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Depression: Major Depression & Unipolar Varieties
Basic Information

Major Depression Resources

Everyone has days where they feel blah, down, or sad. Typically, these feelings disappear after a day or two, particularly if circumstances change for the better. People experiencing the temporary "blues" don't feel a sense of crushing hopelessness or helplessness, and are able, for the most part, to continue to engage in regular activities. Prolonged anhedonia (the inability to experience pleasure), hopelessness, and failure to experience an increase in mood in response positive events rarely accompany "normal" sadness. The same may be said for other, more intense sorts of symptoms such as suicidal thoughts and hallucinations (e.g., hearing voices). Instead, such symptoms suggest that serious varieties of depression may be present, including the subject of this document: Major Depressive Disorder (MDD) or (more informally), Major Depression.

For people dealing with Major Depression, negative feelings linger, intensify, and o...

Fast Facts: Learn! Fast!

What is depression?

  • Major Depression is a serious condition that has physical, psychological, and social symptoms.
  • People experiencing the temporary "blues" don't feel a sense of crushing hopelessness or helplessness, and are able, for the most part, to continue to do their regular activities. For people dealing with Major Depression, negative feelings linger, get stronger, and often become crippling.
  • Major Depression can also be referred to as Unipolar Depression to separate it from Bipolar Depression, which is a different condition.
  • Approximately 1 in 5 women and up to 1 in 10 men may become depressed at some point in their lives.
  • The average age of onset for depression is the mid-20s.
  • Developing depression does not seem to be related to someone's level of education, income, or marital status.

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What are the symptoms of depression?

  • Symptoms can vary a great deal from one person to the next. Typical symptoms include:
    • Trouble sleeping or sleeping too much
    • Being tired and have no energy
    • A dramatic change in appetite resulting in weight loss or gain
    • Feelings of worthlessness, self-hate, and guilt
    • Inability to concentrate, think clearly, or make decisions
    • Agitation, restlessness, and irritability
    • Inactivity and withdrawal from typical pleasurable activities
    • Feelings of hopelessness and helplessness
    • Thoughts of suicide or death
  • Symptoms can also change over time, such as with someone who is initially withdrawn and sad becoming very frustrated and irritable as a result of decreased sleep and the inability to accomplish simple tasks or make decisions.
  • When depression is severe, people may even experience symptoms, such as hallucinations and delusions.

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What are the causes of depression?

  • The biopsychosocial model says that biological, psychological and social factors are all interlinked causes of depression.
  • Depression has been linked to problems or imbalances in the brain with regard to the neurotransmitters serotonin, norepinephrine, and dopamine.
  • A person who has a parent or sibling with depression is almost three times more likely to develop Major Depression than someone with no history of depression in their parents or siblings, which suggests that genetics play a role in the causes of depression.
  • Long-term stress that lasts for a year or more can affect the body's immune system and lead to an increased risk of developing physical illnesses and an increased likelihood of becoming depressed.
  • Psychological factors influencing depression include negative patterns of thinking, low coping skills, judgment problems, and difficulty in understanding and expressing emotions.
  • Personality factors, history and early experiences; and relationships with others are seen as important factors in causing depression.
  • People can also become depressed as a result of social factors such as: experiencing traumatic situations (a family death, divorce, job loss, abusive relationship, etc.), lack of social support/relationships, or harassment (bullying).

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When should I seek help for depression?

  • If your depressed mood lasts for more than two weeks, or is seriously interfering with your ability to function at work, with your family, and in your social life, you should consult with a mental health professional as soon as possible.
  • If you find yourself thinking seriously about suicide, you should make an appointment with a mental health doctor (a psychiatrist, or psychologist) as soon as you can.
  • If you are feeling like you will commit suicide within hours or days unless you receive some relief, then skip making an appointment with a doctor and go immediately to your local hospital emergency room and tell them there that you are feeling suicidal.

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How is depression diagnosed?

  • The diagnosis process often starts with a visit to a primary care doctor who may ask simple questions about your feelings and experiences.
  • A physical examination, medical history and lab tests will be done to determine if your depression is related to a physical condition.
  • If a physical condition is ruled out, then you should see a mental health professional, such as a psychologist or psychiatrist, who will talk with you to learn more about your current problems and symptoms, as well as to obtain a complete history of previous symptoms, a family history, a history of significant stressful life events, and information concerning your lifestyle, social support, alcohol or drug use, and any suicidal thoughts or tendencies you may be experiencing.
  • In order to compare your symptoms to those of other people in order to determine the severity of your symptoms, you may be asked to complete one or more standardized questionnaire forms.

For more information

How is depression treated?

