Depression is
an illness that causes you to feel sad, to lose interest in activities that
you've always enjoyed, to withdraw from others, and to have little energy. It's
different from normal feelings of sadness,
grief, or low energy. Depression can also cause people
to feel hopeless about the future and even to think about suicide.
Many people, and sometimes their families, feel embarrassed or ashamed
about having depression. Don't let these feelings stand in the way of getting
treatment. Remember that depression is a common illness. Depression affects the
young and old, men and women, all ethnic groups, and all professions.
If you think you may be depressed, tell your doctor. Treatment can help
you enjoy life again. The sooner you get treatment, the sooner you will feel
better.
What causes depression?
Depression is a disease.
It's not caused by personal weakness and is not a character flaw. When you have
depression, chemicals in your brain called
neurotransmitters are out of balance.
Most experts believe a combination of family history (your
genes) and stressful life events may cause depression.
Life events can include:
Childbirth, a death in the family, work, or
relationships.
Finding out you have a long-term health problem,
such as arthritis, heart disease, or cancer.
Health problems, such
as
anemia and an underactive thyroid gland (hypothyroidism). Treating the health problem can
usually cure the depression.
Just because you have a family member with depression or
have stressful life events doesn't mean you'll get depression.
You also may get depressed even if there is no reason you can think of.
What are the symptoms?
The symptoms of depression
may be hard to notice at first. They vary among people, and you may confuse
them with just feeling "off" or with another health problem.
The
two most common symptoms of depression are:
Feeling sad or hopeless nearly every day for
at least 2 weeks.
Losing interest in or not getting pleasure from
most daily activities nearly every day for at least 2 weeks.
A serious symptom of depression is thinking about death
or suicide. If you or someone you care about talks about this or feeling
hopeless, get help right away.
You also may:
Lose or gain weight. You also may feel like eating more or less
than usual almost every day.
Sleep too much or not enough almost every day.
Feel restless and not be able to sit still, or you may sit
quietly and feel that moving takes great effort. Others can easily see this
behavior.
Feel tired or as if you have no energy almost every day.
Feel unworthy or guilty nearly every day. You may have low
self-esteem and worry that people don't like you.
Find it hard to focus, remember things, or make decisions
nearly every day. You may feel anxious about things.
If you have some of these symptoms for at least 2 weeks,
talk to your doctor. Treatment may be right for you.
If you think
you may have depression, take a short quiz to check your symptoms:
Depression can be treated in
various ways. Counseling, psychotherapy, and/or antidepressant medicines are
all used. Lifestyle changes, such as getting more exercise, also may help. Your
doctor or mental health professional will help you find the best treatment.
If you have mild or moderate depression, your family doctor or a
mental health professional, such as a counselor or
psychologist, may treat you. If you have severe
depression or if treatment is not helping, you may need to see a
psychiatrist. Some people need to be treated in the
hospital, especially if they have thoughts of suicide.
Work with
your health care team to find the best treatment for you. It may take a few
tries, and it can take several weeks for the medicine to start working. Try to
be patient and keep following your treatment plan.
Depression can
return (relapse). How likely you are to get depression again
increases each time you have a bout of depression.1
Taking your medicines and continuing some types of therapy after you feel
better can help keep that from happening. Some people need to take medicine for
the rest of their lives. This does not stop them from living full and happy
lives.
Let your doctor know if you think you are depressed.
Depression is easy to overlook. The earlier you are treated, the more quickly
you will get better.2
What can you do if a loved one has depression?
If
someone you care for is depressed, the best thing you can do is help the person
get or stay in treatment. Learn about the disease. Talk to the person and
gently encourage him or her to do things and see people. Don't get upset with
the person. The behavior you see is the disease, not the person.
Is suicide a concern?
Many people who have
depression have thoughts of death or thoughts of suicide, and depression can
lead to suicide. Learn the
warning signs of suicide, which include talking a lot
about death, giving things away, or using a lot of alcohol or drugs or both. If
you see these signs in yourself or a loved one, get help.
Call 911 or the
national suicide hotline at 1-800-SUICIDE (1-800-784-2433) or other emergency services if
you (or someone you care about who has
depression):
Plan to harm yourself or others.
Talk, write,
read, or draw about death, including writing suicide notes and talking about
items that can harm you, such as pills, guns, or knives.
Buy guns
or bullets, stockpile medicines, or take other action to prepare for a suicide
attempt. You may have a new interest in guns or other weapons.
Hear
or see things that aren't real.
Think or speak in a bizarre way
that is not like your usual behavior.
