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Depression, depressive mood disorder, anxiety

Depression: Seventeen million Americans each year are affected by depression.  Depression is classified as a mood disorder affecting people’s ability to function with everyday life due to feelings of anger, frustration, loss, or sadness.  Individuals may experience mild, moderate or severe depression and it may manifest as a single episode, recurring episodes, or chronic depression lasting more than two years.

The primary types of depression include:

  • Major depression
    • five or more symptoms must be present
    • an episode must last at least 2 weeks, but tends to continue for 20 weeks
  • Dysthymia
    • a chronic, generally milder form of depression
    • symptoms are similar to major depression but more mild in degree
  • Atypical depression
    • depression accompanied by unusual symptoms, such as hallucinations, delusions, and physical rigidity

Other common forms of depression include:

  • Postpartum depression
    •  experienced by 8% to 20% of women
    •  occurs following the delivery
  • Premenstrual dysphoric disorder (PDD)
    •  experienced by 3% to 8% of women
    •  depressive symptoms occur 1 week prior to menstruation and disappear following menstruation
  • Seasonal affective disorder (SAD)
    • experienced by 5% of adults
    • the majority of those affected are women
    • occurs during the fall-winter season and disappears during the spring-summer season

Depression may also occur with bipolar disorder.  Moods cycle between mania and depression in this disorder.

Signs and Symptoms

Most people feel depressed on occasion.  However, a person experiencing major depression feels substantially depressed for an extended period of time, experiences difficulty enjoying activities that were once pleasurable, and experiences at least five of the following symptoms for 2 weeks or more:

  • Either agitation, restlessness, and irritability or inactivity and withdrawal
  • Extreme difficulty concentrating
  • Fatigue and loss of energy
  • Feelings of hopelessness
  • Feelings of worthlessness, self-hate, and inappropriate guilt
  • Recurring thoughts of death or suicide
  • Significant change in appetite (often resulting in either weight loss or weight gain)
  • Sleep disturbances—at least 90% of people with depression have either insomnia (sleeplessness) or hypersomnia (excessive sleeping)
  • Sudden bursts of anger and a lack of sex drive may also be associated with depression.


The causes of depression are thought to be multifaceted and involve a combination of biologic, genetic, and environmental factors.  Abnormal levels of certain brain chemicals exist in individuals experiencing depression.  Included are serotonin, acetylcholine, and catecholamines such as dopamine. Factors that may alter the levels of these brain chemicals and contribute to the development of depression are:

  • Amount of exposure to light
  • Certain medications, including those for high blood pressure, high cholesterol, or irregular heartbeat
  • Chronic stress such as experienced from loss, abuse, or deprivation in early childhood
  • Heredity  (Recently, the gene SERT has been identified and associated with depression.  It is responsible for regulating the brain chemical serotonin.)
  • Nutritional deficiencies (especially folate [vitamin B9] and omega-3 fatty acids)
  • Serious medical conditions, such as heart attack or cancer
  • Sleep disturbances
  • Social isolation

NOTE: We highly recommend that you have a complete medical evaluation done anytime you have a medical concern. Medical professionals are well trained to identify serious medical conditions. It's recommended that you fully describe your symptoms to your doctor, then work with her/him through to the correct diagnosis.

While there are many anxiety-like medical conditions, most conditions have uniquely identifiable symptoms UNCOMMON to anxiety. If you have seen your doctor and he/she has ruled out this anxiety-like medical condition, you can feel confident that their diagnosis is correct. If, however, you feel he/she has missed something, you should persist with your doctor until you are satisfied. You may also want to get second and even third opinions if you are still unsatisfied.

Because it is common for anxiety sufferers to 'over worry' about their symptoms (since so many conditions produce anxiety-like symptoms we often scare ourselves when we look at all of the conditions we COULD have), having a thorough medical evaluation completed will most often alleviate these fears.

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