If feeling anxious or depressed, it is important to admit to it and get help. Even when family and friends are around for support, professional attention is best. A good first step is to discuss concerns with your regular doctor. He or she can provide advice about the best treatment and suggest a qualified therapist. There are several types of mental health professionals who can provide psychotherapy (counselors, social workers and psychologists), but any medications must be prescribed by a physician (your regular doctor or a psychiatrist). It is important to select a therapist with whom you fee comfortable and can talk honestly about your feelings. Psychotherapy can be done individually, with other family members, or in a group.

There is no single known cause of depression. Rather, it likely results from a combination of genetic, biologic, environmental, and psychological factors. Major negative experiences—trauma, loss of a loved one, a difficult relationship, or any stressful situation that overwhelms the ability to cope—may trigger a depressive episode. Subsequent depressive episodes may occur with or without an obvious trigger. Depression is not an inherent consequence of negative life events; research increasingly suggests that it is only when such events set in motion excessive rumination and negative thought patterns, especially about oneself, that mood enters a downward spiral.
MAOIs are older drugs that treat depression. They work by stopping the breakdown of norepinephrine, dopamine, and serotonin. They’re more difficult for people to take than most other antidepressants because they interact with prescription drugs, nonprescription drugs, and some foods. They also can’t be combined with stimulants or other antidepressants.

Post-traumatic Stress Disorder (PTSD) is a reaction to a highly stressful event outside the range of everyday experience when a person feels very unsafe or threatened. These are unsual experiences such as war, violent attack (verbal, physical or sexual) or a natural disaster. The symptoms usually include irritability, anxiety, flashbacks, repeated nightmares, and avoiding situations that might bring back memories of the event. 


A person with anxiety disorder, however, experiences fear, panic or anxiety in situations where most people would not feel anxious or threatened. The sufferer may experience sudden panic or anxiety attacks without any recognized trigger, and often lives with a constant nagging worry or anxiousness. Without treatment, anxiety and depression disorders can restrict a person's ability to work, maintain relationships, or even leave the house.
Certain medications used for a variety of medical conditions are more likely than others to cause depression as a side effect. Specifically, some medications that treat high blood pressure, cancer, seizures, extreme pain, and to achieve contraception can result in depression. Even some psychiatric medications, like some sleep aids and medications to treat alcoholism and anxiety, can contribute to the development of depression.
Post-traumatic Stress Disorder (PTSD) is a reaction to a highly stressful event outside the range of everyday experience when a person feels very unsafe or threatened. These are unsual experiences such as war, violent attack (verbal, physical or sexual) or a natural disaster. The symptoms usually include irritability, anxiety, flashbacks, repeated nightmares, and avoiding situations that might bring back memories of the event. 

Many factors contribute to depression, and it is likely caused by an imbalance of brain chemicals. Life events (such as stressful life changes) may also contribute to a depressed mood. Depression also tends to run in families. The exact biological cause of depression is still being investigated, including by scientists at McLean like Diego A. Pizzagalli, PhD.


Track your thoughts. Writing down your thoughts is a good way to identify those that are contributing to making you feel down and depressed; these might include thoughts like ‘I’m useless’ or ‘no one cares about me’. Just because we think something, it doesn’t mean it’s true, so learn how to challenge negative thinking. If your mood is really low and you have difficulty challenging your thoughts, avoid writing them down on your own and instead seek help from a mental health professional.
Ketamine is generally safe and has few side effects — besides that dissociative “high” thing, which can distress some people. Researchers still don’t know how well it works, exactly what the dose should be, and how long people ought to be treated with it. Like other antidepressants, how it works isn’t entirely clear either — it has effects on many chemical of our body’s signaling systems. But because it might only take a few treatments over a few weeks to see the same kinds of results that people see with today’s antidepressant pills — and faster — it’s a treatment that might help a lot of people.
Depression drains your energy, hope, and drive, making it difficult to take the steps that will help you to feel better. But while overcoming depression isn’t quick or easy, it’s far from impossible. You can’t just will yourself to “snap out of it,” but you do have more control than you realize—even if your depression is severe and stubbornly persistent. The key is to start small and build from there. Feeling better takes time, but you can get there by making positive choices for yourself each day.
Develop good habits. Take your depression medicine at the same time every day. It's easier to remember if you do it along with another activity such as eating breakfast or getting into bed. Get a weekly pillbox, which will make it easy to see if you've missed a dose. Since people sometimes forget a dose now and then, make sure you know what to do if that happens.

