message about depression, or depressive disorder, is that
there is a wide variety of treatment options. Without treatment,
symptoms of depression can last for weeks, months or years.
For most people, treatment is highly effective. The biggest
hurdle may be persuading yourself, or someone you care about,
to see a professional to determine whether you do suffer from
depression in the first place.
to classify depression into highly distinct categories because
the lines can be blurred at times. The level of severity differs
from person to person as well. But in general, there are three
depression: Severely interferes with the ability to
work, enjoy daily activities, sleep, eat, etc. Episodes
commonly occur several times throughout a person's life.
Less severe than major depression, but is chronic and long-term
and keeps one from feeling good and functioning well. People
who suffer from dysthymia often experience episodes of major
depression as well.
disorder (manic depression): Severe highs (mania) and
extreme lows. Affects judgment and behavior in ways that
can cause serious problems and embarrassment. People with
untreated manic depression may become psychotic (out of
touch with reality).
of depression without mania include:
of sadness or emptiness
of interest in activities that used to be pleasurable, including
sleeping or oversleeping
in appetite and weight
with mania may include many of the symptoms above, plus the
following symptoms during a high:
need for sleep
for men and women to experience depression a little differently.
Men may mask their depression by acting irritable and angry,
while women tend more to experience feelings of hopelessness
or helplessness. Men also tend to avoid seeking treatment
more than women. These are just generalities, however. Depression
strikes across all age and gender, and it's difficult to predict
how it will be expressed from person to person.
are many theories for the causes of depression. Studies of
identical twins indicate that there may be a genetic element.
Other studies suggest that continued trauma and stress can
lead to depression. And sometimes, specific types of events
can trigger a depressive episode.
of Treatment Options
receiving a diagnosis of depression, you need a physical examination
first to rule out any other possible conditions that may be
causing your symptoms. If depression is diagnosed, your doctor
will design a treatment based on the type of depression you
have, the causes and the severity. For mild depression, psychotherapy,
or talking therapy, may be the best choice. But most people
do best with a combination of medication and psychotherapy.
Depression can be caused by chemical imbalances in the brain.
These chemicals, called neurotransmitters, are responsible
for much of the communication that takes place between the
brain and the body. Medications can correct the chemical imbalances.
They reduce the symptoms of current episodes and can often
prevent episodes from recurring.
for depression include:
serotonin re-uptake inhibitors (SSRIs). These are the newest
calls of drugs and they tend to have fewer side effects.
oxidase inhibitors (MAOIS)
may prescribe one drug or a combination of drugs for you.
There may be some improvement in the first week or two, but
most people have to take the drug for three, four, sometimes
as many as eight weeks before experience the full effect.
In some cases, it may even be necessary to try two or three
drugs before finding the one that works for you. It takes
patience in the beginning, which can be quite difficult for
people who are feeling especially down.
need to take medication for the rest of their lives. This
is especially true in cases of manic depression. Other medications
can be stopped, but must be done so gradually. Others may
cause serious side effects, so regular visits with your doctor
taking medication for depression, it's important to be honest
with your doctor about any possible drug or alcohol use, whether
you take the medication as often as you should, whether you
think you want to stop taking the medication or any other
doubts or questions you have.
Many people today believe that taking a pill can be the answer
to all their problems. Sometimes, a pill is enough. But for
some people, psychotherapy, or talking therapy, is an important
part of the equation.
Jamison, a professor of psychiatry at Johns Hopkins School
of Medicine and author of An Unquiet Mind, a chronicle
of her own struggle with manic depression, writes:
can help me deal with the problem of not wanting to take
pills; likewise, no amount of psychotherapy alone can prevent
my manias and depressions. I need both.
are different kinds of talking therapies, but perhaps the
key to having success with psychotherapy is to find a therapist
you respect and feel comfortable with.
St. John's wort is a well known herb that has been popular
in Europe, and to a lesser degree in the U.S., for treating
depression. The National Institutes of Health is currently
conducting a three-year study to determine the effectiveness
of this herb. St. John's wort can interfere with the effectiveness
of medications used for heart disease, depression, seizures,
some cancers and rejections of transplanted organs. It's extremely
important to discuss with your doctor the safety of taking
In cases where the depression is severe and medications do
not seem to have any effect, electroconvulsive therapy may
be considered. It can be highly effective in severe cases.
treatment for depression can improve your important, close
relationships. It can help you to function at your best at
work or at school. It can improve your general outlook in
number of ways. Most importantly, untreated depression can,
in some cases lead to suicide, a highly preventable outcome.
K. Jamison. An Unquiet Mind. Vintage Books, New York, New York, 1995. National Institute of Mental Health; National Mental Health Association; A. Solomon.