Depression, or major depressive disorder, is a mental health condition marked by an overwhelming feeling of sadness, isolation and despair that affects how a person thinks, feels and functions. The condition may significantly interfere with a person's daily life and may prompt thoughts of suicide. Depression isn't the same as sadness, loneliness or grief caused by a challenging life experience, such as the death of a loved one.
Depression can affect people of all ages, races and socioeconomic classes, and can strike at any time. The condition is found in twice as many women as men. Researchers found that women between 40 and 59 have the highest rate of depression (12.3 percent) of any group based on age and gender.
People with depression may experience a variety of symptoms, but most commonly, "a deep feeling of sadness or a marked loss of interest or pleasure in daily activities". Other symptoms of depression may include:
- Irritability, agitation or restlessness
- Lower sex drive
- Inability to focus, concentrate or make decisions
- Insomnia or sleeping too much
- Change in appetite and/or weight, eating too much or too little
- Tiredness and lack of energy
- Unexplainable crying spells
- Unexplainable physical symptoms such as headaches or body aches
- Feeling hopeless or worthless
- Withdrawal from social situations and normal activities
- Thoughts of death or suicide
You may be able to prevent a relapse or keep your symptoms from getting worse if you:
Take your medicine as prescribed. Depression often returns if you stop taking your medicine or don't take it as your doctor advises.
Continue to take your medicine after your symptoms improve. Taking your medicine for at least 6 months after you feel better can help keep you from getting depressed again. If this isn't the first time you have been depressed, your doctor may want you to take medicine even longer. You may benefit from long-term treatment with antidepressants.
Continue cognitive-behavioral therapy after your symptoms improve. Research shows that people who were treated with this type of therapy had less chance of relapse than those who were treated only with antidepressants.
- Eat a balanced diet.
- Get regular exercise.
- Get treatment right away if you notice that symptoms of depression are coming back or getting worse.
- Have healthy sleep patterns.
- Avoid drugs and alcohol.
Major depression can set off a chain of social, emotional and health consequences that add to patients' overall stress. These include alcohol or drug abuse, anxiety, social isolation and relationship conflicts, work or school difficulties, or suicide.
Depression treatment may involve psychotherapy therapy, medications, or a combination of the two.
Prescription drugs, called antidepressants, help alter mood by affecting naturally occurring brain chemicals. There are several categories of antidepressants, but doctors often start with a class of drugs called selective serotonin reuptake inhibitors (SSRIs), and may try other medications if the patient's condition didn't improve.
SSRIs target the brain's serotonin, a signaling chemical (neurotransmitter) that studies have found to be involved in depression. This class of medication includes fluoxetine (commonly known as Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro) and citalopram (Celexa). Side effects, which are usually temporary, include changes in sexual desire, digestive problems, headache, insomnia and nervousness.
Other classes of antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), Norepinephrine and dopamine reuptake inhibitors (NDRIs), Tricyclic antidepressants, and Monoamine oxidase inhibitors (MAOIs).
Medications take time — usually 2 to 4 weeks — to work, and often symptoms such as appetite, concentration problems and sleep improve before people may notice mood changes.
Also known as talk therapy or counseling, this treatment has been shown to help some patients with depression. Several studies have suggested that combining psychotherapy and medication together works best for treating people with severe depression. Different types of psychotherapy include cognitive-behavioral therapy, which helps a person change negative thought patterns and replace them with healthier ones, as well as interpersonal therapy, which is designed to help someone understand and work through difficult relationships. Another form of psychotherapy is problem-solving therapy, which involves coming up with realistic solutions to cope with stressful situations.
Less common treatments:
For patients with severe depression who have not responded to any medication or psychotherapy, doctors may consider transcranial magnetic stimulation (TMS). TMS involves receiving brief magnetic pulses on the scalp to stimulate nerve cells in the brain that are thought to be involved in mood regulation and depression.