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Depression (cont.)

Where can one seek help for depression?

A complete physical and psychological diagnostic evaluation by professionals will help the depressed person decide the type of treatment that might be best for him or her. However, if the situation is urgent because a suicide seems possible, taking the patient to the emergency room is the appropriate course of action. If the patient makes a suicide gesture or attempt, a 911 call is warranted. The patient might not realize how much help he or she needs. In fact, he or she might feel undeserving of help because of the negativity and helplessness that is a part of depressive illness.

Listed below are the types of people and places that will make a referral or provide diagnostic and treatment services. Check the Yellow Pages under "mental health," "health," "social services," "suicide prevention," "hospitals," or "physicians" for phone numbers and addresses.

  • Family doctors


  • Mental-health specialists, such as psychiatrists, psychologists, social workers, pastoral or mental-health counselors


  • Health maintenance organizations


  • Community mental-health centers


  • Hospital psychiatry departments and outpatient clinics


  • Community support groups, often hospital-affiliated


  • University or medical school-affiliated programs


  • State hospital outpatient clinics


  • Family service/social agencies


  • Private clinics and facilities


  • Employee assistance programs


  • Local medical and/or psychiatric societies


What's in the future for depression?

The future is very bright for the treatment of depression. We are close to having genetic markers for bipolar disorder. Soon after, we hope to also have them for major depression. That way, we can know of a child's vulnerability to depression from birth and try to create preventive strategies. For example, we can teach parents early warning signs so that they can get treatment for their children, if necessary, to ward off future problems.

The new world of pharmacogenetics holds the promise of actually keeping the genes responsible for depression turned off so as to avoid the illnesses completely. Also, by studying genes, we are learning more about the matching of patients with treatment. This kind of information will be able to tell us which patients do well on which types of drugs and psychotherapy regimens.

We are learning more about the interactions of the neurochemicals in the brain. Moreover, new categories of neurochemicals, such as neuropeptides and substance P, are being studied. As a result, we will soon be able to develop new drugs that should be more effective with fewer side effects. We are also learning startling things about how maternal stress early in pregnancy can profoundly affect the developing fetus. For example, we now know that maternal stress can greatly increase the risk for the fetus to develop depression as an adult.

Further information is also being discerned about how to most effectively make treatment of depression available and acceptable to all who need it. This is particularly important for children and adolescents, minorities, the elderly and the developmentally disabled, who are known to suffer from lack of adequate access to mental-health treatment that is knowledgeable and respectful of what may be their unique needs and preferences. While sadness will always be part of the human condition, hopefully we will be able to lessen or eradicate the more severe mood disorders from the world to the benefit of all of us.

Depression At A Glance
  • A depressive disorder is a syndrome (group of symptoms) that reflects a sad mood exceeding normal sadness or grief.
  • Depressive disorders are characterized not only by negative thoughts, moods, and behaviors but also by specific changes in bodily functions (for example, eating, sleeping, and sexual activity).
  • One in 10 people will have a depressive disorder in their lifetime, and in one of 10 cases, the depression is a fatal disease as a result of suicide.
  • Some types of depression, especially bipolar depression, run in families.
  • Depression is diagnosed only clinically in that there is no laboratory test or X-ray for depression. Therefore, it is crucial to see a health practitioner as soon as you notice symptoms of depression in yourself, your friends, or family.
  • The first step in getting appropriate treatment is a complete physical and psychological evaluation to determine whether the person, in fact, has a depressive disorder.
  • Depression is not a weakness but a serious illness with biological, psychological, and social aspects to its cause, symptoms, and treatment. A person cannot will it away. Untreated, it will worsen. Undertreated, it will return.
  • There are many safe and effective medications, particularly the SSRIs, that can be of great help in depression.
  • For full recovery from a mood disorder, regardless of whether there is a precipitating factor or it seems to come out of the blue, treatments with medications and/or electroconvulsive therapy (ECT) and psychotherapy are necessary.
  • In the future, through depression research and education, we will continue to improve our treatments, decrease society's burden, and hopefully develop preventive measures.

For further information about depression, please visit the following sites:

Suicide Awareness Voices of Education (SAVE)
http://www.save.org/

APA: Women and Depression (American Psychological Association)
http://www.apa.org/ppo/issues/pwomenanddepress.html

For additional information, you can write or call the following organizations:

D/ART/Public Inquiries; National Institute of Mental Health
Room 15C-05
5600 Fishers Lane
Rockville, MD 20857

National Foundation for Depressive Illness
20 Charles Street
New York, NY 10014

National Depressive and Manic Depressive Association
730 N. Franklin
Suite 501
Chicago, IL 60601
(800) 826-3632
(312) 642-0049
(312) 642-7243--fax
http://www.ndmda.org/

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
(800) 969-NMHA (6642)
http://www.nmha.org/

National Alliance for the Mentally Ill
2101 Wilson Boulevard
Suite 302
Arlington, VA 22201
HelpLine: 1-800-950-NAMI [6264]
http://www.nami.org/

National Alliance for Research on Schizophrenia and Affective Disorders (NARSAD)
60 Cutter Mill Road, Suite 404
Great Neck, NY 11021 USA
Infoline: 1-800-829-8289
http://www.narsad.org/

Substance Abuse and Mental Health Services Administration (SAMHSA)
5600 Fishers Lane
Rockville, MD 20857
http://www.samhsa.gov/

Surgeon General's Report on Mental Illness
To receive a copy of this report, write or call:
Mental Health
Pueblo, Co 81009
1-800-789-2647
http://www.surgeongeneral.gov/library/mentalhealth/home.html

The National Institute of Mental Health (NIMH) for the Depression Awareness, Recognition, and Treatment (DART) program furnished a portion of the foregoing information.

References:

Bluthenthal R, Jones L, Ellison M, Koegel P, Minnium K, Lucas-Wright A, Wells K. Witness for Wellness: A Community-University Participatory Research Mental Health Initiative. Abstract Academy Health Meeting, 21: abstract no. 1104, 2004.

National Institute on Aging. Depression: Don't Let the Blues Hang Around, 3/31/08.

Wisconsin Diabetes Advisory Group. Tools and resources for depression. Essential Diabetes Mellitus Care Guidelines, revised edition, April 2001.

Previous contributing author and editor:

Medical Author: Peter J. Panzarino Jr., MD, FAPA
Previous Medical Editor: Leslie J. Schoenfield, MD, PhD


Last Editorial Review: 6/12/2008


Depression - Effective Treatments

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