All about Depression . How will treatment help me
Major depressive disorder often referred to as depression is a common illness that can affect anyone. About 1 in 20 Americans (over 11 million people) get depressed every year. Depression affects twice as many women as men.
Mood changes and depressive illnesses are more common in people suffering from physical illnesses than in people who are well. Although a person can develop depression in association with almost any physical illness, some diseases are more likely to lead to depression than others. Depression in these conditions can be expected to respond to the same treatments (medication and psychosocial treatments) as any other depressive illness, and so help should be sought and treatment given for the depression, irrespective of its cause
Depression may be caused by many things, including:
- Family history and genetics.
- Other general medical illnesses.
- Certain medicines.
- drugs without prescription.
- Other psychiatric conditions.
Certain life conditions (such as extreme stress or grief), may bring on a depression or prevent a full recovery. In some people, depression occurs even when life is going well. Depression is not your fault. It is not a weakness. It is a medical illness. Depression is treatable.
Physical illnesses in which depression is common
Below are some of the more common conditions in which depression is likely to occur.
Diseases of the nervous system
- Parkinson's disease. About 40 per cent of those with Parkinson's disease will suffer from an episode of depression. It is often missed because some of the symptoms of Parkinson's disease are similar to those of depression. For example, slow movements and reduced speech occur in both depression and Parkinson's disease. It seems likely that the increased occurrence of depression in Parkinson's disease results from both the direct effects of the disease on the brain and the impact of the condition on the sufferer's everyday life.
- Dementia. People with dementia suffer from more depressive symptoms and more depressive illnesses than other people. The difficulty these people have in communicating their distress means the depression can be missed and not treated. The development of features such as a loss of interaction and interest in others and a sense of gloominess may mean that a depressive illness is developing and help should be sought.
- Multiple sclerosis. Depression is more common in this condition, too. It is not clear how much of the depression arises from the effects of the disease on the brain and how much results through the consequences of the disability.
Infections
- Certain viral infections, for example glandular fever (infectious mononucleosis) and influenza (flu), are prone to trigger depression in vulnerable individuals
People who have major depressive disorder have a number of symptoms nearly every day, all day, for at least 2 weeks. These always include at least one of the following:
- Loss of interest in things you used to enjoy.
- Feeling sad, blue, or down in the dumps.
You may also have at least
Persistent sad, anxious or "empty" mood
Sleeping too much or too little; middle-of-night or early-morning waking
Reduced appetite and weight loss, or increased appetite and weight gain
Loss of pleasure and interest in activities once enjoyed, including sex
Irritability, restlessness
Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
Difficulty concentrating, remembering or making decisions
Fatigue or loss of energy
Feeling guilty, hopeless or worthless
Thoughts of death or suicide three of the following symptoms:
- Feeling slowed down or restless and unable to sit still.
- Feeling worthless or guilty.
- Increase or decrease in appetite or weight.
- Thoughts of death or suicide.
- Problems concentrating, thinking, remembering, or making decisions.
- Trouble sleeping or sleeping too much.
- Loss of energy or feeling tired all of the time.
How do you recognise depression in such physical illnesses?
It is important to be aware of the possibility of depression, especially when a person is suffering from one of illnesses mentioned. The difficulty is that some of the key symptoms in depression are very common in these conditions, eg disturbed sleep, poor appetite and tiredness.
This makes these symptoms less helpful for doctors when making the diagnosis of depression. Furthermore, sadness is common following diagnosis of an illness as the sufferer comes to terms with their condition, but a prolonged 'low' mood with frequent weeping is likely to indicate depression has developed.
A physically ill person displaying the following symptoms may in fact be depressed.
- Persistent sadness that does not lift with happy experiences.
- Lack of interest in activities and pastimes that are normally enjoyed.
- Loss of interest in sex.
- A loss of interest in friends and socialising.
- Feelings of guilt and self-blame.
- Marked pessimism about the future.
-
Suicidal thoughts and talk of wishing one were dead.
With depression, there are often other physical or psychological symptoms, including:
- Headaches.
- Other aches and pains.
- Digestive problems.
- Sexual problems.
- Feeling pessimistic or hopeless.
- Being anxious or worried.
What should I do if I have these symptoms?
Too often people do not get help for their depression because they don't recognize the symptoms, have trouble asking for help, blame themselves, or don't know that treatments are available.
Family practitioners, clinics, or health maintenance organizations are often the firstplaces that people go for help. These health care providers will:
- Find out if there is a physical cause for your depression.
- Treat the depression.
- Refer you to a mental health specialist for further evaluation and treatment.
If you do not have a regular health care provider, contact your local health department, community mental health clinic, or hospital. University medical centers also provide treatment for depression.
Treatment reduces the pain and suffering of depression. Successful treatment removes all of the symptoms of depression and returns you to your normal life. The earlier you get treatment for your depression, the sooner you will begin to feel better. As with other medical illnesses, the longer you have the depression before you seek treatment, the more difficult it can be to treat.
Most people who are treated for depression feel better and return to daily activities in several weeks. Because it takes several weeks for treatment to work fully, it is important to get treatment early before your depression gets worse.
Recent research strongly supports the use of medication for the treatment of moderate and severe cases of clinical depression. Antidepressant medication acts on the chemical pathways of the brain related to mood. Many highly effective antidepressants are available, and they are not habit-forming. The two most common types are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Other new types of antidepressants [e.g., alpha-2 antagonists, selective norepinephrine reuptake inhibitors (SNRIs) and aminoketones], and an older class, monoamine oxidase inhibitors (MAOIs) are also prescribed by some doctors
People taking antidepressants should be monitored by a doctor who knows about treating depression, to ensure the best treatment with the fewest side effects. It is also very important that your doctor be informed about all other medicines that are taken (even herbal supplements) to avoid dangerous interactions.
Psychotherapy (talk therapy) with a qualified mental health professional can help teach people better ways of handling problems. Therapy can be effective in treating clinical depression, especially depression that is less severe. Scientific studies have shown that short-term courses of psychotherapy (10 to 20 weeks) are often helpful in treating depression.
Electroconvulsive therapy (ECT) is a procedure only considered for people with severe cases of depression who can not take or do not improve with medication, are at an extreme risk for suicide, or are debilitated due to an unrelated physical illness or to severe depression itself.
