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Many people are surprised when their doctor diagnoses them with Depression. This is due to common misconceptions as to what Depression actually is.

Depression is a biologically-based illness caused by deficits of certain chemicals in the brain. These chemicals, called neurotransmitters, transmit signals between the brain’s neurons and regulate overall mood, sleep, appetite, energy levels, sex drive, anxiety, and ability to experience pleasure. A person with Depression may have difficulty with sleep (too much or too little), appetite (too much or too little), feel fatigued and/or ‘on edge’ much of the time, worry excessively and/or lose interest in pleasurable activities.

Depressed mood is subtle and few of us are aware that our mood is depressed. We may feel that “things just aren’t going right” for us, that others are giving us a hard time or that we just can’t get anything done. Small incidents that are otherwise easily managed become irritating and overwhelming. We may be more forgetful, confused, and irritable, and worry about everything.

Depression has many causes. Some people are genetically prone to producing lower levels of neurotransmitters and may be at risk for episodes of Depression throughout their lives. Trauma or stress may trigger depression. Many people are affected by Seasonal Affective Disorder (SAD) which is caused by a lack of exposure to sunlight. For some people, there is no obvious ‘reason’ for Depression.

Depression has a way of ‘feeding’ itself. When people are depressed, they tend to be less active. Lack of activity depresses the central nervous system and results in lower production of the neurotransmitter Serotonin, with the result that the person will become more depressed. Similarly, depressed people tend to isolate themselves from others, again resulting in lowered production of Serotonin. Surprisingly, Serotonin production can also be affected by a person’s thought processes, with the negative thinking common with depressed mood lowering the production of Serotonin.

Fortunately, most Depressions are easily treated. Aerobic exercise and proper diet are helpful. A doctor may prescribe medication. Anti-depressant medications generally take a few weeks to become effective. It is very important for the patient to take the medication as prescribed. Many people stop taking their medication when they begin to feel better. This has the effect of worsening the Depression. Also, because everyone’s body chemistry is different, it may take a few trials of various anti-depressants to determine which will work best for the person. It is important to work closely with the doctor in monitoring the effects of any medications and to determine when and how to discontinue treatment.

Why Psychotherapy?

Numerous studies have shown that the best treatment for Depression is a combination of medication and psychotherapy. With milder Depressions, psychotherapy and aerobic exercise may be all that is needed to treat the illness. Psychotherapy may be likened to physical therapy in that the patient learns to recognize the onset of a depressive episode learns strategies to prevent relapses, and learns behaviors to promote their well-being. The most effective psychotherapeutic treatment for Depression is Cognitive-behavioral therapy. Cognitive-behavioral therapy focuses on symptom relief and not on underlying causes. Often this is enough to effect relief. In cases where trauma or other factors are contributing to the Depression, other therapies may be used in combination with Cognitive-behavioral therapy.

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