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Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being. Depressed people can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable or restless. They may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present.

Depression is a feature of some psychiatric syndromes such as major depressive disorder but it may also be a normal reaction to certain life events, a symptom of some bodily ailments or a side effect of some drugs and medical treatments.

Causes

Life events

Adversity in childhood, such as bereavement, neglect, unequal parental treatment of siblings, physical abuse or sexual abuse, significantly increases the likelihood of experiencing depression over the life course.

Life events and changes that may precipitate depressed mood include childbirth, menopause, financial difficulties, job problems, a medical diagnosis (cancer, HIV, etc.), bullying, loss of a loved one, natural disasters, social isolation, relationship troubles, jealousy, separation, and catastrophic injury.

Medical treatments

Certain medications are known to cause depressed mood in a significant number of patients. These include interferon therapy for hepatitis C.

Non-psychiatric illnesses

Depressed mood can be the result of a number of infectious diseases, nutritional deficiencies, neurological conditions and physiological problems, including hypoandrogenism (in men), Addison's disease, Lyme disease, multiple sclerosis, chronic pain, stroke, diabetes, cancer, sleep apnea, and disturbed circadian rhythm. It is often one of the early symptoms of hypothyroidism (reduced activity of the thyroid gland).

Psychiatric syndromes

A number of psychiatric syndromes feature depressed mood as a main symptom. The mood disorders are a group of disorders considered to be primary disturbances of mood. These include major depressive disorder (MDD; commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia, a state of chronic depressed mood, the symptoms of which do not meet the severity of a major depressive episode. Another mood disorder, bipolar disorder, features one or more episodes of abnormally elevated mood, cognition and energy levels, but may also involve one or more episodes of depression. When the course of depressive episodes follows a seasonal pattern, the disorder (major depressive disorder, bipolar disorder, etc.) may be described as a seasonal affective disorder.

Outside the mood disorders: borderline personality disorder often features an extremely intense depressive mood; adjustment disorder with depressed mood is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode; and posttraumatic stress disorder, an anxiety disorder that sometimes follows trauma, is commonly accompanied by depressed mood.

Drug use

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Depression is associated with abusive drug use. Both legal and illegal drugs can be abused.

Assessment

Questionnaires and checklists such as the Beck Depression Inventory or the Children's Depression Inventory can be used to detect and assess the severity of depression.

Treatment

Depressed mood may not require any professional treatment, and may be a normal reaction to certain life events, a symptom of some medical conditions, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition, which may benefit from treatment. Different sub-divisions of depression have different treatment approaches.

The UK National Institute for Health and Care Excellence (NICE) 2004 guidelines indicate that antidepressants should not be used for the initial treatment of mild depression, because the risk-benefit ratio is poor. The guidelines recommend that antidepressants treatment in combination with psychosocial interventions should be considered for:

• People with a past history of moderate or severe depression
• Those with mild depression that has been present for a long period
• As a second line treatment for mild depression that persists after other interventions
• As a first line treatment for moderate or severe depression.

The guidelines further note that antidepressant treatment should be continued for at least 6 months to reduce the risk of relapse, and that SSRIs are better tolerated than tricyclic antidepressants.

The American Psychiatric Association 2000 Practice Guideline for the Treatment of Patients with major depressive disorder indicates that, if preferred by the patient, antidepressant medications may be provided as an initial primary treatment for mild major depressive disorder; antidepressant medications should be provided for moderate to severe major depressive disorder unless electroconvulsive therapy is planned; and a combination of antipsychotic and antidepressant medications or electroconvulsive therapy should be used for psychotic depression. It states that efficacy is generally comparable between classes and within classes and that the initial selection will largely be based on the anticipated side-effects for an individual patient, patient preference, quantity and quality of clinical trial data regarding the medication, and its cost.

Irving Kirsch has argued that given an accurate diagnosis of major depressive disorder, in general the type of treatment (psychotherapy and/or antidepressants, alternative therapies, or active intervention) is "less important than getting depressed patients involved in an active therapeutic program."

Moderate levels of physical activity can treat depression by increasing the levels of endorphins and the neurotransmitters serotonin, dopamine, and norepinephrine. Exercise allows individuals to improve their health while building new relationships with others and bolstering the sense of community that comes with exercising as a group. Group activities can lower depression by increasing depressed individuals’ ability to interact with others. Exercise also increases individuals’ self-confidence by promoting social skills that people with depression often lack and interrupts the cycle of isolation from the general population that can further increase depression. Exercise fosters non-demanding behaviors while allowing people to socialize and identify themselves as part of the general population.

Lifestyle strategies that may improve depressed mood include wake therapy, light therapy, eating a healthy diet, meditation, exercise, and smoking cessation.

