depression by aoonto


									                                                                       Frequently Asked questions

                                                                                   Q: What are the different types of
                                                                                   A: Different kinds of depression include:
                                                                                   	    •	 Major depressive disorder. Also
                              Q: What is depression?                                       called major depression, this is a
                              A: Life is full of ups and downs. But                        combination of symptoms that hurt
                                  when the down times last for weeks                       a person's ability to work, sleep,
                                  or months at a time or keep you from                     study, eat, and enjoy hobbies.
                                  your regular activities, you may be suf-         	    •	 Dysthymic (diss-TIME-ic) disor-
                                  fering from depression. Depression is a                  der. Also called dysthymia, this kind       medical illness that involves the body,                  of depression lasts for a long time
         1-800-994-9662           mood, and thoughts. It affects the way                   (two years or longer). The symptoms
  TDD: 1-888-220-5446
                                  you eat and sleep, the way you feel                      are less severe than major depression
                                  about yourself, and the way you think                    but can prevent you from living nor-
                                  about things.                                            mally or feeling well.
                                  It is different from feeling “blue” or
                                                                                        Some kinds of depression show slightly
                                  down for a few hours or a couple of
                                                                                        different symptoms than those described
                                  days. It is not a condition that can be
                                                                                        above. Some may start after a particular
                                  willed or wished away.
                                                                                        event. However, not all scientists agree

                                                          Depression has many different faces:

                                                After 10 years of working for                     Many of Julie’s family members
                                                a company she loved, Kim was                      have suffered with depression.
                                                laid off. She never saw it com-                   But nobody ever talks about
                                                ing. Kim is a single mother                       it. Julie has been dealing with
                                                raising two kids. She has been                    depression since she was a
                                                looking for work for about                        teen. She is now 46. She has
                               eight months now. Since losing her job, she’s       tried to kill herself twice. Julie has never
                               felt like a failure. Kim is up all night, and she   been in counseling. “What is wrong with
                               never feels like eating much. She yells at her      me?” she always asks herself. She just can’t
                               kids often.                                         seem to “shake it off.”
                                             Rose used to be an active             You probably know women with stories
                                             senior citizen. Since retir-          like these. Depression affects both men and
                                             ing, Rose and her husband             women, but more women than men are
                                             have traveled a lot – Europe,         likely to be diagnosed with depression in
                                             Australia, South Africa – they        any given year. That being said, depression is
                                             have been everywhere. Rose’s          not a “normal part of being a woman” nor
                               husband died last year of a heart attack. She       is it a “female weakness.” Many women with
                               has been in mourning for a year. She rarely         depression never seek treatment. But most
                               gets out, and she doesn’t accept visitors           women, even those with the most severe
                               into her home.                                      depression, can get better with treatment.
                   page 1

                                        U.S. Department of Health and Human Services, Office on Women’s Health
                                                                     Frequently Asked questions

                                  on how to label and define these forms              depression in some people.
                                  of depression. They include:                 	   •	 Medical	illness	–	Dealing	with	seri-
                              	   •	 Psychotic depression, which                      ous medical illnesses like stroke, heart
                                     occurs when a severe depressive ill-             attack, or cancer can lead to depression.
                                     ness happens with some form of psy-
                                     chosis, such as a break with reality,
                                     hallucinations, and delusions.            Q: What are the signs of depression?
                                                                               A: Not all people with depression have the
                              	   •	 Postpartum depression, which                  same symptoms. Some people might
                                     is diagnosed if a new mother has a            only have a few, and others a lot. How
                                     major depressive episode within one           often symptoms occur, and how long
                                     month after delivery.                         they last, is different for each person.
                              	   •	 Seasonal affective disorder                   Symptoms of depression include:
  TDD: 1-888-220-5446                (SAD), which is a depression during       	   •	 Feeling	sad,	anxious,	or	"empty"
                                     the winter months, when there is
                                     less natural sunlight.                    	   •	 Feeling	hopeless
                                                                               	   •	 Loss	of	interest	in	hobbies	and	activ-
                                                                                      ities that you once enjoyed
                              Q: What causes depression?
                              A: There is no single cause of depression.       	   •	 Decreased	energy
                                  There are many reasons why a woman           	   •	 Difficulty	staying	focused,	remem-
                                  may become depressed:                               bering, making decisions
                              	   •	 Genetics	(family	history)	–	If	a	woman	   	   •	 Sleeplessness,	early	morning	awak-
                                     has a family history of depression, she          ening, or oversleeping and not want-
                                     may be more at risk of developing it             ing to get up
                                     herself. However, depression may also
                                     occur in women who don’t have a           	   •	 No	desire	to	eat	and	weight	loss	or	
                                     family history of depression.                    eating to “feel better” and weight
                              	   •	 Chemical	imbalance	–	The	brains	of	
                                     people with depression look different     	   •	 Thoughts	of	hurting	yourself
                                     than those who don’t have depres-         	   •	 Thoughts	of	death	or	suicide
                                     sion. Also, the parts of the brain that   	   •	 Easily	annoyed,	bothered,	or	angered
                                     manage your mood, thoughts, sleep,
                                     appetite, and behavior don’t have the     	   •	 Constant	physical	symptoms	that	do	
                                     right balance of chemicals.                      not get better with treatment, such
                                                                                      as headaches, upset stomach, and
                              	   •	 Hormonal	factors	–	Menstrual	cycle	              pain that doesn’t go away
                                     changes, pregnancy, miscarriage,
                                     postpartum period, perimenopause,
                                     and menopause may all cause a             Q: I think I may have depression.
                                     woman to develop depression.                 How can I get help?
                              	   •	 Stress	–	Stressful	life	events	such	as	   A: Below are some people and places that
                                     trauma, loss of a loved one, a bad            can help you get treatment.
                                     relationship, work responsibilities,      	   •	 Family	doctor
                   page 2            caring for children and aging par-
                                                                               	   •	 Counselors	or	social	workers
                                     ents, abuse, and poverty may trigger

