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Anxiety Disorder
Older Adults
  Depression and Bipolar Disorders  

Depression is a complex and confusing term that can refer to a state of mind, a mood, an emotional adjustment problem or a serious psychiatric illness. 

Almost everyone knows what it is like to feel depressed but not everyone knows what it feels like to experience a major depressive illness that seriously impairs their ability to function and cope with life. Conditions that are called clinical depression, major depression, depressive illness, endogenous depression or 'biochemical imbalance' usually manifest physical symptoms such as persistent tiredness, fatigue, loss of interest and pleasure, sleep problems(too little or too much sleep) and appetite changes(eating more or less than usual). There is usually a sad, negative, pessimistic or even hopeless mood but in some cases only unusual impatience and irritability may be present. Disturbances of concentration and attention as well and memory and decision making may be present. The depressed person often worries about his health and fears coming down with a serious illness - including insanity, the fear of which is common in depression. Along with the decreased ability to enjoy and look forward to things the depressed person often loses interest in sex and other activities they formerly enjoyed.

Although depression may and sometimes does arise seemingly from nowhere in the midst of a life without unusual stresses or strains, in many cases there are precipitating causes or triggers for serious depression, such as the loss of an important relationship or a major and stressful life change or illness. Events that might be expected to cause a relatively mild and self-limited depression in normal individuals may initiate a progressive and ongoing depression in those predisposed to depression by genetics or family history.

Medical illnesses and medications may sometimes cause depressions that are indistinguishable from clinical depression. Substance use and abuse, e.g. alcohol, cocaine and other mind and mood altering chemicals may result in chronic and sometimes treatment resistant depressions as long as the substances continue to be consumed.

Depression may consist of a single episode with full remission or of recurrent episodes with full or partial remission between episodes. In general, major depression tends to be a recurrent illness. Individuals who have had one episode have about a 50 per cent chance of having another episode at some time in their lives. In a minority of cases depression is preceded or followed by euphoric or elated mood states with hyperactivity of thought and behavior, including impulsive or irrational decisions which may later be regretted when the bipolar or manic state has worn off.  

Proper treatment of depression requires correct diagnosis of the type and severity of the depression along with an evaluation of all personal, medical and social factors that may be contributing to it or making recovery difficult. By no means must all depressions be treated with anti-depressant medications, although there are some, usually the more severe depressions, that respond best to appropriate psychopharmacologic treatment combined with individual or group psychotherapy.

Psychological theories and treatments of depression focus upon loss, grieving and irrational or unrealistic thoughts. Many depression prone individuals are perfectionistic and hold such high standards for themselves that they are constantly failing to live up to their own demands on themselves, becoming discouraged, demoralized and depressed as a result. Sometimes individuals find their own feelings and thoughts unacceptable and difficult to deal with, as in the case of anger at others which is then denied, repressed or internalized, sometimes turning into depression.  Depression may be a natural and valuable warning sign of an unhealthy lifestyle or relationship and thus likely to remit spontaneously when the afflicted person gives proper heed to the symptom of trouble and begins to take better care of themselves. In other cases depression may signal existential or spiritual difficulties which require attention before the individual can begin to feel better and find more satisfaction in life.

Regardless of cause, most depressions are characterized by a pervasive impairment of the ability to enjoy and take satisfaction in matters great and small. The capacity to look forward to and positively anticipate the future is lost or impaired and is often replaced by a gloomy sense of foreboding and dread of feared or unknown complications and catastrophes. The depressed individual tends to feel weary and heavy laden and to soldier on as though upon a perpetual forced uphill march. His gratifications are few but his worries and tribulations many. Life goes from an interesting three dimensional color production to a flat, stale, two dimensional black and white endless re-run.

Like a bad weather system that so completely obscures the sun and sky that it becomes difficult for those trapped beneath it even to remember what brighter and warmer days were like, depression casts a pall over past, present and future alike. The depressed individual may become convinced, contrary to all evidence, that he has never really been happy, that his entire life has been a tale of misery and suffering, and that the future promises no better but only worse for him. One of the most painful and sometimes lethal features of depressive thinking is its tendency to deprive the sufferer of hope itself. Even individuals who have successfully recovered from previous episodes of severe depression may be convinced that the latest episode is different and that they will never feel well again. But whatever the cause and no matter how severe, depression is always treatable.

Frequently Asked Questions About Psychiatry and Mental Health
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Links Depression Site
News, articles, links.

Andrew's Depression Page

Depression Central
The Internet's central clearinghouse for information on all types of depressive disorders and on the most effective treatments for individuals suffering from Major Depression, Manic-Depression (Bipolar Disorder), Cyclothymia, Dysthymia and other mood disorders.

Electroconvulsive Therapy(ECT)
From Depression Central

Famous People With Bipolar Disorders

News and information about depression and its treatments.

National Depressive and Manic-Depressive Association
The mission of the National Depressive and Manic- Depressive Association is to educate patients, families, professionals, and the public concerning the nature of depressive and manic-depressive illness as treatable medical diseases; to foster self-help for patients and families; to eliminate discrimination and stigma; to improve access to care; and to advocate for research toward the elimination of these illnesses.

National Foundation for Depressive Illness, Inc.
The National Foundation For Depressive Illness (NAFDI) was established in 1983 to provide public and professional information about Affective Disorders, the availability of treatment, and the urgent need for further research.

National Institute on Mental Health
Information about depression and bipolar disorder from the NIMH.

Online Support Groups

Suicide and Suicide Prevention
From Depression Central

Walkers in Darkness, Inc. is a tax exempt charitable organization [501(c)(3)] established to promote the general mental health and well-being of those individuals who are afflicted with, who are associated with individuals who are afflicted with, or who are otherwise interested in, mental and emotional disorders by developing and maintaining a forum which shall provide a means by which the above-described individuals may communicate with one another in an open forum with regard to mental and emotional disorders; and provide access to general educational information pertaining to mental and emotional disorders.

What is Called Depression? 
Phenomenology of depression.

Writings by People With Mood Disorders
From Depression Central