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Depression

Defintion
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called
major depression, major depressive disorder or clinical depression, it affects how you feel, think and
behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal
day-to-day activities, and depression may make you feel as if life isn't worth living.

Sometimes physical problems can cause depression. But other times, symptoms of depression are
part of a more complex psychiatric problem. There are several different types of depression,
including:

Major depressive disorder

Dysthymia

Seasonal affective disorder

Psychotic depression

Bipolar depression

Major Depression
An individual with major depression, or major depressive disorder, feels a profound and constant
sense of hopelessness and despair.
Major depression is marked by a combination of symptoms that interfere with the person's ability
to work, study, sleep, eat, and enjoy once pleasurable activities. Major depression may occur
only once but more commonly occurs several times in a lifetime.
The main types of depression include:

Major depression -- to be diagnosed with major depression, you must have five or more
of the symptoms listed above for at least 2 weeks. Major depression tends to continue for
at least 6 months if not treated. (You are said to have minor depression if you have less
than five depression symptoms for at least 2 weeks. Minor depression is similar to major
depression except it only has two to four symptoms.)

Atypical depression -- occurs in about a third of patients with depression. Symptoms


include overeating and oversleeping. You may feel like you are weighed down and get
very upset by rejection.
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Dysthymia -- a milder form of depression that can last for years, if not treated.

Other common forms of depression include:

Postpartum depression -- many women feel somewhat down after having a baby, but
true postpartum depression is more severe and includes the symptoms of major
depression.

Premenstrual dysphoric disorder (PMDD) -- symptoms of depression occur 1 week


before your menstrual period and disappear after you menstruate.

Seasonal affective disorder (SAD) -- occurs most often during the fall-winter season
and disappears during the spring-summer season. It is most likely due to a lack of
sunlight.

Symptoms

Feelings of sadness, emptiness or unhappiness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in normal activities, such as sex

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so that even small tasks take extra effort

Changes in appetite often reduced appetite and weight loss, but increased cravings for
food and weight gain in some people

Anxiety, agitation or restlessness for example, excessive worrying, pacing, handwringing or an inability to sit still

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things
that are not your responsibility

Trouble thinking, concentrating, making decisions and remembering things

Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide


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Unexplained physical problems, such as back pain or headaches

Causes
Depression often runs in families. This may be due to your genes (inherited), behaviors you learn
at home, or both. Even if your genes make you more likely to develop depression, a stressful or
unhappy life event usually triggers the depression.

Biological differences. People with depression appear to have physical changes in their
brains. The significance of these changes is still uncertain, but may eventually help
pinpoint causes.

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely
play a role in depression. When these chemicals are out of balance, it may be associated
with depressive symptoms.

Hormones. Changes in the body's balance of hormones may be involved in causing or


triggering depression. Hormone changes can result from thyroid problems, menopause or
a number of other conditions.

Inherited traits. Depression is more common in people whose biological (blood)


relatives also have this condition. Researchers are trying to find genes that may be
involved in causing depression.

Life events. Traumatic events such as the death or loss of a loved one, financial
problems, high stress, or childhood trauma can trigger depression in some people.

Treatment
Most people with depression will get better without treatment. However, this may take several
months or even longer. (The average length of an episode of depression is 6-8 months.)

Those most commonly used for moderate or severe depression are:

Cognitive behavioural therapy (CBT). Briefly, cognitive therapy is based on the idea
that certain ways of thinking can trigger, or fuel, certain mental health problems such as
depression. The therapist helps you to understand your thought patterns. In particular, to
identify any harmful or unhelpful ideas or thoughts which you have that can make you
depressed. The aim is then to change your ways of thinking to avoid these ideas. Also, to
help your thought patterns to be more realistic and helpful. Behavioural therapy aims to
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change any behaviours which are harmful or not helpful. CBT is a combination of
cognitive therapy and behavioural therapy. In short, CBT helps people to achieve changes
in the way that they think, feel and behave.

Interpersonal therapy (IPT). This is sometimes offered instead of CBT. IPT is based on
the idea that your personal relationships may play a large role in affecting your mood and
mental state. The therapist helps you to change your thinking and behaviour and improve
your interaction with others.

Other types of therapy sometimes used, depending on circumstances, include:

Behavioural activation. The basis of this therapy is that behaviours such as inactivity
and ruminating on certain thoughts can be key factors in maintaining depression. The
therapist aims to help you to combat these unhelpful behaviours.

Couple therapy. This may be an option for people who have a regular partner and where
the relationship contributes to the depression. Or, where involving the partner is
considered to be of potential useful benefit.

Electroconvulsive therapy (ECT) may be advised as a last resort if you have severe
depression which has not improved with other treatments.

Also regular exercise helps to lift their mood and combat depression!