The Invisible Disease---Depression ?
Depression is a serious medical illness. In contrast to the normal
emotional experiences of sadness, loss, or passing mood states, clinical
depression is persistent and can interfere significantly with an
individual's ability to function.
Symptoms of depression include sad mood, loss of interest or pleasure in
activities that were once enjoyed, change in appetite or weight,
difficulty sleeping or oversleeping, physical slowing or agitation,
energy loss, feelings of worthlessness or inappropriate guilt,
difficulty thinking or concentrating, and recurrent thoughts of death or
suicide. A diagnosis of unipolar major depression (or major depressive
disorder) is made if a person has five or more of these symptoms and
impairment in usual functioning nearly every day during the same
two-week period. Major depression often begins between ages 15-30 or
even earlier. Episodes typically recur.
Some people have a chronic but less severe form of depression, called
dysthymia (or dysthymic disorder), that is diagnosed when depressed mood
persists for at least two years and is accompanied by at least two other
symptoms of depression. Many people with dysthymia also have major
depressive episodes. While unipolar major depression and dysthymia are
the primary forms of depression, a variety of other subtypes exist.
Depression can be devastating to all areas of a person's everyday life,
including family relationships, friendships, and the ability to work or
go to school. Many people still believe that the emotional symptoms
caused by depression are "not real," and that a person should be able to
shake off the symptoms if only he or she were trying hard enough.
Because of these inaccurate beliefs, people with depression either may
not recognize that they have a treatable disorder or may be discouraged
from seeking or staying on treatment because of feelings of shame and
stigma. Too often, untreated or inadequately treated depression leads to
suicide.
Psychotherapy is also effective for treating depression. Certain types
of psychotherapy, cognitive-behavioral therapy (CBT) and interpersonal
therapy (IPT), have been shown to be particularly useful. More than 80
percent of people with depression improve when they receive appropriate
treatment with medication, psychotherapy, or the combination.
Recently there has been enormous interest in herbal remedies for various
medical conditions including depression. One herbal supplement,
hypericum or St. John's Wort, has been promoted as having antidepressant
properties. However, no carefully designed studies have determined the
antidepressant efficacy of the supplement. NIMH is currently enrolling
patients in the first large-scale, multi-site, controlled study of St.
John's wort as a potential treatment for depression.