Patient education: Depression in adults (The Basics)

What is depression? — Depression is a disorder that makes you sad, but it is different from normal sadness. Depression can make it hard for you to work, study, or do everyday tasks.

What causes depression? — Depression is caused by problems with chemicals in the brain called "neurotransmitters." Some people might be more likely to have depression if it runs in their family. Other things might also play a role, including hormones, certain health problems, medicines, stress, being mistreated as a child, family problems, and problems with friends or at school or work.

How do I know if I am depressed? — People with depression feel down most of the time for at least 2 weeks. They also have at least 1 of these 2 symptoms:

●They no longer enjoy or care about doing the things that they used to like to do.

●They feel sad, down, hopeless, or cranky most of the day, almost every day.

People with depression can also have other symptoms. Examples include:

●Changes in your appetite or weight. You might eat too little or too much, or gain or lose weight without trying.

●Sleeping too much or too little

●Feeling tired or like you have no energy

●Feeling guilty, helpless, or like you are worth nothing

●Trouble with concentration or memory

●Acting restless or have trouble staying still, or moving or speaking more slowly than normal

●Repeated thoughts of death or killing yourself

If you think that you might be depressed, see your doctor or nurse. Only someone trained in mental health can tell for sure if you are depressed.

How is depression diagnosed? — Your doctor or nurse will do a physical exam, ask you questions, and might order tests. Depression can have a big impact on your life. Luckily, depression can be treated, and the sooner treatment is started, the better it works.

Get help right away if you are thinking of hurting or killing yourself! — If you ever feel like you might hurt yourself or someone else, help is available:

●In the US, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to www.988lifeline.org/chat.

●Call your doctor or nurse, and tell them it is urgent.

●Call for an ambulance (in the US and Canada, call 9-1-1).

●Go to the emergency department at the nearest hospital.

What are the treatments for depression? — Your doctor or nurse will work with you to make a treatment plan. Treatment can include:

●Helping you learn more about depression

●Counseling (with a psychiatrist, psychologist, nurse, or social worker)

●Medicines that relieve depression

●Creating a plan to limit access to items that you might use to harm yourself

●Other treatments that pass magnetic waves or electricity into the brain

In addition to treatment, getting regular physical activity can also help you feel better.

People with depression that is not too severe can get better by taking medicines or talking with a counselor. People with severe depression usually need medicines to get better, and might also need to see a counselor.

Another treatment involves placing a device against the scalp to pass magnetic waves into the brain. This is called "transcranial magnetic stimulation" ("TMS"). Doctors might suggest TMS if medicines and counseling have not helped.

Some people with severe depression might need a treatment called "electroconvulsive therapy" ("ECT"). During ECT, doctors pass an electric current through a person's brain in a safe way.

When will I feel better? — Most treatment options take a little while to start working.

●Many people who take medicines start to feel better within 2 weeks, but it might be 4 to 8 weeks before the medicine has its full effect.

●Many people who see a counselor start to feel better within a few weeks, but it might take 8 to 10 weeks to get the greatest benefit.

If the first treatment you try does not help you, tell your doctor or nurse, but do not give up. Some people need to try different treatments or combinations of treatments before they find an approach that works. Your doctor, nurse, or counselor can work with you to find the treatment that is right for you. They can also help you figure out how to cope while you search for the right treatment or are waiting for your treatment to start working.

How do I decide which treatment to have? — You and your doctor or nurse will need to work together to choose a treatment for you. Medicines might work a little faster than counseling. But medicines can also cause side effects. Plus, some people do not like the idea of taking medicine.

Seeing a counselor involves talking about your feelings. That is also hard for some people.

What if I take medicine for depression and I want to have a baby? — Some depression medicines can cause problems for an unborn baby. But having untreated depression during pregnancy can also cause problems. If you want to get pregnant, tell your doctor but do not stop taking your medicines. Together, you can plan the safest way for you to have your baby.

It's also important to talk with your doctor if you want to breastfeed after your baby is born. Breastfeeding has lots of benefits for both mother and baby. Some depression medicines are safer than others to use while breastfeeding. But having untreated depression after giving birth can also cause problems, so do not stop taking your medicines. Your doctor can work with you to plan the safest way for you to feed your baby.

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Patient education: Depression in children and adolescents (Beyond the Basics)
Patient education: Depression treatment options for children and adolescents (Beyond the Basics)