Depression Easy to Read

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National Institute of Mental Health

depression easy to read


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Contents

Depression: When the blues dont go away 2

What are the symptoms o depression? 3

Can a person have depressionand another illness at the same time? 4

When does depression start? 4

Is there help? 5

Psychotherapy 5

Medications 6

Othertherapies 7

FDAwarningonantidepressants 8

How can I fnd treatment and who pays? 10

Why do people get depression? 11

What i I or someone I know is in crisis? 12

Personal story 13

NationalInstituteoMentalHealth

NationalInstitutesoHealth

U.S.DepartmentoHealth&HumanServices

NIHPublicationNo.075084


4/20 NationalInstituteoMentalHealth

Depression:Whenthebluesdontgoaway

Everyone occasionally eels blue or sad, but these eelingsusually pass within a couple o days. When a person hasdepression, it intereres with his or her daily lie and rou-tine, such as going to work or school, taking care o chil-dren, and relationships with amily and riends. Depres-sion causes pain or the person who has it and or thosewho care about him or her.

Depression can be very dierent in dierent people or inthe same person over time. It is a common but serious ill-ness. reatment can help those with even the most severedepression get better.

Depression is a common but serious illness.Treatment can help those with depression

get better.


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Depression

Whatarethesymptomsodepression?

Ongoingsad,anxiousoremptyeelings

Feelingsohopelessness

Feelingsoguilt,worthlessness,orhelplessness

Feelingirritableorrestless

Lossointerestinactivitiesorhobbiesthatwere onceenjoyable,includingsex

Feelingtiredallthetime

Difcultyconcentrating,rememberingdetails, ordifcultymakingdecisions

Notabletogotosleeporstayasleep(insomnia);

maywakeinthemiddleothenight,orsleep allthetime

Overeatingorlossoappetite

Thoughtsosuicideormakingsuicideattempts

Ongoingachesandpains,headaches,cramps ordigestiveproblemsthatdonotgoaway.

Not everyone diagnosed with depression will have all othese symptoms. Te signs and symptoms may be dierentin men, women, younger children and older adults.


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NationalInstituteoMentalHealth

Canapersonhavedepressionandanotherillnessatthesametime?

Oen, people have other illnesses along with depression.Sometimes other illnesses come rst, but other times thedepression comes rst. Each person and situation is dier-ent, but it is important not to ignore these illnesses and toget treatment or them and the depression. Some illnessesor disorders that may occur along with depression are:

Anxiety disorders, including post-traumatic stress dis-order (PSD), obsessive-compulsive disorder (OCD),panic disorder, social phobia, and generalized anxietydisorder (GAD);

Alcohol and other substance abuse or dependence;

Heart disease, stroke, cancer, HIV/AIDS, diabetes, andParkinsons disease.

Studies have ound that treating depression can help intreating these other illnesses.

Whendoesdepressionstart?

Young children and teens can get depression but it canoccur at other ages also. Depression is more common inwomen than in men, but men do get depression too. Losso a loved one, stress and hormonal changes, or traumatic

events may trigger depression at any age.


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Depression

Istherehelp?

here is help or someone who has depression. Even insevere cases, depression is highly treatable. Te rst stepis to visit a doctor. Your amily doctor or a health clinicis a good place to start. A doctor can make sure that thesymptoms o depression are not being caused by anothermedical condition. A doctor may reer you to a mentalhealth proessional.

Te most common treatments o depression are psycho-therapy and medication.

Psychotherapy

Several types o psychotherapyor talk therapycanhelp people with depression.

Tere are two main types o psychotherapy commonly used

to treat depression: cognitive-behavioral therapy (CB)and interpersonal therapy (IP). CB teaches people tochange negative styles o thinking and behaving that maycontribute to their depression. IP helps people under-stand and work through troubled personal relationshipsthat may cause their depression or make it worse.

For mild to moderate depression, psychotherapy may bethe best treatment option. However, or major depressionor or certain people, psychotherapy may not be enough.

