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What is depression?

Major Depressive Disorder (or MDD or Depression) is a brain disease that makes you sad, but it is different than normal sadness . Depression can make it hard for you to work, study, or do everyday tasks. Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you.

There are different types of depression; in Major Depressive Disorder you can experience severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes during his life.

Who gets depression?

Overall, 20% of women and 12% of men will experience depression during their lifetime. Currently, estimates are about 17.5 million Americans are currently living with depression. In 2010, the Centers for Disease Control and Prevention (CDC) released a report estimating the percentage of adults with depression during years 2006-2008. Of 235,067 adults surveyed, 9% met the criteria for current depression, including 3.4% who met the criteria for major depression.

The prevalence of depression is approximately two times greater in females compared to males. Major depression is less common in older than younger adults living in the community. The prevalence of depression in older adults declines as they age. Certain groups of older adults have higher rates of depression compared with older adults in general. For example, people with chronic diseases, people, living in nursing homes or receive home health care are more likely to have depression compared to older adults without these factors.

What causes depression?

Depression is a disorder of the brain and is due to multiple causes including factors you inherit from family members (genetic), environmental factors (lack of exercise and poor diet) and psychological factors (stress and loneliness). Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.

Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too. Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Sometimes depression may occur without an obvious trigger.

What are the symptoms of depression?

To be diagnosed with major depression, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.
    Signs and symptoms of depression
  • Persistent sad, anxious, or "empty" feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

How do you diagnose depression?

Before diagnosing a major depressive disorder, in general a doctor performs a medical examination and selected investigations to rule out other causes of symptoms. These exams and tests can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and check for any related complications:
  • Physical exam. Your doctor may do a physical exam and ask in-depth questions about your health. In some cases, depression may be linked to an underlying physical health problem.
  • Lab tests. For example, your doctor may do a blood test called a complete blood count (CBC) or test your thyroid to make sure it's functioning properly.
  • Psychiatric evaluation. To check for signs of depression, your doctor or mental health provider asks about your symptoms, thoughts, feelings and behavior patterns. Your doctor may have you fill out a questionnaire to help answer these questions.

How do you treat depression?

Once diagnosed, a person with depression can be treated in several ways. The most common treatments are medication and psychotherapy.

Antidepressants primarily work on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways that they work.

Several types of psychotherapy—or "talk therapy"—can help people with depression.

Two main types of psychotherapies—cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT)—are effective in treating depression. CBT helps people with depression restructure negative thought patterns. Doing so helps people interpret their environment and interactions with others in a positive and realistic way. It may also help you recognize things that may be contributing to the depression and help you change behaviors that may be making the depression worse. IPT helps people understand and work through troubled relationships that may cause their depression or make it worse.

For mild to moderate depression, psychotherapy may be the best option. However, for severe depression or for certain people, psychotherapy may not be enough.

For cases in which medication and/or psychotherapy does not help relieve a person's treatment-resistant depression, electroconvulsive therapy (ECT) may be useful. ECT, formerly known as "shock therapy," once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to feel better with other treatments.

Resources and Support

There are many resources in the Chicago area for people living with depression.
  1. National Alliance on Mental Illness – Chicago Chapter
    1536 West Chicago Avenue, Chicago, IL 60642
    (312) 563-0445
  2. Depression and Bipolar Support Alliance - Greater Chicago (DBSA-GC)
    6666 N. Western Avenue, Chicago, Illinois 60645
  3. Mental Health America of Illinois (MHAI)
    70 East Lake Street, Suite 900
    Chicago, Illinois 60601
  4. Community Counseling Centers of Chicago
    4740 N Clark St, Chicago, IL 60640