If a suicide threat seems real, call 911, a suicide
hotline, or the police. Stay with the person, or ask someone you trust to stay
with the person, until the crisis has passed. Don't argue or challenge the
person. Tell the person you don't want him or her to die.
Depression is a disease. It is not caused by personal
weakness and is not a character flaw. When you have depression, chemicals in
your brain called
neurotransmitters are out of balance.
Most experts believe a combination of family history (your
genes) and stressful life events may cause depression.
Genes: Your chance of having a bout of
depression is greater if other family members have had depression. You may have
inherited a trait that makes you more likely to get depressed. If this is true
for you, a stressful life event is more likely to trigger depression.
Life events: Stressful life events can trigger depression. For
example, you could become depressed if you have:
Been diagnosed with a long-term (chronic) disease such as
diabetes or
heart disease.
Sometimes even happy life events, such as a marriage or
promotion, can trigger depression because of the stress that comes with
change.
Just because you have a family member with depression or
have stressful life events doesn't mean you'll get depression. You also may get
depression without going through a stressful event.
Other causes
Health problems also can cause
depression. For example, both
anemia and an underactive thyroid gland (hypothyroidism) can lead to depression. Treating the
health problem usually cures the depression.
Certain medicines,
such as
steroids or
narcotics, can cause depression. If you stop using the
medicine, the depression may go away.
For more information on events that could
trigger depression, see the What Increases Your Risk section.
The symptoms of
depression may be hard to notice at first. They can be
different from person to person, and you may confuse them with just feeling
"off" or "down." You also may confuse the symptoms with another health
problem.
The two most common symptoms of depression are:
Feeling sad or hopeless nearly every
day.
Losing interest in or not getting pleasure from most daily
activities, and you feel this way nearly every day.
A serious symptom of depression is thinking about death and
suicide. If you or someone you care about talks about suicide or feeling
hopeless, get help right away.
You also may:
Lose or gain weight. You may also feel like eating more or less
than usual almost every day.
Sleep too much or not enough almost every day.
Feel restless and not be able to sit still, or you may sit
quietly and feel that moving takes great effort. Others can easily see this
behavior.
Feel tired or as if you have no energy almost every day.
Feel unworthy or guilty nearly every day. You may have low
self-esteem and worry that people don't like you.
Find it hard to focus, remember things, or make decisions nearly
every day. You may feel anxious or worried about things.
Are you depressed?
Experts say that if you have
at least five of the above symptoms for 2 weeks or longer, and one of the
symptoms is either sadness or loss of interest, you may have depression and may
need treatment.1 If you have 2 to 4 symptoms for a
period of at least 2 years (1 year for a child), you may have a long-term form
of depression called
dysthymic disorder (dysthymia).1
Even if you have fewer symptoms, you may still
be depressed and may benefit from treatment. No matter how many symptoms you
have, it's important to see your doctor. The sooner you get treatment, the
better your chance for a quick and full recovery.
It's possible
to have periods of both energy and elation (mania) and
depression. This may be
bipolar disorder. If this happens to you, tell your
doctor. The treatments for depression and bipolar disorder are different. For
more information, see the topic
Bipolar Disorder.
If you think you may
have depression, take a short quiz to check your symptoms:
In mild depression, you have few symptoms. They affect your
life, but you can deal with them with treatment.
In moderate depression, you have more symptoms, and they are
beginning to change your life.
In severe depression, the symptoms change your life and affect
your job or career and your relationships.
Depression can affect your physical health. You may have
headaches or other aches and pains or have digestive problems such as
constipation or diarrhea. You may have trouble having sex or may lose interest
in it. If you notice any of these changes, talk to your doctor. Your doctor may
be able to help.
Women also
may feel sad after having a baby. But if you feel very sad after you've had
your baby, see your doctor. You may have
postpartum depression. For more information, see the
topic Postpartum Depression.
Symptoms in older adults
Symptoms of depression
may be different for
older adults. Depression can make older adults confused or forgetful or cause
them to stop seeing friends and doing things. It can be confused with problems
like
dementia.
Symptoms in children and teens
Symptoms of
depression in children and teens can be different from adult symptoms.
These symptoms include doing poorly in school, having
temper tantrums, and becoming sexually active. For more information, see the
topic Depression in Children and Teens.
Warning signs of suicide
Thoughts of suicide are
common in people who have depression. Most people do not act on these thoughts,
but they must be taken seriously.
