Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.
Depression symptoms can vary from mild to severe and can include:
Symptoms must last at least two weeks for a diagnosis of depression.
Major depression. The classic depression type, major depression is a state where a dark mood is all-consuming and one loses interest in activities, even ones that are usually pleasurable. Symptoms of this type of depression include trouble sleeping, changes in appetite or weight, loss of energy, and feeling worthless. Thoughts of death or suicide may occur. It is usually treated with psychotherapy and medication. For some people with severe depression that isn't alleviated with psychotherapy or antidepressant medications, electroconvulsive therapy may be effective.
Persistent depressive disorder. Formerly called "dysthymia," this type of depression refers to low mood that has lasted for at least two years but may not reach the intensity of major depression. Many people with this type of depression type are able to function day to day, but feel low or joyless much of the time. Other depressive symptoms may include appetite and sleep changes, low energy, low self-esteem, or hopelessness.
Bipolar disorder. People with bipolar disorder—once known as manic-depressive disease—have episodes of depression. But they also go through periods of unusually high energy or activity. Manic symptoms look like the opposite of depression symptoms: grandiose ideas, unrealistically high self-esteem, decreased need for sleep, thoughts and activity at higher speed, and ramped-up pursuit of pleasure including sex sprees, overspending, and risk taking. Being manic can feel great, but it doesn't last long, can lead to self-destructive behavior, and is usually followed by a period of depression. Medications for bipolar disorder are different from those given for other depression types, but can be very effective at stabilizing a person's mood.
Seasonal affective disorder (SAD). This type of depression emerges as days get shorter in the fall and winter. The mood change may result from alterations in the body's natural daily rhythms, in the eyes' sensitivity to light, or in how chemical messengers like serotonin and melatonin function. The leading treatment is light therapy, which involves daily sessions sitting close to an especially intense light source. The usual treatments for depression, such as psychotherapy and medication, may also be effective.
Depression Types Unique to Women
Although women are at higher risk for general depression, they are also at risk for two different depression types that are influenced by reproductive hormones—perinatal depression and premenstrual dysphoric disorder (PMDD).
If you suspect that you might suffer from depression, answer the questions below, print out the results, and share them with your health care professional.
Over the last two weeks, how often have you been bothered by any of the following problems?
|Not at all||Several days||More than half the days||Nearly every day|
|1. Little interest or pleasure in doing things|
|2. Feeling down, depressed, or hopeless|
|3. Trouble falling or staying asleep, or sleeping too much|
|4. Feeling tired or having little energy|
|5. Poor appetite or overeating|
|6. Feeling bad about yourself—or that you are a failure or have let yourself or your family down|
|7. Trouble concentrating on things such as reading the newspaper or watching television|
|8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual|
|9. Thoughts that you would be better off dead or of hurting yourself in some way|
If you clicked on any problems above, how difficult have they made it for you to do your work, take care of things at home, or get along with other people?
Not difficult at all Somewhat difficult Very difficult Extremely difficult
Based on Patient Health Questionnaire-9 (PHQ-9) Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues, with an educational grant from Pfizer Inc.
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