Depression: A Treatable Illness

For most people, life includes joy, sorrow and the wide range of emotions in between. Some days, we're up to life's challenges; other days, we feel less successful. But when a gloomy outlook or mood swings doesn't go away, then it's time to do something about it.

In the U.S. each year, more than 15 million people experience depressive illness. Many mistakenly believe there is no help for them, or that depression is a personal weakness they must "snap out of" on their own. In truth, depression is an illness, but it is considered the most treatable of all mental illnesses—an estimated 80 percent of serious depressions can be relieved. Untreated, depression can grow more serious and destructive, even life-threatening.

Warning Signs of Depression

If you—or someone you know—suffers from depressive symptoms for more than two weeks, or in such a way that it limits the ability to function in everyday life, it is time to seek professional help. The number of symptoms—and their severity—varies by individual.

persistent sad, anxious or "empty" mood
fatigue, decreased energy
loss of interest or pleasure in hobbies or activities, including sex
sleep disturbances
changes in appetite or weight
feelings of hopelessness or pessimism
feelings of guilt, worthlessness, helplessness
thoughts of death or suicide, suicide attempts
difficulty in concentrating, remembering, making decisions
chronic aches or persistent physical symptoms that don't respond to treatment

Depression: What Is It?

Depression is a word commonly used to describe an overwhelming weariness or sadness about life—a feeling of physical and emotional fatigue that goes beyond the normal reactions to loss, failure or disappointment.

Life events sometimes trigger sadness or depression that fades with time and emotional healing. But clinical depression is depression that lasts longer than a few weeks or interferes with the ability to participate in everyday life. Clinical depression isn't just a "negative attitude" or "the blues." It is an illness resulting from complex interactions between brain chemicals, hormones and other factors.

What Causes Depression?

The exact causes of depression are not yet fully understood, but several factors are believed to contribute:

Biochemical

a family history of depressive illness
imbalances in neurotransmitters, the naturally occurring chemicals that transmit messages from cell to cell in the brain
fluctuations or imbalances in hormones or other body chemicals
some illnesses, including thyroid disorders
some commonly used medications

Environmental

severe or unrelieved chronic stress
life conditions or events that impose significant stress or change

Women and Depression

Women experience depression more often than men do, and for a variety of reasons. Biology may be a factor for some women, but for many others depression is a response to feelings of powerlessness at home, in relationships or in the workplace. Factors that increase the risk of depression for women include:

Reproductive issues such as infertility, miscarriage, or surgical or early menopause
Sexual or other physical abuse, including battering, rape or sexual molestation
Marriage and children
Poverty or minority status that adds the element of discrimination
Alcohol, food or drug abuse

What Can You Do About Depression?

Get help. Depression often drains energy, motivation and even the desire for a well life. It's important to remember that weariness and hopelessness are part of the illness.

With proper diagnosis and treatment, more positive feelings will return. In the meantime, these self-help steps may be useful:

Do not set difficult goals or take on a great deal of responsibility.
Break large tasks into small ones. Set priorities. Do what you can, as you can.
Avoid asking too much of yourself. Unrealistic expectations only increase feelings of failure.
Try to spend time with other people, rather than alone.
Participate in activities that make you feel better, or might over time. Mild exercise, going to a movie or ball game, or attending religious or social events are a good start.
Avoid making major life decisions about job changes, marriage or divorce until the depression has lessened and you have a more objective view. Discuss concerns with trusted friends or family members.
Be kind to yourself. Help yourself as much as you can, and ask others for support.
Don't blame yourself for negative thinking. Recognize it as a symptom of depression and reach out for help from friends, family, your personal physician and professional counselors.

How Is Depression Treated?

Once depression is diagnosed, a more specific evaluation matches the type of depression or symptoms to the most effective treatment therapies. Depending on the type and severity of the depression, the treatment plan may include medication, psychotherapy or both.

Psychotherapy involves ongoing conversation between the depressed person and a mental health professional to help the patient gain insights, change ineffective behavior patterns and develop more effective coping strategies. Healthcare professionals who specialize in treating depression include psychiatrists, psychologists and other mental health therapists or counselors.

Medications, which must be prescribed by a physician, usually become fully effective within three to six weeks. It is important to continue taking medication as prescribed, even after improvement begins, for the fullest recovery. If the medication does not seem effective, or if side effects are troublesome, the physician may change the prescription.

For Prevention and Long-Term Wellness

Recognize life events that can contribute to clinical depression and be alert for symptoms.
Show an active interest in family or friends you feel are at risk or showing signs of possible depression.
Make an effort to build an active life, developing self-esteem and mastery in areas of interest.
If your personal health history includes previous experience with depression, be alert for symptoms of new episodes. Seek help as soon as possible.
Look for ways to change behavior patterns or responses that contribute to depression.
Reduce stress and seek support at home, in the workplace and in relationships.
Develop more effective coping strategies for dealing with difficult people or situations.
Identify resources near and far: family; friends; social service, mental health, religious and other community organizations; support/recovery groups and medical and counseling professionals.

Help Someone You Know.

Your emotional support and practical encouragement can be a lifeline to someone suffering from depression. Your help can be most effective if you:

Help the person get appropriate diagnosis and treatment.
Maintain as normal a relationship as possible.
Point out distorted or negative thinking without being critical or disapproving.
Acknowledge that the person is suffering and in pain.
Offer kind words and pay compliments.
Express affection.
Show that you care about, respect and value the person.
Help the person stay busy and active. Encourage simple pleasures, hobbies or activities, but don't push.
Avoid blaming the person for symptoms of depression.
Avoid criticizing or voicing disapproval until the depressed person is better able to cope.
Avoid saying or doing anything that worsens the person's poor self-image.
Help the person stick with treatment. If the depression doesn't begin to lessen after several weeks, or if a particular professional advisor or treatment plan seems ineffective, help the person find another.
Express confidence that with time and help, the person will feel better.

Life Links to Depression

Some events or circumstances that can trigger or contribute to a depressive episode:

a serious loss, whether of a personal or business nature
a catastrophic or chronic illness
an injury that changes physical capabilities
relationship difficulties
the birth of a child, unrelieved parenting pressures or family crisis
financial difficulties/pressure
job changes, including promotions or changes in responsibilities
a move to a new area, or change in living arrangements

For more information on depression or mental illness contact:

U.S. Department of Health and Human Services Public Health Service

National Institutes of Health

Rockville, MD 20857

National Mental Health Association

1021 Prince Street

Alexandria, VA 22314-2971

American Psychiatric Association

1400 K Street, N.W.

Washington, DC 20005

American Psychological Association

750 First Avenue, N.E.

Washington, DC 20002

The information in this brochure is based on materials provided by the National Institutes of Health, the National Mental Health Association, the American Psychiatric Association and the American Psychological Association.