  • It is important to know that depression is a HIGHLY treatable condition.
  • There is no single therapy that works equally well for every depressed person.
  • Depression is most often treated with a combination of medication and psychotherapy.
  • Antidepressants help with some of the brain chemistry causes of depression. Typically this will include either a SSRI (selective serotonin reuptake inhibitor), such as Prozac, Zoloft, or Paxil, or a SNRI (serotonin norepinephrine reuptake inhibitor), such as Wellbutrin or Effexor.
  • Psychotherapy helps people understand and then change the behavioral, cognitive and social patterns that cause or contribute to the depressed mood.
  • More severe cases of depression may require different and more frequent therapy than milder cases.
  • People with severe depression who may be engaging in self-destructive behavior, such as attempting suicide, refusing to eat, refusing to get out of bed, or may be showing signs of psychotic behavior, such as hallucinations and delusions, may require inpatient hospitalization.
  • People sometimes turn to Complementary and Alternative Medicine (CAM) techniques such as traditional Chinese Medicine, Acupuncture, Homeopathy, and Herbal Therapy for relief from their symptoms. Very few of these approaches have been tested in clinical trials for depression, so there is often little scientific evidence to support these practices.
  • One of the best studied and most famous CAM remedies for depression is St. John's Wort, which is an herbal preparation of a plant extract. Research does support this as a stand-alone alternative treatment for depression and in parts of Europe this herb is often the preferred remedy for treating depression.
  • If you are interested in CAM approaches, the best plan is to consult with a qualified CAM practitioner who can help determine which combination of treatments, and in what dosages, would be most beneficial for you.

For more information

Are there self-help methods for depression?

  • Self-help approaches to treating depression are best thought of as additions to professional treatments.
  • People should not delay treating depression professionally, or attempt to treat it solely on their own.
  • The more that you take an active role in helping yourself recover, the better your chances of recovery are likely to be.
  • It is important to accept your diagnosis and to take the medications and other therapies that have been prescribed for you regularly.
  • Accept invitations to social events and maintain your typical social schedule as best you can even if you are not enjoying it as much as you used to.
  • One way to reduce the amount of stress you experience is to prioritize the demands you are facing and then to do only the most pressing tasks.
  • Talk about what is bothering you with a therapist or with friends or family members. If you don't feel comfortable talking, then keep a journal and vent through writing.
  • Regular physical exercise is thought to have an antidepressant effect.
  • One way to regain a sense of control is to educate yourself about your illness.
  • Choosing to make positive improvements in your sleep, eating, drug and alcohol use, exercise, social and spiritual habits can end up helping you improve your mood.

For more information

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Book Reviews
A Heart of Stone
A Mood Apart
A Philosophical Disease
Active Treatment of Depression
Adolescent Depression
Against Depression
American Melancholy
An Unquiet Mind
Beating the Blues
Before Prozac
Beyond Blue
Blaming the Brain
Calm Energy
Conquering Postpartum Depression
Conquering the Beast Within
Cry Depression, Celebrate Recovery
Depression 101
Depression Doesn't Always Have to Be Depressing
Depression Fallout
Depression in Context
Depression Is a Choice
Depression, the Mood Disease
Depression-Free for Life
Doctors of Deception
Down Came the Rain
Dysthymia and the Spectrum of Chronic Depressions
Emotional Claustrophobia
Essential Psychopharmacology of Depression and Bipolar Disorder
Everything Is Fine
Experiences of Depression
Handbook of Depression
Handbook of Depression
History of Suicide
How I Stayed Alive When My Brain Was Trying to Kill Me
In Pursuit of Happiness
Journeys with the Black Dog
Killing the Black Dog
LifeForce Yoga to Beat the Blues--Level 1
LifeForce Yoga to Beat the Blues: Level 2
Lifting Depression
Lincoln's Melancholy
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Malignant Sadness
Manufacturing Depression
Mindfulness-Based Cognitive Therapy for Depression
Mood Genes
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Natural Healing for Depression
New Hope for People with Depression
On Depression
On the Edge of Darkness
Out of the Blue
Outsmarting Depression
Overcoming Depression
Potatoes Not Prozac
Prozac and the New Antidepressants
Prozac Backlash
Prozac Diary
Prozac Nation
Puppy Chow Is Better Than Prozac
Quiet Your Mind & Get to Sleep
Raising a Moody Child
Songs from the Black Chair
Speaking of Sadness
Spontaneous Happiness
Student Depression
Subordination and Defeat
Sunbathing in the Rain
Swing Low
Talking Back to Prozac
The American Psychiatric Publishing Textbook of Mood Disorders
The Anatomy of Melancholy
The Anti-Depressant Fact Book
The Antidepressant Era
The Beast
The Bell Jar
The Breakthrough Depression Solution
The Corrections
The Cruelty of Depression
The Depressed Child
The Depression Cure
The Devil Within
The Emotional Revolution
The Family Silver
The Feeling Good Handbook
The Mood Cure
The Nature of Melancholy
The Noonday Demon
The Postpartum Effect
The Secret Strength of Depression
The Van Gogh Blues
The Van Gogh Blues
Understanding Depression
Undoing Depression
Unholy Ghost
Viniyoga Therapy for Depression
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Basic Information
Introduction and Types of DepressionRelated Disorders / ConditionsHistorical and Current UnderstandingsBiology, Psychology and SociologyTreatment - Medication and PsychotherapyAlternative Medicine and Self-Help ResourcesSpecial IssuesReferences
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Related Topics

Anxiety Disorders
Bipolar Disorder
Addictions: Alcohol and Substance Abuse