Depression Treatments

1. Medications

The first-line treatment for depression is an antidepressant. In the STAR*D study, which assessed the effectiveness of depression treatment, about one-third of patients achieved complete remission of their symptoms with the first antidepressant they were given, while another 10 to 15 percent experienced at least a 50 percent improvement in their symptoms. As treatment levels were added, such as switching medications or adding an additional medication, remission rates increased. Seventy percent of those who stuck with the study until the fourth level of treatment became symptom-free.

2. Psychotherapy

Psychotherapy is a process in which a trained professional enters a relationship with a patient for the purpose of helping the patient with symptoms of mental illness, behavioral problems or personal growth. The process involves the patient and therapist sitting in a room talking, which is why it is often called "talk therapy."

Psychotherapy in conjunction with medication is considering to be the most effective treatment for depression.

3. Electroconvulsive Therapy (ECT)

Electroconvulsive therapy, also known as ECT, is a form of treatment for depression which involves the application of a brief electrical pulse to the scalp in order to produce a seizure. Generally, a series of treatments is given over a period of weeks.

Situations when ECT might be administered are when medications have not been effective, when medications might endanger the patient or when a rapid response is needed.

4. Vagus Nerve Stimulation (VNS)

Vagus nerve stimulation, or VNS, involves the use of an implanted device to provide periodic stimulation to the vagus nerve. The device was originally developed as a treatment for epilepsy. It has since been approved in the U.S., Canada and the European Union for treatment-resistant depression in both unipolar depression and bipolar disorder.

DEPRESSION TREATMENT

Antidepressants

Pros
Antidepressants can be very effective in reducing severe physical symptoms of depression.
SSRI's work quickly to increase serotonin levels in the brain and temporarily lift the mood.
In mild cases depression medications can be useful to push through a short term stressful life experiences.
In extreme cases antidepressant medications can play a beneficial supportive role by suppressing
excessive symptoms and increasing the effectiveness of causal treatments.

Cons
When treated solely with depression medication, sufferers face up to an 80% chance of relapse.
Many people report the side effects of depression medication are worse than the depression itself.
Due to their mood lifting effects, depression medication often cause dependency.
Withdrawal from depression medication can cause new symptoms and/or exacerbation of old ones.
Antidepressants don't treat the cause they only temporarily mask the symptoms.
Most depression medication is effective in only one third of cases, partially effective in another third
with the remainder experiencing little or no improvement at all.

So then why are antidepressants so widely prescribed?

Because depression is a condition that pulls you into a downward spiral of negative thoughts and emotions that become so intense the body displays (often severe) physical symptoms. Antidepressants (most commonly prescribed are SSRIs) are designed to treat these symptoms and can be very effective in this regard, however depression medication alone cannot treat the causes. While boosting serotonin levels can be a very welcome temporary relief for the sufferer, when the medication is denied most people find themselves back at square one again.

What is the most effective alternative?

Research into a permanent alternative depression treatment has come a long way in recent years due to some alarming statistics that indicate we are fast becoming a society dependent on depression medication. When you consider that some commonly prescribed antidepressants have relapse rates of up to 80% you can see why studies today show a clear focus on developing long-term solutions rather than simply treating the symptoms with medication.

Depression, Is it serious?

es, depression can be very serious! Some of us experience only one depressive episode in our lives, while others experience several recurrences. Some depressive episodes begin with no apparent reason, while others are associated with a life situation or stress.

Sometimes people who are depressed cannot perform even the simplest daily activities like getting out of bed or getting dressed; others go through the motions, but it is clear they are not acting or thinking as usual. Some people suffer from bipolar depression in which their moods cycle between two extremes - from the depths of despair to frenzied heights of activity or grandiose ideas about their own competence.

Depression can be treated! Between 80 and 90 percent of people with depression - even the most serious forms - can be helped. Symptoms can be relieved quickly with psychological therapies, medications, or often a combination of both. The most important step towards treating depression - and sometimes the most difficult - is asking for help!

Teens and adults share a problem - they often fail to recognize the symptoms of depression in themselves or in people they care about.

STRESS MANAGEMENT

Coping With Stress: Intervention Strategies And Their Applications

	Behavioral Rehearsal
	Cognitive Restructuring/Reframing
	Stress Inoculation
	Systematic Desensitization
	Anger Management
	Thought Stopping Techniques
	Control and Perception of Control
	Self-Esteem Enhancement
	Goal Setting
	Active (Reflective) Listening
	Strategies for Coping with Deprivational Stress (Lack of Stimulation and Challenge)
	Modification of Life-style (Nutrition, Sleep, etc.)

