Depression By Dr. Steve Resnick The Princeton Psychiatric Page

Almost everyone feels down sometimes. It's normal to be sad once in a while and to have occasional mood swings. Though we may call this "being depressed," it is very different from an actual clinical Depression, which is a treatable medical illness characterized by a specific set of symptoms.

Some common symptoms of Depression are sleep disturbance, lack of interest or apathy, social withdrawal, guilt feelings or low self-esteem, diminished energy or motivation, decreased concentration or memory, prolonged sadness or unexplained crying spells, lethargy, changes in appetite, and recurring thoughts of death or suicide.

Depression is a common illness. More than 17 million Americans suffer from a depressive disorder annually, and one in five will experience an episode of Depression at some time in their lives.

Although the specific cause of the illness is unclear, medical research has shown that Depression is related to an imbalance in brain chemicals (neurotransmitters) which transmit signals between nerve cells in the brain. It often occurs "out of the blue", without any apparent cause. It can also be triggered by a stress, or medical illnesses. Other triggers could be change of seasons, childbirth or menstrual cycles. The illness is often passed genetically through families.

Some people have only one episode of major Depression, though it is common for the episodes to recur several times or to be long-lasting. Depression affects people of all ages, races, ethnic groups and social and economic classes. You or someone you know is likely to be affected by the disorder. Women are twice as likely as men to be diagnosed as depressed, but the reason for this is not known.

One of the biggest problems with Depression is that its seriousness is often not recognized. Many people think they should "tough it out," especially if the Depression is triggered by a negative event, such as the death of a loved one, marital problems or loss of one's job. They may minimize their reaction to the event, or think it is "just in their head." Some think they can shake it off through willpower.

What distinguishes Depression from a passing bad mood are the specific symptoms, as well as its severity and duration. Sometimes, differentiating Depression from a normal sad reaction or moodiness is fairly clear cut. Often, however, it requires a professional evaluation. Also, a professional can detect other medical problems that can look like Depression (such as low blood sugar, hormonal problems or anemia, or other psychiatric problems that resemble Depression such as bipolar disorder (also called manic depressive illness), alcohol or substance abuse or social phobia).

Once professionally diagnosed, there are several treatment options. These include individual or group psychotherapy, antidepressant medication (including many new drugs) support groups, and stress management techniques. Education, through brochures, videos and appropriate Web sites helps improve understanding of the disease and its treatments.

If left untreated, Depression can have profound consequences. People with the illness may experience an impairment in job functioning and in social and marital relationships, a lowered immune response and an increased risk of many illnesses. Those suffering from severe Depression who don't seek help have a suicide rate as high as 15 percent.

Even after learning about Depression, many men and women who suspect they might have the illness don't go for help. Unfortunately, there is still a very strong stigma attached to mental illness in general and Depression in particular. Some feel that Depression is a weakness they should be able to handle on their own. This is a terrible misperception. Most people would not think twice about getting medicine for diabetes or high blood pressure, yet they are reluctant to treat Depression. The fact is, Depression and other mental illnesses require appropriate treatment, just like any other medical illness.

Some people are also concerned about what others will think and how they will be labeled if they seek treatment. As a result, they suffer with symptoms for a long time. Even when they come for professional help, they have many concerns about starting therapy or medication. Unfortunately, many people don't understand Depression or other forms of mental illness, so some bias still exists against people who suffer from it. This is starting to change, however. Thanks to improved public awareness and media coverage, many people now have a better understanding about Depression.

Although at this time there is no specific "test" to determine if someone has Depression, the diagnosis is made by a thorough evaluation of current and past symptoms, their medical history, and related issues. The future holds promise, though. Some areas being explored for diagnosis include brain scans, blood tests and more sophisticated questionnaires with computer analyses.

As with diabetes, heart disease and many other chronic illnesses, there is no cure for Depression. Proper treatment, however, can be very successful in managing the symptoms, and most patients can lead well-functioning, productive lives. It's important for anyone who suspects he or she may be suffering from Depression to consult a professional.