Depression Overview

Definition

Feelings of depression are synonymous with feeling sad, blue, down in the dumps, unhappy, and miserable. Depression is a term that people commonly use to refer to states involving sadness, dejection, lack of self-esteem, and lack of energy. In this overview, several types of depression are identified:

• Depressed mood: An emotional state dominated by feelings of sadness, gloominess, or emptiness, which may be associated with lack of energy. This mood state may be a temporary response to an unhappy or stressful event, or it may be persistent.
• Chronic low-grade depression, also known as dysthymia: Depressed mood is present most of the time for a period of two years, and is accompanied by changes in energy, appetite, or sleep, as well as low self-esteem and feelings of hopelessness. These symptoms cause distress and difficulty in functioning, but are not as severe as in major depression (see dysthymia for further information). People who suffer from dysthymia are at increased risk for episodes of major depression. This produces a situation in which mild depression is present most of the time, with occasional periods of more severe depressive symptoms. This is commonly called "double depression."
• Major depression: Severe, persistent depressed mood and loss of interest or pleasure in normal activities, accompanied by decreased energy, changes in sleep and appetite, and feelings of guilt or hopelessness. These symptoms must be present for at least two weeks, cause significant distress, and be severe enough to interfere with functioning. If the depression is very severe, it may be accompanied by psychotic symptoms or by suicidal thoughts or behaviors (see major depression for more information). See also major depression; depression in the elderly and adolescent depression. Alternative Names Blues; Dejection; Discouragement; Gloom; Mood changes; Sadness ConsiderationsMost feelings of depression are a reaction to an unhappy event. It is natural to have some feelings of sadness after a loss such as the death of a relative, or after a major disappointment at home or at work. Depression is more prevalent in women than men and is especially common among adolescents. Mild depression comes and goes and is characterized by downheartedness, sadness, and dejection. Short-term episodes of depression or other mood changes can occur with hormone changes, including those that accompany pregnancy or premenstrual syndrome (PMS), and those occurring shortly after the birth of a baby (postpartum "blues"). Sleep disruption and lack of sunlight during the winter months are other biological factors that can precipitate depressive symptoms. Distorted thought patterns, characterized by feelings of worthlessness, helplessness, and hopelessness are part of the "cognitive triad of depression," and can be a risk factor for depression. It appears that a tendency toward depression is often genetic, but that stressful life circumstances usually play a major role in bringing on depressive episodes. Problems with depression usually begin in adolescence, and are about twice as common in women as in men. Noticeably disturbed thought processes, poor communication and socialization, and sensory dysfunction indicate moderate depression. People with severe depression are withdrawn, indifferent toward their surroundings, and may show signs of delusional thinking and limited physical activity. Common Causes