See also

• Sadness
• Melancholia
• Upset
• Feelings
• Feeling

References

1. Salmans, Sandra (1997). Depression: Questions You Have – Answers You Need. People's Medical Society. ISBN 978-1-882606-14-6.
2. "NIMH · Depression". nimh.nih.gov. Retrieved 15 October 2012.
3. Lindert J, von Ehrenstein OS, Grashow R, Gal G, Braehler E, Weisskopf MG (April 2014). "Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis". Int J Public Health. 59 (2): 359–72. doi:10.1007/s00038-013-0519-5. PMID 24122075.{{cite journal}}: CS1 maint: multiple names: authors list (link)
4. Christine Heim; D. Jeffrey Newport; Tanja Mletzko; Andrew H. Miller; Charles B. Nemeroff. "The link between childhood trauma and depression: Insights from HPA axis studies in humans". Psychoneuroendocrinology. 33 (6): 693–710. doi:10.1016/j.psyneuen.2008.03.008. Retrieved 2014-04-20.
5. Pillemer, Karl; Suitor, J. Jill; Pardo, Seth; Henderson Jr, Charles (2010). "Mothers' Differentiation and Depressive Symptoms Among Adult Children". Journal of Marriage and Family. 72 (2): 333–345. doi:10.1111/j.1741-3737.2010.00703.x. PMC 2894713. PMID 20607119.
6. Schmidt, Peter (2005). "Mood, Depression, and Reproductive Hormones in the Menopausal Transition". The American Journal of Medicine. 118 Suppl 12B (12): 54–8. doi:10.1016/j.amjmed.2005.09.033. PMID 16414327.
7. Rashid, T.; Heider, I. (2008). "Life Events and Depression" (PDF). Annals of Punjab Medical College. 2 (1). Retrieved 15 October 2012.
8. Ehret M, Sobieraj DM (February 2014). "Prevention of interferon-alpha-associated depression with antidepressant medications in patients with hepatitis C virus: a systematic review and meta-analysis". Int. J. Clin. Pract. 68 (2): 255–61. doi:10.1111/ijcp.12268. PMID 24372654.
9. Murray ED, Buttner N, Price BH. (2012) Depression and Psychosis in Neurological Practice. In: Neurology in Clinical Practice, 6th Edition. Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.) Butterworth Heinemann. April 12, 2012. ISBN 978-1437704341
10. Saravane, D; Feve, B; Frances, Y; Corruble, E; Lancon, C; Chanson, P; Maison, P; Terra, JL; et al. (2009). "Drawing up guidelines for the attendance of physical health of patients with severe mental illness". L'Encephale. 35 (4): 330–9. doi:10.1016/j.encep.2008.10.014. PMID 19748369.
11. Rustad, JK; Musselman, DL; Nemeroff, CB (2011). "The relationship of depression and diabetes: Pathophysiological and treatment implications". Psychoneuroendocrinology. 36 (9): 1276–86. doi:10.1016/j.psyneuen.2011.03.005. PMID 21474250.
12. Li, M; Fitzgerald, P; Rodin, G (2012). "Evidence-based treatment of depression in patients with cancer". Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 30 (11): 1187–96. doi:10.1200/JCO.2011.39.7372. PMID 22412144.
13. Gabbard, Glen O. Treatment of Psychiatric Disorders. Vol. 2 (3rd ed.). Washington, DC: American Psychiatric Publishing. p. 1296.
14. American Psychiatric Association (2000a). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR. Washington, DC: American Psychiatric Publishing, Inc. ISBN 0-89042-025-4.{{cite book}}: CS1 maint: ref duplicates default (link)
15. Vieweg, W. V.; Fernandez, D. A.; Beatty-Brooks, M; Hettema, J. M.; Pandurangi, A. K.; Pandurangi, Anand K. (May 2006). "Posttraumatic Stress Disorder: Clinical Features, Pathophysiology, and Treatment". Am. J. Med. 119 (5): 383–90. doi:10.1016/j.amjmed.2005.09.027. PMID 16651048.
16. http://psychcentral.com/lib/depression-and-substance-abuse-the-chicken-or-the-egg/0003570
17. Kovacs, M. (1992). Children's Depression Inventory. North Tonawanda, NY: Multi-Health Systems, Inc.
18. Cheog J et al. for PsychCentral.com. Last reviewed August 26, 2010. Frequently Asked Questions About Depression Accessed May 11, 2013
19. Staff, UK National Institute for Health and Clinical Excellence (NICE) October 2009.
20. "Depression". National Institute for Health and Care Excellence. December 2004. Archived from the original on 15 November 2008. Retrieved 20 March 2013. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
21. "Practice guideline for the treatment of patients with major depressive disorder". National Guideline Clearinghouse. 2010. Archived from the original on 28 October 2008. Retrieved 20 March 2013. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
22. Khan, Arif; James Faucett; Pesach Lichtenberg; Irving Kirsch; Walter A. Brown (July 30, 2012). "A Systematic Review of Comparative Efficacy of Treatments and Controls for Depression". PLoS ONE. 7 (7): e41778. doi:10.1371/journal.pone.0041778. PMC 3408478. PMID 22860015.{{cite journal}}: CS1 maint: unflagged free DOI (link)
23. Craft and Perna 2004….. Craft LL, Perna FM (2004) The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry 6:104–111
24. Skrinar et al. Fitness: a viable adjunct to treatment for young adults with psychiatric disabilities. Psychosocial Rehabilitation Journal, 1992, vol. 15 issue 3 20-28
25. Pelham & Campagna (1993) The effects of exercise therapy on clients in a psychiatric rehabilitation program. Psychosocial rehabilitation Journal. Vol 16(4) 75-84
26. ^ Lopresti, AL; Hood SD; Drummond PD (May 15, 2013). "A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise". J Affect Disord. 148 (1): 12–27. doi:10.1016/j.jad.2013.01.014. PMID 23415826. Retrieved 9 February 2014.
27. Madhav, Goyal (January 6, 2014). "Meditation Programs for Psychological Stress and Well-being". JAMA Intern Med. 174 (3): 357–68. doi:10.1001/jamainternmed.2013.13018. PMID 24395196. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
28. Even, C; Schröder CM; Friedman S; Rouillon F (May 2008). "Efficacy of light therapy in nonseasonal depression: a systematic review". J Affect Disord. 108 (1–2): 11–23. doi:10.1016/j.jad.2007.09.008. PMID 17950467. {{cite journal}}: |access-date= requires |url= (help)
29. Praschak-Rieder, N; Willeit M; Neumeister A; Hilger E; Kasper S (1999). "Therapeutic sleep deprivation and phototherapy". Wien Med Wochenschr. 149 (18): 520–524. PMID 10637957.
30. Taylor, Gemma; Ann McNeill; Alan Girling; Amanda Farley; Nicola Lindson-Hawley; Paul Aveyard (February 13, 2014). "Change in mental health after smoking cessation: systematic review and meta-analysis". BMJ. 348: g1151. doi:10.1136/bmj.g1151. PMC 3923980. PMID 24524926.