It is very important that we learn how to control stress. I have good news and bad news about controlling stress.

The bad news is: We create our own stress.

The good news is: We create our own stress.

Causes of Depression From Ayurvedic Perspective

From the standpoint of Ayurveda there are two main causes of depression.

1. An imbalance in the three doshas, Vata, Pitta, and Kapha.

2. A lack of awareness of one's deeper, inner Self.

From the Ayurvedic point of view, most depression is a kapha imbalance that is the culmination of vata and then pitta going out of balance. Initially the brain's electrochemistry has an erratic overreaction (vata imbalance), which triggers a loss of enzymatic activity in the metabolism (pitta imbalance). Kapha responds by trying to glue everything down, bringing about heaviness, darkness, and stagnation that the mind-body interprets as the negative message of hopelessness and depression. In other words, because of specific etiological factors, vata from the colon, pitta from the intestine, or kapha from the stomach enters the general circulation and lodges in the nervous system, interferes with normal functioning of the mind and nervous system, and causes depression.

Sometimes depression is a pitta disorder. Allergies and the breakdown in metabolic processes they lead to can also disturb brain chemistry. This can cause dramatic mood swings, with depression as one of the consequences. Vata imbalance also can cause depression.

Alternative Solutions to Depression

EXERCISE AND RELAXATION TO COMBAT DEPRESSION

First, given our depressed state, we should redefine our concept of exercise. Exercise then becomes any physical endeavor which is more than what is done on a typical day. In other words, if you have been confined to your bed most days because of your depression or if you spend most of your day vegetating in front of the TV or on the computer, then a beneficial form of exercise might be as simplistic as taking 15 minutes time to perform deep breathing exercises.

Remember we are not looking for the magic silver bullet, just a slight improvement. How might we benefit from that very simple start? That's just it, we have actually begun something to improve our depressed state. We, for that 15 minutes, have focus, direction and purpose. It is a 15 minute respite from the constant negative thoughts. This exercise helps oxygenate our blood, release calming endorphins and some would say, helps regenerate and awaken our Chi or life force.

What else? If we were to do this 15 minutes twice a day for a one week period, the unconscious mind would begin to respond. The unconscious loves repetition, that is, repetition which helps it control stress. That is how we began to rely on suicidal thoughts or self inflicted pain, etc. in order to control stress, in the first place. We use ETS to stop the negative and replace the negative with a more positive, therapeutic method to reduce stress, such as deep breathing exercises and this manuscript. The unconscious will begin to present automatic thoughts that we should breath deep when confronted with excess stress, instead of a flight to suicidal thoughts, self-mutilation, anger or despair.

If you are functioning at a level where it is difficult to begin a regimentation of 15 minuet breathing exercises, here are a few exercises I have used which begin with compulsive acts and change them into therapeutic exercises.

When I am very stressed I have a tendency to pace back and forth. Traditionally I would pace while engaged in a 'problem solving' session, where I would think of a hundred different solutions to my problems, and would end with a hundred and one reasons why those solutions would not work. Eventually I began to realize, at that point in time, my life problems were indeed, unsolvable. At that point I decided to begin working on my depression, instead of trying to solve life problems, over which I had absolutely no control.

My pacing began to be very animated, almost aerobic in nature. I would flail my arms about, do a sort of walking dance or clasp my hands in a isometric fashion. I found it best to keep my shades drawn as my neighbors might not understand the therapeutic nature of my antics. Most importantly my thoughts were preoccupied with what I might do to end my depression, rather than rehashing and reinforcing the constant negative in my life.

There were times when things were so bad that I would sit and rock back and forth, wringing my hands. This is not unlike many repetitive compulsive acts where the unconscious mind has lost control of our emotions, the conscious mind cannot provide solutions and is subsequently put on hold. These acts are a last resort to relieve stress and are highly addictive.

In my search to find ways to end my depression (this was in the days before Prozac and the Internet) I had been casually investigating the Indian and Chinese disciplines of Yoga, Qigong (Chi Kung) and Taiji (Tai Chi). Although I never did much with deep meditation or the spiritual aspects, I did find relaxation, fasting, cleansing, deep breathing and herbal treatments to be extremely beneficial when trying to focus and relieve stress.

I decided that when I had the urge to do nothing but sit, rock back and forth and wring my hands, I would instead perform self applied massage to my hands, feet and ears.

