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A person who feels sad all the time, has unexplained crying spells, or loses interest in usual activities may have major depression, a serious medical illness that should be distinguished from normal temporary feelings of sadness after a loss, such as the death of a relative or friend. The November 12, 2008, issue of JAMA includes an article about depression in heart patients. This Patient Page is based on one previously published in the May 28, 2008, issue of JAMA.
Having at least 5 of these symptoms occurring nearly every day for at least 2 weeks:
Feeling sad or empty
Decreased interest or pleasure in activities
Appetite change with weight loss or weight gain
Decreased or increased sleeping
Fatigue or loss of energy
Feeling worthless or guilty
Being either agitated or slowed down
Difficulty thinking or concentrating
Recurrent thoughts of death or suicide
Bipolar disorder (previously called manic-depressive disorder)—occurrence of episodes of major depression and episodes of abnormally elevated mood called mania (severe) or hypomania (less severe)
Dysthymia—mild depression symptoms lasting for at least 2 years
Postpartum depression—a mother's depression occurring after the birth of her baby
Seasonal affective disorder—major depression occurring regularly in seasons with low sunlight
Medications—Several types of antidepressant medications have been shown to be effective for depression, but they must be taken for several weeks before they begin to work.
Psychotherapy—Several kinds of "talking therapies" have also been shown to be effective for depression. They involve evaluating and changing the thoughts, attitudes, and relationship problems that are associated with depression.
Bright light—Daily exposure to bright light can be helpful for seasonal depression.
Electroconvulsive therapy—A series of treatments involving passage of electric current through the brain while the patient is under anesthesia can often relieve even severe depression. These treatments are usually given about 3 times per week for several weeks.
Anyone who is experiencing symptoms of depression should be evaluated by a doctor. Although individuals with depression often feel that nothing can help them, effective treatments are available. Evaluation and treatment are particularly important to prevent suicide. Depression is the most common cause of suicide.
American Psychiatric Associationhttp://www.psych.org
National Mental Health Associationhttp://www.depression-screening.org
Depression and Bipolar Support Alliancehttp://www.dbsalliance.org
National Institute of Mental Healthhttp://www.nimh.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. The following related Patient Pages have been previously published: one on suicide in the May 25, 2005, issue; one on postpartum depression in the February 13, 2002, issue; one on electroconvulsive therapy in the March 14, 2001, issue; one on adolescent suicide in the December 26, 2001, issue; and one on psychiatric illness in older adults in the June 7, 2000, issue.
Sources: American Psychiatric Association, National Institute of Mental Health, Depression and Bipolar Support Alliance, National Mental Health Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: MENTAL ILLNESS
Torpy JM, Burke AE, Glass RM. Depression. JAMA. 2008;300(18):2202. doi:10.1001/jama.300.18.2202