Depression

Depression is a psychiatric disorder characterized by a profound and long-lasting sadness or despair. It affects approximately eighteen million people in the United States every year and most of them aren't even old enough to vote. Everyone experiences some unhappiness, often as a result of a change, either in the form of a setback or a loss. The painful feelings that accompany these events are usually appropriate, necessary, and transitory and can even give a person an opportunity for personal growth. However, when symptoms persists and impairs daily life, it may be an indication of depression. Severity, duration, and the presence of other symptoms are the factors that distinguish normal sadness from a depressive disorder.

Depression has been referred to by a variety of names in both medical and popular literature for thousands of years. Early English texts refer to it as "melancholia," which was for centuries the generic term for all emotional disorders. Depression is now referred to as a mood disorder, and the primary subtypes are major depression, chronic and usually milder depression, and atypical depression. Other important forms of depression are premenstrual dysphoric disorder, and seasonal affective disorder.

Once depression is identified, most people diagnosed with depression are successfully treated. Unfortunately, depression is not always diagnosed, because many of the symptoms mimic physical illness. Recognizing depression is the first step in treating it.

In major depression, at least five symptoms must occur for a period of at least two weeks, and they must represent a change from previous behavior or mood. Depressed mood or loss of interest must be present. Depressed mood on most days for most of each day ( with Irritability prominent in children and adolescents.), Total or very noticeable loss of pleasure in thing that were once enjoyed, Significant increase or decrease in appetite, weight, or both. Sleep disorders; excessive sleeping or insomnia, Feeling agitated or feeling a sense of intense slowness, Loss of energy and a sense of tiredness all day, Feeling guilty or worthless nearly all the time, Inability to concentrate throughout the day, reoccurring thoughts of death or suicide, overwhelming feeling of hopelessness.

Chronic, but mild depression, or Dysthymia, is characterized by many of the same symptoms that occur in major depression but they are less intense and last much longer -- at least two years. "The symptoms have been described as a "veil of sadness" that covers most activities."(Thase, Michael E., Susan S. Lang) Typically, there are no changes in appetite or sexual drive; severe agitation, and sedentary behavior are not present and neither are Suicidal thoughts. Possibly because of the duration of the symptoms, patients who suffer from chronic depression do not exhibit marked changes in mood or in daily functioning, although they have low energy, a general negativity, and a sense of dissatisfaction and helplessness.

"People who suffer from Dysthymia may also suffer from episodes of major depression; in such cases, the condition is known as double depression."(Thase, Michael E., Susan S. Lang )The family life of such people is often impaired because of their decreased level of emotional and physical energy.

Annual episodes of depression during fall or winter, is known as Seasonal Affective Disorder, people with SAD experience symptoms such as: fatigue, overeating, particularly carbohydrates -- and oversleeping. SAD tends to last about five months in those who live in the northern part of America.

"The syndrome of severe depression, irritability, and tension before menstruation is known as Premenstrual Dysphoric Disorder. It affects an estimated 3% to 8% of women in their reproductive years."(Huston, James E.) A diagnosis of PMDD depends on having five symptoms of depression (from first paragraph) that occur during most menstrual cycles, with symptoms worsening a week or so before the menstrual period and resolving afterward.

Depression is an illness that can afflict anyone, regardless of age, race, class, or gender. "In one large survey, 8.6% of adults over the age of 18 reported having a mental health problem for at least two weeks."( Schimelpfening, Nancy)However, the incidence may be higher since many people fail to seek help for depression and physicians are often reluctant to diagnose depression.

Most adult patients with major or chronic depression are given a trial period of an antidepressant. Some form of psychotherapy is also usually recommended; the type prescribed should be, like the medications, tailored to the needs of the patient. "The combination of antidepressants and therapy appears to be more effective than either treatment alone for most patients"(wikipedia), possibly because patients are more likely to take their medications regularly when they are also undergoing therapy. "For those who fail medications and psychotherapy, other techniques, such as electroconvulsive therapy, are safe and effective.""(wikipedia)

Studies indicate that "children and adolescents with major depression respond as well to placebos, so called "sugar pills" ,as they do to other antidepressants that are known as selective serotonin reuptake inhibitors (SSRIs)."(montgomery, Stuart A., Johan A. den Boer)

Some experts believe teenagers with mild to moderate depression should receive psychotherapy before medications are tried. For children and adolescents with very severe depression that do not