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How to Tell If You're Really Depressed

By Dr. Martha E. Wittenberg ; Updated August 14, 2017

Everyone feels sad sometimes, but when those feelings are severe and long-lasting, you may be clinically depressed. Major depression is relatively common and represents a serious global health issue. In 2002, major depression was the fourth leading cause of disability worldwide. The condition is also linked to other serious illnesses. People who are clinically depressed are more likely to develop heart disease, stroke and diabetes. Major depression can increase the mortality rate for people who have had a heart attack or have diabetes or cancer.

Many factors influence your risk for depression, including chemical changes in your brain, certain medications, genetics, early childhood trauma, hormonal changes or life stressors. People at increased risk often have a family history of depression, a history of trauma, poor social support, low self-esteem or substance-abuse problems.

Major depression is defined as experiencing two or more consecutive weeks of a depressed mood and/or the loss of interest in normal activities. Additionally, four or more of the following symptoms must be present: low energy, poor concentration, feelings of guilt or worthlessness, thoughts of death or suicide, changes in sleep patterns, appetite or weight changes, slowed mental and physical activity, or irritability.

If left untreated, periods of depression usually last for three to five months. The diagnosis of depression usually peaks in the 30s, but it can be diagnosed at any age, beginning in childhood. People who are diagnosed young usually have more severe symptoms and are more likely to have recurrent bouts of depression.

Although you may have some symptoms of depression, you could also be suffering from a condition called dysthymia, or dysthymic disorder. This disorder has less severe symptoms than Major Depression, but is more chronic. Dysthymic disorder is defined as a depressed mood for most days of the week, persisting for at least two years. The symptoms can include poor concentration, low energy, sleep and appetite changes, and feelings of hopelessness.

If you think that you are depressed, you do not have to suffer alone. Visit your doctor for a checkup and explain what you are thinking and feeling. Your physician may have you fill out one or more depression questionnaires. She may also review your medications, ask about drug and alcohol use, perform an exam and check blood tests to ensure that there is no underlying medical problem causing your symptoms.

The Initial treatment for depression includes counseling or psychotherapy. During counseling you will speak with a mental health expert to try to understand your feelings. The counselor will help you examine your negative thoughts and behaviors as well as the way you react to stressful situations. Counseling can help you see yourself more positively and improve your outlook on life.

In addition to psychotherapy, physicians use several classes of prescription drugs to treat depression. These drugs work by enhancing the natural brain chemicals that regulate your mood. Selective Serotonin Reuptake Inhibitors, or SSRIs, work to improve the serotonin levels in the brain. Escitalopram, citalopram, fluoxetine and paroxetine are all types of SSRIs. Serotonin-Norepinephrine Reuptake Inhibitors, or SNRIs, enhance both serotonin and norepinephrine levels. Commonly prescribed SNRIs include duloxetine, venlafaxine and desvenlafaxine. A third class of antidepressants, which includes bupropion, improves your levels of norepinephrine and dopamine.

If you and your physician decide to begin medication for your depression, it will take at least four weeks for the medication to begin improving your symptoms. The effectiveness of the medication usually does not peak until at least six to eight weeks. In the interim, counseling may prove helpful. Studies have shown that the combination of counseling and medication works better than either protocol alone.

More severe types of depression may require hospitalization. In extreme cases, when severe depression is resistant to other treatments, electric shock treatment may be used.

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