Depression: You Don't Have to Feel This Way What is depression? When doctors talk about depression, they mean the medical illness called major depression. Someone with major depression has symptoms like those listed in the box below nearly every day, all day, for 2 weeks or longer. If you're depressed, you may also have headaches, other aches and pains, digestive problems and problems with sex. An older person with depression may feel confused or have trouble understanding simple requests. Symptoms of depression No interest or pleasure in things you used to enjoy Feeling sad or empty Crying easily or crying for no reason Feeling slowed down or feeling restless and unable to sit still Feeling worthless or guilty Weight gain or loss Thoughts about death or suicide Trouble thinking, recalling things or focusing on what you're doing Trouble making everyday decisions Problems sleeping, especially in the early morning, or wanting to sleep all of the time Feeling tired all of the time Feeling numb emotionally, perhaps even to the point of not being able to cry What causes depression? Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another. Depression also seems to be genetic (to run in families). Depression can be linked to events in your life, such as the death of someone you love, a divorce or job loss. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also lead to depression. Depression isn't caused by personal weakness, laziness or lack of willpower. How is depression diagnosed? If you're having symptoms of depression, be sure to tell your doctor so you can get help. Don't expect your doctor to be able to guess that you're depressed just by looking at you. The sooner you seek treatment, the sooner the depression will lift. Once you tell your doctor how you're feeling, he or she may ask you some questions about your symptoms, about your health and about your family history of health problems. Your doctor may also give you a physical exam and do some tests. How is depression treated? Depression can be treated with medicines, or a special type of counseling called psychotherapy, or with both. What about medicines? Many medicines can be used to treat depression. These medicines are called antidepressants and they work very well. They correct the chemical imbalance in the brain that causes depression. Antidepressants work differently for different people. They also have different side effects. So, even if one medicine bothers you or doesn't work for you, another may help. You may notice improvement as soon as 1 week after you start taking the medicine. But you probably won't see the full effects for about 6 to 8 weeks. You may have side effects at first but they tend to lessen after a couple of weeks. How long will I need medicine? How long you'll need to take the medicine depends on your depression. Your doctor may want you to take medicine for 4 to 6 months or longer. You need to take the medicine long enough to reduce the chance that the depression will come back. Talk with your doctor about any questions you have about your medicine. What is psychotherapy? In psychotherapy, you talk with your family doctor, a psychiatrist or a therapist about things that are going on in your life. The focus may be on your thoughts and beliefs or on your relationships. Or the focus may be on your behavior, how it's affecting you and what you can do differently. Psychotherapy often lasts for a limited time, such as 8 to 20 visits. Will I need to go to the hospital? Depression can usually be treated through visits to your doctor. Treatment in the hospital may be needed if you have other medical conditions that could affect your treatment or if you're at high risk of suicide. How long will the depression last? This depends on how soon you get help. Left untreated, depression can last for weeks, months or even years. The main risk in not getting treatment is suicide. Treatment can help depression lift in 6 to 8 weeks, or less. Getting through depression Pace yourself. Don't expect to do everything you normally can. Set a realistic schedule. Don't believe all of your negative thinking, such as blaming yourself or expecting to fail. This thinking is part of depression. These thoughts will go away as your depression lifts. Get involved in activities that make you feel good or feel like you've achieved something. Avoid making big life decisions when you're depressed. If you must make a big decision, ask someone you trust to help you. Avoid drugs and alcohol. Both make depression worse. Both can cause dangerous side effects with your antidepressants. Physical activity seems to cause a chemical reaction in the body that may improve your mood. Exercising 4 to 6 times a week for at least 30 minutes each time is a good goal. But even less activity can be helpful. Try not to get discouraged. It will take time for your depression to lift fully. What about suicide? People with depression sometimes think about suicide. This thinking is part of the depression. If you have thoughts about hurting yourself, tell your doctor, friends or family, or call your local suicide hot line (the number is in the phone book). Get help right away. The good news is that there are people who can help you, and depression can be treated. Reasons to get help for depression Early treatment helps keep depression from getting worse or lasting a long time. Thoughts of suicide are common in people with depression. The risk of suicide is higher if you don't get treatment for your depression. When depression is successfully treated, the thoughts of suicide will go away. Treatment can help you return to your "normal" self, enjoying life. Treatment can help prevent depression from coming back. Other Organizations Depression and Bipolar Support Alliance http://www.dbsalliance.org 800-826-3632 National Institute of Mental Health http://www.nimh.nih.gov/publicat/index.cfm 866-615-6464 National Mental Health Association http://www.nmha.org 800-969-NMHA (800-969-6642) National Alliance for the Mentally Ill http://www.nami.org 800-950-NAMI (800-950-6264) American Psychiatric Association http://www.psych.org 800-35-PSYCH (800-357-7924)