Call 911 or the national suicide hotline at 1-800-SUICIDE (1-800-784-2433) or other emergency services if you (or someone you care about who
has
depression):
Plan to harm yourself or others.
Talk, write,
read, or draw about death, including writing suicide notes and talking about
items that can harm you, such as pills, guns, or knives.
Buy guns
or bullets, stockpile medicines, or take other action to prepare for a suicide
attempt. You may have a new interest in guns or other weapons.
Hear
or see things that aren't real.
Think or speak in a bizarre way
that is not like your usual behavior.
Warning signs of suicide in children and teens may include running away from
home or doing risky or dangerous things, such as driving drunk or abusing
drugs. If you see warning signs in yourself or a loved one, get help.
For
some people, a bout of depression begins with symptoms of
anxiety (such as worrying a lot), sadness, or lack of
energy. This may go on for days or months before you or others think you are
depressed. And other people may feel depressed suddenly. This may happen after
a big change in life, such as the loss of a loved one or a serious accident.
It's possible to have periods of both energy and elation (mania) and depression. This may be
bipolar disorder. If this happens to you, tell your
doctor. The treatments for depression and bipolar disorder are different. For
more information, see the topic
Bipolar Disorder.
How long does depression last?
If you don't get
treated, depression may last from months to a year or longer. A small number of
people feel depressed for most of their lives and always need treatment.
Depression can return, which is called a
relapse. At least half of the people who have
depression once get it again.3 How likely you are to
get depression again increases each time you have a bout of depression.1 You can make having another bout of depression less likely by
following your treatment plan and using your medicines.
Depression and other health concerns
Depression is
linked with many health concerns. These include other diseases, drug or alcohol
use, and pregnancy.
If you have depression and another health
concern, you need to deal with both of them. Read about:
Experts don't know why
some people get
depression and others don't. But certain things make
you likely to get depression. These are called risk factors.
Important risk factors for depression include:
Having a father, mother, brother, or sister who has had
depression.
One-time stressful events, such as the death of a
loved one, losing your independence or your job, or having a serious
accident.
Other risk factors include:
Long-term (chronic) stressful situations, such
as living in poverty, having marriage or family problems, or helping someone
who has a long-term medical problem.
Physical or sexual abuse in childhood or in a relationship, such
as domestic abuse or violence.
Getting older.
Medical risk factors
Medical problems also may
cause depression or make it worse. These problems include:
Call 911 or the national suicide hotline at 1-800-SUICIDE (1-800-784-2433) or other emergency services if you (or someone you care about who
has
depression):
Plan to harm yourself or others.
Talk, write, read,
or draw about death, including writing suicide notes and talking about items
that can harm you, such as pills, guns, or knives.
Buy guns or
bullets, stockpile medicines, or take other action to prepare for a suicide
attempt. You may have a new interest in guns or other weapons.
Hear
or see things that aren't real.
Think or speak in a bizarre way
that is not like your usual behavior.
If you have been diagnosed with depression, call your doctor
if:
You find it hard or it's getting harder to deal
with your job, family, and friends.
You think your treatment is not
helping or you are not getting better.
Your symptoms get worse or
you get new symptoms.
You have any problems with your
antidepressant medicines, such as side effects, or you are thinking about
stopping your medicine.
You are having
manic behavior, such as having very high energy,
needing less sleep than normal, or showing risky behavior such as spending
money you don't have or abusing others verbally or physically.
If you have not been diagnosed with depression, but you think you may be depressed, use the
Feeling Depressed topic to check your symptoms.
Watchful waiting
Watchful waiting is a wait-and-see
approach. If you get better on your own, you may not need treatment. If you get
worse, you and your doctor will decide what to do next. Watchful waiting may be
right for you if you have feelings of
grief or sadness because you have lost a loved one or
have had a stressful life event.
If symptoms do not improve
after 2 weeks, or if you think about suicide, talk with your doctor as soon as
you can.
It also may help to discuss your symptoms with a close
and trusted friend or family member. Sometimes another person can see changes
in your mood or behavior sooner than you can.
Who to see
There any many types of professionals
who treat depression and many types of treatments. A good place to start is
with your family doctor. If treatment by your doctor does not help you, the
next step is to see a mental health professional.
Whomever you
see, it is important that this person has experience treating people with
depression and is trained in proven therapies. It is also important that you
establish a good long-term relationship. If you don't feel comfortable with one
doctor or therapist, try another one.
Health professionals who can
diagnose depression and prescribe medicine include:
Depression may
be diagnosed when you talk to your doctor about feeling sad or when your doctor
asks you questions and discovers that you are feeling sad. You may be seeing
your doctor because you feel sad or because you have another health problem or
concern.
