Depression Overview

November 08, 2009

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Depression Overview

by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.

Everyone has periods where they feel sad, down, or blue. They may say that they are depressed, but true clinical depression is more than that. In addition to being sad or easily irritated, the symptoms of depression often include a loss of ability to enjoy things, low energy, changes in sleep and appetite, and unremitting negative thoughts (for example, blaming yourself for everything). In some cases, these symptoms hit hard for a period of several weeks, then fade; in others, milder symptoms are present daily for months or years.

The types of depression
Depression takes various forms, depending on when the symptoms start, their severity, and related problems such as feelings of anxiety or flatness (that is, the inability to feel much of any emotion at all). When depression alternates with feelings of extremely high energy and unrealistically high self-esteem, the problem may be a form of mania, also called bipolar disorder. For more information, see our article on the different types of depression.

Who gets depression?
As many as one in five people experience depression at some point in their lives. Among school-age children, perhaps two to three percent have depression at any given time--not a small number as serious illnesses go. Among adolescents, approximately 10 percent experience depression. The risk goes up if there is a family history of depression, or if a person has experienced physical or sexual abuse, psychological loss, chronic illness, or other severe stress, either recently or in the past.

Signs to look for
Here are some of the signs of depression you might notice in yourself or in someone you know. The signs of depression are very similar in children, adolescents, and adults:

sadness or irritability (little things make the person angry all of the time)

a loss of enthusiasm for activities; withdrawal from family, friends, teams or clubs; nothing really makes the person happy

sleeping much more or having difficulty falling asleep; eating much more or loss of appetite, with weight gain or loss; unexplained headaches and body aches (especially in children); loss of energy (or, with bipolar disorder, periods of abnormally high energy, elevated spirits, or irritability);

falling grades or work performance; failure to care for physical appearance (if this is a change from before); new alcohol or drug use; comments that sound hopeless or despairing ("What's the use?" "Nothing ever works out for me." "It's all my fault!"), or even suicidal.

If you recognize even one of these signs in yourself or someone close to you, you need to pay attention, look for other signs, and probably get professional help.

Causes and treatments
Often people become impatient with someone who is chronically depressed. They think it's just a matter of the person readjusting his attitude and "snapping out of it." However, true depression is a serious medical condition, one that no one would choose to endure. It can be caused by many factors: Genetics plays an important role, making people either more or less vulnerable to becoming depressed. Stressful and sad life events--either in the past or in the present--also can play a part Depression is not merely a matter of how a person feels; there are also physical changes in hormones and brain functions that go along with it. People with depression can usually pretend to be OK and "put on a good face" for a short period of time, but they cannot cure themselves simply by force of will.

Treatment for mild depression may be mostly a matter of supporting the person, and helping family and friends to rally around. For moderate and severe depression, medication combined with psychotherapy is very effective. There are several different antidepressant medications and several forms of psychotherapy, none of which is clearly superior. Early treatment is important, particularly for childhood depression. Untreated depression tends to get worse and worse over time. With treatment, 80 percent of people with depression get much better.

The articles in this program take a closer look at depression in children, adolescents, and adults, and at how doctors diagnose and treat it.


RELATED INFORMATION

			Depression in Parents
			Depression
			Emotions: What They Mean

Created February 18, 2001
Reviewed August 15, 2004

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