Depression: more than the blues
What is depression? While everyone feels down or sad at times, individuals with a clinical illness of depression, also called a depressive episode, have low moods that get “stuck” and interfere with everyday activities. A depressive episode is a syndrome of low mood, energy and cognition that can cause changes in appetite, sleep, and memory that lasts for at least two weeks. Sadness, frequent crying, severe anxiety, and withdrawal from social activity can be present. Often these symptoms are so severe that people feel hopeless and even lose the will to live or think of suicide.
Some people recognize that they are going through a change that is abnormal, and others may not.
A depressive episode can be part of Major Depressive Disorder or Bipolar Disorder–complex neurobiological illnesses involving chemicals that transmit signals in the brain, hormonal systems and the sleep regulation system. These signals allow parts of the brain to communicate with each other, but in depression, the emotional (limbic) and rational (cognitive) circuits in the brain are impaired.
A depressive episode can be caused by stress, environmental or biological triggers. Stressful life events can cause the initial sadness, but the symptoms may then continue even when the stressor is resolved. Environmental triggers such as change of the seasons may play a role, as can the use of drugs or alcohol. Biological triggers can start an episode, including illnesses like thyroid disease, cancer, or heart disease; hormones such as cortisol or reproductive hormones, or some medications such as pain medications, or steroids.
Medications and psychotherapy can be very effective to treat a depressive episode, and both treatments help the brain to regain health and prevent future episodes. For many, in addition, a healthy lifestyle can improve how they feel. A healthy diet, regular exercise, a regular sleep schedule, eliminating recreational drug use and limiting alcohol use can improve sleep, appetite and energy.
If depression is severe, you should see your primary care doctor, psychiatrist or therapist or counselor. If you are having thoughts of suicide, please seek medical attention immediately. In addition to professional assistance, family and friends who understand that depression is an illness can be good sources of support during this difficult time.
If you feel that you or a loved one may have depression, please contact your primary health care provider, the Penn State Hershey Medical Center at 717-514-8338 or the Pennsylvania Psychiatric Institute at 717-782-6420.
Photo by Penn State Milton S. Hershey Medical Center.
Dr. Erika F. H. Saunders is associate professor and chair of psychiatry at Penn State Milton S. Hershey Medical Center and Penn State College of Medicine.