Krill oil may have benefits, but for now it's best to rely on omega-3 sources that have received greater scientific scrutiny, including fish, fish oil, and plant sources of ALA. The American Heart Association recommends that healthy adults eat at least two servings per week of EPA- and DHA-rich fish, such as salmon, herring, mackerel, sardines, and albacore or bluefin tuna. People with heart disease should consume 1 gram of EPA plus DHA daily from fatty fish or fish oil supplements. Heart experts also recommend getting ALA from food sources such as soy products, flaxseed, walnuts, and oils extracted from flaxseed, canola seed, olives, walnuts, or soybeans.

355 million people are affected by depression, making it one of the most common disorders in the world. Over 40 million American adults are affected by anxiety, making anxiety disorders the most common mental health conditions in the United States. At McLean Hospital, we are committed to providing support for individuals with depression and anxiety through world-class treatment, innovative research into causes and cures, and robust education for patients and families, clinicians, and the broader community.

Over the years, the technique of ECT has improved from the procedure that still invokes stigma in the minds of many. Physicians administer the treatment in the hospital under anesthesia so that people receiving ECT do not hurt themselves or feel emotional or physical pain during the induced seizures or at any other time. Most patients undergo six to 10 treatments. A health care professional passes an electrical current through the brain to cause a controlled seizure, which typically lasts for 20-90 seconds. The patient is awake in five to 10 minutes. The most common side effect is short-term memory loss, which usually resolves quickly. Doctors safely perform ECT as an outpatient procedure.

Express Yourself. Talk about what is bothering you with a therapist or with friends or family members. If you don't feel comfortable talking, then keep a journal and vent through writing. Expressive writing (such as in a journal) for 15 to 20 minutes three or four days in a row helps you get some perspective on what is bothering you. Writing about what you are feeling can also help decrease the pressure you may be feeling in the moment. Talking and journaling about what bothers you are both known to help raise mood.
Do your best to not be this way. Instead, choose to accept your diagnosis and to take the medications and other therapies that have been prescribed for you regularly. Make it a point to talk with your doctor when you are not getting relief as expected or new symptoms develop so that your doctor has a chance to address these concerns. Tell the people that you are close to that you are clinically depressed and ask for their help in overcoming the problem. For instance, your friends can help you resist the urge to withdraw and isolate, and give you feedback as to how you appear to be doing both physically and emotionally. Allow the time necessary for medication therapies to pass before you decide that they aren't working. In general, accept your diagnosis and cooperate as best you can with the people who are trying to help you recover.
Anxiety disorders are the most common type of mental disorder. 50-60% of migraine patients will suffer from an anxiety disorder. Most anxiety disorders involve chronic worry or fear and avoiding things that trigger these feelings. In panic disorder, the patient has recurrent, unexpected feelings of intense fear or terror that seem to come from out of the blue. The heart starts beating rapidly and breathing becomes strained. Other symptoms may involve sweating, fear of dying, or losing control. Although attacks don’t last very long and are not dangerous, many people develop significant anxiety between attacks and come to fear normal body sensations.
Schizophrenia is associated with an imbalance of dopamine (too much) and serotonin (poorly regulated) in certain areas of the brain. Finally, the depressive disorders appear to be associated with altered brain serotonin and norepinephrine systems. Both of these neurochemicals may be lower in depressed people. Please note that depression is "associated with" instead of "caused by" abnormalities of these neurochemicals because we really don't know whether low levels of neurochemicals in the brain cause depression or whether depression causes low levels of neurochemicals in the brain.

Whether or not someone has side effects, which side effects they have, and how frequent they are will depend on the drug and on the dose used. And everyone reacts slightly differently to drugs as well. The risk of side effects increases if other medication is also being taken. One of the drugs may make the side effects of the other worse. These kinds of drug interactions are common in older people and people with chronic illnesses who are taking several different kinds of medication.


Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.

