"The grey drizzle of horror," author William Styron memorably called depression. The mood disorder may descend seemingly out of the blue, or it may come on the heels of a defeat or personal loss, producing persistent feelings of sadness, worthlessness, hopelessness, helplessness, pessimism , or guilt . Depression also interferes with concentration , motivation , and other aspects of everyday functioning.
What Are the Signs of Depression?
Not everyone who is depressed experiences every symptom. Some people experience a few symptoms, some many. The severity of symptoms varies among individuals and over time.
Depression often involves persistent sad, anxious, or empty mood; feelings of hopelessness or pessimism ; and feelings of guilt , worthlessness, or helplessness. It can also involve loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex . Decreased energy, fatigue, or a sense of being "slowed down" are also common, as are restlessness, irritability, and difficulty concentrating, remembering, or making decisions. Many with depression have thoughts of death or suicide.
People with depression may experience disruptions in sleep ( insomnia , early morning awakening or oversleeping) and in eating behavior ( appetite changes, weight loss or gain). Persistent physical symptoms may include headaches, digestive disorders, and chronic pain .
For more see Signs and Symptoms of Depression.
What Causes Depression?
There is no single known cause of depression. Rather, it likely results from a combination of genetic, biologic, environmental, and psychological factors. Major negative experiences— trauma , loss of a loved one, a difficult relationship, or any stressful situation that overwhelms the ability to cope—may trigger a depressive episode. Subsequent depressive episodes may occur with or without an obvious trigger.
Depression is not an inevitable consequence of negative life events, however. Research increasingly suggests that it is only when such events set in motion excessive rumination and negative thought patterns, especially about oneself, that mood enters a downward spiral.
Research utilizing brain-imaging technologies such as magnetic resonance imaging (MRI) shows that the brains of people who have depression look different than those of people who do not. Specifically, the parts of the brain responsible for regulating mood, thinking, sleep, appetite, and behavior appear to function abnormally. It is not clear which changes seen in the brain may be the cause of depression and which may be the effect.
Some types of depression tend to run in families, suggesting there may be some genetic vulnerability to the disorder.
How Is Depression Treated?
Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier treatment begins, the more effective it can be and the greater the likelihood that recurrence can be prevented.
Appropriate treatment for depression starts with an examination by a physician. Certain medications, as well as some medical conditions such as viral infections or a thyroid disorder, can cause the same symptoms as depression and should be ruled out. The doctor should ask about alcohol and drug use, and whether the patient has thoughts about death or suicide.
Once diagnosed, a person with depression can be treated a number of ways. The most common treatments are medication and psychotherapy . Many studies show that cognitive behavioral psychotherapy is highly effective, alone or in combination with drug therapy.
Psychotherapy addresses the thinking patterns that precipitate depression, and studies show that it prevents recurrence. Drug therapy is often helpful in relieving symptoms, such as severe anxiety , so that people can engage in meaningful psychotherapy.
Natural Approaches to Depression
Depression requires active treatment, because the disorder can have enduring effects on brain function that make future episodes more likely. The longer a depression episode lasts, the more likely a future episode.
However, there are many ways to treat depression, and some of the most effective, especially in cases of mild to moderate disorder, do not require a prescription or medical-type intervention of any kind.
Depression can be seen as a kind of cave , and it takes some time and effort to get out of the cave. But it is possible, usually by learning some new patterns of thinking and doing. Nutrition plays a role as well.
For more see Natural Approaches to Depression.
Explore More About Depression
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