Depression

Between 15 and 30 percent of the adult population are diagnosed with depression during their lifetime. Depression is long-lasting - two weeks to several years - and, in its most severe form, makes it impossible for a person to function.

Although more women than men suffer from depression, a recent study at the Virginia Commonwealth University College of Medicine in Richmond suggests that the genetic risk factors for inheriting the disease are equal in both sexes. It is categorized as a “whole body disease” because it also affects physical health and will recur 50 percent of the time. People suffering from depression often avoid treatment because:

• they are embarrassed
• they feel so low they can’t motivate themselves to get help
• they are afraid others will think they are “weak” or “crazy”
• they think nothing can be done to help them feel better

Scientists believe that a lack or imbalance of the chemicals dopamine, norepinephrine, and serotonin, which help relay messages to and from the nerve cells in the brain, plays a major role in what causes depression.

What appears to be a case of “the blues” can escalate into a full-blown depression. So can a normal grief reaction. Doctors aren’t sure why this happens to some people and not others, but they agree that the sooner a depression is treated, the quicker the person will feel better.

The following is a guide to some of the different types of depression:

Major depressive disorder

Also called major or clinical depression, it is characterized by a continually depressed mood and other symptoms. It can come on suddenly, for no apparent reason, be triggered by a stressful event or grow over a period of time. The greatest danger a person with depression faces is thoughts of suicide. In a major depression, the symptoms are not caused by another medical condition, a drug- or alcohol-induced disorder, or bereavement, and there are no other psychotic illnesses present.

Major depression secondary to medical illness

There are several conditions - multiple sclerosis, stroke, hypothyroid, heart disease, cancer, diabetes, and arthritis - in which depression can be a symptom of the disease. It is believed that when depression comes as a result of another illness, it is caused by abnormalities in the relationship between the endocrine and nervous systems and changes in certain areas of the brain. For example, doctors know when a person has a stroke in the left frontal lobe of his or her brain, depression is more common than if the stroke was on the right side or another area. The changes in that section of the brain are the same as the changes that are found in individuals with longstanding high blood pressure, diabetes, heart disease, and other illnesses affecting blood vessels. That fact combined with the burden of living with a chronic or debilitating disease makes it easy to understand why many illnesses go hand-in-hand with depression.

Bipolar disorder

This is also referred to as manic-depressive disorder because it is characterized by extreme mood swings of euphoria and sadness. During the manic or euphoric stage, actions become excessive - incessant talking, shopping sprees, reckless driving, decreased need for sleep, inflated self-esteem, distractibility, and restlessness. During the depressive phase, the same excesses are present but on the low end of the mood spectrum. People feel profoundly hopeless, lose their self-esteem, worry excessively that they have a serious medical illness such as cancer, and have many physical complaints. Some people with a bipolar disorder have periods of normal moods. Others are depressed most of the time. It most commonly begins in adolescence or early adulthood and continues throughout life.

Seasonal affective disorder

This is a major depression that comes on during the winter months and resolves once spring arrives. The most striking symptoms are carbohydrate craving, sleepiness, weight gain, irritability, difficulty in getting along with others, and heavy feelings in the arms and legs. Because of its association with shorter days and less light, it has been successfully relieved in many people with light therapy (sitting in front of a 10,000-lux light box for 10 to 15 minutes daily).

Dysthymic disorder

This is the “simmering” depression. It is diagnosed when a person has a generally depressed mood for most of the day, more days than not, for a period of at least two years. Mild or moderate in severity, many people suffer from dysthymia for years and don?t remember when they first started to feel that way. It is fairly common - 5 to 15 percent of patients in a family doctor’s office have it. People with dysthymia may always be pessimistic, guilt-ridden, irritable, easily hurt by others, or withdrawn. They rarely seek medical help and find it difficult to get along with others. Friends and family members may falsely assume the person with dysthymia is just grouchy or gloomy by nature. It is successfully treated with antidepressant medication, but the treatment may continue for several years.

Adjustment disorder with depressed mood

Some people react to a stressful event - loss of loved one or job, ending of marriage, accident, or major illness - with serious symptoms of depression. This disorder is characterized by marked distress more than what would be considered usual. These people often have difficulties dealing with social and job-related situations. This type of depression usually passes in a few months and does not return. It may or may not require treatment.

ANTIDEPRESSANTS

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