Bupropion inhibits neuronal dopamine reuptake and decreases the rate of norepinephrine activity. In addition to major depressive disorder, the indications for bupropion include smoking cessation. Off-label indications include attention-deficit/hyperactivity disorder and depression associated with bipolar disorder. Common side effects include headache and mild weight loss. Unlike other antidepressants, bupropion does not cause sexual dysfunction.
No matter how hopeless things may feel today, people can get better with treatment — and most do. The key to successful treatment is usually dependent upon the person recognizing there’s a problem, seeking out treatment for it, and then following the treatment plan agreed to. This can be far more challenging for someone who’s depressed than it sounds, and patience is a core necessity when starting treatment.
Parents may need to provide more comfort and support than usual for their children. It is not unusual for a child to regress to an earlier stage of development following a traumatic event. Children may find it hard to separate from parents, become clingy or emotionally needy during a hospital stay. Children usually show signs of greater independence by the time of discharge. Please talk to your physician if these problems do not improve.
There are a lot of different medications for depression. But it's difficult to predict how well a particular medication will help an individual. Because of this, doctors often first suggest taking a drug that they consider to be effective and relatively well tolerated. If it doesn't help as much as expected, it's possible to switch to a different medication. Sometimes a number of different drugs have to be tried out before you find one that works.
Once you have your list of questions, it’s time to seek out referrals. If you know other people in your area who suffer (or have suffered) from depression, ask them. Word of mouth can be a great way to find a good match. If this is not possible, begin with your physician. It’s always a good idea to get a physical if you suspect major depressive disorder because some medical problems can cause similar symptoms. If medical conditions are ruled out as a cause of the symptoms of depression, ask your primary care physician for a list of referrals for therapists.

Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first three months after childbirth. Women can experience psychotic depression, in that the depression causes them to lose touch with reality, have auditory hallucinations (hearing things that aren't actually happening, like a person talking when there is no one there), and delusions (interpreting things completely differently from what they are in reality). Visual hallucinations (seeing things that aren't there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, strange feelings and behaviors, as well as less commonly having suicidal or homicidal thoughts. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes doctors hospitalize women because they are at risk for hurting themselves or someone else, including their baby.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Women—Depression is diagnosed twice as much in women as it is in men. Some reasons for this difference include life-cycle changes, hormonal changes, higher rates of childhood abuse or relationship violence, and social pressures. Women are usually more comfortable seeking help for their problems than men which likely means that depression in men may be highly under-reported. Men generally feel emotionally numb or angry when they are depressed whereas women usually feel more emotional.
8. Check with your doctor before using supplements. "There's promising evidence for certain supplements for depression," Cook says. Those include fish oil, folic acid, and SAMe. But more research needs to be done before we'll know for sure. Always check with your doctor before starting any supplement, especially if you’re already taking medications.

