A to Z Disease

What Is Depression?

Depression is more than just a "down mood." It's a condition that can be characterized by the persistence of several symptoms, including feelings of sadness, emptiness, and isolation.

What Causes Depression?

There is no single cause for depression. Experts believe that a combination of three factors, genetics, the environment, and chemical imbalances in the brain, work together to cause depression.

A normal, functioning brain is a messaging system that controls all bodily functions. Communication within the brain is enabled through billions of cells called neurons. These cells send and receive messages from the rest of your body and with each other. To do this, they release chemicals called neurotransmitters, which communicate with other cells across a gap between them. This gap is called a synapse. When the brain is working normally, the synapses are clear and the neurons release the proper amount of chemical messengers to communicate. But, when a person has depression, the chemical messengers don't function correctly.

Types of Depression

There are a number of different types of depression:

* Major Depression, or "unipolar" depression. This is the most common type of depression. It is considered severe and lasts for weeks or months.
* Dysthymia. This condition is less severe than major depression, but each episode lasts for a longer period of time, often several years.
* Bipolar disorder. Unlike the other types of depression, this condition involves an extreme "up" mood called "mania" in addition to "down" moods. For this reason, this condition is sometimes called manic depressive illness.
* Seasonal Affective Disorder, or SAD. This condition occurs only at a certain time of the year, usually winter. It is a pattern of "down moods" caused by changes in the weather and decreased exposure to sunlight.
* Postpartum Depression. This is caused by hormonal changes after the delivery of a baby. It is much more severe than the usual "baby blues," which affects many women for a short period after delivery.

Symptoms of Depression

Feeling down after a period of stress or trauma is a normal part of the grieving process, but if any of the following symptoms persist, you could suffer from depression:

* Loss of interest in normal daily activities
* Feelings of helplessness, hopelessness, or sadness, including crying spells
* Loss of energy and the ability to concentrate
* Problems sleeping
* Feeling useless or inadequate for an extended period
* Significant weight loss or gain, or extended periods of indigestion
* Fatigue or headaches for extending periods
* Decrease in sexual activity for an extended period of time
* Harming oneself or thoughts of death or suicide

Treating Depression

There are a number of options available to treat depression. Since everyone is different, it's best to speak to your doctor about the right treatment plan for you.

* Psychotherapy. This involves meeting with a psychiatrist or psychologist to talk about your life and problems. The goal is to help uncover the cause of your depression, and find a way to overcome them.
* Anti-depressants. There are two main classes of anti-depressants: SSRIs and MAOIs. SSRIs are typically the first to be prescribed.
o SSRIs, or Selective Serotonin Reuptake Inhibitors, work by increasing the amount of chemical messengers in the brain. These are known to produce side effects, including sexual dysfunction, nausea and anxiety, so they don't work well for everyone.
o MAOIs, or Monoamine Oxidase Inhibitors, are used in some people who have chronic depression. These are prescribed much less often because of the risk of side effects and serious interactions with some foods and other medications
* Stimulants. Stimulants may be prescribed if you can't take an anti-depressant medication like the SSRI or MAOIs. Sometimes, stimulants will be used with an anti-depressant for better results.
* Lithium. This is used to treat Bipolar Disorder. It works by stabilizing mood, to avoid the episodes of exaggerated "ups" and "downs."

There are some important notes regarding medications: First, you and your doctor may need patience in finding the right type of antidepressant and right dosage that works best for you. Like all medications, drugs used to treat depression can cause side effects and need to be carefully selected and finely-tuned.

Second, antidepressants usually don't take effect immediately. In fact, some can take up to eight weeks to kick in.

And third, even if you feel better, you should continue to take them. If you stop once you feel OK, you may relapse into depression. In addition to medication, your doctor may suggest you start a program of psychotherapy.

* Electroconvulsive Therapy. It is used most often in severe cases or when a patient does not respond to medication. The treatment involves putting a patient to sleep with anesthesia, and then passing a mild electrical current through the brain for one to three seconds. Typically a patient will require six to ten treatments.
* Light Therapy. This treatment is specific for people with SAD, and involves increasing the amount of exposure to a light source to mimic the effect of sunlight.

Managing Depression

The key to overcoming depression is to manage your condition on a day-to-day basis. Here are some guidelines:

* See your doctor regularly;
* Take your medications;
* Try to participate in activities;
* Share your feelings and treatment recommendations with a family member or a good friend;
* Eat a healthy diet and get the right amount of sleep;
* Exercise. It can help treat some forms of depression, ease stress and help you relax; and
* Avoid alcohol and recreational drugs, which can worsen chemical imbalances in the brain.

Remember; stick with your treatment plan. It's likely the reason you're feeling better.