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Am Fam Physician. 2006;74(8):1395-1396

What is depression?

When doctors talk about depression, they mean the medical illness called major depression. Someone with major depression has symptoms like those listed in the box below nearly every day, all day, for two weeks or longer. If you’re depressed, you may also have headaches, other aches and pains, stomach problems, and problems with sex. An older person with depression may feel confused or have trouble understanding simple requests.

Symptoms of Depression

  • No interest in things you used to enjoy

  • Feeling sad or empty

  • Crying easily or crying for no reason

  • Feeling slow or restless and not being able to sit still

  • Feeling worthless or guilty

  • Weight gain or loss

  • Thoughts about death or suicide

  • Trouble thinking, remembering things, or focusing on what you’re doing

  • Trouble making decisions

  • Problems sleeping, especially in the early morning, or wanting to sleep more than usual

  • Feeling tired

  • Feeling numb emotionally, perhaps even to the point of not being able to cry

What causes depression?

Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with each other. Depression also seems 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 also can lead to depression.

How is depression diagnosed?

If you’re having symptoms of depression, be sure to tell your doctor so you can get help. The sooner you get treatment, the sooner the depression will go away.

Once you tell your doctor how you’re feeling, he or she may ask you some questions about your symptoms, health, and family history of health problems. Your doctor also may give you a physical exam and do some tests.

How is depression treated?

Depression can be treated with medicines or counseling, or with both.

Medicines called antidepressants can be used to treat depression. They fix the chemical imbalance that causes depression. Antidepressants work differently for different people. They also have different side effects. You might start feeling better as quickly as one week after you start taking the medicine. But you probably won’t feel the full effects for about two months. You may have side effects at first, but they tend to get better after a couple of weeks.

How long will I need medicine?

How long you’ll need to take the medicine depends on your depression. Your doctor may want you to take medicine for six months or longer. You need to take the medicine long enough to reduce the chance that the depression will come back. Talk with your doctor about any questions you have about your medicine.

Will I need to go to the hospital?

Depression usually can be treated through visits to your doctor. Treatment in the hospital may be needed if you have other medical problems that could affect your treatment or if you’re at high risk of suicide.

Getting Through Depression

  • Pace yourself. Don’t expect to do everything you normally can. Set a realistic schedule.

  • Don’t believe all of your negative thinking, such as blaming yourself or expecting to fail. This thinking is part of depression. These thoughts will stop as your depression goes away.

  • Get involved in activities that make you feel good.

  • Do not make big life decisions when you’re depressed. If you must make a big decision, ask someone you trust to help you.

  • Avoid drugs and alcohol. Both make depression worse and can cause dangerous side effects with your antidepressants.

  • Physical activity may improve your mood. Exercising four to six times a week for at least 30 minutes each time is a good goal. But even less activity can be helpful.

  • Try not to get discouraged. It will take time for your depression to go away.

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