Depression is a serious illness that affects nearly 15 million American adults each year. Here's what you need to know.
We all experience changes in our mood—times when we feel sad, distracted, or just plain down in the dumps. Sometimes these feelings are a normal reaction to an upsetting event or situation, such as the death of a loved one or losing your job. Sometimes life's daily stresses can cause you to feel anxious and troubled. And sometimes you feel bad for seemingly no reason at all. But are you depressed?
Defining depression
"Major depressive disorder is a significant medical problem that is amongst the most impairing of all medical conditions," says Mark Zimmerman, M.D., Director of Outpatient Psychiatry at Rhode Island Hospital in Providence, Rhode Island. "It's not just the normal mood swings. Rather, clinical [or major] depression is a persistent condition lasting a minimum of weeks that is associated with a collection of different symptoms." These symptoms may include:
- Persistent sad, anxious, or empty mood
- Sleep problems such as insomnia, disturbed sleep, or oversleeping
- Disturbances in appetite, either increased or decreased
- Fatigue and feeling worn out
- Problems concentrating or focusing on the task at hand
- Feeling like a failure or worthless
- Pervasive and persistent guilt and self-blame about decisions or behaviors in the past
- Lack of pleasure or interest in things that were once enjoyed
- Desire to be dead or thoughts of suicide
An accurate diagnosis is key
To be treated effectively for depression, it's absolutely essential that you get an accurate diagnosis. According to Dr. Zimmerman, a diagnosis of depression requires that these three elements
are present:
- Your symptoms are persistent, lasting throughout the day for a minimum of a few weeks.
- You are experiencing at least five symptoms from the list above and they're affecting other areas of your life, such as sleep, eating, interests, concentration, etc.
- You aren't able to function normally.
"Diagnosis informs treatment and an incorrect diagnosis can result in prescribing medications that are not necessary, as well as failure to prescribe medication or therapy for unrecognized conditions," he says. Because depression is often associated with physical problems like general aches and pains, trouble sleeping, or disturbances in appetite, a thorough evaluation needs to be done for possible causes, including psychological causes. "There's a definite link between physical complaints and psychiatric issues that's increasingly being recognized among primary care doctors," says Dr. Zimmerman.
Causes of depression
Depression is a biopsychosocial condition, which means there's a biological (genetic) component, a psychological (emotional) component, and a social (environmental) component—and they're intertwined.
Studies show that depression tends to run in families, but there's no specific test that can be done to check for it. In addition, people who are depressed have certain brain characteristics that are different from people who are not depressed. "How an individual interacts with the world, and their predisposition to think in a certain way also makes them vulnerable to being depressed," says Dr. Zimmerman. For example, if you say "hello" to a coworker and he doesn't respond, are you likely to think he just didn't hear you and forget about it? Or are you more inclined to think he doesn't like you or he's mad at you? "Someone who is depressed will more likely interpret things in a negative or self-critical way," he says.
Getting help
Treatment for depression usually involves antidepressant medication and psychotherapy, or a combination of the two. Cognitive behavioral therapy—a type of psychotherapy—focuses on working through any negative outlooks that make a person vulnerable to depression. "Individuals with depression tend to withdraw, so a goal of cognitive behavioral therapy may be to get the person engaged and active again," says Dr. Zimmerman. More and more, this approach involves helping people with depression live a healthy lifestyle by exercising, eating healthy foods, and avoiding substances that may worsen their mood.
People with serious medical conditions are also at increased risk for depression. "Medical illness is a stressful event, so it's not surprising to see depressive symptoms in a person who has had a heart attack or has cancer," says Dr. Zimmerman. "Increasing evidence shows that there is a therapeutic benefit to treating depression while treating a severe medical illness."
If you're experiencing symptoms of depression, don't ignore them. Contact a mental health professional or your primary care doctor, or ask a friend or family member to help you get the professional help you need.
