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Depression Basics

Some people say that depression feels like a black curtain of despair coming down on them. Many people feel like they have no energy. Or, they can’t focus. Others feel angry all the time for no reason.
The symptoms of depression can be different for each person, but they do disrupt your life. Many people who have had one episode of depression will have another one.
You may start feeling depression symptoms several weeks before you develop major depressive disorder. To help keep your depression from getting worse:

  • Learn to spot triggers or the return of symptoms early.
  • Work with your doctor.

Most people with depression don’t seek help. Treatment could help most of them. Depression can affect all parts of your life. That’s why treating it is so important. Some people with depression try to harm themselves because they think that they’ll never feel better. But depression is a treatable illness.

Life with depression

Working with your doctor, you can learn to manage depression. You may have to try different medicines. Give it time to find one that works best for you. Your doctor may suggest that you see a counselor. He or she may suggest that you make certain lifestyle changes, like getting more exercise.
Improvement in your depression won’t come overnight. But, with the right treatment, you will start to feel better.

Symptoms of Major Depression

Depression, which doctors call major depressive disorder, disrupts your life. These symptoms last two or more weeks. They include:

  • Feeling sad, grouchy, or tense most of the time
  • Less interest or pleasure in usual activities or hobbies
  • Low energy or feeling tired, even when you’re not active
  • Appetite change with weight gain or loss
  • A change in sleeping habits (trouble sleeping, waking early, or sleeping too much)
  • Feeling restless or slowed down
  • Trouble making decisions or concentrating
  • Feeling worthless, hopeless, or guilty
  • Thoughts of suicide or death

If you have one or more of these symptoms, talk with your doctor.
If you’re thinking of suicide, please contact your doctor, or go to your local hospital or emergency room, as soon as possible.
These 16 simple questions can help you see if you have some common symptoms of depression.
Only your doctor can make a diagnosis of depression. This questionnaire is not meant to take the place of seeing your doctor. Your answers can help you discuss your condition with your doctor, and may help him or her diagnose and treat you.

Answer these questions, print out this page, and share it with your doctor.
For each symptom below, choose the items that best describe you over the past seven days:

Falling asleep:


I never take more than 30 minutes to fall asleep.


I take at least 30 minutes to fall asleep, less than half the time.


I take at least 30 minutes to fall asleep, more than half the time.


I take more than 60 minutes to fall asleep, more than half the time.

Sleeping during the night:


I do not wake up at night.


I have a restless, light sleep, waking up briefly a few times each night.


I wake up at least once a night, but I go back to sleep easily.


I wake up more than once a night and stay awake for 20 minutes or more, more than half the time.

Waking too early:


Most of the time, I wake up no more than 30 minutes before I need to get up.


More than half the time, I wake up more than 30 minutes before I need to get up.


I almost always wake up at least one hour or so before I need to, but I go back to sleep sooner or later.


I wake up at least one hour before I need to and can’t go back to sleep.

Sleeping too much:


I sleep no more than 7-8 hours/night, without napping during the day.


I sleep no more than 10 hours a day, including naps.


I sleep no more than 12 hours a day, including naps.


I sleep more than 12 hours a day, including naps.

Feeling sad:


I do not feel sad.


I feel sad, less than half the time.


I feel sad, more than half the time.


I feel sad, nearly all the time.

Less hungry:


There is no change in my usual appetite.


I eat slightly less often or less food than usual.


I eat much less than usual and only if I make myself.


I rarely eat within a 24-hour period, and only if I force myself, or when others make me eat.

More hungry:


There is no change from my usual appetite.


I feel a need to eat, more often than usual.


I regularly eat, more often and/or more food than usual.


I feel driven to overeat, both at mealtime and between meals.

Weight loss (within the past two weeks):


I have not had a change in my weight.


I feel as if I’ve had a slight weight loss.


I have lost two to four pounds.


I have lost five pounds or more.

Weight gain (within the past two weeks):


I have not had a change in my weight.


I feel as if I’ve had a slight weight gain.


I have gained two to four pounds.


I have gained five pounds or more.



There is no change in my being able to concentrate or make decisions.


I sometimes can’t make decisions or find that my attention wanders.


Most of the time, I struggle to focus my attention or make decisions.


I can’t focus myself well enough to read or make even minor decisions.

View of myself:


I see myself as worthwhile and deserving as other people.


I blame myself for things more than usual.


I largely believe that I cause problems for others.


I think almost constantly about major and minor flaws in myself.

Thoughts of death or suicide:


I do not think of suicide or death.


I feel that life is empty or wonder if it’s worth living.


I think of suicide or death several times a week for several minutes.


I think of suicide or death several times a day in some detail, or I have made specific plans for suicide, or I have actually tried to take my life.

Call your doctor right away if you have thoughts of suicide.


Interest level:


There is no change from usual in how interested I am in other people or activities.


I notice that I am less interested in people or activities.


I find I have interest in only one or two of the activities I used to enjoy.


I have virtually no interest in the activities I used to enjoy.

Energy level:


There is no change in my usual level of energy.


I get tired more easily than usual.


I have to make a big effort to start or finish my usual daily activities (for example, shopping, homework, cooking, or going to work).


I really can’t carry out most of my usual daily activities because I just don’t have the energy.

Feeling slowed down:


I think, speak, and move at my usual rate of speed.


I find that my thinking is slowed down or my voice sounds dull or flat.