CLEANSING OUR BODIES

Proper nutrition and supplements of beneficial herbs, vitamins and minerals will help us combat stress. When we are depressed it is important that we also pay attention to what we should not eat and drink, and that we from time to time cleanse our body of harmful toxins.

There are many ways to cleanse our body, the most efficient way is to fast. I prefer, and recommend a juice fast of 3-7 days length. If you have abused your body and never fasted, if you are on any type of medication or drug, if you are anorexic or bulimic, or have any type of eating disorder, then you MUST check with your doctor before starting a juice fast. If your doctor is against alternative medicine or fasting in any form, then maybe it is time for you to look for a doctor who is truly concerned with your health, rather then simply treating your continued sickness.

I have been forced to combat depression several times in the past twenty years and I continually need to monitor my mind set during periods of increased stress. The most effective tools I have used to combat depression and suicidal thoughts are a combination of Emotional Thought Stopping, exercise/relaxation, and cleansing/juice fasting.

A CHANGE IN MIND SET, A CHANGE IN LIFE STYLE.

Do your homework. Start a through investigation of cleansing/juice fasting, gentle movement exercise, relaxation, herbs, and improved nutrition. Do it. Do it. Do it now! Design a personal program which reflects your needs and your ability (given your depression), one which you are able to start and to maintain over a period of time, be realistic. Your individual program may begin as simple as performing a deep breathing exercise twice a day while sitting on the edge of your bed, drinking 4-6 extra glasses of filtered water each day, and using ETS in order to combat suicidal and self defeating thoughts. Or, you may have the strength to start with aerobic kick boxing, yoga or Tai Chi, a 3-5 day juice fast, supplements of vitamins, minerals and herbs, and using ETS in order to reprogram the unconscious mind in ways which are personally beneficial.

CONCLUSION

Whatever level you start at, there are some common concepts to keep in mind:

-Do not start with a program which is too ambitious, you must be able to maintain your program for at least a two or three week period of time. This provides the unconscious with the needed repetition in order to replace negative thoughts with reinforced positive actions and thoughts.

-When you begin to stop reinforcing your negative and self-destructive thoughts, they must be replaced with alternative methods which combat stress, both in the long run (exercise and proper nutrition) and at the time of incidence (breathing exercises which could be used at work or in a social setting).

-Do not allow the addicted unconscious mind to sabotage your efforts with thoughts such as; 'This is too hard, I could never follow through with such a complicated program, I can't even get out of bed in the morning'. Remember you are allowed to begin at any level of difficulty, which might be as simple as a progressive body relaxation exercise done while lying, spread eagle, on your bed.

Complications Associated With Surveying Medical Student Depression

Depression among medical students is a serious problem. There is considerable evidence that rates of depression and suicide are higher in medical students than in students involved in other graduate studies and that these rates continue to remain elevated when these students become physicians . A recent review reported higher rates of suicide in physicians compared with rates in both the general population and other professionals. Several studies have also documented high rates of depression in medical students compared with the general population. For instance, Clark and Zedlow reported that at least 12% of medical students evidenced significant symptoms of depression on the Beck Depression Inventory (BDI) at three measuring points during their first three years compared with a rate of 3% to 4% observed among the general population . Similarly, Zoccolillo et al. using clinical interviews of students, found a 12% prevalence of major depression in the first two years of medical school. Camp et al. , gathering self-assessments of depressed mood on the Zung inventory, reported scores associated with mild to moderate depression in 20% of medical students in a traditional curriculum compared with 10% of students in a problem-based curriculum. Wolf et al. reported significant depression based on BDI scores in 18% of a medical school class at the end of their first year.

In 1998 we began research that focused on comparing depressed mood in medical students from different curricula (traditional, hybrid, and problem based) at the University of Texas Medical Branch in Galveston. Previous studies have demonstrated lower rates of depression and higher rates of emotional and intellectual satisfaction in a problem-based curriculum compared with a traditional curriculum. Our own problem-based curriculum subjectively appeared to provide greater social support from peers and faculty and a less competitive and more caring environment. In order to objectively assess these observations, we decided to test the hypothesis that rates of depression might be lower in our problem-based or hybrid curriculum compared with the rates in our outgoing traditional curriculum. The BDI was administered with a number of other measures upon matriculation, at the end of year 1, at the end of year 2, and during year 4. The students were given a separate consent form attached to the BDI. This document informed students that if they acknowledged suicidal ideation or scored in a clinically significant range, they would be contacted by the Dean of Students.

