Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Depression facts
- What is a depressive disorder?
- What are myths about depression?
- What are the types of depression, and what are depression symptoms and signs?
- Depression symptoms and signs in men
- Depression symptoms and signs in women
- Depression symptoms and signs in teenagers
- Depression symptoms and signs in children
- What are the risk factors and causes of depression?
- Postpartum depression
- What tests do health-care professionals use to diagnose depression?
- What treatments are available for depression?
- What is the general approach to treating depression?
- What about sexual dysfunction related to antidepressants?
- What about discontinuing antidepressants?
- What are complications of depression?
- What is the prognosis for depression?
- Is it possible to prevent depression?
- What about self-help and home remedies for depression?
- How can someone help a person who is depressed?
- Where can one seek help for depression?
- What is in the future for depression?
- Where can people find more information about depression?
- Depression FAQs
- Find a local Psychiatrist in your town
What are myths about depression?
The following are myths about depression and its treatment.
- It is a weakness rather than an illness.
- If the sufferer just tries hard enough, it will go away.
- If you ignore depression in yourself or a loved one, it will go away.
- Highly intelligent or highly accomplished people do not get depressed.
- Poor people do not get depressed.
- People with developmental disabilities do not get depressed.
- People with depression are "crazy."
- Depression does not really exist.
- Children, teens, the elderly, or men do not get depressed.
- There are ethnic groups for whom depression does not occur.
- Depression cannot look like (present as) irritability.
- People who tell someone they are thinking about committing suicide are only trying to get attention and would never do it, especially if they have talked about it before.
- People with depression cannot have another mental or medical condition at the same time.
- Psychiatric medications are all addicting.
- Psychiatric medications do not work; any improvement felt is in the sufferer's imagination.
- Psychiatric medications are never necessary to treat depression.
- Medication is the only effective treatment for depression. Children and teens should never be given antidepressant medication.
What are the types of depression, and what are depression symptoms and signs?
The pattern of symptoms may fit a pattern within any type of depression. For example, a person who suffers from persistent depressive disorder, major depressive disorder, bipolar disorder, or any other illness that includes depression can have prominently anxious, melancholic, mixed, psychotic, or atypical features. Such features can have a significant impact on the approach to treatment that may be most effective. For example, for the person whose depression includes prominent anxiety, a focus of treatment is more likely to be effective if the sufferer's pattern of repeatedly going over thoughts is a major focus of treatment, versus an individual with melancholic features, who may need more intensive support in the morning when the intensity of depression tends to be worse, or versus a person with atypical features, whose tendency toward weight gain and excessive sleeping may require nutritional counseling to address dietary issues.
Major depressive disorder
Major depression, also often referred to as unipolar depression, is characterized by a combination of symptoms that lasts for at least two weeks in a row, including sad and/or irritable mood (see symptom list), that interferes with the ability to work, sleep, eat, and enjoy once-pleasurable activities. Difficulties in sleeping or eating can take the form of excessive or insufficient of either behavior. Disabling episodes of depression can occur once, twice, or several times in a lifetime.
Persistent depressive disorder (dysthymia)
Persistent depressive disorder, formerly referred to as dysthymia, is a less severe but usually more long-lasting type of depression compared to major depression. It involves long-term (chronic) symptoms that do not disable but yet prevent the affected person from functioning at "full steam" or from feeling good. Sometimes, people with persistent depressive disorder also experience episodes of major depression. This combination of the two types of depression often is referred to as double-depression.
Bipolar disorder (manic depression)
Another type of depression is bipolar disorder, which encompasses a group of mood disorders that were formerly called manic-depressive illness or manic depression. These conditions often show a particular pattern of inheritance. Not nearly as common as the other types of depressive illnesses, bipolar disorders involve cycles of mood that include at least one episode of mania or hypomania and may include episodes of depression, as well. Bipolar disorders are often chronic and recurring. Sometimes, the mood switches are dramatic and rapid, but most often they are gradual, in that they usually take place over several days, weeks, or longer.
When in the depressed cycle, the person can experience any or all of the symptoms of a depressive condition. When in the manic cycle, any or all of the symptoms listed later in this article under mania may be experienced. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, indiscriminate or otherwise unsafe sexual practices or unwise business or financial decisions may be made when an individual is in a manic phase.
A significant variant of the bipolar disorders is designated as bipolar II disorder. (The usual form of bipolar disorder is referred to as bipolar I disorder.) Bipolar II disorder is a syndrome in which the affected person has repeated depressive episodes punctuated by what is called hypomania (mini-highs). These euphoric states in bipolar II do not completely meet the criteria for the full manic episodes that occur in bipolar I.
Symptoms of depression and mania
Not everyone who is depressed or manic experiences every symptom. Some people suffer from a few symptoms and some many symptoms. The severity of symptoms also varies with individuals. Less severe symptoms that precede the more debilitating symptoms are often called warning signs.
Depressive symptoms of major depression or manic depression
- Persistent feelings of sadness, anxiety, anger, irritability, discontent, or "emptiness"
- Feelings of hopelessness or pessimism
- Feelings of worthlessness, helplessness, or excessive guilt
- Loss of interest or inability to feel pleasure in hobbies and activities that were once enjoyed, including sex
- Apathy/lack of motivation
- Social isolation, meaning the sufferer avoids interactions with family or friends
- Sleep changes, like insomnia, early morning awakening, restless sleep, excess sleepiness, or oversleeping
- Appetite changes, like loss of appetite and/or weight, or excessive hunger, overeating, and/or weight gain
- Fatigue, decreased energy levels, slowness in activity or thought
- Crying spells
- Thoughts of death or suicide, suicide attempts
- Restlessness, agitation, irritability
- Inability to concentrate, remember things, or make decisions
- Persistent physical symptoms that do not respond to treatment, such as repeated headaches, digestive disorders, and/or chronic pain
Mania symptoms of manic depression
- Inappropriate or excessive elation
- Inappropriate or excessive irritability or anger
- Severe insomnia or decreased need to sleep
- Grandiose notions, like having special powers or importance
- Increased talking speed and/or volume
- Disconnected thoughts or speech
- Racing thoughts
- Severely increased sexual desire and/or activity
- Markedly increased energy
- Poor judgment
- Inappropriate social behavior
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