v t e Emotions (list)
Emotions	Acceptance Admiration Adoration Aesthetic Affection Agitation Agony Amusement Anger Angst Anguish Annoyance Anticipation Anxiety Apathy Arousal Attraction Awe Belongingness Boredom Calmness Compassion Confidence Confusion Contempt Contentment Courage Cruelty Curiosity Defeat Depression Desire Disappointment Disgust Distrust Doubt Ecstasy Embarrassment vicarious Emotion work Empathy Emptiness Enthrallment Enthusiasm Envy Euphoria Excitement Faith Fear Flow Frustration Gratification Gratitude Greed Grief Guilt Happiness Joie de vivre Hatred Hiraeth Homesickness Hope Horror Hostility Humiliation Hygge Hysteria Ikigai (sense of purpose) Indulgence Infatuation Insecurity Inspiration Interest Irritation Isolation Jealousy Joy Kindness Loneliness Love limerence at first sight Lust Mono no aware Neglect Nostalgia Outrage Panic Passion Pity self-pity Pleasure Pride grandiosity hubris insult vanity Rage Regret Rejection Relief Remorse Resentment Revenge Sadness melancholy Saudade Schadenfreude Sehnsucht Sentimentality Shame Shock Shyness Social connection Sorrow Spite Stress chronic Suffering Surprise Sympathy Trust Wonder sense of wonder Worry
Worldviews	Cynicism Defeatism Fatalism Misanthropy Nihilism Optimism Pessimism Reclusion Weltschmerz
Related	Affect consciousness in education measures in psychology Affective computing forecasting neuroscience science spectrum Affectivity positive negative Appeal to emotion Amygdala hijack Emotion and art and memory and music and sex and sleep classification evolution expressed functional accounts group homeostatic in animals perception recognition in conversation regulation interpersonal work Emotional aperture bias blackmail competence conflict contagion detachment dysregulation eating exhaustion expression and gender intelligence and bullying Empathy quotient intimacy isolation lability labor lateralization literacy prosody reasoning responsivity security symbiosis thought method well-being Emotionality bounded Emotions and culture history in decision-making in the workplace in virtual communication moral self-conscious social social sharing sociology Feeling Group affective tone Interactions between the emotional and executive brain systems Jealousy in art Meta-emotion Pathognomy Pathos Social emotional development Stoic passions Theory affect appraisal constructed emotion discrete emotion somatic marker
Italics indicate emotion names in foreign languages

• Psychology
• Abnormal psychology
• Emotions
• Neuropsychology
• Depression (psychology)
• Psychiatric diagnosis
• Mood disorders