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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. Major depression affects 14 million persons in the United States
each year. The June 18, 2003, issue of JAMA is a theme issue
devoted to articles about depression.
Symptoms of major depression
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
Other types of depression
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
Dysthymia—mild depression symptoms
lasting for at least 2 years
occurring after the birth of a baby
Seasonal affective disorder—major
depression occurring regularly in seasons with low sunlight
Treatments for depression
MedicationsSeveral 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.
PsychotherapySeveral 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 lightDaily exposure to
bright light can be helpful for seasonal depression.
Electroconvulsive therapyA series
of treatments involving passage of electric current through the brain while
the patient is asleep from an anesthetic medication 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. Suicide usually stems from
For more information
American Psychiatric Association888/357-7924http://www.psych.org
National Mental Health Association800/969-6642http://www.depression-screening.org
Depression and Bipolar Support Alliance800/826-3632http://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. A Patient Page on postpartum
depression was published in the February 13, 2002, issue; one on electroconvulsive
therapy was published in the March 14, 2001, issue; one on adolescent suicide
was published in the December 26, 2001, issue; and one on psychiatric illness
in older adults was published in the June 7, 2000, issue.
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. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
Sources: American Psychiatric Association, National Institute
of Mental Health, Depression and Bipolar Support Alliance, National Mental
Topic: MENTAL ILLNESS
Torpy JM, Lynm C, Glass RM. Depression. JAMA. 2003;289(23):3198. doi:10.1001/jama.289.23.3198
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