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When doctors talk about depression, they mean the medical illness called major depression. Someone who has major depression has symptoms like those listed in the Symptoms section nearly every day, all day, for two weeks or longer. There is also a minor form of depression that causes less severe symptoms. Both kinds of depression have the same causes and treatment.

Depression can affect people of all ages and is different for every person. A person who has depression can't control his or her feelings. If you or your child, teen, or older relative is depressed, it's not his or her fault.

Is Depression More Common In Women Than In Men?

What Are The Symptoms Of Depression?

The symptoms of depression are different for every person. You may have one or many of the symptoms listed below. Your symptoms may include only emotional or only physical symptoms, or both.

Emotional Symptoms

• Crying easily or for no reason
• Feeling guilty or worthless
• Feeling restless, irritated, and easily annoyed
• Feeling sad, numb, or hopeless
• Losing interest or pleasure in things you used to enjoy (including sex)
• Thinking about death or suicide

Physical Symptoms

• Changes in appetite (eating more than usual, or eating less than usual)
• Feeling very tired all the time
• Having other aches and pains that don't get better with treatment
• Having trouble paying attention, recalling things, concentrating, and making decisions
• Headaches, backaches, or digestive problems
• Sleeping too much, or having problems sleeping
• Unintended weight loss or gain
  
  The symptoms of depression may be different for children, teens, and seniors.

  
  

What Causes Depression?

Depression may be caused by an imbalance of chemicals in the brain. Sometimes there are insufficient chemical messengers (called neurotransmitters) in the brain. Examples of neurotransmitters that affect your mood include serotonin , norepinephrine and dopamine. A chemical imbalance in the brain may be caused by one or more of the following:

• Your genes. Sometimes depression is hereditary, meaning it runs in your family. If you have a parent or sibling who has depression, you may be more at risk for having depression yourself.
• A medical condition. Problems with your thyroid, nutrient deficiencies, or chronic diseases such as heart disease, diabetes, or cancer may cause depression.
• Events in your life. Depression can be triggered by stressful events in your life, such as the death of someone you love, a divorce, chronic illness, or loss of a job.
• Medicines, drugs, or alcohol. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also lead to depression.

Depression is not caused by personal weakness, laziness, or lack of willpower.

Can Giving Birth Cause Depression?

In the days following the birth of a baby, it is common for some mothers to have mood swings. They may feel a little depressed, have a hard time concentrating, lose their appetite, or find that they can't sleep well even when the baby is asleep. This is called the baby blues and goes away within 10 days after delivery. However, some women have worse symptoms or symptoms that last longer. This is called postpartum depression.  

How Does My Doctor Know If I'm Feeling Depressed?

You need to tell your doctor about your symptoms. Do not expect your doctor to guess that you are depressed just by observing you. You may feel embarrassed, or it may be hard for you to imagine treatment will actually help you feel better. However, don't wait to talk to your doctor. The sooner you seek treatment, the sooner the depression will lift.

How Is Depression Diagnosed?

Reasons To Get Help For Depression

• Early diagnosis and treatment helps keep depression from getting worse or lasting for a long time.
• Diagnosis and treatment can help you return to your "normal" self and enjoy life.
• After you're diagnosed, treatment can help prevent depression from coming back.
• Thoughts of suicide are common in people with depression. The risk of suicide is higher if you don't get help for your depression. When depression is successfully treated, the thoughts of suicide will go away.

How Is Depression Treated?

Will I Need To Go To The Hospital?

How Long Will The Depression Last?

This depends on how soon you get help. Left untreated, depression can last for weeks, months, or even years. The main risk in not getting treatment is suicide. Treatment can help depression lift in eight to 12 weeks or less.

What Medicines Are Used To Treat Depression?

Medicines that treat depression are called antidepressants. They help increase the number of chemical messengers (serotonin, norepinephrine, dopamine) in your brain.