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                          Frequently Asked questions

                              	   •	 Family	service,	social	service	agen-                  overwhelming to cope with, but those
                                     cies, or clergy person                                times don't last forever. People do make
                              	   •	 Employee	assistance	programs	(EAP)                    it through suicidal thoughts. If you can't
                                                                                           find someone to talk with, write down
                              	   •	 Psychologists	and	psychiatrists                       your thoughts. Try to remember and
                                  If you are unsure where to go for help,                  write down the things you are grateful
                                  check the Yellow Pages under mental                      for. List the people who are your friends
                                  health, health, social services, suicide preven-         and family, and care for you. Write about
                                  tion, crisis intervention services, hotlines, hos-       your hopes for the future. Read what you
                                  pitals, or physicians for phone numbers                  have written when you need to remind       and addresses.                                           yourself	that	your	life	is	IMPORTANT!
  TDD: 1-888-220-5446         Q: What if I have thoughts of hurt-                      Q: How is depression found and
                                 ing myself?                                               treated?
                              A: Depression can make you think about                   A:	 Most	people	with	depression	get	better	
                                  hurting yourself or suicide. You may                     when they get treatment.
                                  hurt yourself to:                                        The first step to getting the right
                              	   •	 Take	away	emotional	pain	and	distress                 treatment	is	to	see	a	doctor.	Certain	
                                                                                           medicines, and some medical condi-
                              	   •	 Avoid,	distract	from,	or	hold	back	
                                                                                           tions (such as viruses or a thyroid dis-
                                     strong feelings
                                                                                           order), can cause the same symptoms as
                              	   •	 Try	to	feel	better                                    depression. Also, it is important to rule
                              	   •	 Stop	a	painful	memory	or	thought                      out depression that is associated with
                                                                                           another mental illness called bipolar dis-
                              	   •	 Punish	yourself                                       order. A doctor can rule out these pos-
                              	   •	 Release	or	express	anger	that	you’re	                 sibilities	with	a	physical	exam,	asking	
                                     afraid	to	express	to	others                           questions, and/or lab tests, depending
                                                                                           on the medical condition. If a medical
                                  Yet, hurting yourself does just that—it
                                                                                           condition and bipolar disorder can be
                                  hurts you. If you are thinking about
                                                                                           ruled out, the doctor should conduct a
                                  hurting or even killing yourself,
                                                                                           psychological	exam	or	send	the	person	
                                  PLEASE	ASK	FOR	HELP!	Call	911,	
                                                                                           to a mental health professional.
                                  800-273-TALK	(8255)	or	800-SUI-
                                  CIDE,	or	check	in	your	phone	book	for	                   Once	identified,	depression	almost	
                                  the number of a suicide crisis center.                   always can be treated with:
                                  The	centers	offer	experts	who	can	help	              	   •	 Therapy
                                  callers talk through their problems and
                                                                                       	   •	 Medicine	called	antidepressants
                                  develop a plan of action. These hotlines
                                  can also tell you where to go for more               	   •	 Both	therapy	and	medicine
                                  help in person. You also can talk with                   Some people with milder forms of
                                  a family member you trust, a clergy                      depression do well with therapy alone.
                                  person, or a doctor. There is nothing                    Others	with	moderate	to	severe	depres-
                                  wrong	with	asking	for	help	–	everyone	                   sion might benefit from antidepressants.
                                  needs help sometimes.                                    It may take a few weeks or months
                   page 3         You might feel like your pain is too                     before you begin to feel a change in your

