I have not improved myself, but seeing others improve gives me hope. DBSA Greater Houston participant

WHAT IS DEPRESSION?
Depression is a treatable medical illness involving an imbalance of brain chemicals called neurotransmitters and neuropeptides. Experiencing depression is not a character flaw or a sign of personal weakness. Just like you cannot "wish away" diabetes, heart disease or any other physical illness, you cannot make depression go away by trying to "snap out of it." Episodes of depression often follow stressful events such as marital problems or the death of a loved one. People who have recurrent episodes of major depression are sometimes said to have "unipolar depression" or what used to be called "clinical depression," where the individual experiences periods of low or depressed mood. This is unlike someone with bipolar disorder who goes through periods of both low and high moods. While depression can be linked to genetic history, many people with the illness have no family history of depression. The exact causes of depression still are not clear. What we do know is that both genetics and a stressful environment, or life situation, contribute to its cause or sudden onset. Some of the signs and symptoms of someone suffering with depression:

DIFFERENT KINDS OF DEPRESSION
There are many names for the different types of depression. People with recurrent episodes of major depression are sometimes said to have unipolar depression. Those living with chronic, low-grade depression have what is called dysthymia. When people experience both dysthymia and major depression, they are sometimes said to have double depression.

There are several common triggers for people suffering from depression. For instance, mood disorder symptoms can also arise after a woman gives birth (postpartum depression). Additionally, symptoms can be accompanied by psychosis (psychotic depression) or can occur during the winter season (seasonal affective disorder, SAD).

However, what most mood disorders have in common are major depressive episodes. This is also true of bipolar disorder, another type of mood disorder. People diagnosed with bipolar disorder have mood swings involving both lows (bipolar depression) and highs (called mania if severe or hypomania if mild). To distinguish, when someone experiences the lows of bipolar disorder (bipolar depression), their symptoms are very similar to those that someone with unipolar depression might have.

OTHER TYPES OF DEPRESSION

Postpartum Depression
Postpartum depression is a treatable medical illness characterized by feelings of sadness, indifference, exhaustion, and anxiety that a woman may experience after the birth of her baby. It affects one in every 10 women who have had a child. A 2008 report by the CDC revealed that postpartum depression was more often reported by teenage mothers, mothers with less than twelve years of education, Medicaid patients, smokers, victims of physical abuse before or during pregnancy, and women with traumatic or financial stress during pregnancy.

Depression and other illnesses
Depression often co-exists with other mental or physical illnesses. Substance abuse, anxiety disorders and eating disorders are particularly common conditions that may be worsened by depression, and it is important that the depression and each co-occurring illness be appropriately diagnosed and treated.
According to research by the National Institute for Mental Health (NIMH), anxiety disorders which include post traumatic stress disorder (PTSD), obsessive compulsive disorder, panic disorder, social phobia and generalized anxiety disorder commonly accompany depression. Depression is especially prevalent among people with PTSD, a debilitating condition that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural disasters, accidents, terrorism and military combat. PTSD symptoms include reexperiencing the traumatic event in the form of flashback episodes, memories, or nightmares; emotional numbness; sleep disturbances; irritability; outbursts of anger; intense guilt; and avoidance of any reminders or thoughts of the ordeal. In one NIMH supported study, more than 40 percent of people with PTSD also had depression when evaluated at one month and four months following the traumatic event.

Substance use disorders (abuse or dependence) also frequently co-occur with depressive disorders. Research has revealed that people with alcoholism are almost twice as likely as those without alcoholism to also suffer from major depression. In addition, more than half of people with bipolar disorder type I (with severe mania) have a co-occurring substance use disorder.

Depression has been found to occur at a higher rate among people who have other serious illnesses such as heart disease, stroke, cancer, HIV, diabetes and Parkinson's. Symptoms of depression are sometimes mistaken for inevitable accompaniments to these other illnesses. However, research has shown that the co-occurring depression can and should be treated, and that in many cases treating the depression can also improve the outcome of the other illness.

DEPRESSION ACROSS THE LIFESPAN

Although depression is usually first noticed during the teen or early adult years, a person can have an episode of depression at any age. Without treatment, an episode can last six months or longer. 

Children and Adolescents

Depression may have a slightly different set of symptoms when a child or teen has it. Children and adolescents may be more likely to have symptoms like unexplained aches and pains, irritability and social withdrawal. On the other hand, symptoms more likely to affect adults include slowed speech and activity, sleeping too much and believing things that aren’t true (delusions).

Depression in children may co-occur with anxiety, disruptive behavior disorders or attention deficit disorder. Children should be treated by a physician with knowledge and experience in treating children with mood disorders.

Parents, teachers and health care professionals should be familiar with symptoms of mania, including:

Medication choices for people under 18 years old should be made and monitored carefully. Ask children who take antidepressants often how they are feeling and encourage them to be honest with someone about any major mood changes, especially thoughts of suicide. Educate children in age-appropriate ways about symptoms that mean trouble and need to be reported right away. Make sure they have several phone numbers of support people they can call if they have trouble with worsening symptoms.

Parents should also know the signs of suicidal thoughts such as:

Health care providers, parents and their children must weigh the risks of treating depression compared to the risks and lifetime impact of untreated depression and suicidal ideation. They should discuss all treatment choices, not just the use of antidepressants. All adults who interact with the child should become familiar with all suicide warning signs, regardless of what treatment the child is receiving. In addition, parents should educate teachers about what behavior they must report. 

Older Adults

Depression is not a normal part of growing older.

Older adults may be going through changes such as children moving away, illness, moving to assisted living facilities or the death of loved ones. All of these things can cause feelings of sadness or grief. But when feelings of sadness last for a significant length of time and keep older adults from enjoying life the way they used to, it may be a sign that they should seek treatment.

Depression treatment is especially important for older adults because they may have a greater risk of suicide. Loved ones should watch for signs such as preoccupation with death, increased visits or calls, hopeless statements or refusal to follow doctors’ recommendations for medication or diet plans.

Other illnesses may also be an issue for older adults with depression. Older adults should have complete physical examinations and their health care providers should be informed about all medications they take for all illnesses. Some medications for other illnesses may trigger symptoms of depression or have side effects that look and feel like depression.

It can help older adults to have a group of people to talk to who have had similar experiences and can understand and offer support. They may feel apprehensive or ashamed at first, and not want anyone to know they are coping with a mood disorder. Most people of all ages in DBSA Greater Houston support groups also struggled with these feelings at first and can offer insight and support. DBSA Greater Houston offers these support groups dedicated to the elderly.

TREATMENTS

Treatment of depression may include medication, talk therapy and knowledgeable support. A doctor or therapist may encourage and help in the development of other strategies. DBSA Greater Houston support groups are intended to provide the aspect of knowledgeable support. The most important action is to seek treatment; the right treatment is simply the one that works best.

Check out the depression screening tool on the DBSA national website :