Depression

Depression is more than just the blues or the blahs. It makes a person less able to manage life. It affects a persons mood, mind, body, and behaviors. Depression can be as much an illness as diabetes, etc.

Causes

	Brain chemical imbalances
	Life changes, such as going away to college, the ending of a relationship, retirement, loss of a job or death of a loved one. (See “Grief/Bereavement”.)
	Concern about one’s grades and/or workload
	Worrying about money
	Medical illness, surgery, or disability
	Abuse of alcohol, drugs, and some medications
	Lack of natural, unfiltered sunlight between late fall and spring in some sensitive people. This is called Seasonal Affective Disorder (SAD).
	Holiday “blues”
	Low self-esteem

Depression is a state of sadness and despair.

Symptoms

	Ongoing feelings of sadness, helplessness, hopelessness, guilt, or worthlessness. Crying.
	Loss of interest in activities that used to bring pleasure, including sex
	Fatigue. Loss of energy or enthusiasm.
	Difficulty concentrating or making decisions
	Anger, anxiety, or irritability
	Physical symptoms, such as headaches or digestive problems that don’t respond to treatment and don’t let up
	Changes in eating and sleeping patterns

Whatever the cause, depression can be treated. Treatment includes medication, psychotherapy, and other therapies specific to the cause of the depression, such as exposure to bright light (similar to sunlight) for depression that results from SAD.

Questions to Ask

Have you just attempted suicide, are you making plans for suicide or do you have repeated thoughts of suicide or death?

Have you noticed a loss of interest or pleasure in almost all activities most of the day, nearly every day for at least two weeks?

Have you been in a depressed mood most of the day, nearly every day and have you had any of these problems for at least two weeks? Feeling hopeless, worthless, guilty, slowed down, or restless Changes in appetite or weight Problems concentrating, thinking, remembering, or making decisions Feeling tired all the time. Trouble sleeping or sleeping too much Headaches or other aches and pains Digestive or sexual problems Feeling worried or anxious Thoughts of death or suicide

Has depression interfered with daily activities for more than two weeks? Have you withdrawn from normal activities during this time?

Has the depression occurred with any of the following? Recent delivery of a baby A medical problem Taking over-the-counter or prescription medicine Abusing alcohol or drugs

Are you depressed now and do any of the following apply? You have been depressed before and not gotten treatment. You have been treated for depression in the past and it has returned. You have taken medication for depression in the past. You have a family history of depression in a close relative.

Does the depression come with dark, cloudy weather or winter months and does lift when spring comes?

During holiday times, do you withdraw from family and friends or dwell on past holidays to the point that it interferes with your present life?

Self-Help

	Take medications as prescribed. Get your doctor’s advice before you take over-the-counter herbs, such as St. John’s Wort, especially if you take other medications.
	Don’t use illegal drugs. Limit alcohol. These can cause or worsen depression. Drugs and alcohol can also make medicines for depression less effective. Harmful side effects can happen when alcohol and/or drugs are mixed with medicine.
	Eat healthy foods. Eat at regular times.
	Exercise regularly.
	Try not to isolate yourself. Be with people you trust and feel safe with, even though you feel down.
	Do something you enjoy.
	Relax. Listen to upbeat music. Read a good book. Take a warm bath or shower. Do relaxation exercises.
	Talk to a friend, relative, co-worker or anyone who will let you express the tensions and frustrations you are feeling.
	Keep an emergency number handy (e.g., crisis hotline, trusted friend’s number, etc.) in case you feel desperate.
	If suicidal thoughts are present, remove any weapons, pills, etc. that could be used for suicide and get medical help.

What You Can Do for a Friend or Relative

	The most important thing you can do is to get your friend or relative to seek professional treatment. Their illness, especially if it is severe and has persisted for a long time, will not go away on its own. Try to give positive feedback to the person about seeking help.
	Help them get treatment. You may need to make the initial appointment with a professional. You may need to take them to the appointment.
	Be observant. Do not ignore suicide references. These should be reported to the person’s therapist or physician immediately.
	Know their medication. You should alert their physician about any side effects that you notice when they take medication.
	Be supportive. Depression requires the patience, understanding, love and encouragement of the person’s loved ones and friends.
	Talk to them. Encourage the depressed person to talk about their feelings. Helping them see that they have succeeded at something or are “worthwhile” in other matters can help give them the confidence they need to continue with treatment.
	Encourage the person to go out and do things with you or with others, such as to see a movie or attend a social event. Do things the depressed person enjoyed in the past.
	Seek support from organizations and self-help groups that deal with depression. (See “National Resources”.)

Be with positive people. They’ll lift your morale.