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What is Depression?

Depression is a disorder that affects your thoughts, moods, feelings, behavior and physical health. People used to think it was "all in your head" and that if you really tried, you could "pull yourself out of it." Doctors now know that depression is not a weakness, and you can't treat it on your own. It's a medical disorder with a biological basis.

Sometimes, a stressful life event triggers depression. Other times depression seems to occur spontaneously, with no identifiable specific cause. Whatever the trigger, depression is much more than grieving or a bout of the blues. Depression may occur as repeated episodes over a lifetime, with periods free of depression in between. Or it may be a chronic condition, requiring ongoing treatment over a lifetime. The disorder affects more than 18 million Americans of all ages and races. Medications are available that are generally safe and effective, even for the most severe depression. With proper treatment, most people with serious depression improve, often within weeks, and can return to normal daily activities

Causes

There's no single cause for depression. The illness often runs in families. Experts believe a genetic vulnerability combined with environmental factors, such as stress or physical illness, may trigger an imbalance in brain chemicals called neurotransmitters, resulting in depression. Imbalances in three neurotransmitters — serotonin, norepinephrine and dopamine — seem to be linked to depression. Scientists don't fully understand how imbalances in neurotransmitters cause symptoms of depression. It's not certain whether changes in neurotransmitters are a cause or a result of depression.

Here are factors that contribute to depression:

Heredity Researchers have identified several genes that may be involved in bipolar disorder, and they're looking for genes linked to other types of depression. But not everyone with a family history of depression develops the disorder.

Stress Stressful life events, particularly a loss or threatened loss of a loved one or a job, can trigger depression.

Medications Long-term use of certain medications, such as some drugs used to control high blood pressure, sleeping pills or, occasionally, birth control pills, may cause symptoms of depression in some people.

Illnesses Having a chronic illness, such as heart disease, stroke, diabetes, cancer or Alzheimer's disease, puts you at higher risk of developing depression. Studies reveal an as-yet-unexplained link between depression and heart disease. Depression occurs in up to half of people who've had heart attacks. Left untreated, depression may put you at a higher risk of death in the early years after a heart attack. Having an under active thyroid (hypothyroidism) — even mild hypothyroidism — can also cause depression.

Personality Certain personality traits, such as having low self-esteem and being overly dependent, self-critical, pessimistic and easily overwhelmed by stress, can make you more vulnerable to depression.

Postpartum depression It's common for mothers to feel a mild form of distress that usually occurs a few days to weeks after birth. During this time you may have feelings of sadness, anger, anxiety, irritability and incompetence. A more severe form of the baby blues, called postpartum depression, occurs in approximately 10 percent of childbearing women.

Alcohol, nicotine and drug abuse. Experts once thought that people with depression used alcohol, nicotine and mood-altering drugs as a way to ease depression. But studies show that using these substances may actually contribute to depression and anxiety disorders.

Diet Deficiencies in folate and vitamin B-12 may cause symptoms of depression. Low levels of both nutrients are linked to a poorer response to antidepressant medications.