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Public Information: Choosing a Psychiatrist

The death of a loved one, loss of a job, or the ending of a relationship aredifficult experiences for an individual to endure. It is normal for feelings of sadness or grief to develop in response to such stressful situations. Those experiencing trying times often might describe themselves as being "depressed." But sadness and depression are not the same. While feelings of sadness will lessen with time, the disorder of depression can continue for months, even years.

Depression is a serious medical illness that negatively affects how you feel, the way you think, and how you act. It is a common illness that each year affects 17 million Americans (nearly one in 10). Depression does not discriminate; it affects men and women, young and old, and people of all races, cultures, and incomes.

Fortunately, depression is very treatable. The majority (80%-90%) of people who receive treatment experience significant improvement, and almost all individuals derive some benefit from medical care.

Unfortunately, individuals may not recognize their symptoms as signs of an illness, or they may fear the reactions of coworkers, friends, and family. As a result, millions of people with depression do not seek treatment and unnecessarily experience problems at their jobs or in their relationships.

The costs of depression can be severe. The estimated financial costs of depression in missed days at work, medical expenses, and premature death are $43 billion annually. If you or someone you know may have depression, consult with a psychiatrist or other medical doctor. Remember, depression is one of the most treatable mental illnesses, and, with proper treatment, individuals can regain a healthy outlook on life.

What Is Depression?

Depression has a variety of symptoms, but the most common is a deep feeling of sadness. People with depression may feel tired, listless, hopeless, helpless, and generally overwhelmed by life. Simple pleasures are no longer enjoyed, and their world can appear dark and uncontrollable. Emotional and physical withdrawal are common responses of depressed people.

Depression can strike at any time, but most often appears for the first time during the prime of life, from ages 24 to 44. One in four women and one in 10 men will confront depression at some point in their lives.

Symptoms of Depression

Depression is diagnosed if a person experiences 1) persistent feelings of sadness or anxiety or 2) loss of interest or pleasure in usual activities in addition to five or more of the following symptoms for at least 2 consecutive weeks.

Depression is diagnosed only if the above symptoms are not due to other conditions (e.g., neurological or hormonal problems) or illnesses (e.g., cancer, heart attack) and are not the unexpected side effects of medications or substance abuse.

What Causes Depression?

Several factors play a role in the onset of depression.

Biochemistry. Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for certain symptoms of depression, including anxiety, irritability, and fatigue.

Genetics. Depression can run in families. For example, if one identical twin has depression, the other twin has a 70% chance of also having the illness sometime in life.

Personality. People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be vulnerable to depression.

Environmental factors. Continuous exposure to violence, neglect, abuse, or poverty may make people who are already susceptible to depression all the more vulnerable to the illness.

However, it should be noted that depression can still occur under ideal living circumstances.

How Is Depression Treated?

Unfortunately, depression cannot be controlled for any length of time simply through exercise, through changes in diet, or by taking a vacation. But it is among the most treatable of mental disorders. Between 80% and 90% of people with depression respond well to treatment, and almost all patients gain some relief from their symptoms.

Before a specific treatment is recommended, a psychiatrist will conduct a thorough diagnostic evaluation, consisting of an interview and a physical examination. Its purpose is to reveal specific symptoms, medical and family history, cultural setting, and environmental causes of stress to arrive at a proper diagnosis and to determine the best treatment.

Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, "uppers," or tranquilizers; they are not habit-forming; and they generally have no stimulating effect on people not experiencing depression.

Antidepressants usually take full effect within 3-6 weeks after therapy has begun. If little or no improvement is noted after 6-8 weeks, the psychiatrist will alter the dose of the medication or will add or substitute another antidepressant. Psychiatrists usually recommend that patients continue to take medication for 5 or more months after symptoms have improved.

Psychotherapy, or "talk therapy," may be used either alone for treatment of mild depression or in combination with antidepressant medications for moderate to severe depression.

Psychotherapy can involve only the individual patient or include others. Family or couples therapy helps to address specific issues that can arise within these close relationships. Group therapy involves people with similar illnesses. Depending on the severity of the depression, treatment can take a few weeks or substantially longer. However, in many cases, significant improvement can be made in 10-15 sessions.

Depression is never normal and always produces needless suffering. With proper diagnosis and treatment, depression can be overcome in the vast majority of people. If you are experiencing symptoms of depression, see your physician or psychiatrist, describe your concerns, and request a thorough evaluation. You will feel better.

To find a facility in your community that offers free depression screening, please call National Depression Screening Day's Toll-Free Year-Round Depression Screening Line: 800-573-4433.

Other Sources of Information

Depression Awareness Recognition & Treatment (D/ART)
5600 Fishers Lane, Room 14C03
Parklawn Building
Rockville, MD 20857

National Alliance for the Mentally Ill
200 North Glebe Road, Suite 1015
Arlington, VA 222033754

National Depressive and Manic-Depressive Association
730 N. Franklin, #501
Chicago, IL 60610

National Foundation for Depressive Disorders
P.O. Box 2257
New York, NY 10016

National Institute of Mental Health Information Resources and Inquiries Branch
5600 Fishers Lane, Room 7C02
Rockville, MD 20857

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314

Call APA fastFAX (APA's toll-free fax-on-demand service) for a menu of items available free by fax: 1-888-267-5400.

To request a copy of any title in the series, contact:

American Psychiatric Association
DPA Dept. SG
1400 K Street, N.W.
Washington, DC 20005
Information provided throught writen concent from the American Psychiatric Association