                                        U.S. Department of Health and Human Services, Office on Women’s Health
                                                                   Frequently Asked questions

                                  mood. Some people do best with both               an option or whether you should plan
                                  treatments	–	therapy	and	antidepressants.         to feed your baby formula. Although
                                                                                    breastfeeding has some advantages for
                                                                                    your baby, most importantly, as a moth-
                              Q: Should I stop taking my antide-
                                                                                    er, you need to stay healthy so you can
                                 pressant while I am pregnant?                      take care of your baby.
                              A: The decision whether or not to stay on
                                  medications is a hard one. You should             Before	taking	medication	for	an	anxiety	
                                  talk	with	your	doctor.	Medication	taken	          disorder:
                                  during pregnancy does reach the fetus.      	     •	 Ask	your	doctor	to	tell	you	about	
                                  In rare cases, some antidepressants have             the effects and side effects of the
                                  been associated with breathing and heart             drug.
         1-800-994-9662           problems in newborns, as well as jitteri-   	     •	 Tell	your	doctor	about	any	alterna-
  TDD: 1-888-220-5446             ness, difficulty feeding, and low blood              tive therapies or over-the-counter
                                  sugar after delivery. However, moms                  medications you are using.
                                  who stop medications can be at high risk
                                  of their depression coming back. Talk to    	     •	 Ask	your	doctor	when	and	how	the	
                                  your doctor about the risks and benefits             medication should be stopped. Some
                                  of taking antidepressants during preg-               drugs can’t be stopped abruptly but
                                  nancy. Your doctor can help you decide               must be tapered off slowly under a
                                  what is best for you and your baby. In               doctor’s supervision.
                                  some cases, a woman and her doctor          	     •	 Work	with	your	doctor	to	determine	
                                  may decide to slowly lower her anti-                 which medication is right for you
                                  depressant dose during the last month                and what dosage is best.
                                  of pregnancy. Doing so can help the
                                                                              	     •	 Be	aware	that	some	medications	are	
                                  newborn suffer from fewer withdrawal
                                                                                       effective only if they are taken regu-
                                  symptoms. After delivery, a woman can
                                                                                       larly and that symptoms may come
                                  return to a full dose. This can help her
                                                                                       back if the medication is stopped.
                                  feel better during the postpartum period,
                                  when risk of depression can be greater.         What are SSRIs?
                                                                                  Selective serotonin reuptake
                              Q: Should I stop taking my antide-                  inhibitors (SSRIs) are a kind of
                                 pressant while breastfeeding?                    antidepressant for treating depression
                              A: If you stopped taking your medication            and anxiety disorders.
                                  during pregnancy, you may need to
                                  begin taking it again after the baby is
                                  born. Be aware that because your medi-      Q: Is it safe for young adults to take
                                  cation can be passed into your breast          antidepressants?
                                  milk, breastfeeding may pose some risk
                                                                              A: It may be safe for young people to be
                                  for a nursing infant.
                                                                                    treated with antidepressants. However,
                                  However, a number of research studies             drug companies who make antidepres-
                                  show that certain antidepressants, such           sants	are	required	to	post	a	“black	box”	
                                  as	some	of	the	SSRIs	(see	box	at	right)	          warning label on the medication. A
                                  have been used relatively safely during           “black	box”	warning	is	the	most	serious	
                   page 4         breastfeeding. You should discuss with            type of warning on prescription drugs.
                                  your doctor whether breastfeeding is
                                                                                    It may be possible that antidepressants

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                      Frequently Asked questions

