According to the National Institute of Mental Health (NIMH), more than 17 million Americans suffer from depression every year. Depression is an illness that may be caused by a chemical imbalance in the brain. Some researchers believe that chemical is seratonin. Others have discovered that a tendency to experience depression runs in families and may be inherited like many other diseases. Depression may also be caused after an upsetting event, such as a death, divorce, or loss of a job. Serious or chronic physical illness or major surgery may trigger depression, too. Prescribed medications, including hormones and birth control pills, may also bring on depression, or make it worse. But other types of depression persist and begin to affect the ability to perform daily activities. Depression may also happen at any time, even without a specific event to be depressed about.

Depression is a medical illness that affects how people think, feel, and behave. Many people with depression go undiagnosed for years. It is important that people with symptoms of depression seek medical help, either from their doctor or more from a psychiatrist. Often, a family member, friend, or employer must convince the person to seek help. There is, however, hope for people with depression. Once the illness is properly diagnosed, treatment can help many patients return to more healthy and productive lives.

During depression a person's mood may be described as sad, blue, or unhappy. Self-esteem is low, thoughts are negative, and they may lose the ability to experience pleasure. Concentrating and decision making may be difficult. Anxiety and agitation are common features of depression, although some depressed people are too drained of energy to be either agitated or anxious.

Symptoms of depression are as follows:

· Sad, scared, hopeless, empty, irritable, or blue for weeks or months at a time

· Difficulty concentrating or making decisions

· Trouble sleeping or sleeping too much. Waking up early before 5:00 AM and can't go back to sleep

· Fatigue or lack of energy

· Loss of appetite or overeating

· Crying often or for no reason

· Feelings of guilt and worthlessness

· Social withdrawal

· Thoughts of death and suicide

Depressive symptoms vary from person to person and not everyone will have all or the same symptoms. A depressive episode may last for two weeks or longer. Depression can affect how you feel about other people. Many times a depressed person is no longer interested in being with others, in talking to people, or doing things with their family. Sometimes family members will tell the depressed person to "get over it," which can make the depressed person feel worse.

Until recently, many people thought that suffering from the depression was a sign of weakness or a character flaw. Some people were unwilling to admit they were depressed. Today, most people realize that depression is an illness like any other and can be treated with medicines. Getting treatment is the best way to get better.

There are many medicines available for depression (called antidepressants). It takes 2 or more weeks for these medicines to really take affect and generally people feel better 4-6 weeks after beginning to take the appropriate medication. In addition to medicines, psychotherapy, also called talk therapy, is often involved. Many people with depression are helped by meeting with a health professional trained to discuss their problems. There are many types of professionals with whom to talk. They include social workers, psychologists, or physicians who specialize in treating psychiatric disorders (psychiatrists).

Antidepressants medicines are often effective for most people. No antidepressant works perfectly for all patients. Many times the patient will be switched to a different medication or combination of medicines until the right formula for wellness is found for that particular individual. Unfortunately, the negative effects (side effects) tend to show up before the positive effects. Not everyone experiences side effects and they are different for each type of drug.

Some examples of side effects are:

· Tremors/shakiness

· Nausea

· Headache

· Blurred vision

· Constipation

· Change in appetite

· Weight gain/loss

· Trouble sleeping or lack of energy

· Dry mouth

· Restlessness

· Low blood pressure

· Sexual dysfunction or lack of arousal

 If the side effects become unpleasant, an increase or decrease in medicine dosage or a change of medicine may be called for.

Signs of improvement may be seen early in treatment, although for the others the benefits might take longer. Appetite and sleep return to normal. Interest in hobbies and social interaction gradually returns. Sexual arousal and satisfaction should return to normal after the medication has had time to take affect.

Patients do need to realize that caring for this disease is a lifelong process. Medication (and possible therapy) will be needed for the rest of the person's life. Many patients feel the positive results and quit taking the medication, thinking they are cured. Remember that this illness is not curable. Stopping therapy or medication is only an option that a doctor can give.

Special care must be taken to see that the individual is receiving full benefits of the treatment. Sometimes this means altering ones behaviors. Persons on antidepressant medication are forbidden to drink due to the reaction of the drugs mixed with alcohol. Medication must be taken on the schedule given by the doctor to maintain the level of wellness. If medication makes the person drowsy, driving and operating heavy machinery should be avoided. The person actually should not drive until they know exactly how all medicines affect them and this may take several days or weeks.

Making time for doctor appointments is something else the patient must remember to do. Therapists are usually seen once a week in the beginning of treatment and eventually every other week on a continuing basis. The psychiatrist or doctor, who prescribes medication, utilizes an initial one-hour evaluation and follows up with monthly 10-15 minute appointments, which are eventually spaced, to every other month. Communication between the two caregivers is key for the patient's maximum recovery. Occasionally, the same doctor will serve as therapist and psychiatrist, giving the patient the ability to complete both therapy and medication checks in one appointment.

The patient, himself, plays the biggest role in his recovery. Only he can decide to follow the treatment plan. Upon choosing the path to feeling better, he has lots of options to undertake individually. More exercise, eating healthy, and avoiding stress are just a sample of many ways to speed up the process. Getting advice from others with the disease is also a comfort. Local communities often have support groups and the Internet is full of mailing lists, chat rooms, and websites for people with depression wanting to communicate with each other. Positive thinking and realizing they aren't alone will help advance treatment as much as the medication and therapy.