Depression
Overview
Risk Factors
Depression is more common in women. Many things raise the risk. Examples are:
- A personal or family history of depression
- Long term illness
- Childhood abuse, neglect, or trauma
- Alcohol and drug abuse
- Stress, loss, or major life changes
- Other mental illnesses or brain injury
- Partner abuse
- Little or no social support
SymptomsandDiagnosis
Symptoms
Depression can differ from person to person. Some have only a few symptoms, while others have many.
Symptoms can change over time. They may include:
- Lasting sadness, anxiety, or emptiness
- Loss of interest in hobbies, activities, or sex
- Feeling helpless, hopeless, or guilty
- Sleeping too much or too little
- Feeling tired, restless, or irritable
- Trouble with focus, memory, or decisions
- Changes in eating or weight
- Thoughts of death or suicide
Sometimes there are physical symptoms. Examples are aches and pains that cannot be explained.
Treatments
Treatment
The goal is to ease symptoms and improve function. Treatment depends on the type and severity of depression. Severe depression may need hospital care. Care is urgent if someone might hurt themselves or others.
Options may be:
- Medicines, such as:
- Antidepressants
- Mood stabilizers and antipsychotics—if needed
- Sedatives for anxiety—usually short term
- Ketamine as a nasal spray or IV—may be used if other options do not work
- Other medicines
- Counseling such as cognitive-behavior therapy and others—to improve coping
- Lifestyle changes such as:
- Healthy diet with B vitamins and omega-3 fatty acids—may help ease symptoms
- Daily exercise—may help boost mood
- Supplements, such as St. John's wort and DHEA—may help some
Other treatments may be:
- Light therapy—sitting near an ultra-bright light for a certain time each day
- Sleep deprivation therapy—a short term option that may improve mood
Sometimes symptoms are severe and other treatments do not work. In this case, options may be:
- Electroconvulsive therapy ECT—a brief electric pulse to the brain to help reset it
- Vagus nerve stimulation (VNS)—an implanted device that may alter signals to the brain
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (Major Depressive Affective Disorder; Unipolar Disorder; Unipolar Mood Disorder)
RESOURCES
Depression and Bipolar Support Alliance http://www.dbsalliance.org
Mental Health America http://www.mentalhealthamerica.net
CANADIAN RESOURCES
Canadian Mental Health Association https://cmha.ca
Canadian Psychiatric Association http://www.cpa-apc.org
References
Columbia University. Q&A on bright light therapy. Columbia University website. Available at: http://www.columbia.edu/~mt12/blt.htm. Accessed March 15, 2021.
Depression. Mental Health America website. Available at: http://www.mentalhealthamerica.net/conditions/depression. March 15, 2021.
Depression. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed March 15, 2021.
Depression alternative treatments. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/depression-alternative-treatments. Accessed March 15,
Kandola A, Ashdown-Franks G, et al. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev. 2019;107:525-539.
Major depressive disorder (MDD). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/major-depressive-disorder-mdd. Accessed March 15, 2021.
St. John's wort. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Accessed Macrh 15, 2021.
St. John's wort and depression. National Center for Complementary and Integrative Health website. Available at: https://nccih.nih.gov/health/stjohnswort/sjw-and-depression.htm. Accessed March 15, 2021.
St. John's wort for depression. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/st-johns-wort-for-depression . Accessed March 15, 2021.