If your doctor thinks you are depressed, he or she will
ask you questions about your health and feelings. This is called a
mental health assessment. Your doctor also may:
Depending on your history and risk factors, your doctor may
order other tests.
If you are depressed, your doctor may treat you or refer you for
therapy to treat your symptoms.
Tell your doctor
Always tell your doctor if you
feel sad or have other symptoms of depression. Many times, people are
embarrassed by these feelings and say nothing. Depression can be treated, and
the sooner you get treatment, the better your chance for a quick and full
recovery.
It's possible to have periods of both energy and
elation (mania) and depression. This may be
bipolar disorder. If this happens to you, tell your
doctor. The treatments for depression and bipolar disorder are different. For
more information, see the topic
Bipolar Disorder.
Depression can
be treated in various ways. Counseling, psychotherapy, and antidepressant medicines may all be used. Lifestyle changes, such as
getting more exercise, also may help.
Your doctor or mental health
professional will help you find the best treatment. For severe depression, a
very small number of people may need to stay in a hospital for a short time,
especially if they are thinking about suicide.
Work with your
health care team to find the best treatment for you. To get the most benefit,
be sure you find a therapist who has experience treating people who have
depression and who is trained in proven therapies, and use your medicines as
your doctor directs.
If your depression is mild, you may need only therapy.4
If you have moderate to severe symptoms, your doctor probably
will suggest medicine and/or therapy.
If you are using medicine,
your doctor may have you try different medicines or a combination of medicines.
Evidence shows that adding medicines to therapy for severe depression works
better than therapy alone.5
You may need to go to the hospital if you show
warning signs of suicide, such as having thoughts
about harming yourself or another person, not being able to tell the difference
between what is real and what is not (psychosis), or
using a lot of alcohol or drugs.
If you don't get treated, depression may last from months
to a year or longer. A small number of people feel depressed for most of their
lives and always need treatment.
For more information, see the
Therapy and Medications sections.
If you need help
deciding whether to talk to your doctor about depression, see
some common reasons people don't get help and how to overcome them.
For more information on making changes in your lifestyle to help with
depression, see the Living With Depression section.
Other treatment
Other treatments for depression
include
electroconvulsive therapy (ECT) and alternative or
complementary treatment. ECT involves an electric stimulation to the brain.
Alternative treatments include the herb St. John's wort and omega-3 fatty
acids. For more information on these treatments, see the Other Treatment
section.
One Man's Story:
Stan
"...[T]his was the first time I was willing
to do anything to recover. It's changed my whole life."-Stan
There is little research on whether you
can prevent a first bout of
depression. But several studies suggest that exercise
may help prevent a first bout of depression.6, 7 Exercise also may help prevent depression from coming back
(relapse) and may improve symptoms of mild
depression.6, 7
If
you worry about getting depression, talk to your doctor. Regular screening for
depression helps find depression early, and early treatment may help you get
better faster.
You also may be able to prevent depression by
avoiding alcohol and drugs. Alcohol and drugs can trigger depression. And using
them is often a sign that you have depression.
Preventing depression from coming back
You may be
able to prevent a relapse or keep your symptoms from getting worse if
you:
Take your medicine as prescribed. Depression often returns if
you stop taking your medicine or don't take it as your doctor advises.
Continue to take your medicine after your symptoms improve.
Taking your medicine for at least 6 months after you feel better can help keep
you from getting depressed again. If this is not the first time you have been
depressed, your doctor may want you to take medicine even longer. You may
benefit from long-term treatment with antidepressants.
Continue
cognitive-behavioral therapy after your symptoms
improve. Research shows that those who continued this type of therapy had less
chance of relapse.8
Counseling and
psychotherapy are important parts of treatment for
depression. You will work with a mental health
professional such as a psychologist, licensed professional counselor, clinical
social worker, or psychiatrist. Together, you will develop an action plan to
treat your depression.
The first step is
finding a therapist you trust and feel comfortable
with. The therapist also should have experience treating people who have
depression and should be trained in proven therapies. These therapies
include:5
Cognitive-behavioral therapy (CBT), which teaches you
how to change the ways you think and behave. This can help you stop thinking
bad thoughts about yourself and your life. You can take part in CBT with a
therapist or in a group setting. Also see:
Interpersonal therapy, which looks at your social and
personal relationships and related problems.
Some therapists use acceptance and commitment therapy (ACT).