It takes me several seconds to answer most questions and I’m sure my thinking is slowed.


I am often unable to answer questions without extreme effort.

Feeling restless:


I do not feel restless.


I often fidget, wring my hands, or need to shift how I am sitting.


I have impulses to move about and am quite restless.


At times, I can’t stay seated and need to pace around.

Other Types of Depression

Depressive disorders come in different forms, just like many other illnesses. In addition to major depression, other common types include:

  • Dysthymia. People who have dysthymia may feel mildly depressed on most days for at least two years. They have many depression symptoms, but the symptoms are less severe than with major depressive disorder.
  • Seasonal affective disorder. This illness has the same symptoms as major depressive disorder. But, in seasonal affective disorder, the symptoms return during certain seasons, usually in the fall and winter. While the exact cause is unknown, this illness is thought to be related to seasonal variations of light, as well as changes in certain brain chemicals which may induce feelings of depression.
  • Postpartum depression. This type of depression can occur in women who recently have given birth. It usually happens in the first months after delivery. But it also can happen in the first year after giving birth. The symptoms are the same as major depressive disorder. Often, postpartum depression keeps the mother from bonding with her newborn. It is very important to seek help if you have postpartum depression. Postpartum depression is different from the “baby blues,” which tends to occur during the first few days after delivery and then gets better on its own.

Bipolar disorder is a complex mood disorder that can have some of the same symptoms as major depression. The word bipolar refers to the disorder’s two extremes, mania and depression. The treatments for bipolar disorder are usually different from treatments for major depression.

Causes of Depression

Depression often doesn’t have just one cause. It can be caused by a number of things together. You may have no idea why you have become depressed.
Whatever its cause, depression is not just a state of mind. It is linked to changes in your brain. It may be caused by an imbalance of certain chemicals that carry signals in your brain. These chemicals are called neurotransmitters.
Some of the more common factors involved in depression are:

  • Family history. Genes play an important part in depression. It can run in families for generations.
  • Painful life events and stress. Painful events, like the breakup of a relationship, or the death of a loved one, can trigger depression. You can also get depressed after big life changes, like starting a new job, graduating, or getting married.
  • Negative personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed.
  • Health conditions. Serious medical conditions, like heart disease, cancer, and HIV, may trigger depression. This may be due to the physical weakness and stress they bring on. Depression can make medical conditions worse, since it may weaken the immune system and make pain harder to bear.

Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.

Who Gets Depression?

 Depression isn’t a normal part of life, whatever your age, sex, or health status is. But anyone can have it.

  • Women are more likely to become depressed than men. The higher risk may be due in part to hormone changes during a woman’s life.
  • Men are less likely than women to get help for depression. They may show the common symptoms of depression. But they’re more likely to be angry and hostile. They’re also more apt to mask their condition with alcohol or drug abuse. The risk of suicide is greater for men than for women.
  • Elderly. Older people may lose loved ones. Often, they have to get used to living alone. They may become physically ill and less active than they once were. These changes can raise the risk of depression. Loved ones may think the signs of depression are a normal part of aging, and many older people don’t want to talk about their symptoms. So, older people may not get treatment for their depression.

Depression & Anxiety

Depression and anxiety disorders often occur together. Feeling lonely, hopeless, and sad due to depression can make you afraid and anxious. In turn, feeling afraid and anxious may make you tired and more depressed. It’s a cycle.
There are several types of anxiety disorders. Each has its own symptoms. But they all have these things in common:

  • Extreme fear and dread, even when there is no real danger
  • Emotional distress that interferes with daily life
  • Making changes to avoid situations that bring on anxiety

Like depression, anxiety disorders are treatable with counseling, medicine, or both. Your healthcare provider can discuss treatments for anxiety disorders with you.

Treating Depression
Depression can make you feel hopeless. But, by just taking the first step, deciding to get treatment, can make a difference.

Depression is treatable. Most people, even those with severe depression, improve with treatment. The main ways to treat depression are medicine, counseling (talk therapy), or both.
Your doctor will decide on your treatment based on:

  • How severe your depression is
  • How long your symptoms last
  • The history of your depression

Medicines for depression
Medicines for depression are thought to work by balancing chemicals in the brain. To decide which medicine is best for you, your doctor will take into account:

  • Your symptoms
  • Other medical conditions you have
  • Medicines you take
  • Possible side effects

If your doctor prescribes medicine for depression, give it time. Many people don’t stay on depression medicine long enough for it to work well. It may take a couple of weeks or more before you notice a change in your mood. It may be even longer before you feel the medicine’s full effect.
Your doctor will decide how long you need to stay on medicine. Following your doctor’s directions is key to your treatment success.
Depression medicines developed during the past decade tend to have fewer side effects than older ones. But even the newer medicines may cause side effects.

Some common side effects of medicines for depression include:

  • Nausea
  • Dry mouth
  • Diarrhea or constipation
  • Sexual side effects
  • Dizziness
  • Problems sleeping or drowsiness
  • Nervousness/anxiety
  • Headache
  • Weakness/loss of strength

Talk with your doctor if you have questions about your medicine, or if you have problems you think may be linked to your medicine.

  • Urgent Care
  • Wound Care
  • Echocardiogram
  • Stress Test
  • Ultrasound
  • Holter Monitoring
  • X-Rays
  • Laboratory
  • IV antibiotics
  • Breathing Treatment


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