About

Depression is sometimes called major depressive disorder or clinical depression. Depression is a disorder of mood that causes a person to feel sad and a general loss of interest in life and life events. Depression affects a person’s thinking, behavior, and can cause emotional and physical problems. Normal daily activities become difficult and sometimes a person feels that it’s not worth living.

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Depression is often the result of a chemical imbalance in the brain rather than something you can just ignore or “snap out of.” Episodes of depression can last most of the day for days at a time. Fortunately, depression can be treated with medication or therapy or both.

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Symptoms of Depression can include:

• Feeling sad, tearful, empty or hopeless

• Anger, impatience, frustration, sometimes with small things

• Loss of interest or pleasure in usual activities such as work, sex, hobbies or sports

• Sleep disturbances – insomnia or excessive sleep

• Feeling tired, lack of energy, a feeling that everything is “heavy” and requires a lot of effort

• No appetite and weight loss or excessive eating and weight gain

• Feeling anxious, agitated, or restless

• Slowed thinking, speaking or body movements

• Feelings of worthlessness or guilt, fixating on past failures or self-blame

• Difficulty with memory, concentrating, thinking, and decision making

• Frequent or recurring thoughts of death, suicidal thoughts, suicide attempts or suicide

• Unexplained physical problems, such as body pains or headaches

• Depression can cause interference with daily activities, such as work, school, family relationships and social activities

• Feeling miserable or unhappy without any obvious cause

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 Depression symptoms in older adults 

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, who may feel reluctant or embarrassed to seek help.

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When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as possible. If you don’t want to be treated by a health care provider, talk to a friend, someone you can trust, a clergy member or a close family member.

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When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

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Also consider these options if you're having suicidal thoughts

• Call your doctor or mental health professional. Call a suicide hotline number -- in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

• Reach out to a close friend or loved one.

• Contact a minister, spiritual leader or someone else in your faith community. If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if possible to do safely, take the person to the nearest hospital emergency room.

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Types of depression

People with depression can have varying symptoms, such as anxiety, Symptoms caused by major depression can vary from person to person. You may have depression with specific features, such as anxiety, mania, melancholy, appetite changes, change in sleep patterns, delusions, hallucinations, decreased motor activity, post-partum depression. Other kinds of depression can be diagnosed by your health care provider.

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Treatment

Medications and psychotherapy are effective for most people with depression. A general 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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Medication treatment options for depression

Many types of antidepressants are available, which you and your doctor can discuss and decide which may be most effective. The most commonly prescribed medications belong to two different classes of drugs. There are selective serotonin reuptake inhibitors (SSRIs) which are considered safer and generally cause fewer side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd). The other most commonly prescribed antidepressants are serotonin-norepinephrine reuptake inhibitors (SNRIs). This class of drug includes duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima). There is one more common group of prescribed drugs that include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix). Given the choices mentioned, most patients will be helped by one of these medications.

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Other antidepressants are available for people who don’t respond to the more common medications. These drugs have side effects which can be severe and should only be prescribed and monitored by a physician with sufficient experience and resources to monitor the effects. These drugs are known as tricyclic antidepressants and monoamine oxidase inhibitors. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods such as certain cheeses, pickles and wines and some medications and herbal supplements.

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Finding the right medication

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.

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Risks of abruptly stopping medication

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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Antidepressants and pregnancy

If you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk with your doctor if you become pregnant or you're planning to become pregnant.

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Antidepressants and increased suicide risk

Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teenagers and young adults under age 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

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Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when starting a new medication or with a change in dosage. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a doctor or get emergency help.

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Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

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Psychotherapy

Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.

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Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may also recommend other types of therapies.

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Hospital and residential treatment

In some people, depression is so severe that a hospital stay is needed. This may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

 

Partial hospitalization or day treatment programs also may help some people. These programs provide the outpatient support and counseling needed to get symptoms under control.