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 generally ranked in terms of severity -- mild, moderate, or severe. The degree of your depression, which your doctor can determine, influences how you are treated. Symptoms of depression include:
Trouble sleeping or excessive sleeping
A dramatic change in appetite, often with weight gain or loss
Fatigue and lack of energy
Feelings of worthlessness, self-hate, and inappropriate guilt
Extreme difficulty concentrating
Agitation, restlessness, and irritability
Inactivity and withdrawal from usual activities
Feelings of hopelessness and helplessness
Recurring 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.
The main types of depression include:
Major depression -- five or more symptoms listed above must be present for at least 2 weeks, but major depression tends to continue for at least 6 months. (Depression is classified as minor depression if less than five depressive symptoms are present for at least 2 weeks.)
Dysthymia -- a chronic, generally milder form of depression but lasts longer -- usually as long as two years.
Atypical depression -- depression accompanied by unusual symptoms, such as hallucinations (for example, hearing voices that are not really there) or delusions (irrational thoughts).
Other common forms of depression include:
Postpartum depression -- many women feel somewhat down after having a baby, but true postpartum depression is rare.
Premenstrual dysphoric disorder (PMDD) -- depressive symptoms occur one week prior to menstruation and disappear after you menstruate.
Seasonal affective disorder (SAD) -- occurs during the fall-winter season and disappears during the spring-summer season. Likely to be due to lack of sunlight.
Depression may also occur with mania (known as manic-depression or bipolar disorder). In this condition, moods cycle between mania and 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.
Common Causes:
Depression often runs in families. This may be from 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.
Depression may 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)
Death of a friend or relative
Prolonged pain or having a major illness
Medical conditions such as hypothyroidism (underactive thyroid), cancer, or hepatitis
Nutritional deficiencies (such as folate and omega-3 fatty acids)
Sleeping problems
References:
Moore D, Jefferson J. Major Depressive Disorder. In: Handbook of Medical Psychiatry. 2nd ed. Mosby, Inc., 2004; 134-141.
Screening for Depression Recommendations and Rationale. US Preventive Services Task Force, Guidelines from Guide to Clinical Preventive Services: 3rd ed. Rockville, Md. US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; May 1, 2002.
World Health Organization. The World Health Report 2001 - Mental Health: New Understanding, New Hope. Geneva World Health Organization, 2001.
Guide to Clinical Preventive Services: Screening for Depression, Recommendations and Rationale. Rockville, Md. US Preventive Services Task Force, Dept of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. Ann Intern Med. 2002; 136(10): 760–764.
Practice Guideline for the Treatment of Patients With Major Depressive Disorder, 2nd Ed. Arlington, VA: American Psychiatric Association; 2000.
Review Date: 6/6/2005
Reviewed By: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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