, possible side effects include:

Headache
Nausea
Insomnia and nervousness
Agitation or feeling jittery
Sexual problems
Dry mouth
Constipation
Bladder problems
Blurred vision, or
Drowsiness during the day.


Why do people get depression?

There is no single cause of depression. Depression happens because of a combination of things including:

Genes - some types of depression tend to run in families. Genes are the "blueprints" for who we are, and we inherit them from our parents. Scientists are looking for the specific genes that may be involved in depression.

Brain chemistry and structure - when chemicals in the brain are not at the right levels, depression can occur. These chemicals, called neurotransmitters, help cells in the brain communicate with each other. By looking at pictures of the brain, scientists can also see that the structure of the brain in people who have depression looks different than in people who do not have depression. Scientists are working to figure out why these differences occur.

Environmental and psychological factors - trauma, loss of a loved one, a difficult relationship, and other stressors can trigger depression. Scientists are working to figure out why depression occurs in some people but not in others with the same or similar experiences. They are also studying why some people recover quickly from depression and others do not.