The initial administration of the BDI to the Class of 2001, at the end of the first year, yielded a lower than expected rate of abnormal scores. Only 2% to 3% of students scored 14 or higher, in contrast to 12% to 25% of students in published research in which the BDI had been administered at similar intervals . In response to this discrepancy, we modified the consent form. Specifically, we removed the name of the Dean of Students, although we continued to inform students that they would be contacted "to provide guidance regarding appropriate services" if they had significantly elevated scores.

Our consent form modification had little effect. Arguments arose in our research group between those who felt we had an obligation to act if we identified a depressed student and others who believed that telling the students that they would be contacted was interfering with the collection of valid data. We modified our consent form further, emphasizing that scores would not be a part of a student's academic record. Again, little difference was found in the students' low scores on the BDI. Because of our doubts over the results, we did not submit these data for publication.

The purpose of this follow-up study was to gain an understanding of the nature of the unexpectedly low observed scores and to evaluate the hypothesis that student responses were adversely influenced by concerns over anonymity and potential negative repercussions associated with a high score on the BDI. Specifically, this research was designed to discern students' concerns about the BDI administration, determine whether students intentionally distorted their responses, and identify the reasons for dishonesty among those who reported distortion.

DEPRESSION SOLUTION for MEDICAL STUDENTS

Here's some off-the-cuff suggestions:

1. Give medical students more control over their schedules. There's plenty of studies out there showing that hopelessness is correlated with feeling unable to control what happens to you. Medical school curricula that don't allow any electives until the fourth year, rotations that give students no control over their call schedules, and attendings that don't give students any responsibility for deciding when to go home each day all contribute to the sense that you're not driving your own bus. Also, if you have more control over your schedule, the chances that you'll rotate with your friends will increase, so your sense of isolation will decrease. It's probably much more effective to give students more control than it is to limit their work hours or give them more time off.
2. Adopt a zero-tolerance policy for unprofessional behavior by attendings and residents. It's unprofessional to belittle a medical student (or anyone else) at any time, but especially in front of the patient or the medical team. Attendings who routinely do this often claim that they're just providing constructive criticism, but it's funny how their constructive criticism of people with authority over them is never the same as their criticism of underlings. These attendings know what's right, but they just choose not to do what's right. Everyone's going to be grumpy or angry from time to time, but there are professional and unprofessional ways of expressing anger. Apologies are always free. If medical school deans and department chairs are proactive and lead by example, the instances of unprofessional conduct towards underlings will decrease dramatically. It's got to start from the top.
3. Each service should explicitly define the role of the medical student as much as possible. Many of the problems described in the NYT article above come from not being clear about what the medical student's role is. Vague slogans like "the medical student's role is to learn as much as possible and to assist the team" aren't inaccurate; they're just insufficient. Is the student's primary job to learn as much as possible? Then he or she shouldn't be expected to get burritos for the team at 11 pm. Let them do it if they want, or if it's fair, but don't forget to ask why they aren't reading about the patient they just admitted instead. Or maybe the student's role is to assist the team -- like it often is on a busy ob/gyn service. Be explicit about that. "Hey, we're so busy that the best way to teach you and still care for our patients is to designate you as the all-around gofer. Expect it, keep your antennae out, and you'll learn a lot." Maybe the only role for the student is to observe, like perhaps on a third-year neurosurgery rotation. In that case, explicitly allow the student to go home when there aren't any more cases scheduled.

Medicine can be an infinitely rewarding profession. The intrinsic desirability of the career shouldn't be an excuse for medical schools to get lazy and to neglect the basic principles of effective education. Medical school deans ought to worry when they see such high rates of medical student depression, and they ought to think seriously whether there's anything they can do about it. Even if most depression turns out to be caused by the student's first exposure to sickness and death, for example, the medical schools could ameliorate this problem by admitting more students with clinical backgrounds like EMTs and nurses who've seen sick patients before.

Ultimately, we owe it to our patients to make sure that we're the best physicians we can be. Depressed physicians can't function as well over the long term as non-depressed physicians. If the medical schools did their part, and if the medical students did theirs (by taking care of themselves and seeking help when they need it), our patients would reap the benefits.

Relaxation Vs Depression

Stress, depression, other peoples anger, other peoples bullying, harassment, inconsiderate anti-social behaviour (i.e. noise), failure in others eyes, failure in our own eyes, not enough time to do what we enjoy, too much time doing what we don’t enjoy!

