Introduction

Depression is an issue that affects millions of people in the world whether at work or at home.

• Not only is it a prevalent issue, but also one that is frequently misunderstood.
• While it's not fully known why this disorder occurs, experts think that it is related to naturally occurring chemicals in the brain.
• Other factors may come into play as well.
• Genetics can sometimes be a cause, as can things like stress, trauma, physical and psychological disorders, and even one's individual personality.
• Sometimes, there is no one cause, but rather a combination of various causes.
  So, how do you know if you or a loved one are suffering from this problem?
• There are a multitude of symptoms to look for. Sadness, despair and a lack of energy are commonly described by sufferers.
• While everyone may experience these feelings at one time or another, some people experience them for an extended period of time with no relief.
• This is usually the first sign that a depressive disorder may be to blame.
• The problem can be mild to moderate, in which case the sufferer is able to go about their everyday lives with little or no interruption. Or, the problem may be more severe and lead to interruptions in normal lifestyle and even thoughts of suicide.
  The very first thing you should do if you suspect that this is a problem for you or a loved one is seek help immediately.
• Some people feel uncomfortable talking about their feelings. However, anyone who thinks they might be depressed shouldn't feel guilty or ashamed about this problem.
• Try talking to a trusted family doctor first, who may either treat the problem themselves or refer you to a psychologist or psychiatrist for further evaluation and treatment.
• During the initial consultation, you will be asked about your symptoms so that a diagnosis can be made.
• Once a diagnosis is made, treatment options will be discussed.
  There are various treatments for depression that may be suggested.
• For mild to moderate depression, cognitive behavioral therapy may be recommended. In some cases, medication may be prescribed.
• The most common type of medication for depressed individuals are called antidepressants.
• Examples include medications such as Prozac, Paxil, Zoloft, Effexor and Celexa. Antidepressants are not to be confused with antianxiety medications. Antidepressants work by interacting with brain chemistry and encouraging normal function.
• It usually takes at least four to six weeks for results to occur. During this time, you may want to work with a mental health specialist who can help you learn coping mechanisms and discover the root of the problem.

What is Depression?

Depression is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

What Are the Symptoms of Depression?

Symptoms that people have when they're depressed can include:
depressed mood or sadness most of the time (for what may seem like no reason)
lack of energy and feeling tired all the time
inability to enjoy things that used to bring pleasure
withdrawal from friends and family
irritability, anger, or anxiety
inability to concentrate
significant weight loss or gain
significant change in sleep patterns (inability to fall asleep, stay asleep, or get up in the morning)
feelings of guilt or worthlessness
aches and pains (with no known medical cause)
pessimism and indifference (not caring about anything in the present or future)
thoughts of death or suicide When someone has five or more of these symptoms most of the time for 2 weeks or longer, that person is probably depressed Teens who are depressed may show other warning signs or symptoms, such as lack of interest or motivation, poor concentration, and low mental energy caused by depression. They also might have increased problems at school because of skipped classes. Some teens with depression have other problems, too, and these can intensify feelings of worthlessness or inner pain. For example, people who cut themselves or who have eating disorders may have unrecognized depression that needs attention

Types of Depression:

For some people, depression can be intense and occur in bouts that last for weeks at a time. For others, depression can be less severe but can linger at a low level for years.
Doctors who treat depression distinguish between these two types of depression. They call the more severe, short-lasting type major depression and the longer-lasting but less severe form dysthymia (pronounced: diss-thy-me-uh).
A third form of depression that doctors may diagnose is called adjustment disorder with depressed mood. This diagnosis refers to a depressive reaction to a specific life event (such as a death, divorce, or other loss), when adjusting to the loss takes longer than the normally expected timeframe or is more severe than expected and interferes with the person's daily activities.
Bipolar disorder (also sometimes called manic depressive illness) is another depressive condition that involves periods of major depression mixed with periods of mania. Mania is the term for abnormally high mood and extreme bursts of unusual activity or energy.

Why Do People Get Depressed?

There is no single cause for depression. Many factors play a role including genetics, environment, life events, medical conditions, and the way people react to things that happen in their lives.
Genetics:
Research shows that depression runs in families and that some people inherit genes that make it more likely for them to get depressed. Not everyone who has the genetic makeup for depression gets depressed, though. And many people who have no family history of depression have the condition. So although genes are one factor, they aren't the single cause of depression.
Life Events:
The death of a family member, friend, or pet can go beyond normal grief and sometimes lead to depression. Other difficult life events, such as when parents divorce, separate, or remarry, can trigger depression. Even events like moving or changing schools can be emotionally challenging enough that a person becomes depressed.

Family and Social Environment:

For some teens, a negative, stressful, or unhappy family atmosphere can affect their self-esteem and lead to depression. This can also include high-stress living situations such as poverty; homelessness; and violence in the family, relationships, or community.
Substance use and abuse also can cause chemical changes in the brain that affect mood-alcohol and some drugs are known to have depressant effects. The negative social and personal consequences of substance abuse also can lead to severe unhappiness and depression.