For teens, a combination o medication and psychotherapymay work the best to treat major depression and help keepthe depression rom happening again. Also, a study abouttreating depression in older adults ound that those whogot better with medication and IP were less likely to havedepression again i they continued their combination treat-ment or at least two years.



Medications

Medications help balance chemicals in the brain calledneurotransmitters. Although scientists are not sure exactlyhow these chemicals work, they do know they aect a per-sons mood. ypes o antidepressant medications that helpkeep the neurotransmitters at the correct levels are:

SSRIs (selective serotonin reuptake inhibitors)

SNRIs (serotonin and norepinephrine reuptakeinhibitors)

MAOIs (monoamine oxidase inhibitors)

ricyclics.

Tese dierent types o medications aect dierent chemi-cals in the brain.

Medications aect everyone dierently. Sometimes sev-

eral dierent types have to be tried beore nding the onethat works. I you start taking medication, tell your doctorabout any side eects right away. Depending on which typeo medication, possible side eects include:

Headache

Nausea

Insomniaandnervousness

Agitationoreelingjittery

Sexualproblems

Drymouth

Constipation

Bladderproblems

Blurredvision,or

Drowsinessduringtheday.

Istherehelp?


9/20Depression

St. Johns wort

Te extract rom St. Johns wort (Hypericum peroratum),a bushy, wild-growing plant with yellow owers, has beenused or centuries in many olk and herbal remedies. TeNational Institutes o Health conducted a clinical trial todetermine the eectiveness o the herb in treating adultswho have major depression. Involving 340 patients diag-nosed with major depression, the trial ound that St. Johns

wort was no more eective than a sugar pill (placebo)in treating major depression. Another study is lookingat whether St. Johns wort is eective or treating mild orminor depression.

Other research has shown that St. Johns wort may inter-ere with other medications, including those used to con-trol HIV inection. On February 10, 2000, the FDA issueda Public Health Advisory letter stating that the herb may

interere with certain medications used to treat heart dis-ease, depression, seizures, certain cancers, and organ trans-plant rejection. Te herb also may interere with the eec-tiveness o oral contraceptives. Because o these potentialinteractions, patients should always consult with their doc-tors beore taking any herbal supplement.

Electroconvulsive therapy

For cases in which medication and/or psychotherapy does

not help treat depression, electroconvulsive therapy (EC)may be useul. EC, once known as shock therapy, or-merly had a bad reputation. But in recent years, it hasgreatly improved and can provide relie or people withsevere depression who have not been able to eel better withother treatments.

EC may cause short-term side eects, including conu-sion, disorientation and memory loss. But these side eects

typically clear soon aer treatment. Research has indicatedthat aer one year o EC treatments, patients show noadverse cognitive eects.

Other therapies

Depression


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11/20Depression

Te warning also emphasizes that children, teenagers andyoung adults taking antidepressants should be closely mon-itored, especially during the initial weeks o treatment, orany worsening depression, suicidal thinking or behavior.hese include any unusual changes in behavior such assleeplessness, agitation, or withdrawal rom normal socialsituations.

Results o a review o pediatric trials between 1988 and2006 suggested that the benets o antidepressant medica-tions likely outweigh their risks to children and adolescentswith major depression and anxiety disorders. Te study wasunded in part by the National Institute o Mental Health.

Children, teenagers and young adults taking antidepressantsshould be closely monitored, especially during the initialweeks of treatment, for any worsening depression, suicidalthinking or behavior.


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10 NationalInstituteoMentalHealth

HowcanIfndtreatmentandwhopays?

Most insurance plans cover treatment or depression.Check with your own insurance company to nd out whattype o treatment is covered. I you dont have insurance,local city or county governments may oer treatment at aclinic or health center, where the cost is based on income.Medicaid plans also may pay or depression treatment.