Even in the most severe cases, depression is highly treatable. The condition is often cyclical, and early treatment may prevent or forestall recurrent episodes. Many studies show that the most effective treatment is cognitive behavioral therapy, which addresses problematic thought patterns, with or without the use of antidepressant drugs. In addition, evidence is quickly accumulating that regular mindfulness meditation, on its own or combined with cognitive therapy, can stop depression before it starts by effectively disengaging attention from the repetitive negative thoughts that often set in motion the downward spiral of mood.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They are highly effective and generally cause fewer side effects than the other antidepressants. SSRIs help to alleviate symptoms of depression by blocking the reabsorption or reuptake of serotonin in the brain. Serotonin is a naturally occurring neurotransmitter (chemical) that is used by brain cells to communicate. As SSRIs mainly affect the levels of serotonin and not levels of other neurotransmitters, they are referred to as “selective.”
Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first three months after childbirth. Women can experience psychotic depression, in that the depression causes them to lose touch with reality, have auditory hallucinations (hearing things that aren't actually happening, like a person talking when there is no one there), and delusions (interpreting things completely differently from what they are in reality). Visual hallucinations (seeing things that aren't there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, strange feelings and behaviors, as well as less commonly having suicidal or homicidal thoughts. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes doctors hospitalize women because they are at risk for hurting themselves or someone else, including their baby.
Behavioral activation is the practice of gradually increasing activity to experience more pleasure and mastery in life, according to Joel Minden, Ph.D., a clinical psychologist at the Chico Center for Cognitive Behavior Therapy. The therapeutic technique is relatively new, so it has a limited amount of research backing it. Nonetheless, it did spring from cognitive behavior therapy [CBT], which has mountains of research to support its efficacy.
It's also common for people who are having a difficult time with an anxiety disorder to feel depressed as a result of the way anxiety is interfering with their lives. It's my experience that most patients who experience this will find that their depression lifts naturally as a result of doing better with anxiety, and no special treatment for the depression is necessary.
Clinical depression goes by many names, such as “the blues,” biological or clinical depression, and a major depressive episode. But all of these names refer to the same thing: feeling sad and depressed for weeks or months on end — not just a passing blue mood of a day or two. This feeling is most often accompanied by a sense of hopelessness, a lack of energy (or feeling “weighed down”), and taking little or no pleasure in things that once gave a person joy in the past.
For many people with SAD, simply waiting for spring to arrive is not an option. Light therapy, which generally involves sitting in front of a light box first thing in the morning, can help; so can cognitive behavior therapy, a type of psychotherapy. Physicians also prescribe antidepressants, usually an SSRI (selective serotonin reuptake inhibitor), a category of drug that includes Prozac and Zoloft, or Wellbutrin (bupropion). Combining a number of different approaches under the oversight of a physician may be your smartest move.
Depression is different from anxiety. Rather than feeling anxious and nervous, feelings of gloom and melancholy overwhelm. Feeling sad or down after experiencing a loss or disappointment is an emotion that everyone feels at one time or another. But when low mood and sadness is severe and lasts for long periods of time, it could be due to depression.
Stimulants such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine), or their derivatives (for example, Concerta, Metadate or Focalin; Adderall or Vyvanse, or extended-release mixed salts of amphetamine [Mydayis] respectively), which are primarily used to treat attention deficit hyperactivity disorder (ADHD), are also used for the treatment of depression that is resistant to other medications. The stimulants are most commonly used along with other antidepressants or other medications, such as mood stabilizers, antipsychotics, or even thyroid hormone. They are sometimes used alone to treat depression but rarely. The reason they are usually used sparingly and with other medications for depression is that unlike the other medications, they may induce an emotional rush and a high in both depressed and nondepressed people, particularly if taken in doses or ways other than how they are prescribed. Therefore, the stimulants are potentially addictive drugs.
Major depression is characterized by at least five of the diagnostic symptoms of which at least one of the symptoms is either an overwhelming feeling of sadness or a loss of interest and pleasure in most usual activities. The other symptoms that are associated with major depression include decrease or increase in appetite, insomnia or hypersomnia, psycho motor agitation or retardation, constant fatigue, feelings of worthlessness or excessive and inappropriate guilt, recurrent thoughts of death and suicidal ideation with or without specific plans for committing suicide, and cognitive difficulties, such as, diminished ability to think, concentrate and take decisions. The symptoms persist for two weeks or longer and represent a significant change from previous functioning. Social, occupational, educational, or other important functioning is also impacted. For instance, the person may start missing work or school, or stop going to classes or their usual social activities. 
Being both anxious and depressed is a tremendous challenge. Clinicians have observed when anxiety occurs comorbidly (together) with depression, the symptoms of both depression and anxiety are more severe compared to when each disorder occursalone. Moreover, the symptoms of depression take longer to resolve, making the illness more chronic and more resistant to treatment (read more about: Depression Treatment).

Because depression can affect how a person acts, it might be misunderstood as a bad attitude. Other people may think the person isn't trying or not putting in any effort. For example, a negative or irritable mood can cause someone to act more argumentative, disagreeable, or angry. That can make the person seem difficult to get along with or cause others to keep their distance. Low motivation, low energy, difficulty concentrating, and thoughts of "why bother?" can lead someone to skip classes or school.


