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What is depression? How is it different from just having a couple of "bad days?"

Depression, also known as depressive disorder, is caused by an imbalance of certain chemicals normally present in the brain that help control or initiate certain behaviors. Depression is distinctly different from feeling sad about an event or feeling "blue" for a short period. These feelings pass. Depression is an illness and needs treatment. It's not a weakness or something to feel ashamed about. Symptoms can be long lasting and debilitating and represent a change for most people from their normal experiences. One of the most significant changes is a "loss of joy" or pleasure from situations that once were fulfilling.

Who develops depression?

Anyone can suffer from depression at any time, but certain people are more susceptible to this illness. Up to one in five women will experience depression at least once in her lifetime; her chance of having another episode increases by 50 percent after her first episode. Depression seems to run in families. Prolonged stress, abuse, illness, drug and alcohol use, certain medications and significant losses can trigger depression, especially in those individuals at higher risk for developing it.

Are there different types of depression?

Yes. Two of the most common types of depression are major depression (also known as clinical depression) and dysthymia. Each type of depression shares similar symptoms, but these vary in intensity and duration. Symptoms of major depression include a disruption of normal sleeping and eating patterns, and an increase in negative feelings or thoughts. Dysthymia is a chronic, but less severe type of depression. However, its symptoms can be equally disabling. A person with dysthymia may feel that she never quite functions at her full potential or never quite feels "good." Dysthymia can also occur with major depression, which is a condition sometimes referred to as "double depression."

How can I tell if I'm depressed?

Depression, like other medical illnesses, has a specific set of criteria that medical professionals use to make a diagnosis. Here are a few of the symptoms of depression:

How is depression treated?

Most health experts agree that the best way to treat depression is with a combination of psychotherapy and medication called antidepressants. Psychotherapy consists of discussing possible causes for certain feelings and behaviors with a trained professional, such as a psychiatrist, psychologist, psychiatric nurse specialist, clergy with specialized training, social worker or counselor, and developing strategies for resolving the feelings. Antidepressants work by correcting the imbalance of certain brain chemicals.

Do antidepressants have side effects? How long will I have to take medication?

The newer antidepressants, called selective serotonin reuptake inhibitors (SSRIs) cause fewer side effects than the older types of drugs used to treat depression. Antidepressant medication can cause side effects such as nausea, drowsiness, gastrointestinal upset, anxiety and insomnia, which may subside after your body adjusts to the medication after about a month.

Most people make the mistake of stopping the medication when they first start to experience side effects or without speaking to their health care professional about the side effects. Sexual dysfunction (impotence, loss of desire, inability to reach orgasm) is a possible side effect from SSRIs. In some cases, other medication may be prescribed to lessen these symptoms or another type of SSRI may be suggested.

Because many types of antidepressants are available, it is likely that one can be identified that produces fewest side effects with best results. Most people don't have to take antidepressants forever. Once your depression subsides, you can determine with your health care team what the best course is for you. Short-term treatment, from six-months to one year, is common. But, longer treatment may be necessary to prevent a recurrence. People who have recurrent depression may need to take antidepressants for the rest of their lives.

What are the "baby blues?" Is this depression?

The "baby blues" refers to the short period of time after a woman delivers a baby when she may feel tearful, fatigued and overwhelmed. These feelings can last for a week or two and typically subside once the woman is more rested and hormones related to pregnancy and delivery become more balanced. The "baby blues" are not considered clinical depression; however, postpartum depression is a form of depression that affects some women after they deliver. It is different from the "baby blues" because it lasts longer than six weeks and significantly disables the mother, greatly interfering with her relationship with her baby and other members of her family. The symptoms of postpartum depression are the same as symptoms of other forms of depression.

Can antidepressants be taken during pregnancy and while breast feeding?

Most health care professionals suggest that if a woman can discontinue her antidepressant medication during the first three months of pregnancy, she should do so. However, there is not a lot of research about how antidepressants may affect a developing fetus. Research is equally unclear about how antidepressants may affect a nursing baby. These drugs do pass through to breast milk. Most practitioners suggest that mothers bottle-feed newborns if they need to take antidepressants at this time.