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Alternative Names Return to topBlues; Discouragement; Gloom; Mood changes; Sadness; Melancholy
Definition Return to top
Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.
True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time.
Considerations Return to top
Depression is generally ranked in terms of severity -- mild, moderate, or severe. The degree of your depression, which your doctor can determine, influences how you are treated. Symptoms of depression include:
Low self-esteem is common with depression. So are sudden bursts of anger and lack of pleasure from activities that normally make you happy, including sex.
Depressed children may not have the classic symptoms of adult depression. Watch especially for changes in school performance, sleep, and behavior. If you wonder whether your child might be depressed, it's worth bringing to a doctor's attention.
The main types of depression include:
Other common forms of depression include:
Depression may also occur with mania (known as manic depression or bipolar disorder). In this condition, moods cycle between mania and depression.
Depression is more common in women than men and is especially common during the teen years. Men seem to seek help for feelings of depression less often than women. Therefore, women may only have more documented cases of depression.
Causes Return to top
Depression often runs in families. This may due to your genes (inherited), learned behavior, or both. Even if your genes make you more likely to develop depression, a stressful or unhappy life event usually triggers the onset of a depressive episode.
Depression may be brought on by:
Home Care Return to top
If you are depressed for 2 weeks or longer, you should contact your doctor, who can offer treatment options. Regardless of whether you have mild or major depression, the following self-care steps can help:
If your depression occurs in the fall or winter months, try light therapy using a special lamp that mimics the sun.
Many people try a popular over-the-counter herb called St. John's wort. Some studies do suggest that this herbal remedy may be helpful for mild depression, but not moderate or severe. Be aware that St. John's wort has potential drug interactions and should NOT be taken with prescription antidepressants, birth control pills, protease inhibitors for HIV, theophylline, warfarin, digoxin, reserpine, cyclosporine, or loperamide. Talk to your doctor if you are thinking about trying this herb for mild depression.
If you have moderate to severe depression, the most effective treatment plan will likely be a combination of counseling and medication.
When to Contact a Medical Professional Return to top
Call 911, a suicide hotline, or get safely to a nearby emergency room if you have thoughts of suicide, a suicidal plan, or thoughts of harming yourself or others.
Call your doctor right away if:
What to Expect at Your Office Visit Return to top
A complete history, a psychiatric interview, and a physical examination will be performed to try to classify your depression as mild, moderate, or severe and to see if there is an underlying, treatable cause (such as alcohol abuse or an underactive thyroid). Hospitalization is usually recommended if suicide seems possible.
Expect some exploration of the issues and events associated with your feelings of depression. Your doctor will ask you about:
Treatment will vary according to the cause and severity of your depressive symptoms, as well as your personal preference. The most effective therapy for moderate or severe depression is a combination of antidepressant medication and psychotherapy.
For mild depression, counseling and self-care measures without medication may be enough.
If you are taking medications for other purposes that could cause depression as a side effect, these may need to be changed. DO NOT change or stop any of your medications without consulting your doctor.
For people who are so severely depressed as to be unable to function, or who are suicidal and cannot be safely cared for in the community, psychiatric hospitalization may be necessary.
Prevention Return to top
Healthy lifestyle habits can help prevent depression, or lessen the chances of it happening again. These habits include eating properly, sleeping adequately, exercising regularly, learning to relax, and not drinking alcohol or using drugs.
Counseling may help you through times of grief, stress, or low mood. Family therapy may be particularly important for teens who feel blue.
If you feel socially isolated or lonely, try volunteering or getting involved in group activities.
References Return to top
Moore DP, Jefferson JW. Major Depressive Disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Mosby, Inc., 2004:chap 74.
Guide to Clinical Preventive Services: Screening for Depression, Recommendations and Rationale. Rockville, Md. US Preventive Services Task Force, Dept of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. Ann Intern Med. 2002; 136(10): 760–764.
Practice Guideline for the Treatment of Patients With Major Depressive Disorder, 2nd ed. Arlington, VA: American Psychiatric Association; 2005.
Conway MW, Miller MN. Mood disorders. In: Rakel P, Bope ET, eds. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 281.
Schiffer RB. Psychiatric disorders in medical practice. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 420.Update Date: 1/20/2009 Updated by: Paul Ballas, DO, Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.