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Am Fam Physician. 2002;66(6):1045-1046

What is depression?

Feeling sad or “down” from time to time is normal, but it isn't the same as depression. When doctors talk about depression, they mean the medical illness called major depression. Someone with major depression has most or all of the symptoms listed in the box below nearly every day, all day, for 2 weeks or longer. There is also a “minor” form of depression with less severe symptoms. Minor depression has the same causes and treatment as major depression.

What causes depression?

Your brain has chemicals that help control your moods. When you don't have enough of these chemicals or your brain doesn't respond to them properly, you may become depressed. Depression can be genetic (meaning it can run in families). Depression also can be linked to events in your life, such as the death of a loved one, a divorce, or losing a job. Taking certain medicines, abusing drugs or alcohol, or having other illnesses can also lead to depression. Depression isn't caused by personal weakness.

How is depression diagnosed?

If you're having symptoms of depression, be sure to tell your doctor so you can get help. He or she may ask you some questions about your symptoms, your health, and your family's history of health problems. Your doctor may also give you a physical exam and do some tests.

Symptoms of Depression

  • No interest or pleasure in things you used to enjoy, including sex

  • Feeling sad or numb

  • Crying easily or for no reason

  • Feeling slowed down or feeling restless and irritable

  • Feeling worthless or guilty

  • Change in appetite; unintended change in weight

  • Trouble remembering things, concentrating, or making decisions

  • Headaches, backaches, or digestive problems

  • Problems sleeping, or wanting to sleep all of the time

  • Feeling tired all of the time

  • Thoughts about death or suicide

How is depression treated?

Depression can be treated with medicine, counseling, or both. These treatments are highly effective. Medicine may be particularly important to treat severe depression. Medicines used to treat depression are called antidepressants. They correct the chemical imbalance in your brain. You may have side effects when you first start to take them, but these effects usually go away with time. The medicine can start working right away, but you may not see the full benefit for about 6 to 8 weeks. How long you'll need to take the medicine depends on your depression. Usually it is best to take medicine for at least 6 months. Don't stop taking your medicine without checking with your doctor first.

What about suicide?

People with depression sometimes think about suicide. These thoughts are a common part of depression. If you have thoughts about hurting yourself, tell your doctor, friends, or family right away, or call your local suicide hot line (listed in the phone book). Thoughts of suicide will go away after the depression is treated.

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