• No interest or pleasure in things you used to enjoy
• Feeling sad or empty
• Crying easily or crying for no reason at all
• Feeling slowed down or feeling restless and unable to sit still
• Feeling worthless or guilty
• Change in appetite, leading to weight gain or loss
• Thinking about death or suicide
• Trouble thinking, recalling things or focusing on what you’re doing
• Trouble making everyday decisions
• Problems sleeping, especially in the early morning, or wanting to sleep all of the time or “hide under the covers”
• Feeling tired all of the time
• Feeling numb emotionally, perhaps even to the point of not being able to cry

A new study has indicated that new generation antidepressants only benefit the most severely depressed people.

According to the findings, these drugs ‘do not produce clinically significant improvements in depression in patients who initially have moderate or even severe depression’.

As part of the study, a team from the University of Hull in the UK analysed data on all of the clinical trials that had been submitted to the US Food and Drugs Administration (FDA) for the licensing of four drugs that belong to the SSRI group of drugs.

SSRIs (selective serotonin reuptake inhibitors) are the newest type of antidepressants available. They include Prozac and Seroxat.

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As with nonpregnant women, mild depression in pregnancy and postpartum can be treated with psychological therapies.

If medication is required and a woman is pregnant, she should discuss this with her healthcare provider, as some medications carry a risk of affecting the fetus. This risk needs to be weighed against the risk of the mother’s depression symptoms being untreated or getting worse.

Postpartum depression is usually treated with a mixed approach including psychological treatment, medication, and addressing specific issues in the postpartum period, such as sleep deprivation and family stressors. Psychological treatment can be given in group settings as well as individually. Education on looking after the newborn is useful, too. When deciding on an antidepressant medication, it is important to remember that some medications can be secreted into breast milk and, therefore, may not be the first choice for a breastfeeding woman.

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There are various factors that will influence how well a person with depression is treated will respond to treatment and what his or her chances of relapse. Generally, after one episode of depression there is a 50% chance of relapse.

The following factors are important in predicting how well someone will respond to antidepressant treatment.

• Ongoing life stressors as an adult such as relationship or marital difficulties will place an increased burden on the recovery process and will need to be addressed with psychological therapy.
• Major childhood stressors, such as experiences of child abuse, need to be addressed with psychological therapy at the same time as depression is treated with medication to help improve a child’s coping abilities and recovery.
• Alcohol and/or drug abuse may need to be treated separately from the symptoms of depression. This can be achieved by seeking specialized drug and alcohol counseling and treatment programs. Alcohol and/or drug abuse is a common comorbidity with depression and the prognosis of depression with this comorbidity is not good.
• Psychiatric comorbidities may be treated in addition to the symptoms of depression itself. Common comorbidities to depression are:

1. Anxiety disorders (panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder)
2. Cognitive disorders (specifically dementia)
3. Eating disorders
4. Somatoform disorders
5. Personality disorders
6. Sleep disorders (for example, obstructive sleep apnea)
7. Substance use disorders (drug abuse)

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There are various types of psychological treatments that your healthcare professional can discuss with you. The treatments will involve seeing a trained therapist for several sessions over a period of time. Some people may feel uncomfortable about this form of treatment as it involves revealing personal details to a healthcare professional and it carries a certain social stigma in our society. However, psychological treatments have been proven beneficial in treating depression and reducing the risk of relapse.

Research has shown that various forms of psychological treatment are effective in the treatment of depression including:

• Cognitive-behavioral therapy
• Interpersonal psychotherapy
• Brief dynamic therapy
• Marital therapy
• Family therapy

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Taking care of yourself and making some lifestyle changes may be effective in reducing your symptoms of depression and helping you recover. Some suggested lifestyle and self-care approaches include:

• Eating a healthful balanced diet
• Exercising daily
• Meditation
• Breathing exercises to reduce stress
• Avoiding smoking, drugs and excessive alcohol
• Surrounding yourself with a supportive friends and family
• Making sure you get enough sleep
• Planning pleasant events into your day

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Your healthcare professional will able to diagnose whether you are suffering from depression and its severity (mild, moderate, or severe) and he or she will be able to advise you on the best treatment approach. The goals of the treatment of depression include treating the symptoms as well as addressing the psychological, social, and physical issues that may have contributed to its development.

