Depression: Myths, Causes, and Types of Depressive Disorders

We all feel blue occasionally. Few of us have escaped the pain of a job loss, a failed relationship, or a loved one's death. Heartache and grief are natural parts of life. But when sadness persists and interferes with your day-to-day activities, there's a chance it might be depression.
In this section, you'll learn more about depression and the myths surrounding it, causes of depression, and the different types of depression.

You'll find a list of symptoms, some treatment options, and tips for living with depression from day to day.

About Depression
Depression is a serious medical disorder with biological causes—just like high blood pressure or diabetes—and can be treated in most people.

Left untreated, depression wreaks havoc on a person's quality of life. It may worsen symptoms of other diseases, and even can be fatal. People who have a stroke or heart attack, for example, are more likely to die if they have depression.

Also, people with depression are more likely to attempt suicide—which is more common among elderly people than any other age group.

Dispelling Myths About Depression
Many people mistakenly believe that depression is normal for older people, or that little can be done about it. We may think depression is a character flaw, a sign of weakness, or something that we should be able to "snap out of."

It's time to dispel these and other myths about depression.

While it is true that depression is more common in older people than in the general population, it is not an inevitable part of aging. Nor is it something that we can control at will, or something we should be ashamed of.

Because of these myths, and the biases that arise from them, many people suffer from depression that is not diagnosed or treated. In fact, some studies show that less than 25 percent of people with depression are accurately diagnosed and adequately treated.

This problem may be even worse among the elderly, who often have other medical conditions that make it more difficult to diagnose and treat depression.

What Causes Depression?
Depression is a brain disorder in which changes occur in certain brain chemicals called neurotransmitters. Scientists are still trying to learn what causes these chemical imbalances; many experts believe a combination of genetic, psychological, and environmental factors is involved.

Environmental factors that might trigger depression include grief from the loss of a loved one, serious financial difficulties, or problems in relationships, all of which can cause serious ongoing stress. Other factors linked to depression include low self-esteem, consistent pessimism, and a tendency to be overwhelmed by stress. These attributes may actually be an early form of depression, or they may predispose a person to depression.

Scientists have not yet discovered the exact role our genes play in depression. Some types of depression run in families, suggesting that there is a genetic basis for the disorder. However, many people with depression have no family history. And not everyone with a family history of depression develops the condition.

Depression and Chronic Illness
Studies suggest that at least 25 percent of people who have a chronic illness also have depression. It may seem natural to feel depressed and frustrated by persistent illness. However, it is critical to realize that depression is a serious medical condition, and can be treated effectively in most people.

The ongoing stress associated with chronic health problems is believed to initiate changes in the brain's stress-response system that may set the stage for depression. People who have had a stroke, a heart attack, or heart surgery are particularly at risk.

Types of Depressive Disorders
Recent brain research suggests that depression may be a chronic condition, and that its symptoms occur throughout life in some people. For example, studies have shown that people who have even one depressive "episode" in their lives are at increased risk for developing major depression. Depression in later life may actually be a recurrence of an earlier episode.

A diagnosis of depression might specify one of two primary types:

• Major Depressive Disorder
• Bipolar disorder

Major Depressive Disorder
Major depressive disorder (sometimes known as unipolar depression) is a depressed state that lasts several weeks or months with no significant intervening manic episodes. It is often categorized either as major depression or as dysthymia.

• Major depression may be diagnosed in a person who experiences five or more depressive symptoms (see Symptoms of depression) nearly every day in a two-week period—especially if the symptoms interfere with his or her day-to-day life.
• Dysthymia is a less severe, but no less important, form of depression. It usually involves two or more symptoms that may not disable a person, but which keep him or her from feeling good and functioning well.

Bipolar Disorder (Manic-Depressive Illness)
Bipolar disorder—commonly called "manic depression"—is less common than, but just as serious as, major depressive disorder. It is associated with an even higher risk of suicide.

Bipolar disorder is a brain-based mental illness, and is separate from major depressive disorder. It involves a cycle of mood changes from severe highs (mania) to severe lows (depression), intermixed with normal periods.

Mood changes may happen quickly, sometimes over the course of a single day. But people with bipolar disorder more often go through intensive periods of mania lasting for several days, followed by lengthy periods of depression. Sometimes, between episodes, people with bipolar disorder can go for weeks or even years with no symptoms.

When in the depressed cycle, person with bipolar disorder may have any or all of the symptoms of a depressive disorderThe same person, in the manic cycle, may have any or all of the following symptoms:

Symptoms of Mania

• Exaggerated optimism and self-confidence
• Decreased need for sleep without experiencing fatigue
• Grandiose delusions, inflated sense of self-importance
• Excessive irritability, aggressive behavior
• Increased physical and mental activity
• Racing speech, fleeting thoughts, easily distracted
• Impulsiveness or poor judgment
• Reckless behavior, such as spending sprees, rash business decisions, erratic driving, flagrant affairs

Depressive disorders require immediate medical attention, preferably by a specialist. Next, you'll learn about the symptoms of depression, how to get help, and current treatments available. You'll also find some tips to help you or a loved one live with depression.