While everyone feels “blue” at times, depression is much more serious, making you feel sad and helpless, and the feelings do not go away. Depression interferes with your life, your family and relationships. It inhibits your ability to think and act. With help, however, you can feel better.

People with depression may feel unhappy, sad, down or miserable nearly every day; they can feel helpless, hopeless or worthless and lose interest in hobbies, friends and activities that used to please them. Other signs include difficulty sleeping or oversleeping, weight gain or loss, a feeling of low energy or tiredness, loss of interest in sex and difficulty concentrating or making decisions. Sometimes physical symptoms such as stomachaches, headaches or backaches are present. There may be thoughts of death or suicide.

Depression is a medical disorder of the brain affecting about 20 million people in the United States. The tendency for depression seems to run in families, and it is much more common in women. It is caused by an imbalance in brain chemicals which affect your mood and body. No one knows what happens in the brain to cause depression, but we know that the neurotransmitters norepinephrine and serotonin are involved. Changes in their levels cause an increase in unhappy feelings, which can cause further changes in brain chemicals. This cycle continues as the problem develops into depression.

Certain factors may trigger depression, including normal grief over a death, break-up or other loss; or life stresses such as physical abuse, job loss or sudden financial changes. In some cases, years may go by before depression sets in.

Drugs and alcohol can upset the brain’s chemical balance, leading to depression. Some depressed people turn to alcohol and drugs to numb the pain, but in the long run this makes depression worse. Depression can be a side effect of certain medications for high blood pressure, cancer, pain and other problems. Inform your health care provider of your medications. Do not stop any ordered medication without your provider’s approval.

Being physically ill can leave anyone frustrated and sad, but some health problems may cause actual changes in your brain that lead to depression. Other health issues, such as an overactive thyroid, may be mistaken for depression. Hormones carry messages in the bloodstream that may affect brain chemicals. Women may get depressed when hormone levels change quickly before their periods, postpartum or during menopause.

With antidepressant medication, counseling and self-help measures, depression is treatable. The first step to feeling better is to visit your health care provider or behavioral health professional for a thorough evaluation.

Antidepressants increase the number of neurotransmitters in your brain. Individuals react differently to antidepressants; if one medication does not work, another may help. Improvement may begin in as little as a week, but the full effects usually come after eight to 12 weeks. Side effects tend to decrease after a few weeks. Do not stop taking medication without the approval of your doctor.

A professionally trained behavioral health professional, usually a psychologist or psychiatrist, provides talk therapy, which can be done one on one or as part of a group. A combination of individual and group therapies is successful for many, along with the use of antidepressants.

Remember, this illness is not your fault. Recovery is a process and takes time. Because depression can cloud judgment, wait to feel better before making major decisions such as changing jobs, moving or getting married or divorced. Depression saps your energy and concentration. You will not be able to do everything you used to do. Set small goals; do what you can.

Depression is the most common cause of suicide. People considering suicide may not know they are depressed. Certain thoughts, feelings and actions can signal that a person needs help. Watch for warning signs: threats or talk of suicide, buying a gun or weapon, statements such as, “I won’t be a problem much longer” or “Nothing matters”, giving away possessions, making a will or planning their funeral, suddenly being happy or calm after being depressed.

If you think someone is suicidal, ask, “Have you thought about suicide?” Most people will tell the truth. If they say “yes,” they may have a plan. Find out as much as you can. The more detailed the plan, and the easier to carry out, the more immediate the danger. If you notice serious signs, get help immediately. Call a health care professional, mental health clinic or suicide hotline. Do not hesitate to call 911 in an emergency. The National Suicide Hotline is 800 784 2433 (800 SUICIDE).

Self-Help

Take care of yourself during and after treatment:

•Keep moving. Studies show exercise fights depression.

•Avoid drugs and alcohol. Decrease caffeine intake.

•Reduce stress with relaxation exercises and techniques.

•Eat a balanced diet to stay healthy.

•Do not isolate yourself. Take part in fun activities when you can.

•Talk openly with people you trust. Accept help.

National Alliance on Mental Illness
nami.org

National Institute of Mental Health
nimh.nih.gov