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Basic Information
Description
A continuing feeling of sadness, despondency or hopelessness with accompanying symptoms. Major depression occurs in about 1 in 10 Americans. It affects both sexes, but is more common in women. It can be difficult to treat, but there is continued improvement in effectiveness of treatment.
Frequent Signs and Symptoms
  • Loss of interest in life; boredom.
  • Listlessness and fatigue.
  • Insomnia; excessive or disturbed sleeping.
  • Social isolation.
  • Appetite loss or overeating.
  • Loss of sex drive.
  • Constipation.
  • Difficulty making decisions; concentration difficulty.
  • Unexplained crying bouts.
  • Intense guilt feelings over minor or imaginary misdeeds.
  • Irritability.
  • Various pains, such as headache or chest pain, without evidence of disease.
Causes
  • A truly depressive illness has no single obvious cause. Some bio. logical factors can play a part, e.g., physical illness, hormonal disorders, certain drugs.
  • Social and psychological factors can play a part.
  • Inherited disorders may contribute (manic depression runs in families).
  • May relate to the number of disturbing events in a person's life.
Risk Increases With
  • Unexpressed anger or other emotion.
  • Compulsive, rigid, perfectionistic or highly dependent personalities.
  • Family history of depression.
  • Alcoholism.
  • Failure in occupation, marriage or other interpersonal relationships.
  • Death or loss of a loved one.
  • Loss of something important (job, home, investments).
  • Job change or move to a new area.
  • Surgery, such as mastectomy for cancer.
  • Major illness or disability.
  • Passing from one life stage to another, such as menopause or retirement.
  • Use of some drugs, such as reserpine, beta-adrenergic blockers or benzodiazepines.
  • Withdrawal from mood-altering drugs, such as narcotics, amphetamines or caffeine.
  • Some diseases, including diabetes mellitus, cancer and hormonal abnormalities.
Preventive Measure
  • Maintain good communication with family and dose friends.
  • Raise children with love and reasonable expectations in school and home.
  • Anticipate and prepare for major life changes where possible.
Expected Outcome
Spontaneous recovery in many cases, but professional help can shorten the duration and help you learn to cope in the future. Recurrence is common. The recovery rate is high, despite one's pessimism while depressed.
Possible Complications
  • Withdrawal from family and friends.
  • Neglect of personal appearance.
  • Mendon of wanting "to end it all" or being "a burden to others."
  • Evidence of a suicide plan (e.g., buying or cleaning a gun).
  • Sudden cheerfulness after prolonged despondency.
  • Hallucinations or psychotic behavior.
  • Manic behavior, characterized by inappropriate overactivity and comic or irresponsible behavior.
Treatment/Post Procedure Care
General Measures
  • Approach to therapy consists of treating acute symptoms, avoiding a relapse, and maintenance therapy to prevent recurrence.
  • Psychotherapy or counseling along with drug treatment appears to obtain the best results.
  • Different types of psychotherapy are available including cognitive therapy, behavioral therapy and interpersonal therapy. Each may take 12-20 sessions over 12-16weeks.
  • Hospitalization or inpatient at special treatment center may be required for severe depression.
  • Seek support groups. Contact social agencies for help. Call the National Mental Health
  • Association (800) 969 6642, the National Foundation for Mental Illness (800) 239-1263 or the National Depressive and Manic Depressive association (800) 826-3632.
  • Call your local suicide-prevention hot line if you feel suicidal.
  • Electroconvulsive therapy (use of electric shocks to produce a seizure) used in severe cases. It is effective and safe.
Medication
  • Anti-depressant drugs for some persons with prolonged or moderately severe depression.
  • Specific drugs are used for alternating mania and depression.
  • Anti-anxiety drugs may be prescribed.
  • Sedatives maybe prescribed temporarily for insomnia.
  • Hormonal therapy, particularly estrogen replacement for premenopausal (the 5 to 10 year period before menopause) women.
Activity
  • No restrictions. Maintain daily activities and interests even if you don't feel like it. Attend social functions, concerts, athletic events, plays and movies. Keep in touch with friends and loved ones.
  • A regular exercise program can help relieve depression.
Diet
Eat a normal, well-balanced diet even if you have no appetite. Vitamin and mineral supplements may be necessary.
Notify Your Healthcare Provider If
  • You or a family member has symptoms of depression.
  • You feel suicidal or hopeless.
  • Symptoms of depression recur after treatment.

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