Depression is a medical disorder characterized by feelings of sadness, hopelessness, pessimism, and a general loss of interest in life, combined with a sense of reduced emotional well-being.
The three most common types of depression are major depression, dysthymia and bipolar disease:
Major depression is manifested by a combination of symptoms (see Symptoms below) that interfere with the ability to work, sleep, eat and enjoy once pleasurable activities. These symptoms occur without any apparent cause and deepen and persist day-in and day-out for two weeks or longer.
Dysthymia is marked by mild to moderate depressive symptoms that last at least two years. People with this condition have fewer symptoms than those with major depression, but the symptoms last longer and develop more slowly. On average, symptoms can last 16 years before there is a diagnosis. Sometimes people with dysthymia also experience major depressive episodes.
Bipolar disorder, formerly called manic-depressive illness, involves cycles of depression and elation (mania). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, a person can have any or all of the symptoms of depression. When in the manic cycle, any or all manic symptoms (see Symptoms below) may be experienced.
Depression is caused by a combination of genetic (inherited), psychological and environmental factors. Depression, especially bipolar disorder, has been shown to run in families. Additionally, having too little or too much of certain neurochemicals in the brain have shown to be the cause of depression.
The psychological makeup of a person, such as low self-esteem, pessimism and stress, can also cause depression. Environmental or other associated health factors, such as a serious loss, chronic illness, pregnancy, childbirth, difficult relationships, financial problems, unwelcome changes in life patterns, alcohol, drug abuse and medications can also trigger a depressive episode.
About 10 to 15 percent of all depression is caused by medical illness or medicine. Once these conditions are treated or the medication stopped or changed, the depression will usually go away.
The symptoms of depression include:
Loss of interest in the things that the person once enjoyed
Feeling sad, blue, or down in the dumps
Feeling slowed down or restless and unable to sit still
Feeling worthless or guilty
An increase or decrease in appetite or weight
Thoughts of death or suicide
Problems concentrating, thinking, remembering or making decisions
Trouble sleeping or sleeping too much
Loss of energy or feeling tired all of the time
Headaches
Digestive problems
Sexual problems
Feeling pessimistic or hopeless
Being anxious or worried
The symptoms of mania are:
Feeling unusually "high," euphoric or irritable
Severe insomnia
Grandiose notions
Increased talking
Disconnected and racing thoughts
Increased sexual desire
Markedly increased energy
Poor judgment
Inappropriate social behavior
Diagnosis of depression involves a psychological/physical history and evaluation. According to the American Psychiatric Association, if a person experiences a loss of interest in the things they once enjoyed and are feeling sad, blue, or down in the dumps for at least two (2) weeks, and are experiencing at least five (5) of the other symptoms of depression, they may have major depression. If a person experiences euphoria, irritability, or a feeling of being "high" with four (4) other symptoms of mania for at least one (1) week, they may have bipolar disorder.
In addition to listing the symptoms, the doctor will also ask when the symptoms began, how long they have lasted, how severe they are, whether the individual has had them before, and if so, whether or not they were treated and what treatment was received, as well as whether or not other family members have had these symptoms.
Furthermore, a mental status examination will be done to determine if speech, thought patterns or memory have been affected. The physical examination will either diagnosis and/or rule out any medical conditions (such as thyroid disease, cancers or neurologic diseases) that could be causing the depression.
Treatment usually involves medication, psychotherapy or a combination of both. Other treatments may include electroconvulsive therapy (ECT), light therapy and alternative treatments.
Medication
There are more than 20 antidepressant drugs currently available. Antidepressants correct the chemical imbalance in the brain. Because a variety of drugs target different neurotransmitters and imbalances of these neurotransmitters can vary from patient to patient, some drugs may be more effective than others for any individual. Sometimes a combination of drugs is best.
There are four (4) groups of antidepressant medications most commonly used to treat depression:
Tricyclic antidepressants (TCAs) which include Elavil, Janimine, Tofranil, Pamelor, and Norpramin. TCAs work by slowing the rate at which neurotransmitters (chemical messengers) re-enter brain cells. This increases the concentration of the neurotransmitters in the central nervous system which relieves depression.
Monoamine oxidase inhibitors (MAOIs) include Nardil and Parnate. MAO is an enzyme responsible for breaking down certain neurotransmitters in the brain. MAOIs inhibit this enzyme and restore more normal mood states.
Lithium carbonates, including Eskalith and Lithobid. Lithium reduces excessive nerve activity in the brain by altering the chemical balance within certain nerve cells. This drug is effective is treating bipolar disorder.
Selective serotonin reuptake inhibitors (SSRIs) include Prozac, Zoloft and Paxil. SSRIs act specifically on serotonin, making it more available for nerve cells, thus easing the transmission of messages without disrupting the chemistry of the brain.
Medication usually produces a marked improvement by six weeks, but may require up to 12 weeks for full effect.
Psychotherapy
Psychotherapy involves talking to family doctor, counselor or therapist about things that are occurring in a person's life. The aim of psychotherapy is to remove all symptoms of depression and return a person to a normal life.
There are three psychotherapies available to treat depression: behavioral therapy, cognitive therapy or interpersonal therapy. Behavioral therapy focuses on current behaviors, cognitive therapy focuses on thoughts and thinking patterns, and interpersonal therapy focuses on current relationships.
Although psychotherapy may begin to work right away, it may take eight to 10 weeks to show a full effect for some people.
Electroconvulsive therapy (ECT)
ECT, also called electroshock treatment, is used for severely depressed patients and/or those who have not responded to antidepressant medication and/or psychotherapy. During this therapy, an electric current travels through electrodes placed on the temples, causing a generalized shock that produces biochemical changes in the brain.
Light Therapy
In light therapy, a special kind of light called a broad-spectrum light, is used to give people the effect of having a few extra hours of daylight each day. Light therapy is helpful in treating people with seasonal affective disorder (SAD). SAD is a serious depression that recurs each year at the same time, starting in fall or winter and ending in spring.
During the treatment process try these helpful tips:
Do not set difficult goals or take on a great deal of responsibility.
Break large tasks into small ones, set priorities, and do what you can.
Try to be with other people.
Participate in activities that make you feel better.
Do not overdo it or become upset if the treatment does not work right away.
Do not make major life decisions.
Do not expect to snap out of depression.
Do not expect too much of the depressed person.
© 2025 Lovina Medical Dr Ben Umeze. All rights reserved.
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