The National Institute of Mental Health (NIMH) estimates that 18.8 million Americans-12.4 million women and 6.4 million men-suffer from a depressive illness every year.
This year, 12 percent of women and more than 6 percent of men in this country will suffer from depression.
Q: What is depression?
A: Depression is a condition that last two weeks or more and interferes with a person's ability to carry on daily tasks and enjoy activities that previously brought pleasure. It is not the "blues."
Q: What causes depression?
A: Researchers believe that some depression is caused by an abnormal functioning of the brain, but genetic make-up and life history can also determine a person's tendency to be depressed.
Q: How prevalent is depression?
A: In the June 18, 2003, issue of the "Journal of the American Medical Association," Ronald C. Kessler, Ph.D., of the Department of Health Care Policy at Harvard Medical School, and his colleagues reported that about 35 million (or 16.2 percent) of adults in the U.S. have suffered from a "major depressive disorder" at least once in their lifetime.
Q: Is depression a serious disease?
A: Yes. The NIMH maintains that, "Depressive illness can often interfere with normal functioning and cause pain and suffering not only to those who have the disorder, but to those who care about them. Serious depression can destroy family life as well as the life of the ill person."
In a national study of depression, Dr. Ronald C. Kessler (Department of Health Care Policy at Harvard Medical School) found that nearly all the respondents who reported a major depressive disorder in 2002 also reported that their social and/or work lives were negatively affected by their illness.
Walter F. Stewart, Ph.D., of the Outcomes Research Institute at Geisinger Health Systems, and his colleagues found that workers with depression reported an average 5.6 hours per week lost productivity time. Eighty-one percent of the lost productivity time was attributable to reduced performance at work.
Q: Can depression be "cured"?
A: No. Depression can be treated, but without ongoing treatment, it will very likely recur.
Q: Everyone talks about being "depressed" once in a while; how can a person recognize the difference between feeling blue and being depressed?A: Five or more of the following symptoms (including at least one of the first two) can indicate what the NIMH calls a "major depressive disorder":
- Persistent sad, anxious, or "empty" mood
- Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
- Feelings of hopelessness, pessimism, guilt, worthlessness, helplessness
- Decreased energy, fatigue, being "slowed down"
- Difficulty concentrating, remembering, making decisions
- Insomnia, early morning wakening, or oversleeping
- Appetite or weight loss or overeating and weight gain
- Thoughts of death or suicide; suicide attempts
- Restlessness; irritability
- Persistent physical symptoms that do not respond to treatment
Q: Are some people more likely to become depressed than others?
A: Yes. Some types of depression run in families. So, some depression (bipolar disorder, for example) may occur in people who have a different genetic makeup than people who do not experience depression.
- People who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress are prone to depression.
- Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness.
- A serious loss, difficult relationship, financial problem, or any stressful change in life pattern can trigger depression.
Q: What are the current approved treatments for depression?
A: Depending upon the severity of the illness and the patient's response, depression can be treated with:
- Psychotherapy (talk therapy)
- Antidepressants (medication)
- ECT (electroconvulsive therapy)
- VNS Therapy™ (vagus nerve stimulation)
Q: What medications are used to treat depression?
A: Typically, the following medicines are used to treat depression:
- Selective serotonin reuptake inhibitors (SSRIs); e.g., Paxil®, Prozac®, Zoloft®
- Serotonin norepinephrine reuptake inhibitors (SNRIs); e.g., Effexor®, Cymbalta®
- Tricyclics; e.g., Tofranil®
- Monoamine oxidase inhibitors (MAOIs); e.g., Eldepryl®, Marplan®, Nardil®, Parnate®
- Bupropion; e.g., Wellbutrin®
- 5HT2 antagonists; e.g., Desyrel®
Q: What is electroconvulsive therapy?
A: Electroconvulsive therapy (ECT), which has also been called “shock therapy,” uses electrodes placed at precise locations on the patient’s head to deliver electrical impulses to the brain. This stimulation causes a brief seizure within the brain. Typically, ECT is reserved for patients whose illnesses are severe or life threatening or who cannot take antidepressants.
More information about depression, its symptoms, treatments, and prognosis is available at www.nimh.nih.gov or nimhinfo@nih.gov.
