Living with depression, anxiety and bipolar disorder
October 2007
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Understanding depression
 

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Almost 10 percent of American adults, or about 19 million people age 18 and older, and 6 percent of youth experience some form of depression every year. A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats, sleeps, feels and thinks. A depressive disorder is not the same as a passing blue mood, nor can people with a depressive illness merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

Types of Depression
Three types of depressive disorders are the most common, however, within these types there are variations in the number of symptoms, their severity, and persistence.

Major depression is made up of a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.

A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.

Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Bipolar disorder is recently being viewed as a spectrum disorder, including bipolar I and bipolar II and spanning a continuum of symptoms.

Symptoms of depression

Causes of depression
Doctors believe that depression may have a number of complex and interacting causes. Some factors include losing a loved one, stressful life events, and drug or alcohol abuse. Mood disorders are sometimes caused by medical conditions, such as strokes or hypothyroidism. Certain medications are associated with depression; antihypertensives and oral contraceptives are the most frequent examples.

Brain imaging has revealed that neural circuits responsible for the regulation of moods, thinking, sleep, appetite, and behavior fail to function properly in people with depression and that critical neurotransmitters--chemicals used by nerve cells to communicate--are out of balance. The hormonal system that regulates the body's response to stress also is overactive in many depressed people.

 

 

 

 

Woman who is depressedSome types of depression run in families, however, it can also occur in people who have no family history of depression. Very often, a combination of genetic, psychological, and environmental factors is involved. Later episodes of illness typically are precipitated by only mild stresses, or none at all.

Treatment for depression
There are a variety of antidepressant medications and psychotherapies used to treat depression. People with moderate to severe depression most often benefit from antidepressants.

Some people with milder forms may do well with psychotherapy alone. In this "talk therapy" a person discusses with a mental health professional the feelings, thoughts and behaviors that seem to cause difficulty in order to better understand and manage their problems..

Most people with depression do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression.

When people are unresponsive to psychotherapy and medications or they work too slowly to relieve severe symptoms, such as psychosis or recurring thoughts of suicide, electroconvulsive therapy (ECT) may be considered. ECT is believed to affect the chemical balance of the brain's neurotransmitters.

Years of research are now promising new antidepressant medications that may relieve depression in hours, rather than weeks. Such fast acting medications could potentially treat patients at risk for suicide, which continues to claim 30,000 lives each year.

For more information:
Depression and Bipolar Support Alliance
National Alliance on Mental Illness
Mental Health America

Related articles
Bipolar II and Bipolar Spectrum Disorder
Causes of depression
Guide to psych meds
Real men-real depression
Seasonal Affective Disorder
Understanding Bipolar Disorder
Which type of therapy is right for me?

Sources:
The National Institute of Mental Health (NIMH)
National Institutes of Health (NIH)
Food and Drug Administration


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