Major Depression

What Is It?

Major depression is an illness that involves the way a person thinks and feels. Depression usually involves extreme sadness or a sense of despair, but it can be felt as irritability, a lack of pleasure or interest in pleasurable activities, or a loss of energy. Depression is considered a mood disorder. It comes in many forms with a wide variety of symptoms, and the symptoms can vary significantly between different people. Major depression is more than just a passing blue mood, a "bad day," or temporary sadness over a specific event. The mood changes that come with major depression last for at least two weeks and usually much longer.

Depression usually affects a person's ability to work, sleep, eat and enjoy leisure activities. Many people with depression also have anxiety and tend to worry more about their physical health. They may have problems in their relationships and with sexual functioning. People with depression are more likely to abuse alcohol or other substances.

The cause of major depression is not clear, but it probably involves chemicals called neurotransmitters that carry messages between brain cells. Changes in some hormones may play a role in depression. An episode of depression can be triggered by a stressful life event, such as the death of a loved one. But in many cases, depression does not appear to be related to a specific event. Major depression may occur just once in a person's life or may return periodically throughout life. Some people who have repeated episodes of major depression also have a long pattern of a milder depressed mood called dysthymia. If a woman has a major depressive episode within a month after delivering a baby, it is called postpartum depression. Depression also can occur mainly during the winter months. This condition is called seasonal affective disorder, or SAD.

Episodes of depression can occur at any age. Depression affects women twice as often as men. People who have a family member with major depression are more likely to develop depression or drinking problems.

When major depression alternates with periods of intense happiness and energy, the illness is called bipolar disorder.

Symptoms

A depressed person may notice a weight gain or loss, eat more or less than usual, have difficulty concentrating, and have trouble sleeping or sleep more than usual. He or she may feel tired and have no energy for work or play. The person can appear slowed down or agitated and restless. The symptoms can be quite noticeable to others.

Perhaps the most painful and most dangerous symptom of this illness is an unshakable feeling of worthlessness and guilt. The person may feel guilty about a specific life experience or may feel general guilt not related to anything specific.