1. Depression - Understanding Your Illness

Understanding Your Illness

Learning about the factors involved in depression, and the different types of depressive disorders will help you to have an educated conversation with your doctor about your condition. This article is from the National Institute for Mental Health website and has been lightly edited for clarity and flow.

Depression is a real illness
When a person has depression, it interferes with daily life and normal functioning. It can be painful, both for the person with depression and for those who care about him or her. Doctors call this condition "depressive disorder," or "clinical depression." Depression is a real illness. It is not a sign of a person's weakness or a character flaw. You can't "snap out of" clinical depression, and most people who experience depression need treatment to get better.

Factors that play a role in depression
Many factors can play a role in depression, including genetics, brain biology and chemistry, and life events such as trauma, loss of a loved one, a difficult relationship, an early childhood experience, or any stressful situation.

Depression can happen at any age, but often begins in the teens or early 20s or 30s. Most chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. In fact, high levels of anxiety as a child could mean a higher risk of depression as an adult. Depression can co-occur with other serious medical illnesses such as diabetes, cancer, heart disease, and Parkinson's disease. Depression can make these conditions worse, and vice versa. Sometimes medications taken for these illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Types of Depression
There are several types of depressive disorders.

Major depression interferes with the ability to work, sleep, study, eat, and enjoy life. The good news is that major depression doesn't usually last forever. Some people experience only one period of major depression during their lives, but it usually occurs in several episodes.

Persistent depressive disorder is a depressed mood that lasts for at least two years. A person might be diagnosed with this disorder after experiencing episodes of major depression, along with periods of less severe symptoms, as long as the symptoms have lasted for at least two years.

Psychotic depression occurs when a person has severe depression plus some form of psychosis. Examples might be: having disturbing false beliefs, a break with reality (delusions), or hearing/seeing upsetting things that others can't hear or see (hallucinations).

Postpartum depression is much more serious than the typical "baby blues" that many new mothers go through. For about 10 to 15 percent of women, the hormonal and physical changes of having a child, combined with the new responsibility of caring for a newborn, can be overwhelming and lead to depression. This condition should be taken seriously, for the health of both mother and child.

Seasonal affective disorder (SAD) refers to depression that sets in during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Light therapy sometimes helps to treat SAD, but close to half of people with SAD do not get better with light therapy alone. Antidepressant medication and talk therapy can also reduce SAD symptoms, either along with or instead of light therapy.

Bipolar disorder is different from depression. The reason it is included in this list is because someone with bipolar disorder experiences episodes of extremely low mood, or depression. However, bipolar disorder also causes extremely high moods, called "mania." "Getting evaluated by an appropriate professional is especially important if you think your depression might be part of a Bipolar Disorder," says Dr. Jon Betlinski, a psychiatrist at Oregon Health & Science University and one of the authors of this booklet.

Treatment for Depression
Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Most adults see an improvement in their symptoms when treated with antidepressant drugs, talk therapy (psychotherapy), or a combination. Other tips that may help you or a loved one during treatment for depression: try to be active and exercise, set realistic goals for yourself, try to spend time with other people, and confide in a trusted friend or relative. Try to let others help you. Often during treatment for depression, sleep and appetite will begin to improve before your mood lifts.

You are not alone
If you have depression, you may feel exhausted, helpless, and hopeless. It may be extremely difficult to take any action to help yourself. But you are not alone. Expect your mood to improve gradually, not immediately. With time and treatment, the depression will lift.