WHAT IS A DEPRESSIVE DISORDER?

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

TYPES OF DEPRESSION

Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. This pamphlet briefly describes three of the most common types of depressive disorders. However, within these types there are variations in the number of symptoms, their severity, and persistence.

Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.

A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.

Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.

SYMPTOMS OF DEPRESSION AND MANIA

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Depression

• Persistent sad, anxious, or "empty" mood

• Feelings of hopelessness, pessimism

• Feelings of guilt, worthlessness, helplessness

• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

• Decreased energy, fatigue, being "slowed down"

• Difficulty concentrating, remembering, making decisions

• Insomnia, early-morning awakening, or oversleeping

• Appetite and/or weight loss or overeating and weight gain

• Thoughts of death or suicide; suicide attempts

• Restlessness, irritability

• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Mania

• Abnormal or excessive elation

• Unusual irritability

• Decreased need for sleep

• Grandiose notions

• Increased talking

• Racing thoughts

• Increased sexual desire

• Markedly increased energy

• Poor judgment

• Inappropriate social behavior

HOW TO HELP YOURSELF IF YOU ARE DEPRESSED

Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:

• Set realistic goals in light of the depression and assume a reasonable amount of responsibility.

• Break large tasks into small ones, set some priorities, and do what you can as you can.

• Try to be with other people and to confide in someone; it is usually better than being alone and secretive.

• Participate in activities that may make you feel better.

• Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help.

• Expect your mood to improve gradually, not immediately. Feeling better takes time.

• It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation.

• People rarely "snap out of" a depression. But they can feel a little better day-by-day.

• Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.

• Let your family and friends help you.