1. What Is Depression?
Depression may be described as feeling sad, blue, unhappy, miserable or down in the
dumps. Most of us feel this way at one time or another for short periods. But true clinical
depression is a mood disorder in which feelings of sadness, loss, anger or frustration
interfere with everyday life for an extended time.
Depression is a common condition. The National Institute of Mental Health (NIMH) estimates
that about 10 percent of American adults experience some form of depression. For people
with chronic illnesses, the number can be higher. For example, NIMH estimates that about
25 percent of people with cancer have depression, and one study of people with multiple
sclerosis found that 41.8 percent had significant symptoms of depression.
The symptoms of depression can be mild, moderate or severe. But even when symptoms
are mild, the condition is not the same as temporarily having the blues. People cannot snap
out of depression by force of their will. And while practicing healthy habits may help,
getting regular exercise, eating right or taking a vacation may not completely alleviate
depression.
Depression is more common in women than men and is especially common during the teen
years. Men seem to seek help for feelings of depression less often than women.
Therefore, women may only have more documented cases of depression.
2. What Causes Depression?
Depression often runs in families and may be due to heredity, learned behavior or both. Even
with a genetic predisposition, it is usually a stressful or unhappy life event that triggers the onset
of a depressive episode. While the exact causes of depression are unknown, several factors
appear to affect its onset:
Biochemistry: Nerve cells in the brain send and receive messages that control your emotions and
feelings, with the help of chemicals called neurotransmitters. Scientists believe that depression
symptoms occur when some of these neurotransmitters, including serotonin and
norepinephrene, are not delivered correctly, causing a chemical imbalance.
Genetics: A family history of depressive disorder puts people at greater risk, but depression also
strikes people who have no family members with the illness. Depression that results from a
person’s biology or genetic inheritance is sometimes referred to as endogenous depression.
Personality: People who are pessimistic or have low self-esteem or low tolerance for stress are
more likely to develop depression.
Difficult life situations: Depression may be more likely in people who are facing serious problems
in their lives, such as abuse, violence or poverty. Difficult times, such as divorce, the death of a
loved one, financial problems or moving from your home can also contribute to depression. This
type of depression is sometimes referred to as reactive depression.
Other illnesses: People who have certain other medical conditions – such as cancer, heart
disease, stroke, diabetes, Parkinson’s disease and hormonal disorders – are more likely to
develop depression.
Depression may also be brought on by:
Disappointment at home, work, or school (in teens, this may be breaking up with a boyfriend or
girlfriend, failing a class or parents divorcing)
Drugs such as sedatives and high blood pressure medications
Alcohol or drug abuse
Chronic stress
Childhood events like abuse or neglect
Social isolation (common in the elderly)
Nutritional deficiencies (such as folate and omega-3 fatty acids)
Sleeping problems
3. What Are the Symptoms of Depression?
Not everyone who is diagnosed with depression has the same symptoms. Some experience
only a few symptoms, others have most of them. How severe the symptoms are and how
long they last also varies from person to person. To be diagnosed with major depression, a
person must have at least five of the following symptoms nearly every day for at least two
weeks:
Feeling sad or empty
Decreased interest or pleasure in activities
Appetite change with weight loss or weight gain
Decreased or increased sleeping
Fatigue or loss of energy
Feeling worthless or guilty
Being either agitated or slowed down
Difficulty thinking or concentrating
Recurrent thoughts of death or suicide
Low self-esteem is common with depression, so are sudden bursts of anger and lack of
pleasure from activities that normally make you happy, including sex.
Depressed children may not have the classic symptoms of adult depression. Watch
especially for changes in school performance, sleep and behavior. If you wonder whether
your child might be depressed, it’s worth bringing to a doctor’s attention.