In ACT, you work with a therapist to learn to accept your negative feelings but
not let them run your life. You learn to make choices and act based on your
personal values, not negative feelings.
Mindfulness strategies are
another type of therapy. They seek to focus your attention on what is happening
at the moment without trying to change it. These strategies teach you to let go
of past regrets and not worry about the future. They may help with depression
in some people.
Other treatments you may have heard of include
problem-solving therapy, which looks at your current
problems and helps you solve them, and
family therapy, which brings you and your family
together to discuss your relationships and depression. Experts don't know how
well these therapies work for depression.5
When you hear 'counseling' or 'therapy,' you may think of lying on a
couch and talking about your childhood. But most of these treatments do not
look for hidden memories. They deal with how you think about things and how you
act each day.
One Woman's Story:
Debbie
"I walked into the therapist's
office crying, mute. I felt as if no one heard me."-Debbie
How long your treatment lasts depends on how severe your
depression is and how well you respond to treatment. Short-term counseling or
therapy usually lasts from 10 to 20 weeks, and you usually see your mental
health professional once a week. But you may need to meet with your health
professional more often or for a longer time.
Medicines
Antidepressant medicines may improve or
completely relieve the symptoms of
depression. If you are mildly depressed, you may not
have to take them, but most people with moderate or severe depression need
medicine.
Antidepressant medicines work in different ways. No
antidepressant works better than another, but different ones work better or
worse for different people. The side effects of antidepressant medicines are
different and may lead you to choose one instead of another.
You
may have to try different medicines or take more than one to help your
symptoms. Most people find a medicine that works within a few tries. Other
people take longer to find the right one and may need to take the
antidepressant and another type of medicine, such as an antiseizure, mood
stabilizer, antipsychotic, or antianxiety medicine.
Together you
and your doctor will decide if you need medicine, what things you'll need to
think about if you need medicine, and which medicine is right for you.
If you take
antidepressants, you should take them for at least 6 months after you begin to
feel better. This can help prevent you from feeling depressed again (relapse). If this is not the first time you have been
depressed, your doctor may want you to take these medicines even longer.
You may start to feel better within 1 to 3 weeks after starting your
antidepressant medicine. But it can take as many as 6 to 8 weeks to see a great
deal of improvement. If you have questions or concerns about your medicines, or
if you do not notice that you feel better by 3 weeks, talk to your
doctor.
Some people need to remain on medicine for several months
to years. Others will need medicine long-term. This is more likely if you have
had several bouts of depression that you had to treat in the hospital or that
led you to attempt suicide.
Don't quit taking your medicines
without talking to your doctor. If you quit suddenly, it can cause dizziness,
anxiety, fatigue, and headache. If you and your doctor decide you can quit
using medicine, gradually reduce the dose over several weeks.
Antidepressant medicines
have side effects. You may notice the side effects before you notice that the
medicine is helping you. Side effects vary depending on the medicine you
take.
Common side effects include diarrhea,
headaches, loss of sexual desire, not feeling like eating, having an upset
stomach, and feeling on edge.
Most side effects are mild and will go away after you take the
medicine for a few weeks.
Call your doctor right away and stop
taking the medicine if you have serious side effects such as chest pain,
hives, shortness of breath, trouble swallowing, or
swelling of your lips.
If your side effects are less serious but
bother you, talk with your doctor about how to deal with the side effects or to
see whether you should try another antidepressant medicine.
Antidepressant medicines have helped many people and are
considered safe. But like all medicines, they may cause problems in certain
people.
People who are taking medicines for other health problems
need to know about medicine interactions. Talk with your doctor about the best
way to track whether a combination of medicines is harming you. People who are
taking a lot of medicines also are more likely to have harmful side effects.
When you're going through
depression, you can't just shake if off. You might
have a couple of good days followed by a bad day or a string of bad days. And
you don't know how long it will last. Depression is not like the flu or a
sprained ankle, where your doctor can tell you about how long it will take to
get better.
When you're getting better, many experts call it
recovery. Recovery is finding your path to the life you
care about. There are
10 principles of recovery that can help you recover from depression on your
terms. They help you gain self-confidence and respect for yourself.
During your recovery, be patient and kind to yourself. Remember that
depression is not your fault and is not something you can overcome with
willpower alone. You need treatment for depression, just like for any other
illness.
Continuing your treatment, helping yourself, getting
support, and having a healthy lifestyle are all part of your recovery. Your
symptoms will fade as your treatment starts to work. Don't give up. Focus your
energy on getting better. Your mood will improve. It just takes some
time.
