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Depression Fast Facts

Between 20% and 50% of children who are diagnosed with depression have relatives with a history of depression. Nearly half of adolescents who are diagnosed with depression will continue to have symptoms of the disorder for as long as four years after diagnosis. As many as 70% of adolescents diagnosed with depression will experience a relapse of symptoms in adulthood.

While anger and irritable outbursts have not historically been considered a symptom of depression, more recent research has suggested that chronic irritability or anger is often present in those diagnosed with the disorder.

Antidepressant drugs are often used to elevate a patient’s mood and lessen the severity of depressive symptoms. Electroconvulsive therapy is sometimes used to treat severe depression, especially when psychosis is present at the same time or the condition is deemed to be putting the life of the patient in danger.

The most commonly successful therapeutic method for combating depression is cognitive behavioral therapy (CBT).

What is Depression?

Depression is a mood disorder that is often referred to as clinical depression, major depression, or major depressive disorder. It’s characterized by a persistent low mood, during which the sufferer has feelings of sadness and/or low self-worth.

Although periods of sadness are common in everyone, the symptoms of major depression become so severe that they interfere with the daily routines, social functioning and personal relationships of the sufferer. In many cases, the symptoms become so pervasive that they threaten the integrity of relationships, employment, or financial well-being, and suicidal tendencies are not uncommon among depression sufferers.

Symptoms of Depression

There are many symptoms of major depression, and not all of them need to be present for a sufferer to be diagnosed with the disorder. In general, however, the symptoms must have been present for at least two weeks before a diagnosis can be made.

The most common symptoms of depression include:

  • Persistent sadness
  • Feelings of emotional flatness or disengagement
  • Feelings of low self-worth or helplessness
  • Persistent hopeless, morbid, or pessimistic feelings
  • Feelings of anxiety
  • Problems with concentration
  • Chronic irritability or angry outbursts
  • Lack of interest in activities that were once pleasurable
  • Chronic fatigue or lower than normal energy levels
  • Restlessness or excessive energy
  • Problems with sleep, including insomnia or sleeping too much
  • Appetite changes that result in changes, either decreases or increases, in weight
  • Suicidal thoughts or suicide attempts

Clinicians will sometimes diagnosis Subsyndromal Symptomatic Depression (SSD) in patients who have two or more of these symptoms that aren’t severe enough in-depth or duration to warrant a diagnosis of major depression.

Subtypes of Depression

Some depressive disorders are characterized by a unique cluster of symptoms or a specific cause of the symptoms. These types of depression include:

  • Postpartum depression. This disorder is defined by periods of major depression in a woman during pregnancy or soon after giving birth. The symptoms are more severe than typical postpartum mood fluctuations, and the result can be life-threatening.
  • Psychotic depression. This disorder is diagnosed when symptoms of major depression are accompanied by symptoms of psychosis, such as hallucinations or delusions.
  • Seasonal affective disorder. Thought to be caused by decreased levels of sunlight during the winter months, this disorder manifests its symptoms during the winter, and the symptoms typically subside in the spring. The diagnosable seasonal affective disorder occurs in the patient consistently year after year.
  • Persistent depressive disorder. This disorder, also called dysthymia, is characterized by periods of depression that last more than two years. The depression may increase or decrease in severity over that time period, but it never goes away.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes Depression?

Doctors and researchers have not yet determined exactly what causes major depression, but they have identified several risk factors that increase the likelihood that an individual will develop the disorder.

  • Genetic Predisposition. People with a family history of depression are three times more likely to be diagnosed with major depression than those with no family history of the disorder. Researchers have begun to identify genes that may play a role in the development of depression, but the exact genetic mechanism that makes some people more prone to developing the disorder has not yet been pinpointed.
  • Biological Causes. Some hormonal imbalances, such as the abnormal levels of cortisol experienced by sufferers of Cushing’s Disease, have been linked to depression.
  • Environmental Risk Factors. While poor sleep habits are a common symptom of major depression, there is some suggestion that lack of adequate sleep may also be a risk factor for developing depression.
  • Drug Abuse. Excessive alcohol consumption or the abuse of drugs or other substances often occur in tandem with major depression.
  • Other Illnesses. Chronic severe illnesses such as Parkinson’s disease, diabetes, heart disease, obesity or chronic pain are very often accompanied by major depression. The depressive moods may be caused by the effects of the disease on the patient’s life, or they may be caused by biological changes that occur in the patient’s body as part of the disease.

