Jennifer Gregg, Ph.D.: From the Iraq War Clinician Guide: Appendix J, pp. 193-4
Depression is a common problem in which severe and long lasting
feelings of sadness or other problems get in the way of a person's
ability to function. In any given year, as many as 18.8 million
American adults - 9.5% of the adult population - experience some
type of depression. Unlike a blue mood that comes and goes,
depression is a persistent problem that affects the way a person
eats and sleeps, thinks about things, and feels about him- or
herself.
What are the Symptoms of Depression?
The symptoms of depression can vary quite a bit, but most people
who experience depression feel down or sad more days than not, or
find that things in their life no longer seem enjoyable or
interesting. Additionally, people with depression may notice
changes in their sleeping, eating, concentration, or feelings about
themselves, and may find themselves feeling hopeless. These
symptoms typically last for at least 2 weeks without letting
up.
What Causes Depression?
Depression has many causes. Difficulty coping with painful
experiences or losses contributes to depression. People returning
from a war zone often experience painful memories, feelings of
guilt, or regret about their war experiences, or have a tough time
readjusting back to normal life. Trouble coping with these feelings
and experiences can lead to depression. Some types of depression
run in families, and depression is often associated with chemical
imbalances and other changes in the brain.
How is Depression Treated?
There are many treatment options for depression. An evaluation
should be done by a healthcare professional to help determine which
type of treatment is best for an individual. Typically, milder
forms of depression are treated by psychotherapy, and more severe
depression is treated with medications or a combination of
psychotherapy and medication. Your doctor can help you determine
which treatment is best for you.
Psychotherapy
There are a number of types of psychotherapy (or talk therapy)
that are used to treat depression. These treatments may involve
just a few sessions, or may last 10-20 weeks or longer.
Psychotherapy treatments tend to focus on helping patients learn
about their problems and resolve them, through working with a
therapist and learning new patterns of behavior to help decrease
depression. Two of the main types of psychotherapy for depression
are interpersonal therapy and cognitive-behavioral therapy.
Interpersonal therapy focuses on the patientâs relationships
with other people, and how these relationships may cause and
maintain depression. Cognitive-behavioral treatments help patients
change negative styles of thinking and acting that can lead to
depression
Medication
In addition to psychotherapy, there are several types of
antidepressant medications used to treat depression. These include
selective serotonin reuptake inhibitors (SSRIs), tricyclics, and
monoamine oxidase inhibitors (MAOIs). The newer medications for
treating depression, such as the SSRIs, generally have fewer side
effects than older types of medications. A healthcare provider may
try more than one type of medication, or may increase the dosage,
to find a treatment that works. Improvements in symptoms of
depression typically occur after the medication is taken regularly
for 3 to 4 weeks, although in some medications it may take as long
as 8 weeks for the full effect to occur.
Antidepressant medications are typically safe and effective.
They help patients feel less depressed and generally do not make
people feel ãdruggedä or different during their daily
lives. The side effects of depression medications vary depending on
the medication, and can include dry mouth, constipation, bladder
problems, sexual problems, blurred vision, dizziness, drowsiness,
headache, nausea, nervousness, or insomnia. Because of side effects
or because they begin feeling better, patients are often tempted to
stop taking their medication too soon. Some medications must be
stopped slowly to give your body time to readjust to not having the
medication. Never stop taking an antidepressant without consulting
your doctor.
What Can I Do about Feelings of Depression?
Depression can make a person feel exhausted, worthless,
helpless, hopeless, and sad. These feelings can make you feel as
though you are never going to feel better, or that you should just
give up. It is important to realize that these negative thoughts
and feelings are part of depression, and often fade as treatment
begins working. In the meantime, here is a list of things to try to
improve your mood:
Talk with your doctor or healthcare provider
Talk with family and friends, and let them help you
Participate in activities that make you feel better, or that
you used to enjoy before you began feeling depressed
Set realistic goals for yourself
Engage in mild exercise
Try to be with others and get support from them
Break up goals and tasks into smaller, more reachable
ones
Where Can I Find More Information About Depression?
