Depression is a common problem in which severe and long lasting feelings of sadness or other problems get in the way of a person's ability to function. In any given year, as many as 18.8 million American adults - 9.5% of the adult population - experience some type of depression. Unlike a blue mood that comes and goes, depression is a persistent problem that affects the way a person eats and sleeps, thinks about things, and feels about him- or herself.

What are the Symptoms of Depression?

The symptoms of depression can vary quite a bit, but most people who experience depression feel down or sad more days than not, or find that things in their life no longer seem enjoyable or interesting. Additionally, people with depression may notice changes in their sleeping, eating, concentration, or feelings about themselves, and may find themselves feeling hopeless. These symptoms typically last for at least 2 weeks without letting up.

What Causes Depression?

Depression has many causes. Difficulty coping with painful experiences or losses contributes to depression. People returning from a war zone often experience painful memories, feelings of guilt, or regret about their war experiences, or have a tough time readjusting back to normal life. Trouble coping with these feelings and experiences can lead to depression. Some types of depression run in families, and depression is often associated with chemical imbalances and other changes in the brain.

How is Depression Treated?

There are many treatment options for depression. An evaluation should be done by a healthcare professional to help determine which type of treatment is best for an individual. Typically, milder forms of depression are treated by psychotherapy, and more severe depression is treated with medications or a combination of psychotherapy and medication. Your doctor can help you determine which treatment is best for you.

Psychotherapy

There are a number of types of psychotherapy (or talk therapy) that are used to treat depression. These treatments may involve just a few sessions, or may last 10-20 weeks or longer. Psychotherapy treatments tend to focus on helping patients learn about their problems and resolve them, through working with a therapist and learning new patterns of behavior to help decrease depression. Two of the main types of psychotherapy for depression are interpersonal therapy and cognitive-behavioral therapy. Interpersonal therapy focuses on the patientâs relationships with other people, and how these relationships may cause and maintain depression. Cognitive-behavioral treatments help patients change negative styles of thinking and acting that can lead to depression

Medication

In addition to psychotherapy, there are several types of antidepressant medications used to treat depression. These include selective serotonin reuptake inhibitors (SSRIs), tricyclics, and monoamine oxidase inhibitors (MAOIs). The newer medications for treating depression, such as the SSRIs, generally have fewer side effects than older types of medications. A healthcare provider may try more than one type of medication, or may increase the dosage, to find a treatment that works. Improvements in symptoms of depression typically occur after the medication is taken regularly for 3 to 4 weeks, although in some medications it may take as long as 8 weeks for the full effect to occur.

Antidepressant medications are typically safe and effective. They help patients feel less depressed and generally do not make people feel ãdruggedä or different during their daily lives. The side effects of depression medications vary depending on the medication, and can include dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness, drowsiness, headache, nausea, nervousness, or insomnia. Because of side effects or because they begin feeling better, patients are often tempted to stop taking their medication too soon. Some medications must be stopped slowly to give your body time to readjust to not having the medication. Never stop taking an antidepressant without consulting your doctor.

What Can I Do about Feelings of Depression?

Depression can make a person feel exhausted, worthless, helpless, hopeless, and sad. These feelings can make you feel as though you are never going to feel better, or that you should just give up. It is important to realize that these negative thoughts and feelings are part of depression, and often fade as treatment begins working. In the meantime, here is a list of things to try to improve your mood:

• Talk with your doctor or healthcare provider
• Talk with family and friends, and let them help you
• Participate in activities that make you feel better, or that you used to enjoy before you began feeling depressed
• Set realistic goals for yourself
• Engage in mild exercise
• Try to be with others and get support from them
• Break up goals and tasks into smaller, more reachable ones

Where Can I Find More Information About Depression?

National Institute of Mental Health (NIMH) Depression Fact Sheet

National Alliance for the Mentally Ill (NAMI)*

This fact sheet was based on:

Iraq War Clinician Guide, Appendix J, pp. 193-4