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Endogenous Depression

Endogenous Depression

What is depression? — Depression is a disorder that makes you sad, but it is different than normal sadness (figure 1). Depression can make it hard for you to work, study, or do everyday tasks.
How do I know if I am depressed? — Depressed people feel down most of the time for at least 2 weeks. They also have at least 1 of these 2 symptoms:
They no longer enjoy or care about doing the things they used to like to do.
They feel sad, down, hopeless, or cranky most of the day, almost every day.
Depression can also make you:
Lose or gain weight
Sleep too much or too little
Feel tired or like you have no energy
Feel guilty or like you are worth nothing
Forget things or feel confused
Move and speak more slowly than usual
Act restless or have trouble staying still
Think about death or suicide
If you think you might be depressed, see your doctor or nurse. Only someone trained in mental health can tell for sure if you are depressed.
See someone right away if you want to hurt or kill yourself! — If you ever feel like you might hurt yourself or someone else, do one of these things:
Call your doctor or nurse and tell them it is urgent
Call for an ambulance (in the US and Canada, dial 9-1-1)
Go to the emergency room at your local hospital
Call the National Suicide Prevention Lifeline:
What are the treatments for depression? — People who have depression can get 1 or more of the following treatments:
Medicines that relieve depression
Counseling (with a psychiatrist, psychologist, nurse, or social worker)
A device that passes magnetic waves or electricity into the brain
People with depression that is not too severe can get better by taking medicines or talking with a counselor. People with severe depression usually need medicines to get better, and might also need to see a counselor.
Another treatment involves placing a device against the scalp to pass magnetic waves into the brain. This is called "transcranial magnetic stimulation" or "TMS." Doctors might suggest TMS if medicines and counseling have not helped.
Some people whose depression is severe might need a treatment called "electroconvulsive therapy" or "ECT." During ECT, doctors pass an electric current through a person's brain in a safe way.
When will I feel better? — Both treatment options take a little while to start working.
Many people who take medicines start to feel better within 2 weeks, but it might be 4 to 8 weeks before the medicine has its full effect.
Many people who see a counselor start to feel better within a few weeks, but it might take 8 to 10 weeks to get the greatest benefit.
If the first treatment you try does not help you, tell your doctor or nurse, but do not give up. Some people need to try different treatments or combinations of treatments before they find an approach that works. Your doctor, nurse, or counselor can work with you to find the treatment that is right for you. He or she can also help you figure out how to cope while you search for the right treatment or are waiting for your treatment to start working.
How do I decide which treatment to have? — You and your doctor or nurse will need to work together to choose a treatment for you. Medicines might work a little faster than counseling. But medicines can also cause side effects. Plus, some people do not like the idea of taking medicine.
On the other hand, seeing a counselor involves talking about your feelings with a stranger. That is hard for some people.
Is depression the same for teenagers? — No. The symptoms of depression are a little different for teenagers than they are for adults. Some teenagers are moody or sad a lot of the time. That makes it hard to tell when they are really depressed. Teenagers who are depressed often seem cranky. They get easily "annoyed" or "bothered." They might even pick fights with people. Also, when treating a teenager, doctors and nurses usually suggest trying counseling first, before trying medicine. That's because there is a small chance that depression medicines can cause problems for some teenagers. Even so, some depressed teenagers need medicine. And most experts agree that depression medicine is safe and appropriate to use in teenagers who really need it.
What if I take medicine for depression and I want to have a baby? — Some depression medicines can cause problems for an unborn baby. But having untreated depression during pregnancy can also cause problems. If you want to get pregnant, tell your doctor but do not stop taking your medicines. The two of you can plan the safest way for you to have your baby.
It's also important to talk with your doctor if you want to breastfeed after your baby is born. Breastfeeding has lots of benefits for both mother and baby. Some depression medicines are safer than others to use while breastfeeding. But having untreated depression after giving birth can also cause problems, so do not stop taking your medicines. Your doctor can work with you to plan the safest way for you to feed your baby.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15342 Version 14.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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