DEPRESSION


About Your Diagnosis

Depression is a very common psychiatric complaint affecting at one time or another about 80% of individuals. In the medical sense, depression is not the same thing as being temporarily sad when bad things happen. This is normal. However, if sadness lasts for a matter of days or weeks, or prevents you from doing things such as working or being involved with your family, or involves any thoughts of hurting or killing yourself, then psychiatric evaluation for depression is indicated.


Depression is more common in women than in men. It can occur at any age, either after something happens in an individual's life or for no apparent reason.


Living With Your Diagnosis

One of the features of depression is trouble sleeping. This can be difficulty falling asleep, but more likely it is awakening early in the morning for no reason. Patients who are depressed often are wide awake at three or four in the morning, and are unable to fall asleep again. Less commonly, depression can involve too much sleep, where the individual might sleep most of the day. In addition to sleep problems, depression also involves changes in appetite. Some individuals do not eat when they are depressed and may lose a lot of weight. Others eat more when they are depressed. Other features of depression include losing interest in things that you once liked to do; being unable to concentrate on reading or watching television because your mind is wandering to other topics; feeling sad; having crying spells, often times for no reason; feeling badly about yourself, or feeling like your future is not going to be any better; being very agitated or restless, or moving and speaking very slowly; and losing interest in sexual activity.

In severe forms, depression involves suicidal thoughts–that is, wanting to kill yourself–or homicidal thoughts–wanting to kill someone else. Or it may involve thinking about death all the time, dreaming about death, or wishing you were dead without actually planning to take your own life. Occasionally depression also involves psychotic features such as hearing voices, seeing things that aren't there, including individuals who may have previously died, and feeling that individuals are following you or talking about you behind your back (paranoia).


Depression can also be caused by certain drugs such as alcohol or "downers," such as Librium, Valium, Ativan, barbiturates, and similar drugs. There are also other medications that can cause depression. The list of these medications is very long, so you should always check with your doctor to see whether any medication you may be taking has been associated with depression.


There are also some medical conditions, such as thyroid disease and stroke, that are frequently associated with depression.


There are no specific laboratory or x-ray tests to diagnose depression. It is diagnosed on the basis of some of the symptoms mentioned earlier.


Treatment

Depression is treatable; therefore it is important to alert your family or your doctor if you experience any of the symptoms of depression. The treatment of depression usually involves using medications and talking to a therapist or a psychiatrist, usually at least once a week. The medications that are used to treat depression are called antidepressants, and there are many of them. Some of the more commonly used drugs are Zoloft, Prozac, Paxil, Elavil, Effexor, Sinequan, and Wellbutrin. Your doctor will have chosen an antidepressant that is designed to treat whatever particular symptoms of depression you may have. Some of these drugs will increase your sleep and appetite, but you should keep in mind that it takes about 2—3 weeks before you will begin feeling the effects of these drugs on depression. So, do not expect relief from the depression right away when starting antidepressant medication.


There are some side effects to the treatment of depression, and they depend on the drug that is used. However, some of the more common side effects include weight gain, sexual problems, oversedation, and nausea and diarrhea. If you have any side effects, let your doctor know because you may be able to take a different drug.


The DOs
* Decrease your exposure to stress.
* Make sure your diet is healthy.
* Exercise regularly.


The DON'Ts

* Don't use alcohol or drugs, because these will increase your depression or interfere with some of the medications that are being used to treat depression.
* Don't take any prescription or over-the-counter medication without first discussing it with the doctor who prescribed your medication for depression.


When to Call Your Doctor

* If your depression symptoms get worse.
* If you have any side effects from the medication you are taking.
* Call immediately if you have any suicidal thoughts or thoughts about killing or hurting someone else.
* Call immediately if you have any psychotic features, such as hearing voices or seeing things that are not there, or feeling paranoid.
* If depression related to grief involves suicidal thoughts. Depression can normally occur as part of grief–that is, after the death of a loved one. This depression related to grief usually gets somewhat better as time passes.


For More Information
Contact your family doctor, your local mental health center, your local crisis center hot line, or check out the following Web site:
Clinical Depression Screening Test
http://sandbox.xerox.com/pair/ cw/testing.htm/