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DEPRESSION

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

Depression is an illness that comes in many forms, from major depression and seasonal affective disorder, to dysthymia and bipolar disorder. Depression increasingly afflicts people worldwide, interfering with concentration, motivation and many other aspects of everyday functioning.


It is a complex disorder, involving many systems of the body, including the immune system, either as cause or effect. It disrupts sleep, and it interferes with appetite, in some cases causing weight loss, in others weight gain. Because of its complexity, a full understanding of depression has been misunderstood. Scientists have some evidence that the condition is related to the gut and its population of bacteria, which is heavily influenced by
diet. Of course, depression involves mood and thoughts as well as the body, and it causes pain for both those with the disorder and those who care about them. 
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Everyone experiences an occasional blue mood; depression is a more pervasive experience of bleak outlook and lack of energy.
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​Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:


  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches


For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.
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Depression is not a sign of personal weakness or a condition that can be willed or wished away. People with a depression cannot merely "pull themselves together" and get better. 

However, even in the most severe cases, depression is highly treatable. The condition is often cyclical, and early treatment may prevent or forestall recurrent episodes. Many studies show that the most effective treatment is cognitive behavioral therapy, which addresses problematic thought patterns, with or without the use of antidepressant drugs.


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It is estimated that some 38 million American adults struggle with depression.
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The World Health Organization projects that by 2030, the amount of disability and life lost due to depression will be greater than that from war, accidents, cancer, stroke, or any other health condition besides heart disease.



We can understand the puzzling tenacity of depression by posing the opposite question: How has nature built us with the capacity to become depressed? Depression may be a byproduct of evolution, which has shaped not only the physical structures of our bodies but the basic mechanisms of our minds.


Mood is a key adaption that we share with other animals.

Our moods have been selected for study because they flexibly tune behavior to situational requirements. High moods lead to more efficient pursuit of rewards. Low moods focus attention on threats and obstacles and restrain behavior.


Moods are a clever adaptation because they integrate multiple aspects of how well or poorly we are doing. Moods track key resources in our external environment (like food, allies, and potential mates) and our internal environment (for example, fatigue, hormone levels, and adequacy of hydration). When conditions are unfavorable, or when goals are unreachable, low moods pause behavior to ensure that an animal does not engage in fruitless efforts. This efficiency is important given that resources of every sort—time, energy, or money—are finite.


Just as pain protects us from injury, the unpleasant aspects of low mood are in keeping with its utility. People in a low mood may blame and criticize themselves, turn situations that went wrong over and over in their heads, and experience pessimism about the future. These characteristics, although uncomfortable, are also potentially useful in that a keen awareness of what has already gone wrong can help a person avoid similar stressors in the future.


Experiments reported by psychologist Joseph Forgas have provided some of the strongest demonstrations of ways in which low mood benefits thinking and decision making.
 In more severe forms of low mood, these costs are much higher, such as damage to the body from the release of stress hormones.



Why has depression become so prevalent?

Though more research needs to be done on what actually causes depression, we should certainly take into account that an ancient mood system has collided with a highly novel operating environment created by a remarkable species. Depression is worse in humans than in other mammals not because our species has more flaws but because of our unique strengths. Advanced language enables clarity and sometimes wallowing; our ability to set ambitious long-term goals sets up new opportunities for failure; our elaborate culture presents expectations for happiness that cannot possibly be fulfilled.



Genetics may also play an important role as to whether or not someone is predisposed to the condition. A British research team recently isolated a gene that appears to be prevalent in multiple family members with depression. This particular chromosome (3p25-26) was found in more than 800 families with recurrent depression. Scientists believe that as many as 40 percent of those with depression can trace it to a genetic link and environmental and other factors also have a huge influence on whether or not the individual will develop the disease.


Research has also shown that people with parents or siblings who have depression are up to three times more likely to have the condition, due to heredity or environmental factors that have a strong influence.


For example, a person who grows up with someone with depression may be more susceptible to the disease. A child who watches a depressed parent or sibling may learn to mimic that person’s behavior under certain conditions. A child who sees a parent spend days in bed may not think it unusual. Gender may also be a factor. One study found that women had a 42 percent chance of hereditary depression, while men had only a 29 percent chance.

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How can we better contain depression?


Expect no magic pill. Due to the variables of our brain chemistry, depression treatment simply isn't a one size fits all situation. The human brain is the most intricate organ of any species known to man and it can be tough to override responses that are hardwired into the body and mind but not
completely impossible.

It's important to follow the economy of our moods and where they lead. Attending to the sources that bring so many into low mood states. Such as, routines that feature too much work and too little sleep. We need broader mood literacy and an awareness of tools that interrupt low mood states before they morph into longer and more severe ones. These tools include altering how we think, the events around us, our relationships, and conditions in our bodies. If you feel as though you may be struggling with majordepressive disorder, contact your primary care doctor, who is most likely to complete a physical exam to rule out other cause of your symptoms such as thyroid function, vitamin deficiency, etc.

A psych professional, will then be able to clearly evaluate your mental health supplying a diagnosis if needed.
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Always seek the advice of your physician or other qualified health provider with any question you may have regarding a medical condition.

If you think you may have a medical emergency, call your doctor or 911 immediately!


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 ​Treatment

Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.
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If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.
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MEDICATIONS
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If a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.



RISKS OF ABRUPTLY STOPPING YOUR MEDS

Don't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur.
Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, and quitting suddenly may cause a sudden worsening of depression.
​ Work with your doctor to gradually and safely decrease your dose.
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​The content of this Site is for informational purposes only.
​ The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any question you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Mental Health VB does not recommend or endorse any specific tests, products, procedures, opinions, or other information that may be mentioned on the Site. 
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