Your self-care
You can take many steps to help
yourself when you feel depressed or are waiting for your medicine to work.
These steps also help prevent depression from coming back.
Be real in what you expect and what you can do. Set goals you
can meet. If you have a big task to do, break it up into smaller steps you can
handle. Don't take on more than you can handle.
Don't blame
yourself or others for your depression.
Think about putting off big decisions until your depression has
lifted. Wait a bit on making decisions about marriage, divorce, or jobs. Talk
it over with friends and loved ones who can help you look at the whole
picture.
Get support from others. Your family can help you get the right
treatment and deal with your symptoms.
Social support and support groups give you the chance
to talk with people who are going through the same things you are.
Tell people you trust about depression. It is usually
better than being alone and keeping it a secret.
Try to be part of religious, social,
holiday, or other activities.
If you have any other health problems, like diabetes, heart
disease, or high blood pressure, continue with your treatment for them. Tell
your doctor about all of the medicines you take, with or without a
prescription.
You also can help yourself by thinking about what is good in your
life. You can:
Help others who are not as well off as you
are.
Thank people for the small and big things they do for you.
Be thankful for big things like having a home, family, and
friends.
Be thankful for little things like making people laugh,
enjoying a piece of music, or finding warm gloves for the winter.
One Woman's Story:
Cheryl
"If you keep your thoughts in, they will
never be quiet. It helps my depression to express them."-Cheryl
Get regular exercise. People who are fit usually have
less
anxiety,
depression, and stress than people who aren't
fit.9 Even something as easy as walking can help you
feel better. Find a way you can be active.
Eat a balanced diet. This helps your body deal with
tension and stress. Whole grains, dairy products, fruits, vegetables, and
protein are part of a balanced diet.
Get enough sleep. A good night's sleep can help mood
and stress levels. Avoid sleeping pills unless your doctor prescribes them.
Deal with stress. Too much stress can help trigger
depression. You can do a lot to help relieve stress. For more information, see
the topic
Stress Management.
Avoid drinking alcohol or using illegal drugs or medicines that
have not been prescribed to you. Having a
substance abuse problem makes treating depression
harder.
Both problems need to be treated.
Prevent depression from coming back. Take your medicine as your
doctor advises. Depression often returns if you stop taking your medicine or
don't take it as your doctor advises. For more information, see the Prevention
section.
Other Treatment
Other treatments for
depression include brain stimulation and treatment
with herbs or dietary supplements.
Brain stimulation
Electroconvulsive therapy (ECT) may be used to treat severe depression or depression that does not
get better with medicine and counseling or therapy. In ECT, electricity is
briefly sent to the brain through electrodes placed on your head. Studies have
shown that ECT is an effective short-term treatment for depression.10, 11
Other types of brain
stimulation have not been well studied and may be expensive. They usually are
considered only if other treatment does not work. They include:
Deep brain stimulation. A device that uses electricity to
stimulate the brain is put in your head. It is used for Parkinson's disease but
has not been well studied for depression.
Vagus nerve stimulation. A generator the size of a pocket watch
is placed in your chest. Wires go up from the generator to the vagus nerve in
your neck. The generator sends tiny electric shocks through the vagus nerve to
the brain.
Transcranial magnetic stimulation. An electromagnet is placed
on your head and sends magnetic pulses that stimulate your brain.
Complementary therapies
Complementary therapies are sometimes used for
depression. Always tell your doctor if you are using any of them.
The herb
St. John's wort can help treat depression. A review of studies found that
the herb can work just as well as prescribed antidepressants in some people who
have major depression.12 St. John's wort also may have
fewer side effects than prescribed medicines.
SAM-e ( S-adenosylmethionine) is sometimes used to
treat depression. Some studies show that SAM-e may help with symptoms of
depression, but more studies are needed to determine its safety and how well it
works.15
For Family and Friends
If someone you care about is
depressed, you may feel helpless. Maybe you're
watching a once-active or happy person slide into inactivity or you're seeing a
good friend lose interest in favorite activities. The change in your loved
one's or friend's behavior may be so big that you feel you no longer know him
or her.
Here are some things you can do to help:
Help the person get treatment or stay in treatment. This is the
best thing you can do.
Be active. People who are fit usually have less
anxiety, depression, and stress than people who aren't fit.9
Deal with stress. Too much stress can help trigger
depression, but simple things can relieve stress. For more information, see the
topic
Stress Management.
Eat a balanced diet. This helps the body deal with
tension and stress. Whole grains, dairy products, fruits, vegetables, and
protein are part of a balanced diet.
