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Depression


Definition:

Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.

Clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for a longer period of time.

For more information on the symptoms and treatment of depression, see:

Alternative Names:

Blues; Gloom; Sadness; Melancholy

Common Causes:

Depression often runs in families. This may be due to your genes (inherited), behaviors you learn at home, or both. Even if your genes make you more likely to develop depression, a stressful or unhappy life event usually triggers the depression.

Many factors can cause depression, including:

  • Alcohol or drug abuse
  • Medical conditions and treatments, such as:
    • Certain types of cancer
    • Long-term pain
    • Sleeping problems
    • Steroid medications
    • Underactive thyroid (hypothyroidism)
  • Stressful life events, such as:
    • Abuse or neglect
    • Breaking up with a boyfriend or girlfriend
    • Certain types of cancer
    • Death of a relative or friend
    • Divorce, including a parent's divorce
    • Failing a class
    • Illness in the family
    • Job loss
    • Long-term pain
    • Social isolation (common cause of depression in the elderly)
Home Care:

If you are depressed for 2 weeks or longer, contact your doctor or other health professional before your symptoms get worse.

No matter what type of depression you have and how severe it is, the following self-care steps can help:

  • Get enough sleep.
  • Follow a healthy, nutritious diet.
  • Exercise regularly.
  • Avoid alcohol, marijuana, and other recreational drugs.
  • Get involved in activities that make you happy.
  • Spend time with family and friends.
  • If you are a religious or spiritual person, talk to a clergy member or spiritual advisor.
  • Consider meditation, tai chi, or other relaxation methods.
  • Add omega-3 fatty acids to your diet. You can get them from over-the-counter supplements or by eating fish such as tuna, salmon, or mackerel.

If your depression occurs in the fall or winter months, try light therapy using a special lamp that is like sunlight.

If you have moderate to severe depression, the most effective treatment plan will likely involve a combination of talk therapy, lifestyle changes, and medication.

Call your health care provider if:

Call 911, a suicide hotline, or go to a nearby emergency room if you have thoughts of harming yourself or others.

Call your doctor if:

  • You hear voices that are not there.
  • You cry often without cause.
  • Your depression has affected your work, school, or family life for longer than 2 weeks.
  • You have three or more symptoms of depression.
  • You think one of your current medications may be making you feel depressed -- DO NOT change or stop taking any medications without talking to your doctor.
  • You think you should cut back on drinking, a family member or friend has asked you to cut back, you feel guilty about the amount of alcohol you drink, or you drink alcohol first thing in the morning.
What to expect at your health care provider's office:

Your health care provider will find out how severe your depression is (mild, moderate, or severe) and look for the cause by doing a:

  • Health history
  • Mental health interview
  • Physical examination

If there is a risk of suicide, you may need to stay in the hospital for treatment.

You will talk with the health care provider about the issues and events that may be causing your depression. Your doctor will ask you about:

  • Your mood and other symptoms (sleep, appetite, concentration, energy)
  • Possible stressors in your life and support systems in place
  • Whether you have had thoughts about ending your life
  • Drug and alcohol use, and any medications you are currently taking

Treatment will depend on your symptoms. For mild depression, counseling and self-care may be enough. The most effective therapy for moderate or severe depression is a combination of antidepressant medication and talk therapy.

Your primary care doctor may refer you to a psychiatrist if your depression is moderate to severe, or if it does not improve with treatment.

For more treatment information, see: Major depression

References:

Fava M, Cassano P. Mood disorders: Major depressive disorder and dysthymic disorder. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 29.

American Psychiatric Association. Practice guidelines for the treatment of patients with major depressive disorder. 2nd ed. September 2007.


Review Date: 3/25/2012
Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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