Antidepressants work differently for different people. They also have different side effects. Thus, even if one medicine affects you or doesn't work for you, another may help. You may notice improvement as soon as one week after you start taking the medicine. However, you probably won't see the full effects for about eight to 12 weeks. You may have side effects at first, but they tend to decrease after a couple of weeks. Don't stop taking the medicine without checking with your doctor first.

How Does Counselling Help?

For mild to moderate depression, counselling may be a good treatment option. For major depression and for some people with minor depression, counselling may not be enough. A combination of medicine and talk therapy is usually the most effective way of treating more severe depression. If you continue the combination treatment for at least a year, you are less likely to have depression come back.

In psychotherapy, you talk with a trained therapist or counsellor about things that are going on in your life. The focus may be on your thoughts and beliefs, on things that happened in your past, or on your relationships. Or the focus may be on your behaviour, how it's affecting you, and what you can do differently. Psychotherapy usually lasts for a limited time, such as eight to 20 visits.

What Is Electroconvulsive Therapy?

Electroconvulsive therapy (also called ECT or electroshock therapy) is a procedure used to help treat certain mental illnesses. Electric currents are passed through the brain in order to trigger a seizure (a short period of irregular brain activity), lasting about 40 seconds. Medicine is given during ECT to help prevent damage to muscles and bones.

Electroconvulsive therapy may help people who have the following conditions:

• Severe depression that does not respond to antidepressants (medicines used to treat depression) or counselling.
• Severe depression in patients who can't take antidepressants.

Tips On Getting Through Depression

DO:

• Pace yourself.
• Get involved in activities that make you feel good or feel like you've achieved something.
• Avoid drugs and alcohol. Both make depression worse and can cause dangerous side effects with antidepressant medicines.
• Exercise often to make yourself feel better. Physical activity seems to cause a chemical reaction in the body that can improve your mood. Exercising four to six times a week for at least 30 minutes each time is a good goal. Even a moderate amount of activity can be helpful.
• Eat balanced meals and healthy foods.
• Get enough sleep.
• Take your medicine and/or go to counselling as often as your doctor recommends. Your medicine won't work if you only take it once in a while.
• Set small goals for yourself, because you may have less energy.
• Encourage yourself.
• Get as much information as you can about depression and how to treat it.
• Call your doctor or the local suicide crisis centre right away if you start thinking about suicide.

DON'T:

• Don't isolate yourself. Stay in touch with your loved ones and friends, your religious advisor, and your family doctor.
• Don't believe in negative thoughts you may have, such as blaming yourself or expecting to fail. This thinking is part of depression. These thoughts will go away as your depression lifts.
• Don't blame yourself for your depression. You didn't cause it.
• Don't make major life decisions (for example, about separation or divorce). You may not be thinking clearly while you are depressed, so the decisions you make at this time may not be the best ones for you. If you must make a big decision, ask someone you trust to help you.
• Don't expect to do everything you normally can. Set a realistic schedule.
• Don't get discouraged. It will take time for your depression to lift fully. Be patient with yourself.
• Don't give up.

Suicide

People who have depression sometimes think about suicide. This thinking is a common part of the depression. If you have thoughts about hurting yourself, tell someone. You could tell your doctor, your friends, your family, or call your local suicide hotline.

Get help right away. There are people who can help you, and depression can be successfully treated.

American Psychiatric Association , DSM-5 Task Force : Major depression disorder: DSM-5.2013.American Psychiatric Association Washington, DCpp. 160-188.

Chang B., Gitlin D., Patel R.: The depressed patient and suicidal patient in the emergency department: evidence-based management and treatment strategies. Emerg Med Pract 2015; 13: pp. 1-23.

 Feldman M.D., Christensen J.F.: Behavioral medicine: a guide for clinical practice.4th edition2014.McGraw-Hill MedicalNew York

 Kane R.L.: Diagnosis and management of depression. Essentials of clinical geriatrics.2013.McGraw-Hill MedicalNew York

 Simms L.J., Prisciandaro J.J., Krueger R.F., et. al.: The structure of depression, anxiety and somatic symptoms in primary care. Psychol Med 2012; 42: pp. 15-28.

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