I you are unsure where to go or help, ask your amily doctor.Others who can help are:

Psychiatrists,psychologists,licensedsocialworkers,

orlicensedmentalhealthcounselors

Healthmaintenanceorganizations

Communitymentalhealthcenters

Hospitalpsychiatrydepartmentsandoutpatientclinics

Mentalhealthprogramsatuniversitiesormedicalschools

Statehospitaloutpatientclinics

Familyservices,socialagenciesorclergy

Peersupportgroups

Privateclinicsandacilities

Employeeassistanceprograms

Localmedicaland/orpsychiatricsocieties.

You can also check the phone book under mental health,health, social services, hotlines, or physicians orphone numbers and addresses. An emergency room doctoralso can provide temporary help and can tell you whereand how to get urther help.


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11Depression

Whydopeoplegetdepression?

Tere is no single cause o depression. Depression happensbecause o a combination o things including:

genes some types o depression tend to run in amilies.Genes are the blueprints or who we are, and we inheritthem rom our parents. Scientists are looking or the spe-cic genes that may be involved in depression.

brain chemistry and structure when chemicalsin the brain are not at the right levels, depression can occur.Tese chemicals, called neurotransmitters, help cells in thebrain communicate with each other. By looking at pictureso the brain, scientists can also see that the structure o thebrain in people who have depression looks dierent than inpeople who do not have depression. Scientists are workingto gure out why these dierences occur.

environmental and psychological factors trauma, loss o a loved one, a difcult relationship, andother stressors can trigger depression. Scientists are work-ing to gure out why depression occurs in some people butnot in others with the same or similar experiences. Teyare also studying why some people recover quickly romdepression and others do not.



WhatiIorsomeoneIknowisincrisis?

Iyouarethinkingaboutharmingyoursel,orknowsomeonewhois,tellsomeonewhocanhelpimmediately.

Callyourdoctor.

Call911orgotoahospitalemergencyroomtoget immediatehelporaskariendoramilymemberto

helpyoudothesethings.

Callthetoll-ree,24-hourhotlineotheNational SuicidePreventionLielineat1-800-273-TALK (1-800-273-8255);TTY:1-800-799-4TTY(4889) totalktoatrainedcounselor.

Makesureyouorthesuicidalpersonisnotletalone.

Personalstory


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NowImseeingthespecialistonaregularbasis

ortalktherapy,whichhelpsmelearnwaysto

dealwiththisillnessinmyeverydaylie,andIm

takingmedicineordepression.

Everythingdidntgetbetterovernight,butIfnd

myselmoreabletoenjoylieandmychildren.

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formoreinformationondepression

VisittheNationalLibraryoMedicinesMedlinePluswww.nlm.nih.gov/medlineplusEnEspaol,http://medlineplus.gov/spanish

Forinormationonclinicaltrialsordepressionwww.nimh.nih.gov/studies/index.cm

NationalLibraryoMedicineClinicalTrialsDatabasewww.clinicaltrials.gov

InormationromNIMHisavailableinmultipleormats.Youcanbrowseonline,downloaddocumentsinPDF,andorderpaperbrochuresthroughthemail.IyouwouldliketohaveNIMHpublications,youcanorderthemonlineatwww.nimh.nih.gov.IyoudonothaveInternetaccessandwishtohaveinormationthatsupplementsthispublication,pleasecontacttheNIMHInormationCenteratthenumberslistedbelow.

PleasechecktheNIMHWebsiteathttp://www.nimh.nih.govorthemostup-to-dateinormationonthistopic.

NationalInstituteoMentalHealthScienceWriting,Press&DisseminationBranch6001ExecutiveBoulevardRoom8184,MSC9663Bethesda,MD20892-9663Phone:301-443-4513or1-866-615-NIMH(6464)toll-reeTTY:301-443-8431

TTY:866-415-8051FAX:301-443-4279E-mail:[email protected]:http://www.nimh.nih.gov

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Nin Insiu Mn HhU.S. DepartMeNt of HealtH & HUMaN ServIceS

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NIH pubiin N. 07-5084


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U.S. Department of HealtH & HUman ServiceS

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Depression Easy to Read