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Depression

What is depression? How do I know I have depression? What’s the difference between depression and just having a bout of the blues?Read on for answers!

 

Depressive Disorders

A depressive disorder is not a passing blue mood but rather persistent feelings of sadness and worthlessness and a lack of desire to engage in formerly pleasurable activities. A complex mind/body illness, depression can be treated with drugs and/or therapy.

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Depression is one of the most treatable illnesses, but only about 25% seek help!

depressive disorder is an illness that involves the body, mood, and thoughts. It interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care  about him or her.

A depressive disorder is not the same as a  passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without  treatment, symptoms can last for weeks, months, or years. Depression is a common but serious illness, and most people who experience it need  treatment to get better. Appropriate treatment, however, can help most  people who suffer from depression.

Depressive disorders come in  different forms, just as is the case with other illnesses such as heart disease. Three of the most common types of depressive disorders are  described here. However, within these types there are variations in the  number of symptoms as well as their severity and persistence.

Major depression is manifested by a combination of symptoms (see symptom  list) that interfere with the ability to work, study, sleep, eat, and  enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.

Dysthymic disorder, also called dysthymia, involves long-term (two  years or longer) less severe symptoms that do not disable, but keep one  from functioning normally or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in  their lives.

Seasonal affective disorder (SAD) is characterized by the onset of a depressive illness during the  winter months, when there is less natural sunlight. The depression  generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can  reduce SAD symptoms, either alone or in combination with light therapy.

Bipolar disorder, also called manic-depressive illness is not as prevalent as major  depression or dysthymia, and characterized by cycling mood changes:  severe highs (mania) and lows (depression).

Symptoms

  • Persistent sad, anxious, or empty mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Difficulty concentrating, remembering, or making decisions
  • Insomnia, early morning awakening or oversleeping
  • Appetite and/or weight loss, or overeating and weight gain
  • Thoughts of death or suicide, suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain

Treatment

Treatment for depression can consist of talk therapy, behavior therapy, and medication. Several research studies suggest that a combination of talk therapy and medication is most effective.

Without treatment, the likelihood increases that subsequent episodes of depression will be more severe and longer in duration.

Medication treatment can be very effective, especially for more severe depression. Most commonly, a class of medications called SSRIs is prescribed. SSRIs are medications like Prozac*, Zoloft*, Celexa*, Lexapro*, Paxil*. These medications increase the availability of serotonin (a neurotransmitter). Other medications include a class that increases serotonin and norepinephrine (other neurotransmitters), like Effexor* and Cymbalta*. Wellbutrin* is another treatment option, enhancing dopamine. Older medications include tricyclics and MAOIs. Many doctors will also prescribe mood stabilizers to the regimen.

The important thing to remember for those needing this kind of treatment is that there is no way to predict which medication will work for any one person and in what dosage. Most medications need several weeks to achieve their full therapeutic effect, although some will begin to “kick in” after a few days (a week or so).

* registered trade marks.

 

Co-occurring diseases

Chronic episodes of depression may be "causally linked" to an increased risk  for coronary heart disease (CHD), new research suggests. The latest findings from the ongoing Whitehall II study, which began more than 2 decades ago, showed that those who had depressive symptoms during 1 or 2 assessments over time did not have an added risk for CHD. However, there was a highly significant increase in risk if they reported symptoms during 3 or more assessments.

Click here to read more details about this study, including the comments of some medical experts, and references.

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