Depression

Description:

When a person's feelings of sadness persist beyond a few weeks, he or she may have depression. According to the National Institute for Mental Health, three to four million men are affected by depression; it affects twice as many women. Researchers do not know the exact mechanisms that trigger depression. Two neurotransmitters-natural substances that allow brain cells to communicate with one another-are implicated in depression: serotonin and norepinephrine.

Symptoms:

  • Changes in appetite and sleeping patterns
  • Feelings of worthlessness, hopelessness and inappropriate guilt
  • Loss of interest or pleasure in formerly important activities
  • Fatigue
  • Inability to concentrate
  • Overwhelming sadness
  • Disturbed thinking
    • Physical symptoms such as headaches or stomachaches (e.g. a Hopi might complain of being heartbroken)
  • Suicidal thoughts or behaviors

Formal Diagnosis:

  • Four or more of the previous symptoms have been present continually, or most of the time, for more than 2 weeks
  • The term clinical depression merely means the episode of depression is serious enough to require treatment
  • Major depression is marked by far more severe symptoms, such as literally being unable to drag oneself out of bed
  • Another form of depression, known as seasonal affective disorder, is associated with seasonal changes in the amount of available daylight

Treatment:

Some types of cognitive/behavioral therapy and interpersonal therapy may be as effective as medications for some people who have depression. Special bright light helps many people who have seasonal affective disorder.

Three major types of medication are used to treat depression: tricyclics; the newer selective serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAO inhibitors). Electroconvulsive therapy uses small amounts of electricity applied to the scalp to affect neurotransmitters in the brain. Usually referred to as ECT, this highly controversial and potentially life-saving technique is considered only when other therapies have failed, when a person is seriously medically ill and/or unable to take medication, or when a person is very likely to commit suicide. Substantial improvements in the equipment, dosing guidelines and anesthesia have significantly reduced the possibility of side effects.

Source: SAMHSA's Mental Health Information Center


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