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   A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression


    Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. This pamphlet briefly describes three of the most common types of depressive disorders. However, within these types there are variations in the number of symptoms, their severity, and persistence.


    Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

  •     Persistent sad, anxious, or "empty" mood .
  •     Feelings of hopelessness, pessimism .
  •     Feelings of guilt, worthlessness, helplessness .
  •     Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex.
  •     Decreased energy, fatigue, being "slowed down"
  •     Difficulty concentrating, remembering, making decisions.
  •     Insomnia, early-morning awakening, or oversleeping.
  •     Appetite and/or weight loss or overeating and weight gain.
  •     Thoughts of death or suicide; suicide attempts.
  •     Restlessness, irritability.
  •     Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

  •     Abnormal or excessive elation
  •     Unusual irritability
  •     Decreased need for sleep
  •     Grandiose notions
  •     Increased talking
  •     Racing thoughts
  •     Increased sexual desire
  •     Markedly increased energy
  •     Poor judgment
  •     Inappropriate social behavior


Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.

In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.

People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.

or an early form of the illness is not clear.

In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically are precipitated by only mild stresses, or none at all.

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