Depression,Common,Characterist health Depression

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Common Characteristics of DepressionNow and then, everyone feels down; differentiating normalsadness from clinical depression is sometimes difficult. In response tolife circumstances--for example, the loss of a loved one or job, or anillness--all of us become sad, and some of us become depressed--acondition commonly referred to as reactive depression. Others,particularly people with a family history of depression, seem to havean inherited tendency for depression and may become depressed in theabsence of obvious external distress or upset.Diagnosis of DepressionThe American Psychiatric Association has defined depression, inpart, as "loss of interest or pleasure in all or almost all usualactivities and pastimes." As a clinical condition, depression isusually identified by the extent to which its symptoms interfere withnormal functioning. In contrast, the feelings of melancholy that are anatural consequence of stressful or sorrowful life events are moretransitory. Grief is dealt with more or less philosophically, the senseof self remains intact and the daily round of involvements is resumed.Stressful circumstances that can result in depression may occurat any age from infancy through old age. Hereditary depression also mayoccur at any age, and it tends to recur. Very often, it alternates withperiods of extreme euphoria--a condition often referred to asmanic-depression.In diagnosing depression, at least four of the followingsymptoms must be present most of the time for a minimum of two weeks(except in children under 6 years of age, in which case at least threeof the first four must be noted): (1) altered eating habits, manifestedby marked increase or decrease in appetite and significant change inweight; (2) insomnia or excessive sleepiness; (3) hyperactivity orslowed movement; (4) loss of interest or pleasure in usual activitiesor decrease in sexual drive; (5) loss of energy or fatigue; (6)feelings of worthlessness, guilt or self-reproach; (7) reduced abilityto concentrate or think, and (8) recurrent thoughts of death or suicideor attempted suicide. Some symptoms of depression, such as feelings of guilt or inadequacy,may be apparent only to the person experiencing them. But thesefeelings in turn bring about changes in attitudes and behavior that arenoticeable to friends, family, colleagues: a withdrawal from the usualrelationships; an inability to find pleasure in the normal joys ofliving; overreacting to the minor irritations of daily life; emotionalinstability and inexplicable mood swings; impaired concentration;crying spells, anxiety attacks and an increasing inability to get outof bed in the morning to face the day's responsibilities.Physical symptoms also may appear--insomnia, headaches,gastrointestinal disturbances and, in some cases, a change in appetiteor sexual function.A child of any age may be sending out signals for help indealing with a depression when he or she complains of headaches andcramps with no physical cause; refuses to see friends; has ragingtantrums for no reason; neglects schoolwork, and is self-destructive.A transitory post-partum depression--also known as"after-the-baby blues"--is a common and normal condition that mayaffect both parents. However, if the new mother's feelings ofhelplessness or entrapment and resentment persist to the point whereshe keeps losing sleep or is afraid to handle the baby because shethinks she might harm it, professional help is needed.Depression may also manifest itself as a reaction--probablybiochemical--to such infectious diseases as hepatitis, mononucleosisand tuberculosis. A number of drugs, particularly central nervoussystem depressants, or "downers," especially alcohol and barbituratesamong others, also may be responsible for feelings of depression. Treatment of DepressionSome people with a genetic tendency to recurrent sieges of milddepression are able to deal with the problem without medication. Theyfind relief in working at meaningful and productive tasks, in spendingtime with friends who enhance their self-esteem or in regularlyscheduling strenuous exercise, which may be alternated with periods ofrelaxation or medication. In many patients, antidepressant drugs along with or followed bycounseling may be required. Most studies have shown that psychotherapyand medication are complementary and additive in value. The medicationseems to affect the specific symptoms and the psychotherapy affects theproblems of living. The most commonly prescribed types of drugs are:Tricyclic antidepressants. These drugs work through the centralnervous system to relieve the symptoms. Most take several days or evenup to four to six weeks to have their full effect. Some tricyclicantidepressants are combined with anti-anxiety agents if anxiety ispresent.Monoamine oxidase (MAO) inhibitors. These drugs block the actionof an enzyme that aids in the breakdown of certain chemicals in thebrain. They are faster acting than the tricyclic antidepressants,usually working within several days. People taking MAO inhibitors mustbe careful not to eat foods containing tyramine--for example, certaintypes of ripe cheese or red wine--because the combination may lead todangerously elevated blood pressure. They should obtain a diet sheetfrom their physician with details of foods to be avoided.Lithium salts. These are naturally occurring crystalline salts,used to treat manic depression, a disorder marked by extreme moodswings from exhilaration to deep depression. They may be given incombination with an anti-depressive drug during the acute phase, andthen be taken alone to prevent the mood swings. The lithium dosageshould be carefully monitored by a doctor, since even a slight overdosemay have toxic effects.Other non-drug treatments are also available, and may berecommended, depending upon the severity and duration of thedepression. Summing UpDepression can be a serious illness that interferes with one's abilityto function and cope with life's adversities. Fortunately, a number ofeffective treatments for depression have been developed, and mostpeople now recognize that telling a depressed person to "buck up" isnot likely to do any good. Most cases of depression improve within afew months of treatment. Even when symptoms continue beyond that time,they are likely to be sufficiently alleviated so that the patient canresume most normal activities; at the same time, he can learn how toavoid unnecessarily stressful situations and achieve an increasinglevel of equanimity through an individually prescribed combination ofself-awareness, suitable medication and--where indicated--a program ofcounseling, psychotherapy or other treatments. Article Tags: Mood Swings, Tricyclic Antidepressants