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[[File:Lange-MigrantMother02.jpg|thumb|200px|[[Dorothea Lange]]'s photograph ''[[Migrant Mother]]'' shows the despair of a woman trying to provide for her family during a time of economic hardship]]
{{Otheruses|Depression}}
'''Depression''' is a state of low mood and aversion to activity. A depressed person will experience or display some of the following:<ref name="NIMH">{{cite web | url = http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml | title = Depression | accessdate = 2010-05-22 | date = 2009-09-23 | publisher = [[National Institute of Mental Health]]}}</ref>
*Persistent sadness, anxiety or feelings of emptiness
*Feelings of hopelessness, helplessness and/or pessimism.
*Feelings of worthlessness or guilt
*Contemplating suicide or suicide attempt
*Problems concentrating, remembering details and making decisions
*Fatigue and loss of energy
*Persistent aches, pains or digestive problems that are resistant to treatment
*Irritability or restlessness
*Insomnia, waking early, or excessive sleeping
*Overeating, or appetite loss
*Loss of interest in activities that once were pleasurable (e.g., hobbies, sex, social activities, etc.)
For a discussion of mental illnesses featuring depression see [[mood disorder]], [[adjustment disorder]] and [[borderline personality disorder]].
== References ==
{{Reflist}}


'''Depression''' is a state of low [[mood]] and aversion to activity. The [[Diagnostic and Statistical Manual of Mental Disorders]] defines a depressed person as experiencing feelings of sadness, helplessness and hopelessness. In traditional [[colloquy]], feeling "depressed" is often synonymous with feeling "[[sadness|sad]]", but both [[clinical depression]] and non-clinical depression can also refer to a conglomeration of more than one feeling.

The precise number of individuals who have severe depression are not known but estimates indicate that about 12 million adults in the US have depression. Depression cuts across all barriers and affects all [[Race (classification of human beings)|races]], cultures and [[Social class|social classes]]. The disorder generally begins in early [[adult|adulthood]] but can occur at any age. While hospital data reveal that more women have depression, it is hypothesized that this is because men are less likely to seek treatment. Depression occurs in various grades and symptoms are likely to vary in intensity.

Slight depression is of minor consequence. One may become slightly depressed over a loss of a job; break up of a romantic relationship or [[divorce]]. Other causes of slight depressions include loss of a parent, sibling, marital stress, job [[anxiety]], moving or not having a great job. Slight depression may present with feelings of [[sadness]], sleeping problems, [[irritability]], being easily annoyed and feeling tired. Slight depression is reversible and short term. Most people get over slight depression with time and [[Supportive psychotherapy|supportive therapy]].

There are some individuals whom may develop mild depression, which may start gradually for no reason. The individual may start to feel tired, restless, [[lonely]] and have difficulty sleeping. In many cases, the individual loses interest in sex and wants to be left alone. One may be able to go to work but not have any enjoyment. Mild depression may last a lot longer than slight depression, but can be overcome with changes in lifestyle, [[psychotherapy]] and [[social support]]. <ref>[http://www.mayoclinic.com/health/depression/DS00175 Depression and major depression definition] Mayo Clinic. Retrieved on 2010-02-07</ref>

However, some individuals develop [[Major depressive disorder|severe depression]], which may induce feelings of [[suicidal ideation]] as it is common in severe depression. In severe depression, one may feel sad constantly, cry for no apparent reason, have trouble sleeping and focusing , become [[fatigue (medical)|fatigued]], feel worthless, have [[headache|headaches]] or even [[back pain|backache]] . <ref>[http://www.mayoclinic.com/health/depression/DS00175 Depression causes and treatment] MedicineNet. Retrieved on 2010-02-07</ref>
While slight depression has a cause, both mild and severe depression generally are complex disorders, which are not well understood. Mild depression may be related to the environment, such as being unable to cope with a certain job, unemployment, financial problems or loss of a loved one. No one understands why severe depression occurs. Even though many [[Neuroimaging|brain imaging]] studies have been done, the exact [[Neurotransmitter|neurotransmitters]] in the brain which play a role in depression are still in question. Some studies do show that severe depression may be more common in families. <ref>[http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml What is depression] National institute of mental health. Retrieved on 2010-02-07</ref>
Although the exact causes of depression are unknown, there are several risk factors that can trigger or increase the risk of depression. <ref>[http://www.netdoctor.co.uk/diseases/facts/depression.htm Depression overview] netDoctor Portal. Retrieved on 2010-02-07</ref>

