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About Depressive Illness

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More than 12 million Americans suffer from depressive illness each year. The cost in human suffering cannot be estimated.  Depressive illnesses impact everyday functioning and cause pain not only to those who have a disorder, but also to those who care about them.  Depression can be devastating for families, but it also has a profound effect on society at large.  Lost workdays, impaired performance on the job, and the cost of psychological and medical treatment are estimated at costing $43 billion a year.

 A depressive disorder is a "whole body" illness, interfering with the way you eat and sleep, the way you feel about yourself, and the way you think about the world.  It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Causes include one or more of these factors: shortage or imbalance of certain chemicals in the brain, stressful life changes (negative or positive), family history of depression, major illness or injury, and drugs (including alcohol and over-the-counter, used alone or in combination). Without treatment, symptoms can last for weeks, months, or years.  

 Among all psychiatric conditions, depressive illnesses are the most responsive to treatment.   Yet, sadly, only about a third of those who have them are receiving treatment. Family members and friends can learn to recognize depressive symptoms and then seek help for themselves or their loved ones.  Anyone who has several of the following symptoms for two weeks or longer may have a depressive disorder and should seek assessment immediately from a qualified mental-health professional: 

·        Persistent sad, "empty" or numb feelings most of the day, nearly every day

·        loss of interest or pleasure in activities that were once enjoyed, including sex

·        significant changes in weight or appetite

·        sleep disturbance (insomnia, night waking or sleeping too much)

·        fatigue or loss of energy

·        feelings of worthlessness or inappropriate guilt

·        poor personal care

·        problems thinking, concentrating, remembering or making decisions

·        restlessness, irritability

·        feelings of hopelessness

·        persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

·        recurrent thoughts of death or suicide

 Depression in young people may have some of the same symptoms but may also look different than it does in adults.  Because of emotional and cognitive immaturity, children are less able to talk about their internal experiences in ways other people can understand.  They are more likely to act out their feelings of distress than to be able to talk about them directly. This makes it easier for parents to minimize their depression or miss it completely.  When adults address oppositional behavior but ignore the emotional distress underlying such behavior, the problems may get worse instead of better.  Children may appear to be sad, cry frequently, lose interest in activities and express feelings of worthlessness.  However, particularly with younger children, such symptoms may alternate with periods of play and normal appearing behavior.  Irritability, hyperactive behavior, falling academic performance, and use of alcohol or drugs are frequently seen in depressed youngsters.  Prolonged depression can lead to suicide, the third leading cause of death for 15 to 24-year-olds, and the sixth for 5 to 15-year-olds. When a child's mood or behavior interferes with his functioning at home or at school and persists beyond a few weeks, an evaluation is needed.

 The best treatment for depression is usually a combination of psychotherapy and medication.  Psychotherapy helps people understand some of the reasons for the depression and helps identify ways to cope and change.  Medications, when recommended by a physician, can help relieve the symptoms of depression.  Such medications are not addictive and can serve as a chemical "crutch" while the person heals.