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Understanding Depression

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Depression Information Health Report
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Symptoms & Treating Depression

Sadness touches all of our lives at different times, but depression can have enormous depth and staying power. It is more than a passing bout of sadness or dejection, or feeling down in the dumps. It can leave you feeling continuously burdened and can sap the joy out of once pleasurable activities.

Thankfully, effective treatment is available. One study found that those who stuck with treatment, depression lifted completely in seven out of 10 people.

Treatment can lighten your mood, strengthen your connections with loved ones, allow you to find satisfaction in interests and hobbies, and make you feel more like yourself again.

This report provides in-depth information on treatment options, including medication, therapy, exercise, and new approaches such as transcranial magnetic stimulation. You’ll also learn about the biology of depression and bipolar disorder. The report also includes a special section with practical tips for overcoming treatment hurdles and getting the best treatment.

Prepared by the editors of Harvard Health Publications in collaboration with Michael Craig Miller, M.D., Editor-in-Chief, The Harvard Mental Health Letter, Assistant Professor of Psychiatry, Harvard Medical School. 48 pages. (updated: 2008)

Table of Contents:

  • What is depression?
    • What is major depression?
    • What is dysthymia?
    • What is bipolar disorder?
  • What causes depression?
    • The brain
    • Genes
    • Stressful life events
    • Medications
    • Medical problems
  • Suicide: Recognizing the risk
    • Other grounds for concern
  • How is depression diagnosed?
  • Treating depression
    • What you should know about medications
    • Medications for depression
    • Medications for bipolar disorder
    • Psychotherapy for depression and bipolar disorder
    • Electroconvulsive therapy
    • Newer approaches
  • Complementary and alternative treatments for depression
    • Herbs and supplements
    • Exercise
    • Mindfulness meditation
  • Strategies for success: Tips for leaping common hurdles and getting good treatment
    • Overcoming stigma
    • Navigating the health care system
    • Finding the right treatment
    • Sticking with treatment
    • Tips for managing side effects
  • The problem of recurrence
    • Aggressive treatment pays off
    • Keeping up with medication
  • Getting help
  • Depression, sex, and age
    • Differences among the sexes
    • Children and teenagers
    • Older adults
  • Glossary
  • Resources

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Here's an Excerpt from this Depression Special Health Report

Some people find that the first medication they try delivers great results: their depression lifts, they feel more like themselves, and they have few or no side effects. But for many others, finding the right medication is a frustrating exercise in trial and error.

What if a simple test could tell you what medication is right for you? Right now, such a test doesn’t exist. But as researchers uncover which genes influence mood and clarify their function, the hope is that these discoveries will make this kind of testing possible and will eliminate some of the guesswork involved in prescribing antidepressants.

In effect, depression may be many diseases, not a single one. Scientists have found that dozens of genes affect mood, and as our genetic endowments differ, so do our depressions. That may be more apparent when symptoms differ—for example, when one person experiences depression as profound sadness and another primarily feels listless and takes pleasure in nothing. But even when symptoms are similar, the underlying causes may vary—and thus the same drug that works marvelously for one person may have little effect on another.

If gene- and protein-based work being done in labs today fulfills its promise, future patients will receive different medicines for different types of depression. Researchers are pursuing the goal of targeting medication more effectively one “snip” at a time. Those snips, or SNPs, are single nucleotide polymorphisms—small variations in the DNA sequence that can have big consequences.

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