It’s no wonder we feel the need to relax!

I feel that many people think that “relaxing” is some sort of hippy new age bull crap and only something for wimps. I feel pity for them, but there view (or ignorance) has no right to impact on our own path.

Most people use “distraction” as their way to relax. TV, books,getting blind drink. drugs

Unfortunately, that IS distraction and not relaxation. It may make you feel better at the time, or more likely, oblivious to how you feel, but that is not true relaxation.

I’m not necessarily talking about mediation (which people often confuse with being asleep), or burning incense candles and going “homm”. There is nothing wrong with that though!

But relaxation is a state of mind. It is a viewpoint or an opinion of yourself.
That probably sounds strange right now, as it is (phew ey), but we will explain that over the coming of the days.

Peace & Light!

Exercises for Depression

Imagine a depression treatment that soothed the mind and emotions, protected the heart and zapped away excess weight -- without side effects.

Sound too good to be true? It's not. Such a remedy already exists, and it doesn't come in a pill bottle, say experts from the University of Texas Southwestern Medical Center.

Aerobic exercise can make a big difference in mild to moderate depression, say Andrea Dunn, PhD, and colleagues in the American Journal of Preventive Medicine's January edition.

The researchers found that 30-minute aerobic workouts of moderate intensity, done three to five times weekly, cut mild to moderate depression symptoms nearly in half. That's comparable to other depression treatments, say researchers.

Depression Common, Treatment Rare

In any given year, nearly 19 million adults in America have a depressive illness, says the National Institute of Mental Health. That's more than 9% of the population.

Many suffer silently, not getting treatment that could help.

Only 23% of depressed people seek treatment and just 10% receive adequate treatment. That's partly due to social stigma associated with treatment, say the researchers.

With that in mind, they studied a socially accepted antidepressant -- exercise. Studies have shown that exercise can help relieve depression, but no one knew exactly how well it worked.

Participants were 80 adults with mild to moderate depression. All were 20 to 45 years old. None were taking other depression treatments.

Fitness Makeover

The participants signed on for a major fitness overhaul. Before the study, they were largely sedentary, working out less than three times weekly for no more than 20 minutes per session.

Those couch-potato days vanished when the 12-week study began. Participants were randomly assigned to one of five groups to test different fitness strategies.

Two groups did moderate aerobic exercise. One group worked out 3 days per week; the other group exercised 5 days per week. They worked out on treadmills or stationary bikes.

The other groups took it a bit easier. Two groups did low-intensity aerobic workouts for 3 or 5 days weekly. For comparison, the last group didn't do any aerobic exercise. Instead, they stretched and did flexibility exercises for 15 to 20 minutes 3 days per week.

Cheating was out of the question. Everyone exercised under the watchful eye of fitness pros at the Cooper Institute in Dallas.

Exercise = Talk Therapy, Drugs

After 12 weeks, participants were rescreened for depression symptoms. All three groups had lower scores than at the beginning of the study.

The moderate-intensity groups had the biggest improvement. Their symptoms fell by 47%. In addition, depression had gone into remission for 42% of those participants, according to their depression test scores.

That's comparable to other depression treatments, say the researchers. They cite remission rates of 36% for cognitive behavior therapy and 42% for the antidepressant medication Tofranil (imipramine) -- an older antidepressant -- in other studies.

Lower-intensity aerobic exercise and stretching/flexibility weren't as beneficial. Low-intensity exercise cut depression symptoms by 30%, compared to 29% for stretching/flexibility.

It didn't matter whether the workouts were done 3 or 5 days per week.

"The key is the intensity of the exercise and continuing it for 30-35 minutes per day," says psychiatry professor Madhukar Trivedi, MD. Trivedi worked on the study and directs the university's mood disorders research program.

Keep in mind that this study focused on mild to moderate depression in younger adults. It didn't address severe depression, or other groups of patients.

Depression is a serious illness affecting the whole body and deserves professional help. No one suggests trading talk therapy or prescription drugs for gym memberships. Instead, exercise might be one more option to consider in planning treatment. It's also a good idea to get your general health checked out before launching a new fitness program.

What should I do if I think I am depressed?

First of all don’t worry any further. Being diagnosed with depression is not the end, it’s the beginning.

Go and see your G.P, explain all the symptoms you have and why you think you may be depressed, sometimes just talking this through helps a great deal.