One Woman's Story:
Susan
"Having a friend or loved one to help you
can really help."-Susan
Depression
can lead to suicide. Call 911 or the national suicide hotline at 1-800-SUICIDE (1-800-784-2433) or other emergency services if the person:
Plans to harm himself or herself or others.
Talks,
writes, reads, or draws about death, including writing suicide notes and
talking about items that can harm him or her, such as pills, guns, or
knives.
Buys guns or bullets, stockpiles medicines, or takes other
action to prepare for a suicide attempt. The person may have a new interest in
guns or other weapons.
Hears or sees things that aren't real.
Thinks or speaks in a bizarre way that is not usual.
If a person or family member
who is depressed talks about suicide and has a plan and a way to carry it out,
follow these guidelines.
Stay with the person, or ask someone you
trust to stay with the person, until the crisis has passed.
Get
professional help.
Don't argue with the person ("It's not as bad
as you think") or challenge him or her ("You're not the type to commit
suicide").
Tell the person you don't want him or her to die. Talk
about the situation as openly as possible.
Helping yourself
If you are spending a lot of time
helping or caring for someone who has depression, find your own support. This
can help you deal with the illness. These
caregiver tips also can help you.
Don't help too much. A common mistake caregivers make is
providing too much care. Even if they don't say so, people like to help
themselves. Take some time off.
Don't do it alone. Ask others to help you, or join a support
group. The more support you have, the more help you can give.
Get help from a local organization. Your city or state may have
programs to help you. Ask at your local or state health department. The
National Alliance on Mental Illness (NAMI) provides contact information for
support organizations nationwide. Go to www.nami.org and choose "Find
Support."
Other Places To Get Help
Organizations
American Psychological Association
750 First Street NE
Washington, DC 20002-4242
Phone:
1-800-374-2721 (202) 336-5500
TDD:
(202) 336-6123
Web Address:
www.apa.org
The American Psychological Association provides
information and brochures on a number of topics, including stress, anxiety, and
depression. Visit their http://helping.apa.org site for information on the
mind/body connection, family and relationships, and how therapy works.
Depression and Bipolar Support
Alliance
730 North Franklin Street
Suite 501
Chicago, IL 60610-7224
Phone:
1-800-826-3632 includes a hotline for help with depression and bipolar disorder (312) 642-0049
Fax:
(312) 642-7243
Web Address:
www.dbsalliance.org
The Depression and Bipolar Support Alliance publishes
brochures, books, and videotapes about the treatment of mood disorders, all
available free of charge or for a nominal fee. It also has an information and
referral line, and its Web site contains helpful information.
Mental Health America
2000 North Beauregard Street, 6th Floor
Alexandria, VA 22311
Phone:
1-800-969-NMHA (1-800-969-6642) hotline for help with depression (703) 684-7722
Fax:
(703) 684-5968
TDD:
1-800-433-5959
Web Address:
www.mentalhealthamerica.net
Mental Health America (formerly known as the National
Mental Health Association) is a nonprofit agency devoted to help people of all
ages live mentally healthier lives. Its Web site has information about mental
health conditions. It also addresses issues such as grief, stress, bullying,
and more. It includes a confidential depression screening test for anyone who
would like to take it. The short test may help you decide whether your symptoms
are related to depression.
National Alliance on Mental Illness
(NAMI)
Colonial Place Three
2107 Wilson Boulevard
Suite 300
Arlington, VA 22201-3042
Phone:
1-800-950-NAMI (1-800-950-6264) hotline for help with depression (703) 524-7600
Fax:
(703) 524-9094
TDD:
(703) 516-7227
E-mail:
info@nami.org
Web Address:
www.nami.org
The National Alliance on Mental Illness is a national
self-help and family advocacy organization dedicated solely to improving the
lives of people with severe mental illnesses such as schizophrenia, bipolar
disorder (manic depression), major depression, obsessive-compulsive disorder,
and panic disorder. NAMI focuses on support, education, advocacy, and research.
The mission of the organization is to "eradicate mental illness and improve the
quality of life of those affected by these diseases."
National Institute of Mental Health
(NIMH)
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone:
1-866-615-6464 toll-free (301) 443-4513
Fax:
(301) 443-4279
TDD:
1-866-415-8051 toll-free
E-mail:
nimhinfo@nih.gov
Web Address:
www.nimh.nih.gov
The National Institute of Mental Health (NIMH) provides
information to help people better understand mental health, mental disorders,
and behavioral problems. NIMH does not provide referrals to mental health
professionals or treatment for mental health problems.
