Categories
Disease & Condition

Depression (major depressive disorder)

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest.

Symptoms

Although depression may occur only one time during your life, usually people have multiple episodes of depression. During these episodes, symptoms occur most of the day, nearly every day and may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren’t your responsibility
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

When to see a doctor

If you feel depressed, make an appointment to see your doctor as soon as you can. If you’re reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.

Risk factors

  • Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic
  • Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
  • Childhood trauma or depression that started when you were a teen or child
  • Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
  • Being lesbian, gay, bisexual or transgender in an unsupportive situation
  • History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
  • Abuse of alcohol or illegal drugs
  • Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
  • Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

Complications

Examples of complications associated with depression include:

  • Excess weight or obesity, which can lead to heart disease and diabetes
  • Pain and physical illness
  • Alcohol or substance misuse
  • Anxiety, panic disorder or social phobia
  • Family conflicts, relationship difficulties, and work or school problems
  • Social isolation
  • Suicidal feelings, suicide attempts or suicide
  • Self-mutilation, such as cutting
  • Premature death from other medical conditions

Tests and diagnosis

These exams and tests can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and check for any related complications:

  • Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.
  • Lab tests. For example complete blood count or test your thyroid to make sure it’s functioning properly.
  • Psychological evaluation.

Treatments and drugs

Medications and psychological counseling (psychotherapy) are very effective for most people with depression

Medications

Many types of antidepressant medications are available, including those below. Discuss possible major side effects with your doctor or pharmacist.

  • Selective serotonin reuptake inhibitors (SSRIs). SSRIs include fluoxetine, paroxetine, sertraline, citalopram and escitalopram.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine, venlafaxine, desvenlafaxine and levomilnacipran
  • Norepinephrine-dopamine reuptake inhibitors (NDRIs). Bupropion falls into this category.
  • Atypical antidepressants. Such as trazodone, mirtazapine, vortioxetine and vilazodone. These medications don’t fit into any other antidepressant categories.
  • Tricyclic antidepressants. These antidepressants — such as imipramine, nortriptyline, amitriptyline, doxepin, trimipramine, desipramine and protriptyline — can be very effective, but tend to cause more-severe side effects than newer antidepressants.
  • Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine, phenelzine and isocarboxazid — may be prescribed, typically when other medications haven’t worked, because they can have serious side effects.
  • Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects

Antidepressants and pregnancy

If you’re pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk with your doctor if you become pregnant or you’re planning to become pregnant.

Psychotherapy

Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health provider.

Other treatment options

Electroconvulsive therapy (ECT)

Transcranial magnetic stimulation (TMS)

 

Leave a Reply

Your email address will not be published. Required fields are marked *