==Symptoms==
There are many symptoms that signify depression. The frequency, duration, and severity of these symptoms will vary depending on the individual. <ref>[http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml Depression], National Institute of Health, 23 September 2009.</ref> Some signs and symptoms that can occur include:<ref>[http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml Depression], National Institute of Health, 23 September 2009.</ref><ref>[http://helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm Understanding Depression: Signs, Symptoms, Causes, and Help], Helpguide.org: Understand, Prevent and Resolve Life's Challenges.</ref>
*The most common feature of clinical depression is dysphoria, otherwise known as feeling down in the dumps
*Anger and/or irritability.
*Persistent sadness, the feeling of being "empty", and anxious.
*Changes in sleep patterns (insomnia, in particular during the early hours of the morning, or oversleeping which is also known as hypersomnia).
*Loss of interest in everyday activities.
*Appetite or weight changes (a significant weight gain or loss, by more than 5% of body weight).
*Irritability or restlessness.
*Loss of energy.
*Concentration problems.
*Fear of failure.
*Repetition in speech.
*Unexplained aches and pains.
*Frequent thoughts of suicide or death.
*Compulsive-obsessive disorders (such as chewing fingernails).
*Inability to control spending or eating.
*Feeling worthless or ignored.
*Loss of sexual inhabitions and erectile dysfunction/vaginal dryness

==Causes==
It is estimated that about 1 out of 6 adults suffer from depression.<ref>[http://www.abilify.com/depression/about/depression-treatment.aspx Add-on Depression treatment], Otsuko America Pharmaceutical, Inc., July 2009</ref> Although depression does not have a single cause, many things contribute to the feeling of depression, such as family history, pessimistic personality, trauma and stress, physical conditions, and other psychological disorders. <ref>[http://www.depression.com Understanding Depression], GlaxoSmithKline, 1997-2009.</ref> Gender may additionally be a contributing factor. The ratio of depression in men and women is 1:2. <ref>[Rao, U., & Chen, L. (n.d.). Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders. National Center for Biotechnology Information. Retrieved February 24, 2010, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766280/?tool=pubmed</ref>

===Risk factors===
* Having a family member or relative with depression.
* Having a family member who has committed suicide.
* Stressful events like losing a job, death of a loved one, financial difficulties.
* Having depression as a child or teenager.
* Having a [[chronic (medicine)|chronic]] illness like [[heart disease]], [[Alzheimer's disease]], [[AIDS]], or [[cancer]].
* Having a personality where one has low [[self-esteem]], no confidence, being dependent on others or being [[criticism|criticized]] all the time.
* Having just delivered a baby ([[postpartum depression]]).
* Having little or no money and being of a low [[socioeconomic status]]. Cultural considerations are relevant to mixed episodes as well.
Slight and mild depression may not cause any complications. But severe depression can have an agonizing toll on the individual and the family. When severe depression is untreated it can quickly lead to [[disability]] and suicidal thinking. Severe depression can also cause deep emotional turmoil, changes in behavior, and legal and monetary problems. <ref>[http://www.emedicinehealth.com/depression/article_em.htm Depression Facts and Causes] eMedicine Health Portal. Retrieved on 2010-02-07</ref>

