April 2003

Symptoms of Depression Symptoms vary from person to person and vary over time. Not everyone who is depressed has every symptom. Some people have a few, and some have many. Persistent sad, anxious or "empty" mood Feelings of hopelessness, pessimism Feelings of guilt, worthlessness, helplessness Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex Decreased energy, fatigue Difficulty concentrating, remembering and making decisions Insomnia, early-morning awakening, or oversleeping Appetite and/or weight loss or overeating and weight gain Thoughts of death or suicide, suicide attempts Restlessness, irritability Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain Source: National Institutes of Mental Health

Where To Get Help Family doctors Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors Health maintenance organizations Community mental health centers Hospital psychiatry departments and outpatient clinics University - or medical school - affiliated programs State hospital outpatient clinics Family service, social agencies, or clergy Private clinics and facilities Employee assistance programs Local medical and/or psychiatric societies Source: National Institutes of Mental Health

The Widespread Effects of Depression
by Mary Sullivan

Depression is one of the leading causes of disability worldwide. That's the word from NIH's National Institute of Mental Health (NIMH), the component of the federal government that studies depression and other mental illnesses.

You probably know depression as a medical condition that primarily affects the brain. Its symptoms include a persistent sad, anxious or "empty" mood, feelings of hopelessness, pessimism and worthlessness, and a loss of interest in hobbies and activities once enjoyed. The "Symptoms of Depression" side box contains a more complete description.

But according to Dr. Husseini Manji, chief of NIMH's Laboratory of Pathophysiology, the psychological symptoms of depression are just the "tip of the iceberg." Because the brain is the body's "control center," the effects of depression spread throughout the body, often resulting in problems with sleep, appetite, energy level, motivation, memory, and concentration. Performing everyday activities can be an enormous challenge for people who are depressed.

A Devastating Illness

"Depression needs to be recognized as a devastating illness," Dr. Manji explains. "It can occur with other diseases, but it is a very real medical condition in its own right."

Research shows that depression increases the risk of death for people of all ages. For those with other illnesses such as type 2 diabetes and certain infections, depression can make their symptoms worse. Elderly people with depression may be at higher risk for Alzheimer's disease, and depression may increase their chance of being admitted into a nursing home.

No one knows better the ravages of depression than the estimated 20 million Americans of every age who suffer from depression. Although women and older people seem to have higher rates of depression, depression can strike anyone at any time. Those who have recently experienced a traumatic event, such as a divorce, job loss or sudden death of a loved one, may be at higher risk.

More Than Stressed Out

Dr. Manji emphasizes that depression is not a character flaw, a lack of willpower or a sign of emotional weakness. "You can't simply wish or will depression away," he says.

People who are "stressed out" may think that their current situation is to blame, but a prolonged case of the blues that interferes with normal functioning is usually the result of a chemical imbalance in the brain," he explains.

That's why treatment is so important — and the sooner the better. There are a variety of treatments that work, including medications and psychotherapy. NIMH researchers and others are constantly looking at new ways to treat and prevent depression.

If you think you may be depressed, seek professional help (see "Where to Get Help") and learn ways to cope to help you feel better (see "Tips for Coping With Depression"). Don't let depression keep you down.

— a report from The NIH Word on Health, April, 2003

For more information on depression, see NIMH's booklet on depression at http://www.nimh.nih.gov/publicat/depression.cfm. Links to other depression publications from NIH can be found at http://health.nih.gov/result.asp?disease_id=183. You can also phone, fax or send e-mail to:

National Institute of Mental Health
Information Resources and Inquiries Branch
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
Telephone: 301-443-4513
Fax: 301-443-4279
TTY: 301-443-8431
E-mail: nimhinfo@nih.gov