Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2000;61(5):1523-1524

What is depression?

When doctors talk about depression, they usually mean major depression. Someone with major depression has symptoms like those listed below nearly every day, all day, for 2 weeks or longer. If you are depressed, you may also have headaches, other aches and pains, digestive problems, and problems with sex or lack of desire for sex.

An older person with depression may feel confused or have trouble understanding simple requests. Older people with depression are also more likely to feel tired, weak or anxious, and to have trouble sleeping.

What causes depression?

Depression has been connected with chemical imbalances in the brain. Depression also seems to be genetic (to run in families). Depression can be linked to events in your life, such as the death of someone you love, a divorce or a job loss. Taking certain medicines, abusing drugs or alcohol, or having other illnesses or diseases can also lead to depression.

Depression isn't caused by personal weakness, laziness or lack of willpower. It is a medical illness that can be treated.

How is depression diagnosed?

If you have symptoms of depression, be sure to tell your doctor. Once you tell your doctor how you're feeling, he or she may ask you some questions about your symptoms, about your health and about your family history. Your doctor may also give you a physical exam and do some basic tests.

Symptoms of depression

  • No interest or pleasure in things you used to enjoy

  • Feeling sad or empty

  • Crying easily or crying for no reason at all

  • Feeling numb and not being able to cry

  • Feeling slowed down or feeling restless and unable to sit still

  • Feeling worthless or guilty

  • Change in appetite, leading to weight gain or loss

  • Thinking about death or suicide

  • Trouble thinking, recalling things or focusing on what you're doing

  • Trouble making everyday decisions

  • Not sleeping well or wanting to sleep all of the time

  • Feeling tired all of the time

How is depression treated?

Treatment may involve medicine or counseling, or both.

What about medicines?

Many medicines can be used to treat depression. These medicines are called antidepressants. They require a prescription from your doctor. They fix the chemical imbalance in the brain. They are not like tranquilizers.

Antidepressants work differently for different people. They also have different side effects. So, if one medicine bothers you or doesn't work for you, another may be helpful.

You may notice some effects of the antidepressant as soon as one week after you start taking it. But you probably won't see the full effects for about six to eight weeks. Your doctor may want you to take medicine for four months or much longer.

How long will the depression last?

Left untreated, most depressions go away in about six months to a year. Treatment can make depression better in three weeks or less.

What about suicide?

Suicide is a danger if you are depressed. It may become more of a danger just as you start to get better, because your energy level may get better before your mood does. So you may have the energy to carry out thoughts of suicide.

Be sure to talk to your doctor, friends or family, or call your local suicide hot line (the number will be in your phone book) if you think you might want to try to kill yourself. Remember—depression can be treated.

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