American Psychiatric Association (2000). Depressive disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 349-381. Washington, DC: American Psychiatric Association.
Schulberg HC, et al.
(1999). Best clinical practice: Guidelines for managing major depression in
primary medical care. Journal of Clinical Psychiatry, 60(7): 19-28.
American Psychiatric Association (2000). Practice
guidelines for the treatment of patients with major depressive disorder
(revision). American Journal of Psychiatry, 157(4,
Suppl): S1-S45.
Chilvers C, et al. (2001). Antidepressant drugs and
generic counselling for treatment of major depression in primary care:
Randomised trial with patient preference arms. BMJ,
322(7289): 772-775.
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http://www.clinicalevidence.com.
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Buchner DM (2008). Physical activity. In L Goldman, D
Ausiello, eds., Cecil Textbook of Medicine, 23rd ed.,
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and other physical treatments), search date April 2006. Online version of
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www.clinicalevidence.com.
UK ECT Review Group (2003). Efficacy and safety of
electroconvulsive therapy in depressive disorders: A systematic review and
meta-analysis. Lancet, 361(9360): 799-808.
Linde K, et al. (2008). St. John's wort for major
depression. Cochrane Database of Systematic Reviews
(4).
Peet M, Horrobin DF (2002). A dose-ranging study of
the effects of ethyl-eicosapentaenoate in patients with ongoing depression
despite apparently adequate treatment with standard drugs. Archives of General Psychiatry, 59(10): 913-919.
Keller JR (2002). Omega-3 fatty acids may be effective
in the treatment of depression. Topics in Clinical Nutrition, 17(5): 21-27.
Agency for Healthcare Research and Quality (2002).
S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease. Summary. Evidence Report/Technology
Assessment No. 64 (AHRQ Publication No. 02-E033). Rockville, MD: Agency for
Healthcare Research and Quality.
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This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
American Psychiatric Association (2000). Depressive disorders. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 349-381. Washington, DC: American Psychiatric Association.
Schulberg HC, et al.
(1999). Best clinical practice: Guidelines for managing major depression in
primary medical care. Journal of Clinical Psychiatry, 60(7): 19-28.
American Psychiatric Association (2000). Practice
guidelines for the treatment of patients with major depressive disorder
(revision). American Journal of Psychiatry, 157(4,
Suppl): S1-S45.
Chilvers C, et al. (2001). Antidepressant drugs and
generic counselling for treatment of major depression in primary care:
Randomised trial with patient preference arms. BMJ,
322(7289): 772-775.
Butler R, et al. (2007). Depression in adults:
Psychological treatments and care pathways, search date April 2006. Online
version of BMJ Clinical Evidence (8). Available at:
http://www.clinicalevidence.com.
Wiles NJ, et al. (2007). Physical activity and common
mental disorders: Results from the Caerphilly study. American Journal of Epidemiology, 165(8): 946-954.
Butler R, et al. (2007). Depression in adults (drug
and other physical treatments), search date April 2006. Online version of
Clinical Evidence. Also available online:
http://www.clinicalevidence.com.
Paykel ES (2007). Cognitive therapy in relapse
prevention in depression. International Journal of Neuropsychopharmacology, 10: 131-136.
Buchner DM (2008). Physical activity. In L Goldman, D
Ausiello, eds., Cecil Textbook of Medicine, 23rd ed.,
pp. 64-67. Philadelphia: Saunders.
Butler R, et al. (2007). Depression in adults (drug
and other physical treatments), search date April 2006. Online version of
Clinical Evidence. Available at:
www.clinicalevidence.com.
UK ECT Review Group (2003). Efficacy and safety of
electroconvulsive therapy in depressive disorders: A systematic review and
meta-analysis. Lancet, 361(9360): 799-808.
Linde K, et al. (2008). St. John's wort for major
depression. Cochrane Database of Systematic Reviews
(4).
Peet M, Horrobin DF (2002). A dose-ranging study of
the effects of ethyl-eicosapentaenoate in patients with ongoing depression
despite apparently adequate treatment with standard drugs. Archives of General Psychiatry, 59(10): 913-919.
Keller JR (2002). Omega-3 fatty acids may be effective
in the treatment of depression. Topics in Clinical Nutrition, 17(5): 21-27.
Agency for Healthcare Research and Quality (2002).
S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease. Summary. Evidence Report/Technology
Assessment No. 64 (AHRQ Publication No. 02-E033). Rockville, MD: Agency for
Healthcare Research and Quality.