Social Risk Factors. Major life events, such as divorce, unemployment, or the loss of a loved one often trigger the onset of depressive symptoms.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Is Depression Hereditary?

Studies of families in which major depressive disorder occurs strongly suggest that a genetic component may be a key factor in the development of the disorder.

  • In the general population, the rate of occurrence of the major depressive disorder appears to be relatively consistent in all cultures around the world, with the rate of occurrence falling somewhere between 8% and 12%.
  • Some studies have found that when one twin has the disorder, the other twin also has the disorder at a rate of as much as 38%.
  • Two studies have found that women seem to be much more likely to inherit the disorder than men. The studies showed that women seem to inherit the condition at a rate of about 40%, while men inherit it at a rate of about 30%.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Depression Detected?

A major depressive disorder is not very common in children in the years before adolescence, but the disorder becomes much more prevalent in adolescents. Some studies have suggested that as many as one in five adolescents will have experienced symptoms of depression before they’re out of their teen years. Once they have experienced symptoms, more than half of them will experience a recurrence of symptoms within two years, and fully 70% will experience a relapse within five years.

However, major depression is often difficult to spot in adolescents. Depressive episodes may resolve themselves without treatment, half the time within two months, and the first signs noticed are often physical symptoms, such as fatigue or aches and pains, which may be misdiagnosed.

Potential early signs of major depression in young people include:

  • Separation anxiety (in pre-adolescents)
  • Poor sleep habits
  • Decline in grades
  • Withdrawal from social activities
  • Anger or irritability
  • Pessimism
  • Lethargy
  • Unexplained aches or pains
  • Symptoms of ADHD
  • Substance abuse
  • Self-harm

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Depression Diagnosed?

A diagnosis of major depressive disorder begins with the determination that the patient has a cluster of the symptoms that define the disorder and that the symptoms have been present for at least two weeks. A doctor will begin with a physical exam to rule out biological problems that may be causing symptoms that mimic those of depression; this exam may include lab tests.

If, after these exams, the doctor suspects that major depression is the cause of the symptoms, he or she may recommend a psychological or psychiatric assessment to further solidify the diagnosis.

Diagnostic steps may include:

  • A physical exam. This exam will be aimed at ruling out physical conditions that could be causing the symptoms.
  • Blood tests. These tests will look at the patient’s blood chemistry for issues such as thyroid function, electrolyte imbalances, anemia, chronic infection, and cancer. Screenings for drugs and alcohol may also be conducted to rule out symptoms that may be caused by substance abuse.
  • Psychological assessments. These assessments may take the form of questionnaires or talk sessions with a mental health professional to assess the patient’s mood, mental state, and mental health history. Family members or caregivers may also be asked to participate in these assessments.

The results of the psychological assessments will be compared to the diagnostic criteria for major depression in the Diagnostic and Statistical Manual of Mental Disorders. Comparison of these criteria will help a psychiatrist to decide whether the symptoms indicate depression, another psychiatric problem, or a coincidence of depression and another condition.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Depression Treated?

Major depression currently has no known reliable cure, but a combination of medications and psychotherapy is often effective at reducing the severity of symptoms in many patients.

Medication

Several different medications may be used to treat and manage the symptoms of major depression. Individual medication plans are dependent on the age of the patient, the patient’s responsiveness to treatments, and the severity of their symptoms.

  • Selective serotonin reuptake inhibitors (SSRIs). These drugs work by increasing the levels of serotonin, a neurotransmitter chemical in the brain, and higher levels of serotonin seem to help to elevate mood in many people. Common SSRIs include citalopram, escitalopram, fluoxetine , paroxetine, sertraline, and vilazodone.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs). These drugs work similarly to SSRIs in that they increase serotonin levels, but they also increase the level of norepinephine, another neurotransmitter.
  • Other antidepressants. Drugs such as bupropion, mirtazapine, nefazodone, trazodone, and vortioxetine work differently from SSRIs or SNRIs but can be effective at treating depression. Tricylclic antidepressants such as imipramine, nortriptyline, amitriptyline, doxepin, trimipramine, desipramine, and protriptyline tend to have more problematic side effects, so they’re less commonly used to treat depression unless the patient has already shown no improvement from SSRIs.
  • Monoamine oxidase inhibitors (MAOIs). Drugs such as tranylcypromine, phenelzine, and isocarboxazid can have potentially serious side effects, so they are typically only used to treat depression when other medications don’t work.