Teen Depression
If you are the parent of a teenager, then you are likely already aware of the many dangers of depression. Teen depression is a pretty common occurrence and it can affect anyone. If you have children, you need to inform yourself about teenage depression so you can try to prevent it and look out for it with your teens. Symptoms of Teen Depression Some common symptoms of teen depression are:
♣ Frequent sadness
♣ Crying, often for no reason
♣ Withdrawal
♣ Refusal to eat or over-eating
♣ Feelings of hopelessness
♣ Talk of death or suicide
♣ Obsession with death and suicide Causes of Teen Depression
There are different causes for teen depression.
The teen years are hard for anyone and with pressures from friends, school and parents, it can sometimes get to be too much. If this is combined with drug or alcohol use, it is almost always a recipe for depression.
A depressed teen may have problems at home or get picked on at school. Sometimes the depression may come from another problem such as an eating disorder, addiction or medical condition. Some teens just need to eat a better diet and get more rest. Help for Teen Depression
There are different treatments for depression but teen depression should not be treated the same as depression in adults. There are medications available to help with depression but typically, it is not needed or only needed for a temporary amount of time. Teen depression involves knowing what is causing the depression and counseling. Getting to the root of the problem is often all it takes to help a teen with depression.
As the parent of a depressed teen, it’s important that you try to understand your teen, listen to him and try not to be accusing.

Try to respect your teen’s opinions and problems and not try to blame yourself. You need to understand that being a teenager is hard and your child is justified in their feelings even if you may not agree or understand.
When you realize this, you can help your child. And remember to give lots of love and support and encouragement.

Medical Conditions:

Certain medical conditions can affect hormone balance and therefore have an effect on mood. Some conditions, such as hypothyroidism, are known to cause a depressed mood in some people. When these medical conditions are diagnosed and treated by a doctor, the depression usually disappears.
For some teens, undiagnosed learning disabilities might block school success, hormonal changes might affect mood, or physical illness might present challenges or setbacks.

How long does depression last?

The depressed feelings we all experience after a serious loss or disappointment may last for a short or a long time. How long depends on the person, the severity of the loss, and the support available to help the person to cope with it.
Clinical depression may also last for short or long periods. It rarely becomes permanent. Without professional treatment, it may end naturally after several weeks or months. With treatment, it may end much more quickly.

Depression and Medical Disorders:

Clinical depression commonly accompanies general medical illnesses, although it is often undetected and untreated. In fact, while the rate of major depression among persons in the community is estimated to be between two to four percent, among primary care patients it is between five and ten percent, and among medical inpatients it is between ten and fourteen percent. An additional two to three times as many persons in these groups experience depressive symptoms.
Some studies have suggested that nearly 65% of all visits to primary care physicians involve emotional symptoms associated with psychological problems, with depression being the most common problem. Yet, very few primary care patients are referred for psychological treatment. For this reason, you should consult a psychologist when you have signs of depression, even after you consult your family physician. Research suggests that recognition and treatment of co-occurring depression may improve the outcome of medical conditions, enhance your quality of life, and reduce the degree of pain and disability experienced by the medical patient.
Recently, there has been research suggesting a better recovery rate from many serious illnesses, when psychological treatment is offered as well as medical treatment. This makes a lot of sense, since a serious medical condition can easily result in a reactive depression. There has also been some research that suggests that psychological distress can reduce the effectiveness of your natural immune system, making it more difficult for your body to fight disease. While conclusive evidence of all of these factors is not yet available, there is enough evidence to suggest that psychological treatment may be a benefit to your health, in addition to any medical treatment.

Does depressive illness follow a pattern?

Unfortunately, once a person has had a clinical depression, he/she is more likely to suffer from depression again. For example, some people experience seasonal cycles of depression, particularly in winter. This is called Seasonal Affective Disorder (S.A.D.).
Five to ten percent of people who experience depression also experience states of exaggerated happiness or elation called mania. The occurrence of both depression and mania at different times is called bipolar affective disorder, while a repeated experience of depression alone is termed unipolar affective disorder.

When Depression Is Severe?

People who are extremely depressed and who may be thinking about hurting themselves or about suicide need help as soon as possible. When depression is this severe, it is a very real medical emergency, and an adult must be notified. Most communities have suicide hotlines where people can get guidance and support in an emergency.
Although it's important to be supportive, trying to cheer up a friend or reasoning with him or her probably won't work to help depression or suicidal feelings go away. Depression can be so strong that it outweighs a person's ability to respond to reason. Even if your friend has asked you to promise not to tell, severe depression is a situation where telling can save a life. The most important thing a depressed person can do is to get help. If you or a friend feels unsafe or out of control, get help now. Tell a trusted adult, call 911, or go to the emergency room.
Depression doesn't mean a person is "crazy." Depression (and the suffering that goes with it) is a real and recognized medical problem. Just as things can go wrong in all other organs of the body, things can go wrong in the most important organ of all: the brain. Luckily, most teens who get help for their depression go on to enjoy life and feel better about themselves.

