What is depression?
Nearly everyone has felt depressed, sad, or blue at one time or another. A depressed mood is a normal reaction to loss, life's struggles, or injured self-esteem. Sometimes, however, depression becomes intense, lasts for long periods, and prevents a person from leading a normal life.
What are the symptoms of depression?
The major symptoms of depression include the following:
- Feeling extremely sad, anxious, or "empty"
- Feeling hopeless
- Feeling worthless
- Having thoughts of death or suicide (If you are having thoughts of suicide, call your local 24-hour suicide hotline right away.)
- Attempting suicide
- An increase or decrease in the need for sleep
- Loss of enjoyment from things that were once pleasurable
- Loss of energy
- Difficulty concentrating, thinking, or making decisions
- Changes in appetite that lead to weight loss or gain
The following physical signs also may be present:
- Headache
- Stomach ache
- Digestive problems
- Problems with sexual function
Depression that has these characteristics is a medical condition called major depressive disorder, one of a number of depressive illnesses. More than 10 million Americans suffer from major depressive disorder each year, but most never get treatment. When left untreated, depression can become worse, last for years, and cause untold suffering.
If you suffer from depression, it is important to remember that depression is a medical disorder that can be treated successfully.
What are the treatment options for depression?
The most common treatment for depression includes the combination of antidepressant medicine and psychotherapy.
Psychotherapy is used to treat mild and moderate forms of depression. A licensed mental health professional helps people with depression by focusing on behaviors, emotions and ideas that contribute to depression. They also help the depressed person identify and understand life problems that contribute to their illness in order to enable them to regain a sense of control. Psychotherapy can be done on an individual or group basis and can include family members and spouses. It is most often the first line of treatment for depression.
Medicines are commonly used to treat depression. Your family doctor or a psychiatrist can prescribe the medications, which are chosen based on your symptoms. The cost of medicines and potential side effects are important considerations when choosing this type of treatment for depression.
Electroconvulsive therapy (ECT) is a procedure in which an electric current is used to produce a seizure in the patient. It is believed that ECT results in the release of chemicals in the brain that aid communication between nerves. It is one of the fastest and most effective ways to relieve symptoms in severely depressed or suicidal patients who are suffering from mania. ECT is used when severe depression is unresponsive to other forms of therapy. It also is used when medication is considered unsafe. ECT may only be temporary and therefore requires continued psychotherapy and medication under a psychiatrist’s care. On occasion, ECT is prescribed on a regular basis (monthly to quarterly) to prevent further episodes of depression.
Vagal Nerve Stimulation (VNS) has been FDA-approved for use as a treatment for depression. For many years it has been used to treat refractory epilepsy. VNS involves a simple surgical procedure in which a pacemaker-like device is implanted in the chest. Connected to the device is a wire, which is run through the neck into the large vagus nerve. Through the lead, the device sends electricity to the nerve, which relays information to and from the brain. Through these electrical impulses, the symptoms of depression may be relieved.
Alternative treatments
Alternative treatments can sometimes provide relief that traditional western medicine cannot. While some alternative treatments have become accepted as part of modern health care practice, others still have not been proven safe and effective.
Experimental treatments
Investigation is currently being done regarding the use of deep brain stimulation (DBS) to treat depression. During a DBS surgery, electrodes are implanted within the brain to deliver electrical impulses. In the case of depression, it blocks the signals within the brain that cause the symptoms of these disorders. The success of DBS surgery is directly related to finding the specific area in the brain for stimulation. The stimulation can be adjusted as a patient’s condition changes over time.
