Bravo, Rocio

MT 11.07.07

DEPRESSION

Throughout the course of our lives, we all experience episodes of unhappiness,

sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy

or difficulty such as divorce or loss of a job, we may feel depressed. Most of us

are able to cope with these and other types of stressful events. Depressive

disorders come in different form; three of the most common types of depressive

disorders are discussed below.

TYPES

Major Depression - Major depression is characterized by a persistent sad mood

and/or an inability to experience pleasure. These symptoms are constant,

interfering with the ability to lead a productive and enjoyable life. Left untreated, a

major depressive episode typically lasts for about six months. Some people may

experience just a single episode of depression in their lifetime, but more

commonly, major depression is a recurring disorder.

Atypical Depression - Atypical depression is a common subtype of major

depression. It features a specific symptom pattern, including a temporary mood

lift in response to positive events. You may feel better after receiving good news

or while out with friends. However, this boost in mood is fleeting. Other symptoms

of atypical depression include weight gain or significant increase in appetite,

sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to

rejection.

Dysthymia - Dysthymia, or dysthymic disorder, is a type of “low-grade”

depression that lasts for at least two years. Dysthymia is less severe than major

depression, but the chronic symptoms prevent one from leading life to the fullest.

If you have dysthymic disorder, you are mildly to moderately depressed on more

days than not, although you may have brief periods of normal mood. Many

people with dysthymia also experience major depressive episodes, a condition

known as “double depression”.

Seasonal Affective Disorder (SAD) - Some people who experience recurring

episodes of depression show a seasonal pattern known as seasonal affective

disorder (SAD). SAD is a major depression that occurs in the fall or winter when

the amount of sunlight is limited. In SAD, the depression goes away once the

seasons turn again in the spring. SAD is more common in northern climates and

in younger people.

Postpartum Depression - Many new mothers suffer from some fleeting form of

the “baby blues.” Postpartum depression, in contrast, is a longer lasting and

more serious depression thought to be triggered by hormonal changes

associated with having a baby. Postpartum depression usually develops soon

after delivery, but any depression that occurs within six months of childbirth may

be postpartum depression.

CAUSE
A serious loss, chronic illness, relationship problems, work stress, family crisis,

financial setback, or any unwelcome life change can trigger a depressive

episode. Very often, a combination of biological, psychological, and

environmental factors are involved in the development of depressive disorders,

as well as other psychological problems.

SIGNS AND SYMPTOMS

Feelings of helplessness and A bleak outlook—nothing will ever get better and

hopelessness there’s nothing you can do to improve your

situation.
Loss of interest in dailly No interest in or ability to enjoy former hobbies,

activities pastimes, social activities, or sex.

Appetite or weight changes Significant weight loss or weight gain—a change

of more than 5% of body weight in a month.

Sleep changes Either insomnia or oversleeping (also known as

hypersomnia).
Psychomotor agitation or Either feeling “keyed up” and restless or sluggish

retardation and physically slowed down.

Loss of energy Feeling fatigued and physically drained. Even

small tasks are exhausting or take longer.

Self-loathing Strong feelings of worthlessness or guilt. Harsh

criticism of perceived faults and mistakes.

Concentration problems Trouble focusing, making decisions, or

remembering things.
Irritability Easily annoyed or frustrated. Lashing out in

anger or snapping at others.

Aches and pains New or worse physical symptoms, including

headaches, backaches, diarrhea or constipation,

 abdominal pain, and aching joints.
People suffering from depression often show distorted thinking. Everything looks

bleak to them, and they hold extremely negative views about themselves, their

situation, and the future. Trapped in their pessimism, they obsess over their

problems and blow them out of proportion. Unable to see a light at the end of the

tunnel, they may even start to see suicide as their only way out.

TREATMEANT

Exercise: According to a report published in Psychosomatic Medicine, regular

(3-4 times per week) exercise may fight depression just as effectively as

prescription medication (anti-depressants).

Massage: The most obvious way in which massage can aid with symptoms of

depression is that massage feels wonderful and, as previously stated, touch

often has an uplifting effect on a person's mood. Massage also relieves pain,

both by promoting the production of mood-enhancing biochemicals and also by

improving circulation, loosening muscles and easing tightness in tense areas.

Psychotherapy: The psychotherapy is another good way to fight depression.

Though many people often mistake psychotherapy for counseling, it involves

listening to the depressed person and drawing out an intervening subject. It is

practiced only by psychotherapist. It is a very good method to fight depression.

Medication: Selective serotonin reuptake inhibitors (SSRIs). Doctors often

consider selective serotonin reuptake inhibitors, such as fluoxetine (Prozac,

Sarafem), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and

escitalopram (Lexapro), as the first-line treatment for depression because they

have fewer serious side effects. They seem to work by increasing the availability

of the neurotransmitter serotonin in your brain. Drugs similar to SSRIs include

serotonin and norepinephrine reuptake inhibitors (SNRIs), such as trazodone

(Desyrel, Trialodine) and venlafaxine (Effexor), and dopamine reuptake inhibitors,

such as bupropion (Wellbutrin).

Tricyclic and tetracyclic antidepressants. These medications also affect

neurotransmitters, but by a different mechanism than that of SSRIs. They may be

used for any type of depression, be it mild or severe. Among tricyclic

antidepressants are amitriptyline, desipramine (Norpramin), nortriptyline (Aventyl,

Pamelor), protriptyline (Vivactil), trimipramine (Surmontil), and a combination of

perphenazine and amitriptyline. Tetracyclics include maprotiline and mirtazapine

(Remeron).

Monoamine oxidase inhibitors (MAOIs). These drugs, which include

phenelzine (Nardil) and tranylcypromine (Parnate), prevent the breakdown of

neurotransmitters. The drugs have potentially serious side effects if combined

with certain other medications or food products. Doctors rarely use them unless

other options have failed. Your doctor may prescribe them if you have chronic

depression and eat or sleep excessively.

Stimulants. Your doctor may initially prescribe a stimulant such as

methylphenidate (Ritalin, Concerta), dextroamphetamine (Dexedrine, Dextrostat)

or modafinil (Provigil) if you can't take antidepressants because they're

contraindicated due to another medical condition. These medications are also

sometimes given in conjunction with antidepressants.

Lithium and mood-stabilizing medications. Doctors prescribe lithium (Eskalith,

Lithobid), valproic acid (Depakene), divalproex (Depakote) and carbamazepine

(Tegretol, Carbatrol) to treat bipolar depression. Medications called atypical

antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal) and

quetiapine (Seroquel) were initially developed for treatment of psychotic

disorders. Doctors sometimes also use them to treat bipolar disorder.