What Happens in the Brain When Someone Is Depressed?

Depression involves the brain's delicate chemistry - specifically, it involves chemicals called neurotransmitters. These chemicals help send messages between nerve cells in the brain. Certain neurotransmitters regulate mood, and if they run low, people can become depressed, anxious, and stressed. Stress also can affect the balance of neurotransmitters and lead to depression.
Sometimes, a person may experience depression without being able to point to any particular sad or stressful event. People who have a genetic predisposition to depression may be more prone to the imbalance of neurotransmitter activity that is part of depression.
Medications that doctors use to treat depression work by helping to restore the proper balance of neurotransmitters

How is depression treated?

Depression is the most treatable of mental illnesses. Most people who suffer from depression are helped by the treatment they get, which usually includes medication and/or psychological counseling. Support from family, friends and self-help groups can also make a big difference.
Many people who are seriously depressed wait too long to seek treatment or they may not seek treatment at all. They may not realize that they have a treatable illness, or they may be concerned about getting help because of the negative attitudes held by society towards this type of illness.
Psychotherapy:
Psychological treatment of depression (psychotherapy) assists the depressed individual in several ways. First, supportive counseling helps ease the pain of depression, and addresses the feelings of hopelessness that accompany depression. Second, cognitive therapy changes the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create depression and sustain it. Cognitive therapy helps the depressed person recognize which life problems are critical, and which are minor. It also helps him/her to develop positive life goals, and a more positive self-assessment. Third, problem solving therapy changes the areas of the person's life that are creating significant stress, and contributing to the depression. This may require behavioral therapy to develop better coping skills, or Interpersonal therapy, to assist in solving relationship problems.
Unfortunately, many poorly trained counselors never move beyond providing supportive counseling. This alone will not eliminate the depression. As a result, the depression, and the therapy, continues indefinitely, with little improvement. Supportive counseling "feels" helpful, and as part of the overall treatment plan does help. But, unless the depressed person makes critical life changes, the depression will continue. These changes are both internal and external. Internal changes are usually needed in problem assessment, self-evaluation, the evaluation of others, and the expectations the depressed person has for himself/herself, others and about life. External changes may be needed in problem solving skills, stress management, communication skills, life management skills, and the skills needed to develop and sustain relationships.
The length of treatment will vary, according to the severity of the depression, and the number and kind of life problems that need to be addressed. Most people will begin to experience some relief with 6 to 10 sessions, and approximately 70-80% of those treated notice significant improvement within 20-30 sessions. Mild depression may be treated in less session, and more significant depression may require extended treatment. Treatment sessions are usually scheduled once per week, although they may be scheduled more frequently initially, or if the person is experiencing significant life crises.
Medication:
Except in the more severe depressions, and bipolar depression, medication is usually an option, rather than a necessity. Antidepressant medication does not cure depression; it only helps you to feel better by controlling certain symptoms. If you are depressed because of life problems, such as relationship conflicts, divorce, loss of a loved one, job pressures, financial crises, serious medical problems in yourself or a family member, legal problems, or problems with your children, taking a pill will not make those problems go away.
However, some symptoms of depression, such as sleep and appetite disturbances, significant concentration problems, and chronic fatigue, interfere with your ability to make the life changes necessary to eliminate the depression. In more serious depression, suicidal thoughts and urges, and preoccupation with death, may require medication in addition to psychotherapy. Antidepressant medication can help relieve those symptoms, and allow you to make needed life changes. The decision to take medication, in addition to participating in psychological treatment, should be discussed with your treating psychologist and your primary care physician. Your thoughts and feelings regarding medication, after considering information about both the benefits and risks involved, are an important part of a collaborative treatment approach between psychologist and client. If medication is part of your treatment, either your primary care physician or a psychiatrist will supervise the medical part of your treatment, while you continue psychotherapy with a psychologist. If you have a chronic medical condition or a serious illness, and you are taking medication for that condition, then the medical specialist treating that problem should be involved in your treatment. The medical specialist may supervise all of your medications, or coordinate the medical treatment with the physician providing the antidepressant medications.

What can friends and family do?

It can be difficult to be with and to help someone who is seriously depressed. Some people who are depressed keep to themselves, while others may not want to be alone. They may react strongly to the things you say or do. It is important that you let them know that it is okay to talk about their feelings and thoughts. Listen and offer support rather than trying to contradict them or talk them out of it. Let them know you care. Ask them how you can help, and offer to contact their family doctor or a mental health professional. Find out about local self-help groups and attend a meeting with them. Try to be patient and non-judgmental. Most of all don't do it alone - get other people to provide help and support too.