Biological influences of depression are varied, but may relate to [[malnutrition]], [[Fructose malabsorption]]<ref>{{cite journal |author=Ledochowski M, Widner B, Murr C, Sperner-Unterweger B, Fuchs D |title=Fructose malabsorption is associated with decreased plasma tryptophan |journal=Scand. J. Gastroenterol. |volume=36 |issue=4 |pages=367–71 |year=2001 |pmid=11336160 |doi=10.1080/003655201300051135}}</ref>, [[heredity]], [[hormone]]s, [[Seasonal Affective Disorder|seasons]], [[stress (medicine)|stress]], [[illness]], drug or alcohol use, [[neurotransmitter]] malfunction, long-term exposure to dampness and mold,<ref>{{cite journal| title=Dampness and Mold in the Home and Depression: An Examination of Mold-Related Illness and Perceived Control of One’s Home as Possible Depression Pathways |author=Edmond D. Shenassa, Constantine Daskalakis, Allison Liebhaber, Matthias Braubach, and MaryJean Brown |year = 2007 |volume= 97 |issue= 10 | journal = American Journal of Public Health | doi = 10.2105/AJPH.2006.093773 | pmid = 17761567 | url = http://www.ajph.org/cgi/content/abstract/97/10/1893| pages=1893| pmc=1994167}}</ref> back injury, and to aerosol exposure.<ref>{{cite journal | title = Symptoms of mothers and infants related to total volatile organic compounds in household products | journal = Arch Environ Health | year = 2003 | volume = 58 |issue = 10 | pages = 633–41 | pmid = 15562635 | doi = 10.3200/AEOH.58.10.633-641 | author = Farrow, Alexandra | first2 = H | first3 = K | first4 = J}}</ref><ref>[http://www.news-medical.net/?id=5680 Air fresheners can make mothers and babies ill], University of Bristol press release issued 19 October 2004</ref> There are also correlations between long term sleep difficulties and depression. Up to 90% of patients with depression are found to have sleep difficulties.<ref>{{cite journal |author=Roth T |title=Prevalence, associated risks, and treatment patterns of insomnia |journal=J Clin Psychiatry |volume=66 Suppl 9 |issue= |pages=10–3; quiz 42–3 |year=2005 |pmid=16336036 |doi= |url=}}</ref>

==Complications==
When depression is neglected or severe, it can lead to:
* [[Suicide]].
* [[Substance abuse]].
* [[Alcoholism]].
* [[Anxiety]].
* Heart problems.
* Weight problems.
* Work-related problems.
* Family conflicts.
* Interpersonal difficulties.
* Social isolation and loneliness.

==Treatments==
{{Main|Treatment for depression}}

==As a [[defense mechanism]]==
A number of authors have suggested that depression is an [[natural selection|evolutionary adaptation]]. A low or depressed mood can increase an individual's ability to cope with situations in which the effort to pursue a major goal could result in danger, loss, or wasted effort.<ref name="Nesse00">{{cite journal |author=Nesse R |title=Is Depression an Adaptation? |journal=Arch. Gen. Psychiatry |volume=57 |issue= 1|pages=14–20 |year=2000 |pmid= 10632228|doi= 10.1001/archpsyc.57.1.14|url=http://www.google.com/url?sa=t&source=web&ct=res&cd=1&url=http%3A%2F%2Fwww-personal.umich.edu%2F%257Enesse%2FArticles%2FIsDepAdapt-ArchGenPsychiat-2000.pdf&ei=jk3MSovRNJ6qtgeY-6HtAQ&rct=j&q=%22is+depression+an+adaptation%22&usg=AFQjCNG_VSyM2WmMZebjLpzjgcj8CVluDQ}}</ref> In such situations, low motivation may give an advantage by inhibiting certain actions. This theory helps to explain why depression is so prevalent, and why it so often strikes people during their peak reproductive years. These characteristics would be difficult to understand if depression were a dysfunction, as many psychiatrists assume.<ref name="Nesse00"/>

Depression is a predictable response to certain types of life occurrences, such as loss of status, divorce, or death of a child or spouse. These are events that signal a loss of reproductive ability or potential, or that did so in humans' ancestral environment. Depression can be seen as an adaptive response, in the sense that it causes an individual to turn away from the earlier (and reproductively unsuccessful) modes of behavior.

A depressed mood is common during illnesses, such as [[influenza]]. It has been argued that this is an evolved mechanism that assists the individual in recovering by limiting his/her physical activity.<ref name="Nesse94">''Why We Get Sick: The New Science of Darwinian Medicine'', Randolphe M. Nesse and George C. Williams | Vintage Books | 1994 | ISBN 0-8129-2224-7</ref> The occurrence of low-level depression during the winter months, or [[seasonal affective disorder]], may have been adaptive in the past, by limiting physical activity at times when food was scarce.<ref name="Nesse94"/> It is argued that humans have retained the instinct to experience low mood during the winter months, even if the availability of food is no longer determined by the weather.<ref name="Nesse94"/>

