Depression

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Depression is a mental illness marked by feelings of profound sadness and lack of interest in activities. Depression is not the same as a blue mood. It is a persistent low mood that interferes with the ability to function and appreciate things in life. It may cause a wide range of symptoms, both physical and emotional. It can last for weeks, months, or years. People with depression rarely recover without treatment.

While the exact cause is not known, factors that may play a role in depression include:

Having a family history of depression (genetic link)
Having a certain type of brain chemistry
Experiencing stressful or traumatic life events (eg, death in the family, divorce, job loss)

Brain

Treatment

Treatment may involve the use of medicine and/or psychotherapy.

Severe depression can require hospital care, especially if you are at risk of hurting yourself or others.

Antidepressant Medications

Antidepressant medicines may be most effective in people with severe depression. These medicines can take 2-6 weeks to reach their maximum effectiveness. There are many different types of medicines to treat depression. You will work with your doctor to find the medicine that benefits you the most and has the least side effects.

Therapy

Psychotherapy for depression consists of various types of counseling. These include cognitive-behavior therapy (CBT), interpersonal therapy, psychodynamic therapy, or a combination of these. Therapy is designed to help you cope with difficulties in relationships, change negative thinking and behavior patterns, and resolve difficult feelings.

Diet and Exercise

Dietary Changes

Research suggests that diets high in tryptophan and certain B vitamins may be helpful. There is also mixed evidence that omega-3 fatty acids may reduce symptoms.

If you want to take supplements or change your diet, talk to your doctor first.

Dietary Supplements and Herbal Therapy

The herb St. John's wort may be an effective alternative to standard medicines with fewer side effects. However, St. John's wort may reduce the effectiveness of many drugs, such as antidepressants, birth control pills, blood thinners, and other medicines. It is important that you talk to your doctor before trying any herb.

There is also some evidence that dehydroepiandrosterone (DHEA), a hormone that is available as a dietary supplement, may help some people.

Exercise

A regular exercise program has been shown to relieve some of the symptoms. It should play a large role in the overall management of depression.

Procedures

Electroconvulsive Therapy (ECT)

ECT is the use of an electric stimulus to produce a generalized seizure. It may be used in people with severe or life-threatening depression. ECT is also used for people who cannot take or do not respond to medicine. It is considered a safe and effective procedure.

Vagus Nerve Stimulation (VNS)

VNS is used as therapy for depression when multiple trials of medicine do not work. A pacemaker-like device stimulates the vagus nerve in the neck.

Vagus Nerve

Stimulation of the vagus nerve (yellow) at the neck is a depression therapy option.

Transcranial Magnetic Stimulation (TMS)

TMS involves the application of low-frequency magnetic pulses to the brain. The change in electrical field stimulates nerves. There are a number of studies that show the benefits of TMS for the treatment of depression. It may be used if you have not gotten better with medicines and psychotherapy.

Other Treatment Options

Bright Light Therapy

Your doctor may recommend bright light therapy. This involves being exposed to high levels of light from a special "light box" that has a screen on it.

Meditation

Meditation may help to improve the symptoms of depression.

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Last reviewedMarch 2013by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.