Depression Disorder

Depression is a major psychiatric disorder that affects millions of Americans and their families, friends, and colleagues.  The National Institute of Mental Health reports that 18.8 million adults, or about 9.5 percent of the U.S. adult population, suffer from some form of depressive disorder.

The linkage between depression and physical illnesses makes it, in the words of the World Health Organization, "the world's second-most disabling disease after heart disease."

Symptoms of depression

• Ongoing sad, anxious or empty feelings
• Feelings of hopelessness
• Feelings of guilt, worthlessness, or helplessness
• Feeling irritable or restless
• Loss of interest in activities or hobbies that were once enjoyable, including sex
• Feeling tired all the time
• Difficulty concentrating, remembering details, or difficulty making decisions
• Not able to go to sleep or stay asleep (insomnia); may wake in the middle of the night, or sleep all the time
• Overeating or loss of appetite
• Thoughts of suicide or making suicide attempts
• Ongoing aches and pains, headaches, cramps or digestive problems that do not go away.

What is Depression?

The American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) lists nine symptoms for major depression, five or more which must be present over the same two-week period, including one of the first two:

• Feeling depressed most of the day, nearly every day.
• Markedly diminished pleasure.

The other seven symptoms include:

• Significant weight gain or loss.
• Insomnia or hypersomnia.
• Psychomotor agitation or retardation.
• Fatigue or loss of energy.
• Feelings of worthlessness or inappropriate guilt.
• Diminished ability to think or concentrate.
• Recurrent thoughts of death, suicidal thinking, and suicide attempts.

How is depression treated?

Medications and counseling are the cornerstones of depression therapy.  Reacting to depression as soon as it is noticed is important. With prompt treatment, a depressed person can return to a happier lifestyle and more balanced outlook on life.  There are effective treatments for depression, including antidepressants and talk therapy.  Most people do best by using both.

How long will the depression last?

This depends on how soon you get help. Left untreated, depression can last for weeks, months or even years. The main risk in not getting treatment is suicide. Treatment can help depression lift in 6 to 8 weeks, or less.

Reasons to get help for Depression

• Early treatment helps keep depression from getting worse or lasting a long time.
• Thoughts of suicide are common in people with depression.
• The risk of suicide is higher if you don't get treatment for your depression.
• When depression is successfully treated, the thoughts of suicide will go away.
• Treatment can help you return to your "normal" self, enjoying life.
• Treatment can help prevent depression from coming back.

Other Types of Depression

Dysthymia Depression

Dysthymia is chronic mild to moderate chronic depression, as opposed to major depression. The DSM-IV mandates the same symptoms as for major depression, except for suicidality, but requires only three symptoms in all, so long as they have persisted over two years. Mild to moderate is a misnomer, as dysthymia can make a person’s life as miserable as major depression.

Melancholic Depression

Melancholic depression is major depression with an emphasis on lack of pleasure or lack of reactivity to pleasure. Other characteristics include (three or more): Depressed mood, depression at worst in the morning, early morning awakening, psychomotor agitation or retardation, significant weight loss, and inappropriate guilt.

Atypical Depression

Atypical depression is a misnomer, as more outpatients suffer from atypical depression than from other forms of depression. Atypical depression is major depression that differs from melancholic depression in that patients react positively to external events, plus (two or more): Significant weight gain (as opposed to weight loss), hypersomnia (as opposed to insomnia), leaden paralysis, and sensitivity to personal rejection.

Bipolar Depression

Bipolar depression is a feature of bipolar disorder, also known as manic depression, an illness characterized by mood swings from depression to mania. The diagnostic criteria for bipolar depression are the same as for major depression, but bipolar patients tend to have atypical features. Bipolar patients who rapid cycle can be up and down in a matter of minutes, and in mixed states depression and mania are present at once.

Psychotic Depression

Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.

Catatonic Depression

Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.

Postpartum Depression

Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the “baby blues.” Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth.

Dual Diagnosis/Co-Occurring Disorder

Depression disorders often occurs together with substance abuse and substance dependence disorders.  Often the substance use is the result of an attempt to "self-medicate" but just as often substance dependence is the primary disorder with depression being secondary.  In either case, both disorders must be treated simultaneously to achieve an effective outcome.

Disclaimer: This assessment is not intended to diagnose or treat any medical or emotional condition. It is advised that you consult your physician with any concerns regarding this condition.

If you have additional questions, or if you would like us to provide you with a no-cost, no-commitment, confidential consultation, please contact one of our treatment specialists.