The definition of a genetic disease is a disorder or condition caused by abnormalities in a person's genome. Some types of genetic inheritance include single inheritance, including cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis. Other types of genetic diseases include multifactorial inheritance. Still other types of genetic diseases include chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Stay Socially Engaged. The core symptoms of depression push people to stop participating with others socially and emotionally and motivate them to isolate. It is important to work to resist these urges to isolate as best you can. Let your family, friends and associates help you. Accept invitations to social events and maintain your typical social schedule as best you can even if you are not enjoying your participation as much as you used to. Staying socially engaged provides you with social support, offers you a distraction from the repetitive negative ruminations you are otherwise going to be prone to experiencing, may offer some pleasure even if that feeling is fleeting for a while, and can provide you with opportunities for reality testing (so that you don't take your depressive ideas about how worthless you are too seriously).
Invite the depressed person for walks, outings, and to the movies and other activities. Be gently insistent if the depressed individual refuses your invitation. Encourage participation in activities that once gave pleasure, such as hobbies, sports, or religious or cultural activities. However, do not push the depressed person to undertake too much too soon. The depressed person needs company and diversion, but too many demands can increase feelings of failure and exhaustion.
The study has also gone beyond to compare the level of depressive mood between the victims and non-victims of the daily bullying. Although victims were predicted to have a higher level of depressive mood, the results have shown otherwise that exposure to negative acts has led to similar levels of depressive mood, regardless of the victim status. The results therefore have concluded that bystanders and non-victims feel as equally depressed as the victim when being exposed to acts such as social abuse.[29]
Krill oil may have benefits, but for now it's best to rely on omega-3 sources that have received greater scientific scrutiny, including fish, fish oil, and plant sources of ALA. The American Heart Association recommends that healthy adults eat at least two servings per week of EPA- and DHA-rich fish, such as salmon, herring, mackerel, sardines, and albacore or bluefin tuna. People with heart disease should consume 1 gram of EPA plus DHA daily from fatty fish or fish oil supplements. Heart experts also recommend getting ALA from food sources such as soy products, flaxseed, walnuts, and oils extracted from flaxseed, canola seed, olives, walnuts, or soybeans.
Once you have your list of questions, it’s time to seek out referrals. If you know other people in your area who suffer (or have suffered) from depression, ask them. Word of mouth can be a great way to find a good match. If this is not possible, begin with your physician. It’s always a good idea to get a physical if you suspect major depressive disorder because some medical problems can cause similar symptoms. If medical conditions are ruled out as a cause of the symptoms of depression, ask your primary care physician for a list of referrals for therapists.

People who wonder if they should talk to their health professional about whether or not they have depression might consider taking a depression quiz or self-test, which asks questions about depressive symptoms that are included in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), the accepted diagnostic reference for mental illnesses. In thinking about when to seek medical advice about depression, the sufferer can benefit from considering if the sadness lasts more than two weeks or so or if the way they are feeling significantly interferes with their ability to function at home, school, work, or in their relationships with others. The first step to getting appropriate treatment is accurate diagnosis, which requires a complete physical and psychological evaluation to determine whether the person may have a depressive illness, and if so, what type. As previously mentioned, the side effects of certain medications, as well as some medical conditions and exposure to certain drugs of abuse, can include symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through a clinical interview, physical examination, and laboratory tests. Many primary care doctors use screening tools, which are symptom tests, for depression. Such tests are usually questionnaires that help identify people who have symptoms of depression and may need to receive a full mental health evaluation.
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Postpartum depression, in which mothers experience symptoms of major depression after giving birth. Mood impairment is much stronger, and lasts longer, than the “baby blues” — the relatively mild symptoms of depression and anxiety that many new mothers experience. Feelings of extreme sadness, anxiety, or exhaustion can make it difficult for the mother to bond with or care for her baby.

Education for people with depression is extremely valuable. Education provides a knowledge base that potentially gives the person greater control over his or her disorder. Greater control in turn may lead to reduced feelings of helplessness and an increased sense of well-being. Providing education for families or carers is also very important to help increase the support and assistance they provide to the person.
Antidepressant medication side effects and drug interactions are barriers to successful treatment for depression. Some side effects of antidepressants resolve with continued use while other side effects can be managed by dose reduction or adding other therapies. Appropriate management of side effects and avoiding drugs and alcohol that may interact with antidepressants may improve the success of depression therapy.
^ Jeronimus BF, Kotov R, Riese H, Ormel J, et al. (October 2016). "Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants". Psychological Medicine. 46 (14): 2883–2906. doi:10.1017/S0033291716001653. PMID 27523506.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.
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