What is depression?
Depression is often the word most people use to describe what is known in medical terms as a major depressive episode (MDE). The distress seen in people who suffer from an MDE goes beyond the normal sadness that everyone experiences at times. In fact, major depression is a serious medical condition that can impair a person’s ability to function and enjoy life.
Although scientists don’t fully understand the cause for depression, many experts believe that a genetic predisposition combined with environmental and social factors may trigger an imbalance in brain chemicals called neurotransmitters.
Whatever the cause, people with untreated MDE may experience physical complaints, feelings of despair, and difficulty with relationships. Untreated MDE may even lead to suicide attempts.
What are the symptoms?
MDEs usually include mental and emotional symptoms that go beyond the experience of feeling unhappy. A person experiencing an MDE feels sad, helpless, and hopeless or loses interest in normal daily activities.
In addition, the person will also have some or all of the following symptoms:
- feelings of excessive guilt or worthlessness nearly every day
- trouble thinking, concentrating, and making decisions
- fatigue or lack of energy nearly every day
- anxiety or unusual slowness or restlessness
- significant weight loss or gain
- sleeping too little or too much
- less interest in sex
- thoughts of suicide or death
Depression becomes an illness when these symptoms are severe, last for at least two weeks, and interfere with one’s work or social life.
What are the risk factors?
MDEs are not uncommon. They affect people of all ages, but on average they start in the late 20s, occurring more often in women than men. Fifteen to twenty per cent of people experience one or more MDEs in their lives, even if they aren’t aware of it. Only 31% of people who experience an MDE ever seek medical help.
You have an increased risk for MDE if you:
- have a family history of MDE
- abuse drugs or alcohol
- gave birth recently
In the weeks after giving birth, 50 to 80% of women experience a mild depression commonly called “baby blues,” which isn’t serious. However, about 10% of women experience postpartum depression, which is longer and more severe than the baby blues. If you are feeling depressed after giving birth, talk to your physician; you may need treatment.
How is it diagnosed?
If you or your relatives and friends suspect you are having an MDE, you should see a doctor or mental health professional, who can diagnose it by asking questions and listening to how you feel.
How can I treat major depressive episodes (MDEs)?
If you or someone you know is experiencing an MDE, it is important to remember that there is help and that with appropriate treatment, it is possible to recover.
You should work with your doctor to develop a treatment program. The program may include psychotherapy, medication, lifestyle modifications, or a combination of these approaches. Be sure to follow your program to increase your chances of recovery. It is also important to visit your doctor regularly to make sure the treatment program is working and to decide when you can reduce or stop your medication.
Psychiatrists, psychologists, or family doctors may provide short-term or long-term psychotherapy. Psychotherapy can help people determine the possible sources of their depression and what they can do to help deal with an MDE.
A form of psychotherapy called cognitive therapy can help alter negative beliefs and ways of thinking. Cognitive therapy uses exercises to help people identify negative thoughts and see how those thoughts influence their feelings and sometimes cause depression.
Antidepressants are medications that influence the functioning of certain chemicals in the brain called neurotransmitters. Antidepressants can re-establish the balance of these chemicals, which helps relieve the symptoms of depression. However, it takes time (several weeks) for them to become effective.
The majority of people experiencing an MDE will improve on medications. Some antidepressant medications are more useful for particular symptoms of depression such as sleeping problems or excess worry, but most of the differences are mainly in the side effects. Talk to your doctor or Peoples pharmacist if you are uncomfortable taking medication or are experiencing occasional side effects.
The length of the treatment varies from one person to another, but it is extremely important to take the medication for the entire prescribed period. Otherwise, your symptoms may reappear.
Some researchers have found St. John’s wort to be effective for mild to moderate depression. Current concerns about St. John’s wort include variable quality and occasional interactions with other medications. Before starting St. John’s wort, talk to your Peoples pharmacist about brand quality and possible medication interactions, and make sure your health-care provider knows you will be taking it.
Research has shown that regular exercise such as jogging, brisk walking, or cycling helps reduce MDE symptoms. Before starting regular exercise, fill out an exercise safety questionnaire (PAR-Q), available from most fitness centres or your local Peoples Drug Mart or Peoples Pharmacy.
Make sure your doctor tells you about the various symptoms that can signal the onset of an MDE. A lot of people who experience an MDE get depressed again. If you experience three or more MDEs in a five-year period, you may need to consider long-term treatment with medication.
Where can I find out more about depression?
For more information about your medications or other health issues:
- talk to your Peoples pharmacist
- read People First, a health magazine of practical information available free from your neighbourhood Peoples Drug Mart or Peoples Pharmacy
Canadian Mental Health Association
Regional locations are listed on the Web site and in the phone book.
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