| IntroductionDepression is a serious
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| | Although both generations of medications
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| medical condition. In contrast to the
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| | are effective in relieving depression,
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| normal emotional experiences of sadness,
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| | some people will respond to one type of
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| loss, or passing mood states, clinical
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| | drug, but not another. Other types of
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| depression is persistent and can
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| | antidepressants are now in
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| interfere significantly with an
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| | development.Certain types of
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| individual's ability to function. There
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| | psychotherapy, specifically
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| are three main types of depressive
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| | cognitive-behavioral therapy (CBT) and
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| disorders: major depressive disorder,
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| | interpersonal therapy (IPT), have been
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| dysthymic disorder, and bipolar disorder
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| | found helpful for depression. Research
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| (manic-depressive illness).Symptoms and
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| | indicates that mild to moderate
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| Types of DepressionSymptoms of depression
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| | depression often can be treated
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| include sad mood, loss of interest or
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| | successfully with either therapy alone;
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| pleasure in activities that were once
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| | however, severe depression appears more
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| enjoyed, change in appetite or weight,
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| | likely to respond to a combination of
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| difficulty sleeping or oversleeping,
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| | psychotherapy and medication. 7 More than
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| physical slowing or agitation, energy
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| | 80 percent of people with depressive
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| loss, feelings of worthlessness or
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| | disorders improve when they receive
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| inappropriate guilt, difficulty thinking
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| | appropriate treatment.In situations where
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| or concentrating, and recurrent thoughts
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| | medication, psychotherapy, and the
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| of death or suicide. A diagnosis of major
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| | combination of these interventions prove
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| depressive disorder is made if a person
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| | ineffective, or work too slowly to
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| has 5 or more of these symptoms and
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| | relieve severe symptoms such as psychosis
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| impairment in usual functioning nearly
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| | (e.g., hallucinations, delusional
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| every day during the same two-week
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| | thinking) or suicidality,
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| period. Major depression often begins
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| | electroconvulsive therapy (ECT) may be
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| between ages 15 to 30 but also can appear
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| | considered. ECT is a highly effective
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| in children. 1 Episodes typically
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| | treatment for severe depressive
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| recur.Some people have a chronic but less
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| | episodes.The possibility of long-lasting
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| severe form of depression, called
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| | memory problems, although a concern in
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| dysthymic disorder, which is diagnosed
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| | the past, has been significantly reduced
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| when depressed mood persists for at least
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| | with modern ECT techniques. However, the
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| 2 years (1 year in children) and is
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| | potential benefits and risks of ECT, and
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| accompanied by at least 2 other symptoms
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| | of available alternative interventions,
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| of depression. Many people with dysthymia
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| | should be carefully reviewed and
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| develop major depressive
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| | discussed with individuals considering
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| episodes.Episodes of depression also
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| | this treatment and, where appropriate,
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| occur in people with bipolar disorder. In
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| | with family or friends.One herbal
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| this disorder, depression alternates with
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| | supplement, hypericum or St. John's wort,
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| mania, which is characterized by
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| | has been promoted as having
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| abnormally and persistently elevated mood
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| | antidepressant properties. Results from
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| or irritability and symptoms including
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| | the first large-scale, controlled study
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| overly-inflated self-esteem, decreased
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| | of St. John's wort for major depression,
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| need for sleep, increased talkativeness,
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| | which was funded in part by NIMH, are
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| racing thoughts, distractibility,
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| | expected in 2001. Note: There is evidence
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| physical agitation, and excessive risk
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| | that St. John's wort can reduce the
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| taking. Because bipolar disorder requires
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| | effectiveness of certain medications. Use
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| different treatment than major depressive
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| | of any herbal or natural supplements
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| disorder or dysthymia, obtaining an
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| | should always be discussed with your
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| accurate diagnosis is extremely
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| | doctor before they are tried.Research
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| important.Facts About DepressionMajor
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| | FindingsBrain imaging research is
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| depression is the leading cause of
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| | revealing that in depression, neural
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| disability in the U.S. and worldwide. 2
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| | circuits responsible for moods, thinking,
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| Depressive disorders affect an estimated
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| | sleep, appetite, and behavior fail to
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| 9.5 percent of adult Americans ages 18
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| | function properly, and that the
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| and over in a given year, 3 or about 18.8
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| | regulation of critical neurotransmitters
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| million people in 1998. Nearly twice as
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| | is impaired. Genetics research, including
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| many women (12 percent) as men (7
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| | studies of twins, indicates that genes
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| percent) are affected by a depressive
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| | play a role in depression. Vulnerability
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| disorder each year.Depression can be
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| | to depression appears to result from the
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| devastating to family relationships,
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| | influence of multiple genes acting
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| friendships, and the ability to work or
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| | together with environmental factors.Other
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| go to school. Many people still believe
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| | research has shown that stressful life
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| that the emotional symptoms caused by
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| | events, particularly in the form of loss
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| depression are "not real," and that a
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| | such as the death of a close family
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| person should be able to shake off the
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| | member, may trigger major depression in
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| symptoms. Because of these inaccurate
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| | susceptible individuals. The
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| beliefs, people with depression either
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| | hypothalamic-pituitary-adrenal (HPA)
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| may not recognize that they have a
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| | axis, the hormonal system that regulates
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| treatable disorder or may be discouraged
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| | the body's response to stress, is
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| from seeking or staying on treatment due
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| | overactive in many people with
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| to feelings of shame and stigma. Too
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| | depression. Research findings suggest
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| often, untreated or inadequately treated
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| | that persistent overactivation of this
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| depression is associated with
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| | system may lay the groundwork for
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| suicide.TreatmentsAntidepressant
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| | depression.Studies of brain chemistry,
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| medications are widely used, effective
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| | mechanisms of action of antidepressant
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| treatments for depression. Existing
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| | medications, and the cognitive
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| antidepressants influence the functioning
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| | distortions and disturbed interpersonal
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| of certain chemicals in the brain called
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| | relationships commonly associated with
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| neurotransmitters. The newer medications,
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| | depression, continue to inform the
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| such as the selective serotonin reuptake
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| | development of new and better
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| inhibitors (SSRIs), tend to have fewer
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| | treatments.New Clinical TrialsNIMH is
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| side effects than the older drugs, which
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| | funding two new, large-scale, multi-site
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| include tricyclic antidepressants (TCAs)
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| | clinical trials on treatments for major
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| and monoamine oxidase inhibitors (MAOIs).
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| | depression in adults and adolescents.
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