In order to assist you in finding the best approach to treatment your healthcare professional may refer you to a mental health specialist like a psychiatrist, who specializes in the diagnosis and treatment of mental illnesses. Your healthcare professional is more likely to refer you to a mental health specialist if your depression is severe, if you are expressing suicidality, if you experience a relapse, or if you need specialized treatments such as psychotherapy. He or she might also refer you if your depression is part of another mental illness such as bipolar disorder, or if its not clear whether your symptoms represent depression.

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It is very important that you discuss with your healthcare professional what to expect with treatment and especially treatment duration. Antidepressants generally take 4 to 6 weeks to have an effect, so don’t give up on the medication immediately. See you healthcare professional for a regular checkup during the first 6 weeks to determine whether the treatment is working. Sometimes you may need to start on a lower dose and taper the dosage upwards to reach the medication’s full effectiveness.

Talk to your healthcare professional if you experience side effects from your antidepressant medication; he or she may suggest one of the following approaches:

• Starting the medication at a low dose and slowly tapering it up
• Sticking to low doses of the medication and adding in another medication for an increased effect, if needed
• Taking the medication at a different time of the day. To reduce, for example, the feeling of tiredness or sleepiness, you might try taking the medication at night instead of in the morning.
• Try a different medication

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The statistics

• In any given 1-year period, 9.5% of the population, or about 20.9 million American adults, suffer from a depressive illness.
• The prevalence of major depression in women is about two times higher than in men—this difference begins in early adolescence and persists through one’s mid-50s, corresponding to the reproductive years in women.
• The prevalence of postpartum depression (PPD) is 5% to 10%, which is the same prevalence of depression in nonpregnant women of the same age.

How does depression affect women differently?

Certain side effects of depression occur much more prevalently in women than in men. For example, symptoms such as anxiety and eating disorders are much more common in women. Men have an increased risk of completed suicide and alcohol or drug abuse.

• Episodes of depression may be longer in women; depression may be more chronic and recurrent.
• Factors that contribute to depression for women include stressful The goals of treatment in depression involve reducing your current symptoms as well as preventing chronic symptoms and relapse of your depression. While there are specific recommendations for preventing chronic symptoms and relapse, preventing the development of depression altogether is not as clear cut. There are many different treatments available for depression, however, many people with depression are not properly diagnosed and treated, perhaps due to the social stigma surrounding depression. In addition, many healthcare professionals find it difficult to diagnose depression if people do not talk about their symptoms and can hide the signs. However, you should understand that the earlier depression is treated the shorter duration of the illness and the less likely it is to become chronic and relapsing. events, seasonal changes, and hormonal changes such as menopause.
• In terms of treatment, women seem to respond better to selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) than tricyclic antidepressants (TCAs).
• Both men and women can be treated to remission with therapy, and remission rates are higher for both men and women when accompanied by a serotonin-norephinephrine reuptake inhibitor (SNRI).

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Depression comes in many different forms, each of which affects sufferers in different ways. The three most common forms of depression are:

Major Depression: Also known as clinical depression or unipolar depression, this type of depression is characterized by a combination of symptoms (above) that interfere with the ability to function normally and to enjoy activities that were once pleasurable, including sex. Treatment should be sought if any of these symptoms occur at once, if symptoms persist for 2 weeks or more, or if symptoms interfere with ordinary functioning. Major depression may occur once in a lifetime or may recur.

Dysthymia: This type of depression is less severe than major depression, but the symptoms are long-term and chronic. While a person suffering from dysthymia won’t be disabled by the illness, he/she will not function well or feel good. Many people who battle dysthymia may also experience major depression in their lives.

Bipolar Personality Disorder (BPD): This illness is characterized by cycling mood swings with severe highs (mania) and severe lows (depression). The mood swings may be dramatic and sudden, but more often they are gradual. When the person is in a depressed phase, he/she may experience any or all of the symptoms of depression.

Symptoms of mania

• Abnormal or excessive elation
• Unusual irritability or restlessness
• Grandiose notions
• Increased talking
• Racing thoughts, jumping from one idea to another
• Increased sexual desire
• Markedly increased energy and reduced sleep requirements
• Poor judgment
• Inappropriate social behavior
• Impulsive activity (for example, spending sprees or drug use)