What is depression?

When doctors talk about depression, they mean the mental illness called Major Depression. Someone with major depression has symptoms like those listed below nearly every day, all day, for two weeks or longer. If you are depressed, you may also have headaches, other aches and pains, stomach problems, and problems with sex. An older person with depression may feel confused or have trouble understanding simple requests.  It is not unusual to have depression begin or worsen around the time of holidays or certain anniversaries.

• No interest in things that you used to enjoy
• Feeling sad or empty
• Crying easily or crying for no reason
• Feeling slow or restless and not being able to sit still
• Feeling worthless or guilty
• Weight gain or loss
• Thoughts about death or suicide
• Trouble thinking, remembering things, or focusing on what you are doing
• Trouble making decisions
• Problems sleeping, especially in the early morning, or wanting to sleep more than usual
• Feeling tired
• Feeling numb emotionally, perhaps even to the point of not being able to cry

What causes depression?

Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with each other. Depression also seems to run in families.

Depression can be linked to events in your life, such as the death of someone you love, a divorce, or job loss. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also lead to depression.

How is depression diagnosed?

If you are having symptoms of depression, be sure to tell your doctor so you can get help. The sooner you get treatment, the sooner the depression will be treated. Once you tell your doctor how you are feeling, he or she may ask you some questions about your symptoms, health, and family history of health problems.  Your doctor may also give you as physical exam and do some tests.

How is depression treated?

Depression can be treated with medicines or counseling or with both.

Medicines called anti-depressants can be used to treat depression. They fix the chemical imbalance that can cause depression.  Anti-depressants work differently for different people. They also have different side effects.  You might start feeling better as quickly as one week after you start taking the medicine, but you probably won’t feel the full effects until about two months. You may have some side effects at first, but they tend to get better after a couple of weeks.  If not, you need to let your physician know.

How long will I need medicine?

How long you will need to take the medicine depends on your depression. Your doctor may want you to take medicine for six months or longer. You need to take the medicine long enough to reduce the chance that the depression will come back. Sometimes after you have suffered two or more significant depressions in your life, the doctor may suggest that you stay on anti-depressants indefinitely. Talk with your doctor about any questions that you have about your medicine.

Will I need to go to the hospital?

• Pace yourself.  Don’t expect to do everything you normally can.  Set a realistic schedule.
• Don’t believe all of your negative thinking, such as blaming yourself or expecting to fail.  This thinking is part of depression.  These thoughts will stop as your depression goes away.
• Get involved in activities that make you feel good.
• Do not make big life decisions when you are depressed.  If you must make a big decision, ask someone you trust to help you.
• Avoid drugs and alcohol.  Both make depression worse and can cause dangerous side effects with your anti-depressants.
• Physical activity may improve your mood.  Exercising 4-6 times a week for at least 30 minutes each time is a good goal, but even less activity can be helpful.
• Try not to get discouraged.  It will take time for your depression to go away.