Psychotherapy

A combination of medication and psychotherapy is often the most effective approach to controlling the effects of depression. The most common therapeutic approach is cognitive-behavioral therapy (CBT), an approach that focuses on helping the patient to identify a pattern of harmful thoughts and to construct strategies and solutions for dealing with them that don’t interfere with functionality.

Other Therapies

In some severe cases of depression, when more traditional medications and therapies are ineffective, some providers try alternative therapies, such as:

  • Electroconvulsive Therapy. In this therapy, an electric current is passed through the brain, disrupting the function of neurotransmitter chemicals. This therapy is usually used on patients who don’t respond to medication, can’t take medication, or are deemed to be at high risk for suicide.

Transcranial magnetic stimulation (TMS). This therapy transmits intermittent electromagnetic pulses through the brain in an attempt to stimulate nerve function. This therapy, too, is usually used on those who don’t respond to medications.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does Depression Progress?

In some cases, depressive episodes can resolve on their own, but depression is very likely to recur in most people. Left untreated, depressive symptoms can become more severe and result in significant complications, including:

  • Weight gain and its consequences
  • Substance abuse
  • Anxiety disorders
  • Panic disorders
  • Relationship dysfunction
  • Employment or school dysfunction
  • Social anxiety
  • Self-harm
  • Suicide

With treatment, however, symptoms of depression very often are controlled within six months to a year, and continued treatment can be very effective at preventing a recurrence.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Depression Prevented?

There is no way to prevent major depression, but prompt diagnosis and an effective treatment plan can help to manage symptoms and prevent the most severe of the disorder’s consequences. In many cases, treatment may be stopped when symptoms resolve, but continuing an effective treatment plan may prevent recurrences.

It’s important for those diagnosed with major depression to seek a regular evaluation from their mental health providers and to stick to any prescribed plan for medication. Stopping an antidepressant abruptly can be especially dangerous, as it can cause withdrawal symptoms and a return to a severe depressive state.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Depression Caregiver Tips

Caring for someone with major depression can be very frustrating and exhausting. Many of the disorder’s symptoms manifest in ways that are emotionally taxing for the sufferer’s loved ones, and those who are close to someone with depression are at risk of developing depression themselves.

Caregivers for someone with major depression should consider these tips in order to help the sufferer and themselves to cope with the disorder:

  • Learn as much as possible about the disorder.
  • Don’t expect the sufferer to simply get better on their own.
  • Seek out appropriate professional treatment for the sufferer.
  • Do everything possible to support the sufferer in the pursuit of treatment.
  • Try not to take outbursts of anger or frustration as a personal attack, but see it as a symptom of the disorder.
  • Be supportive of the sufferer and acknowledge any improvements.
  • Find a support group for caregivers.
  • Take time away from the sufferer when possible.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Depression Brain Science

Current research on major depressive disorder is focused in many different areas, from finding the genetic source of some forms of the disorder to identifying the most effective therapies, both physical and psychological. Scientists are especially interested in understanding more fully the brain chemistry involved in depression so that more effective medications can be developed, particularly for those who don’t respond well to existing drugs.

For example:

  • The Food and Drug Administration has recently approved the anesthetic ketamine as a treatment for major depression. Scientists were able to develop a form of the well-established drug that can be administered via a nasal spray, and the treatment shows promise for treating medication-resistant depression.
  • Researchers are using imaging technologies to take a look at a part of the brain called the hippocampus, which is smaller than normal in some people with depression. It is possible, scientists think, that the hippocampus in these people does not produce enough new nerve cells in the brain, leading to a depressed mood.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Depression Research

Scientists are working on several research projects to expand on what is known about Depression.  The research will improve knowledge about the factors that increase the risk for Depression, as well as the causes, and best treatments, and will aid people living with Depression and their caregivers.

We are currently gathering the information required to support projects such as Neurobiological Underpinnings of Placebo Response in Depression and Neuroimaging in Patients Undergoing TMS for Depression (NIPUTFD).

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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