An alternative theory <ref>''How Sadness Survived: The Evolutionary Basis of Depression'', Paul Keedwell | Radcliffe Publishing | 2008 | ISBN 1846190134</ref> posits that depression is a plea for help. However this view is not widely credited by evolutionary biologists: depression is observed in other species that are not social, and depression in humans is often actively hidden from others; even when it is apparent, it often fails to elicit a positive response.<ref>{{cite journal |author=Hendrie C A |title=Depression as an evolutionary adaptation: implications for the development of preclinical models. |journal=Med. Hypotheses |volume=72 |issue= 3|pages=342–347 |year=2009 |pmid= 19153014|doi= 10.1016/j.mehy.2008.09.053|url= |first2=AR}} PMID 19153014</ref>

Milder depression has been associated with what has been called [[depressive realism]], or the "sadder-but-wiser" effect, a view of the world that is relatively undistorted by positive biases.<ref name="PositiveIllusions">{{cite book |last=Taylor |first=SE |title=Positive Illusions: Creative Self-deception and the Healthy Mind |publisher=Basic Books |location=New York, NY, USA |year=1991 |isbn=0465060536}}</ref>

==Psychiatric disorders==
{{Main|Types of psychological depression}}
Episodes of depressed mood are a core feature of the following psychological disorders, as specified by the [[DSM-IV]]:
*[[Adjustment disorder]] with depressed mood
*[[Anorexia Nervosa]]
*[[Bipolar disorder]]
*[[Bulimia Nervosa]]
*[[Cyclothymia]]
*[[Depressive Disorder Not Otherwise Specified]]
*[[Dysthymia]]
*[[Major depressive disorder]]
*[[Postnatal depression]]
*[[Schizoaffective disorder]]
*[[Seasonal affective disorder]] (SAD)

==See also==
* [[Catastrophization]]
* [[Grief]]
* [[Happiness]]
* [[Mood disorder]]
* [[Treatment for depression]]

==References==
{{reflist}}

== External links ==
* {{dmoz|Health/Mental_Health/Disorders/Mood/Depression|Depression}}
* ''[http://www.sciencedaily.com/news/mind_brain/depression/ Depression Research News]'' at ''[[ScienceDaily]]''
* [http://www.nami.org National Alliance on Mental Illness] – Depression support, advocacy, and education
* [http://www.ndmda.org National Depressive and Manic Depressive Association] - [[National Depressive and Manic Depressive Association]]
* [http://med.stanford.edu/depression/ Stanford Depression Research Clinic]
* [http://www.samhsa.gov/ Substance Abuse and Mental Health Services (SAMHSA)] – [[United States Department of Health and Human Services]] (HHS)
* [http://www.doingwell.org.uk/ Doing Well] – Depression self-assessment and information from the UK National Health Service
* [http://www.depressionhelpebooks.com/ Help for Depression] – Depression - Information about Depression, Stress, Anxiety
* [http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/depression/depression.aspx Depression] information from mental health charity The Royal College of Psychiatrists
* [http://www.challengingdepression.co.uk Challenging Depression] – Depression management
* [http://www.depressionalliance.org Depression Alliance] – Depression Alliance is a UK charity for people with clinical depression and anxiety
* [http://www.health-products.co.za Health Products] – Depression management
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Revision as of 12:38, 29 May 2010

Dorothea Lange's photograph Migrant Mother shows the despair of a woman trying to provide for her family during a time of economic hardship

Depression is a state of low mood and aversion to activity. A depressed person will experience or display some of the following:[1]

  • Persistent sadness, anxiety or feelings of emptiness
  • Feelings of hopelessness, helplessness and/or pessimism.
  • Feelings of worthlessness or guilt
  • Contemplating suicide or suicide attempt
  • Problems concentrating, remembering details and making decisions
  • Fatigue and loss of energy
  • Persistent aches, pains or digestive problems that are resistant to treatment
  • Irritability or restlessness
  • Insomnia, waking early, or excessive sleeping
  • Overeating, or appetite loss
  • Loss of interest in activities that once were pleasurable (e.g., hobbies, sex, social activities, etc.)

For a discussion of mental illnesses featuring depression see mood disorder, adjustment disorder and borderline personality disorder.

References

  1. ^ "Depression". National Institute of Mental Health. 2009-09-23. Retrieved 2010-05-22.
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