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Depression

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Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Thoughts of death or suicide

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Expert Q&A: Depression

Everyone experiences a range of emotions over the course of days and weeks, typically varying based on events and circumstances. When disappointed, we usually feel sad. When we suffer a loss, we grieve. Normally these feelings ebb and flow. They respond to input and changes. By contrast, depression tends to feel heavy and constant. People who are depressed are less likely to be cheered, comforted or consoled. People who recover from depression often welcome the ability to feel normal sadness again, to have a “bad day,” as opposed to a leaden weight on their minds and souls every single day.

The term “high-functioning depression” underscores the reality that many individuals with depression face – going through the motions of their day to day lives, appearing normal on the surface, while silently struggling with symptoms of depression. However, it is critical to note that though this term has gained prominence on various social media platforms and may be helping to lessen the stigma of depression, it is not a specific medical diagnosis.

Among people who are treated for major depressive disorder and recover, at least half are likely to experience a recurrent episode sometime in their future.It is difficult to determine at what point this may occur or what circumstances, if any, may trdigger it. If a person experiences several episodes of major depression, a psychiatrist or other mental health professional may suggest long-term treatment.

A wide variety of treatments have been proven effective in treating depression. Some involve talking and behavioral change. Others involve taking medications. There are also techniques that focus on neuromodulation, which incorporates electrical, magnetic or other forms of energy to stimulate brain pathways. Examples of neuromodulation include electroconvulsive therapy (ECT), vagus-nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and deep-brain stimulation (DBS).

The choice of therapy should be guided by the nature and severity of depression, past responses to treatment, and the preferences of the individual in treatment. 

Total openness is important. You should talk to your healthcare professional about all of your symptoms, important milestones in your life and any history of abuse or trauma. Also tell your them about past history of depression or other emotional symptoms in yourself or family members, medical history, medications you are taking — prescribed or over-the-counter. It is also key to share how depression has affected your daily life and whether you have ever thought about suicide.

It is important to see a healthcare professional as soon as you notice significant changes in your mood, difficulties in your work/school or home life, or if those close to you have commented about any concerning changes in your mood, personality and/or behavior. More serious symptoms, such as suicidal thinking, require immediate attention.

 

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Author

Alan Gelenberg, M.D.

Alan Gelenberg, M.D.

Professor Emeritus, University of Arizona

Medical leadership for mind, brain and body.

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