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KEY POINTS
- Major depression is severe depression that lasts more than 2 weeks. Depression is a condition in which you feel sad, hopeless, and uninterested in daily life.
- Treatment may include medicines, therapy, and learning ways to manage stress. In severe cases, you may need to be treated in the hospital.
- If you are depressed and feel that you could hurt yourself or someone else, call your healthcare provider or therapist right away.
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What is major depression?
Major depression is severe depression that lasts more than 2 weeks. Depression is a condition in which you feel sad, hopeless, and uninterested in daily life. The depression may keep you from doing everyday activities. You may have major depression only once, or you may have it many times in your life.
What is the cause?
The exact cause of depression is not known. Possible causes include:
- The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
- Depression is more common if you have a direct relative who has depression. Major depression may be more likely if you inherit certain genes.
- Childhood abuse, neglect, or poverty can increase the risk for developing depression during childhood or many years later. Stress also plays a part.
- People who have low self-esteem or a negative attitude about life are at higher risk for depression.
- Some medicines can cause depression or make it worse. These include some blood pressure medicines, sleeping pills, seizure medicines, and steroids such as prednisone.
- A major medical problem such as heart disease, cancer, or chronic pain increases your risk for depression.
- Other mental health problems, such as anxiety disorders, post-traumatic stress disorder, or eating disorders increase your risk for depression.
- Alcohol or drug abuse increases your risk.
Depression is more common in women than in men. It can start at any age.
What are the symptoms?
Besides feeling very sad and uninterested in things you usually enjoy, symptoms may include:
- Being irritable
- Having trouble falling asleep, waking up very early, or sleeping more than usual
- Noticing changes in your appetite and weight, either up or down
- Feeling very tired or low energy
- Losing interest in sex
- Feeling worthless and guilty
- Not being able to concentrate or remember things
- Feeling hopeless or just not caring about anything
- Having physical symptoms such as headache or joint pain
- Thinking often about death or suicide
How is it diagnosed?
Your healthcare provider or therapist will ask about your symptoms. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms. You may have lab tests to check for other possible causes of your symptoms.
How is it treated?
Depression can be successfully treated with medicine, therapy, or both.
Medicine
Several types of medicines can help. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.
Therapy
Seeing a mental health therapist is helpful. Cognitive behavioral therapy (CBT) is a form of therapy that helps you identify and change thought processes and learn ways to better cope with stress. Learning ways to replace negative thoughts with more positive ones can help your depression.
Interpersonal therapy can help you work on one or two problem areas, such as relationships with friends and family.
Repetitive Transcranial Magnetic Stimulation (rTMS) may be another option. It uses magnetic pulses to stimulate nerve cells in the brain and relieve symptoms of depression.
If you have severe depression that doesn’t improve enough with medicine and therapy, electroconvulsive therapy (ECT) can be very helpful. In ECT, a controlled electric current is passed through the brain, producing a very brief seizure. This can decrease symptoms that affect your thoughts, emotions, and actions.
Other treatments
A diet rich in fruits and vegetables is recommended. A multivitamin and mineral supplement may also be recommended. Learning ways to relax may help. Yoga and meditation may also be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and therapy.
Claims have been made that certain herbal and dietary products help control depression symptoms. Omega-3 fatty acids may help to reduce symptoms of depression. St. John's wort may help mild symptoms of depression. It will not help severe cases of depression. No herb or dietary supplement has been proven to consistently or completely relieve the symptoms of depression. Supplements are not tested or standardized and may vary in strengths and effects. They may have side effects and are not always safe. Talk with your healthcare provider before you use any of these products.
How can I take care of myself?
- Take your medicines every day, even if you are feeling well. Do not stop taking your medicine without your healthcare provider’s approval.
- Get support. Talk with family and friends. Consider joining a support group in your area.
- Be active. Do things you might enjoy, even if you don’t feel like doing it.
- Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
- Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, try to quit. Exercise according to your healthcare provider's instructions.
- Avoid alcohol and drugs because they can make your symptoms worse.
- Check your medicines. Certain medicines can add to the symptoms of depression. If you have had depression, tell all healthcare providers who treat you about all medicines you are taking, including nonprescription products and natural remedies.
- Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.
Get emergency care if you or a loved one have serious thoughts of suicide or harming others.
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