All You Need To know About Depression

Life is full of ups and downs. But when the down times last for weeks or months at a time or keep you from your regular activities, you may be suffering from depression. Depression is a medical illness that involves the body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things.


It is different from feeling "blue" or down for a few hours or a couple of days. It is not a condition that can be willed or wished away.
Different kinds of depression include:
Major depressive disorder. Also called major depression, this is a combination of symptoms that hurt a person's ability to work, sleep, study, eat, and enjoy hobbies.
Dysthymic (diss-TIME-ic) disorder. Also called dysthymia, this kind of depression lasts for a long time (two years or longer). The symptoms are less severe than major depression but can prevent you from living normally or feeling well.
Some kinds of depression show slightly different symptoms than those described above. Some may start after a particular event. However, not all scientists agree on how to label and define these forms of depression. They include:

Psychotic depression, which occurs when a severe depressive illness happens with some form of psychosis, such as a break with reality, hallucinations, and delusions.
Postpartum depression, which is diagnosed if a new mother has a major depressive episode within one month after delivery.
Seasonal affective disorder (SAD), which is a depression during the winter months, when there is less natural sunlight.
What causes depression?
There is no single cause of depression. There are many reasons why a woman may become depressed:
Genetics (family history)  If a woman has a family history of depression, she may be more at risk of developing it herself. However, depression may also occur in women who don't have a family history of depression.

Chemical imbalance – The brains of people with depression look different than those who don't have depression. Also, the parts of the brain that manage your mood, thoughts, sleep, appetite, and behaviour don't have the right balance of chemicals.
Hormonal factors – Menstrual cycle changes, pregnancy, miscarriage, postpartum period, perimenopause, and menopause may all cause a woman to develop depression.

Stress – Stressful life events such as trauma, loss of a loved one, a bad relationship, work responsibilities, caring for children and aging parents, abuse, and poverty may trigger depression in some people.

Medical illness – Dealing with serious medical illnesses like stroke, heart attack, or cancer can lead to depression.

What are the signs of depression?
Not all people with depression have the same symptoms. Some people might only have a few, and others a lot. How often symptoms occur, and how long they last, is different for each person. Symptoms of depression include:

Feeling sad, anxious, or "empty"
Feeling hopeless
Loss of interest in hobbies and activities that you once enjoyed
Decreased energy
Difficulty staying focused, remembering, making decisions
Sleeplessness, early morning awakening, or oversleeping and not wanting to get up
No desire to eat and weight loss or eating to "feel better" and weight gain
Thoughts of hurting yourself
Thoughts of death or suicide
Easily annoyed, bothered, or angered
Constant physical symptoms that do not get better with treatment, such as headaches, upset stomach, and pain that doesn't go away

I think I may have depression. How can I get help?
Below are some people and places that can help you get treatment.
Family doctor
Counselors or social workers
Family service, social service agencies, or clergy person
Employee assistance programs (EAP)
Psychologists and psychiatrists
If you are unsure where to go for help, check the Yellow Pages under mental health, health, social services, suicide prevention, crisis intervention services, hotlines, hospitals, or physicians for phone numbers and addresses.

What if I have thoughts of hurting myself?
Depression can make you think about hurting yourself or suicide. You may hurt yourself to:
Take away emotional pain and distress
Avoid, distract from, or hold back strong feelings
Try to feel better
Stop a painful memory or thought
Punish yourself
Release or express anger that you're afraid to express to others

You might feel like your pain is too overwhelming to cope with, but those times don't last forever. People do make it through suicidal thoughts. If you can't find someone to talk with, write down your thoughts. Try to remember and write down the things you are grateful for. List the people who are your friends and family, and care for you. Write about your hopes for the future. Read what you have written when you need to remind yourself that your life is IMPORTANT!

How is depression found and treated?
Most people with depression get better when they get treatment.
The first step to getting the right treatment is to see a doctor. Certain medicines, and some medical conditions (such as viruses or a thyroid disorder), can cause the same symptoms as depression. Also, it is important to rule out depression that is associated with another mental illness called bipolar disorder. A doctor can rule out these possibilities with a physical exam, asking questions, and/or lab tests, depending on the medical condition. If a medical condition and bipolar disorder can be ruled out, the doctor should conduct a psychological exam or send the person to a mental health professional.

Once identified, depression almost always can be treated with:
Therapy
Medicine called antidepressants
Both therapy and medicine
Some people with milder forms of depression do well with therapy alone. Others with moderate to severe depression might benefit from antidepressants. It may take a few weeks or months before you begin to feel a change in your mood. Some people do best with both treatments — therapy and antidepressants.

Should I stop taking my antidepressant while I am pregnant?
The decision whether or not to stay on medications is a hard one. You should talk with your doctor. Medication taken during pregnancy does reach the fetus. In rare cases, some antidepressants have been associated with breathing and heart problems in newborns, as well as jitteriness, difficulty feeding, and low blood sugar after delivery. However, moms who stop medications can be at high risk of their depression coming back. Talk to your doctor about the risks and benefits of taking antidepressants during pregnancy. Your doctor can help you decide what is best for you and your baby. In some cases, a woman and her doctor may decide to slowly lower her antidepressant dose during the last month of pregnancy. Doing so can help the newborn suffer from fewer withdrawal symptoms. After delivery, a woman can return to a full dose. This can help her feel better during the postpartum period, when risk of depression can be greater.

Should I stop taking my antidepressant while breastfeeding?
If you stopped taking your medication during pregnancy, you may need to begin taking it again after the baby is born. Be aware that because your medication can be passed into your breast milk, breastfeeding may pose some risk for a nursing infant.

What are SSRIs?
Selective serotonin reuptake inhibitors (SSRIs) are a kind of antidepressant for treating depression and anxiety disorders.
However, a number of research studies show that certain antidepressants, such as some of the SSRIs (see box at right) have been used relatively safely during breastfeeding. You should discuss with your doctor whether breastfeeding is an option or whether you should plan to feed your baby formula. Although breastfeeding has some advantages for your baby, most importantly, as a mother, you need to stay healthy so you can take care of your baby.

Before taking medication for an anxiety disorder:
Ask your doctor to tell you about the effects and side effects of the drug.
Tell your doctor about any alternative therapies or over-the-counter medications you are using.
Ask your doctor when and how the medication should be stopped. Some drugs can't be stopped abruptly but must be tapered off slowly under a doctor's supervision.
Work with your doctor to determine which medication is right for you and what dosage is best.
Be aware that some medications are effective only if they are taken regularly and that symptoms may come back if the medication is stopped.

Is it safe for young adults to take antidepressants?
It may be safe for young people to be treated with antidepressants. However, drug companies who make antidepressants are required to post a "black box" warning label on the medication. A "black box" warning is the most serious type of warning on prescription drugs.


How can I help myself if I am depressed?
You may feel exhausted, helpless, and hopeless. It may be very hard to do anything to help yourself. But it is important to realize that these feelings are part of the depression and do not reflect real life. As you understand your depression and begin treatment, negative thinking will fade. In the meantime:

Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social, or other activities.
Set realistic goals for yourself.
Break up large tasks into small ones, set some priorities and do what you can as you can.
Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
Be confident that positive thinking will replace negative thoughts as your depression responds to treatment.