What is depression?

By Dr. Dionne Hart, MD

The brain is vital to thinking, personality, mood, and daily function. Much of the brain’s functions remains a mystery; however, there is evidence depression is related to chemical changes in the brain.

Depression is a medical illness that affects an individual’s mood, thought process, and function. A patient with depression may experience sadness most days, crying spells, anxiety, irritability, and an inability to feel enjoyment. Depressed patients often have difficulty concentrating, making decisions, completing goals, performing well at work or school, and recalling events.

Depressed patients and their loved ones may notice slowed movements, low energy, sleep disturbance, changes in appetite, or isolation. Those affected often feel hopeless, leading to thoughts of ending their life.
Depression is the leading cause of disability worldwide. At least 350 million people live with depression.

Why should I care about depression?

Depression is a medical illness, just like heart disease or diabetes. Having depression doesn’t mean you are a weak person or defective in anyway. Untreated depression can negatively impact relationships, work
performance, or ability to comply with treatment for other illnesses such as diabetes or hypertension. Individuals with untreated depression may attempt suicide.

According to the Centers for Disease Control and Prevention (CDC), the groups more likely to meet criteria for depression are women, African Americans, Hispanics, persons with less than a high school education, divorced individuals, persons 45-64 years of age, people who are unemployed, and those without health insurance.

What causes depression?

There is no single cause of depression. Symptoms of depression may emerge slowly in response to a stressor such as a significant loss or the death of a loved one, or the symptoms may appear suddenly.  Depression may also be caused by a medical illness such as hypothyroidism or fluctuations in hormones such as during or after pregnancy. Women are two to three times more likely to have an episode of depression.

Patients with a single episode of depression are likely to have another episode. Depressed patients are likely to have a close family member with depression.

How is depression diagnosed?

Depression cannot be diagnosed with a blood test. Depression is diagnosed after completing a detailed history of medical problems, overall health, daily function, and life stressors with a mental health or primary care provider.

Can depression be prevented?

Patients with recurrent episodes may choose to take antidepressants to prevent episodes even after active symptoms are resolved.

How is depression treated?

Treatment for depression is based upon the patient’s symptoms and the severity of symptoms. Some patients may respond to therapy with a mental health professional or a trained spiritual advisor or a medication known as an antidepressant. The ideal treatment is a combination of therapy and an antidepressant.

Examples of antidepressants are Prozac, Celexa, Effexor and Wellbutrin. Common side effects are . Some side effects diminish with time.

Adolescents and young adults are closely monitored after beginning antidepressants as their energy may improve before negative thoughts improve, increasing risk of suicidal behaviors. Support from family members and friends helps patients with depression.

Action steps for anyone with depression 

Meet with a mental health provider or a primary care doctor.

Discuss treatment options with your provider.

Discuss any changes in symptoms or side effects with your provider.

Call for emergency assistance if you have thoughts of hurting yourself or someone else.

Meet regularly with your provider during treatment.

Include family members and friends when appropriate.

Participate in light exercise and eat a balanced diet.

Dr. Dionne Hart is a psychiatrist in Rochester, MN. Her practice name is Care from the Hart. Dr. Hart chairs the AMA Minority Affairs Section and MMA Minority and Cross Cultural Affairs Committee. She is a proud member of the NMA and MN Black Physicians.