If you feel you are not up to seeing your G.P straight away, confide in a close friend or family member. This can be done is one foul swoop or over a short period of time, having someone you trust is incredibly important.

If you can’t bring yourself to speak to anyone face-to-face there are many online help groups, websites and forums dedicated to people seeking refuge and advice on depression, one being our own 100% People Forum.

“I found solitude from an internet forum; I felt I could discuss my feelings openly because I didn’t have to say the words out loud. Eventually a fellow member persuaded me to get medical help.”

Finally you must always remember you are not alone, people can beat depression, and they have!

Symptoms of depression

There are many symptoms of depression that the sufferer and friends and family can easily pick up on. Obviously not everyone suffers with all of the listed symptoms so it’s always best to consult your doctor however you feel.

Almost constant feeling of:
• Misery, sadness
• Exhaustion
• Small tasks becoming completely impossible
• Life is passing you by
• Life isn’t worth living
• Being a burden to others
• Having no confidence in yourself or others
• Life being unfair
• Irritable and angry

Other symptoms to look out for:
• Difficulty sleeping at night, waking very early, having long lapses of sleep and/ or disturbing dreams
• Feeling scared, uncomfortable in social situations and of being alone
• Finding it very difficult to think rationally
• Physical aches and pains that don’t appear to have been caused by particular events or accidents.
• The want and/ or need to eat compulsively or to stop eating all together.

This last point is obviously integral to those depressed due to a weight problem. It can cause the person to either, put on more weight and hinder the problem further or dramatically loose weight if they stop eating altogether. This evidently will become a great risk to the person’s health, especially if this develops into an eating disorder. See our page on Eating Disorders.

Dealing with Depression

Depression can easily get in the way of an individual’s daily activities and his or her’s normal functions, one’s zest for life can quickly and easily dissipate due to depression. So in place of an individual’s sunny disposition is more or less a person who hates his or herself, having no self-confidence, trying to isolate one’s self from the world and basically just not caring about living any more. More so, a person suffering from depression isn’t the only one who’s going to suffer from this destructive illness, his or her loved ones are sure to follow suit.

Still, people tend to not recognize depression. Being honest with one’s self is key to being able to cure such an illness. Never overlook the various symptoms, depressed individuals often exhibit uncharacteristic behaviors such as suddenly lacking interest in one’s hobbies or other stuff that he or she usually enjoys. Sleeps too much or suffers from insomnia, suddenly becoming anti-social, talks a lot about death or being a worthless person. There are many other symptoms but if you or someone you know exhibits these symptoms, talk to your doctor.

DEPRESSION incase of STUDENTS

Depression is a growing problem and may be affecting you.

This site offers students comprehensive information and discussion about:

• what depression is and how it works
• what contexts depression flourishes in
• self-help strategies for tackling depression
• how to get further support and help

The site has been developed in consultation with students who have been affected by depression, low mood or suicidal thoughts. Many of their stories and suggestions are included on the site.

No two people have exactly the same experience. No single strategy offers a "miracle cure" to banish depression. This site aims to provide balanced and well-researched discussion about a wide range of perspectives on depression. The individual site user should choose what strategies are useful for his or her own circumstances. The suggestions given on this site must not be seen as a substitute for professional help.

How Do People Respond to Someone Who's Depressed?

Sometimes friends or family members can recognize that a person is depressed. They may respond with love, kindness, or support, hoping that the sadness will soon pass. They may offer to listen if the person wants to talk - although depressed people often don't feel much like talking or can't find the words to describe what's wrong. If the depressed feeling doesn't pass with a little time, friends or loved ones may encourage the person to get help from a doctor or mental health professional.

But not everyone recognizes depression when it happens to someone they know. And some people have incorrect ideas about what it means to be depressed. People who don't understand may react to the depressed person's low energy with criticism, scolding them for acting lazy or not trying. Some people mistakenly believe that depression is simply an attitude a person can change or a mood they can shake. It's not that easy.

Many people just don't realize that depression can cause so many problems or so much pain. Sometimes even people who are depressed don't take their condition seriously enough. Some people have the mistaken belief that depression comes from weakness or is a character flaw. This myth causes some people to hide their depression. Feeling embarrassed, they may avoid getting help.

Occasionally, when depression causes physical symptoms, a person may see their doctor and be relieved to have a normal physical exam. Once in a while, even a well-meaning doctor may minimize or even overlook a person's depression by concluding that there's nothing wrong when medical tests come back normal.

How Do People Respond to Someone Who's Depressed?