DEPRESSION

General Information

DEFINITION--A continuing feeling of sadness, despondency or hopelessness with accompanying symptoms. Major depression occurs in about 1 in 10 Americans but there is continued improvement in treatment.

BODY PARTS INVOLVED--Nervous system.

SEX OR AGE MOST AFFECTED--Both sexes, but is more common in women; all ages.

SIGNS & SYMPTOMS

• Loss of interest in life; boredom.
• Listlessness and fatigue.
• Insomnia; excessive or disturbed sleeping.
• Social isolation; feeling not useful or needed.
• Appetite loss or overeating; constipation.
• Loss of sex drive.
• Difficulty making decisions; concentration difficulty; unexplained crying bouts.
• Intense guilt feelings over minor or imaginary misdeeds.
• Irritability; restlessness; thoughts of suicide.
• Various pains, such as headache or chest pain, without evidence of disease.

CAUSES

• A truly depressive illness has no single obvious cause. Some biological factors can play a part (physical illness, hormonal disorders, certain drugs).
• Social and psychological factors play a part.
• Inherited disorders may contribute (manic-depression runs in families).
• May relate to the number of disturbing events in a person's life at one time.

RISK INCREASES WITH

• Unexpressed anger or other emotion.
• Compulsive, rigid, perfectionist or highly dependent personalities.
• Family history of depression; alcoholism.
• Failure in occupation, marriage or other relationships; death or loss of a loved one.
• Loss of something important (job, home, etc).
• Job change or move to a new area.
• Surgery, such as mastectomy for cancer.
• Major illness or disability.
• Passing from one life stage to another, such as menopause or retirement.
• Use of some drugs, such as reserpine, beta-adrenergic blockers or benzodiazepines.
• Withdrawal from mood-altering drugs, such as narcotics, amphetamines or caffeine.
• Some diseases, including diabetes mellitus, cancer of the pancreas and hormonal abnormalities.

HOW TO PREVENT

Anticipate and prepare for major life changes. Avoid risk factors when feasible.

What To Expect

DIAGNOSTIC MEASURES-- Medical history and physical exam by a doctor (sometimes a psychiatrist). Psychological testing.

APPROPRIATE HEALTH CARE

• Self-care for mild depression.
• Psychotherapy or counseling along with drug treatment appears to obtain the best results for more severe depression.
• Hospitalization or inpatient at treatment center may be required for severe depression.
• Rarely, electroconvulsive therapy.

POSSIBLE COMPLICATIONS

• Suicide. Warning signs include withdrawal from family and friends, neglect of personal appearance, mention of wanting "to end it all" or being "a burden to others", evidence of a suicide plan, such as buying or cleaning a gun, sudden cheerfulness after despondency.
• Failure to improve.

PROBABLE OUTCOME--Spontaneous recovery in many cases, but professional help can shorten the duration and help you learn to cope in the future. Recurrence is common. The recovery rate is high, despite one's pessimism.

How To Treat

GENERAL MEASURES--

• If symptoms appear mild to moderate, try some self-care ideas: talk to friends and family; exercise regularly; eat a balanced, low-fat diet; avoid alcohol; maintain your normal routines (if overscheduling is a problem though, try to slow down); see fun movies; learn relaxation techniques and practice them; take a vacation if possible; write down your feelings in a journal or diary; try to work out interpersonal problems (it's best however, to avoid making major decisions at this time); stay as active as possible.
• Seek support groups. Contact social agencies for help. Call your local suicide-prevention hot line if you feel suicidal.

MEDICATION--Your doctor may prescribe:

• Antidepressant drugs (often tricyclics) to accompany therapy.
• Lithium for alternating mania and depression.

ACTIVITY--No restrictions. Maintain daily activities--even if you don't feel like it.

DIET--Eat a normal, well-balanced diet--even if you have no appetite. Vitamin and mineral supplements may be necessary.

Call Your Doctor If

• You have symptoms of depression.
• You feel suicidal or hopeless.