                                  make children, adolescents, and young              right way, it can become severe and, in
                                  adults more likely to think about sui-             some cases, may be linked with suicide.
                                  cide or commit suicide. In 2007, the
                                  FDA	said	that	makers	of	all	antidepres-
                                                                                 Q: How can I help myself if I am
                                  sant	medications	should	extend	the	
                                  warning to include young adults up
                                  through age 24.                                A:	 You	may	feel	exhausted,	helpless,	and	
                                                                                     hopeless. It may be very hard to do any-
                                  The warning says that patients of all              thing to help yourself. But it is impor-
                                  ages taking antidepressants should                 tant to realize that these feelings are part
                                  be watched closely, especially during              of the depression and do not ref lect real       the first weeks of treatment. Possible             life. As you understand your depression
         1-800-994-9662           side effects to look for are worsening             and begin treatment, negative thinking
                                  depression, suicidal thinking or behav-            will fade. In the meantime:
  TDD: 1-888-220-5446
                                  ior, or any unusual changes in behavior
                                  such as sleeplessness, agitation, or with-     	   •	 Engage	in	mild	activity	or	exercise.	
                                  drawal from normal social situations.                 Go	to	a	movie,	a	ballgame,	or	anoth-
                                  Families	and	caregivers	should	pay	close	             er event or activity that you once
                                  attention to the patient, and report any              enjoyed. Participate in religious,
                                  changes in behavior to the patient’s                  social, or other activities.
                                  doctor. The latest information from the               * Set realistic goals for yourself.
                                  FDA	can	be	found	on	their	Web	site	at	         	   •	 Break	up	large	tasks	into	small	ones,	
                                                           set some priorities and do what you
                                                                                        can as you can.
                              Q: Can I take St. John’s wort to                   	   •	 Try	to	spend	time	with	other	people	
                                 treat depression?                                      and confide in a trusted friend or
                              A: St. John's wort is a plant with yellow                 relative. Try not to isolate yourself,
                                  flowers that has been used for centuries              and let others help you.
                                  for health purposes, including depression
                                                                                 	   •	 Expect	your	mood	to	improve	
                                  and	anxiety.	However,	research	studies	
                                                                                        gradually, not immediately. Do not
                                  from the National Institutes of Health
                                                                                        expect	to	suddenly	"snap	out	of"	your	
                                  found that St. John’s wort was not effec-
                                                                                        depression.	Often	during	treatment	
                                  tive in treating major depression.
                                                                                        for depression, sleep and appetite
                                  Other	research	shows	that	St.	John’s	wort	            will begin to improve before your
                                  can make some medicines not work or                   depressed mood lifts.
                                  that it can cause dangerous side effects.
                                                                                 	   •	 Postpone	important	decisions,	such	
                                  The herb appears to interfere with certain
                                                                                        as getting married or divorced or
                                  drugs used to treat heart disease, HIV,
                                                                                        changing jobs, until you feel better.
                                  depression, seizures, certain cancers, and
                                                                                        Discuss decisions with others who
                                  organ transplant rejection. The herb may
                                                                                        know you well and have a more
                                  also make birth control pills not work
                                                                                        objective view of your situation.
                                  as well. Because of this, people should
                                  always consult their doctors before taking     	   •	 Be	confident	that	positive	thinking	
                                  any herbal supplement.                                will replace negative thoughts as your
                   page 5         St. John's wort is not a proven therapy for           depression responds to treatment. n
                                  depression. If depression is not treated the

                                        U.S. Department of Health and Human Services, Office on Women’s Health
                                                                  Frequently Asked questions

                              For more information
                              For	more	information	on	depression,	call	at	1-800-994-9662	or	con-
                              tact the following organizations:

                              National Institute of Mental Health            National Mental Health Information
                              Phone	Number:	(866)	615-6464                   Center, SAMHSA, HHS
                              Internet Address:      Phone	Number:	(800)	789-2647
                                                                             Internet Address: http://mentalhealth.   National Suicide Prevention Lifeline 
                              Phone	Number:	(800)	273-TALK	(8255)
                              Internet Address: http://www.                  Depression and Bipolar Support
  TDD: 1-888-220-5446                  Alliance
                                                                             Phone	Number:	(800)	826-3632
                              Kristin Brooks Hope Center                     Internet Address:
                              Phone	Number:	(800)	SUICIDE	(784-2433)
                              Internet Address:

                                  Reviewed by:
                                  Catherine	Roca,	M.D.
                                  Office	for	Special	Populations
                                  National	Institute	of	Mental	Health
                                  National Institutes of Health

                                  All	material	contained	in	this	FAQ	is	free	of	copyright	restrictions,	and	may	be	copied,	
                                  reproduced,	or	duplicated	without	permission	of	the	Office	on	Women's	Health	in	the	
                                  Department	of	Health	and	Human	Services.	Citation	of	the	source	is	appreciated.

                                  Content	last	updated March 17, 2010.

                   page 6

                                     U.S. Department of Health and Human Services, Office on Women’s Health

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