Depressive Illnesses are a Major Public Health Problem
Depression Takes a Terrible Toll. The economic cost of depressive illnesses is $30-44 billion a year; the human costs cannot be estimated. The lives of approximately 19 million adults and millions more--family and friends--are affected, often disrupted.

Many Suffer Needlessly
Depression Often Is Not Treated. Even though effective treatments are available, only one in three depressed people gets help. Most people with a depressive illness do not get appropriate treatment because their symptoms.

Depressive Illnesses are Serious

• Depression Affects the Whole Person. Serious depressions are "whole body" disorders, affecting body, feelings, thoughts, and behaviors. They are not the temporary blues or the passing sad moods that everyone experiences after a loss.
• Depression Sometimes Can Disable. Depressive illnesses involve a set of painful symptoms that can last for months, sometimes years. They change people. Sometimes symptoms are so disabling that they interfere with the ability to function. Some who suffer severe forms of depression are unable to eat or get out of bed. An estimated 15 percent of people hospitalized for depression eventually take their own lives.

Depressive Illnesses Come in Various Forms

• Depression Can Occur More Than Once. Some people have one episode of depression in a lifetime; many have recurrent episodes. Others have ongoing, chronic symptoms.
• Depression Can Involve Mood Cycles. Almost two million people experience cycles of terrible "lows" and inappropriate "highs." This emotional roller coaster is called "bipolar disorder" or "manic-depressive illness."

Causes of Depression

• Causes Are Not Always Known. In some cases, symptoms appear suddenly for no apparent reason. In others, the symptoms seem to be associated with a life crisis, stress, or other illness. Research shows that depressive illnesses run in families.

An Accurate Diagnosis is Needed

• Diagnosis Involves a Good Checkup. To diagnose clinical depression and rule out other problems there should be:
  • A complete physical examination and medical work up
  • A complete history of current and previous symptoms
  • Questions about illnesses of other family members
  • Questions about mood, memory, and changes in relationships

Know the Symptoms of Depression
Depression Hurts. Symptoms of depression can include:

• Persistent sad, anxious, or "empty" mood
• Loss of interest or pleasure in activities, including sex
• Restlessness, irritability , or excessive crying
• Feelings of guilt, worthlessness, helplessness,hopelessness, pessimism
• Sleeping too much or too little, early-morning awakening
• Appetite and/or weight loss or overeating and weight gain
• Decreased energy, fatigue, feeling " slowed down"
• Thoughts of death or suicide, or suicide attempts
• Difficulty concentrating, remembering, or making decisions
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Know the Symtoms of Mania

• Abnormally elevated mood
• Irritability
• Severe insomnia
• Grandiose notions
• Increased talking
• Racing thoughts
• Increased activity, including sexual activity
• Markedly increased energy
• Poor judgment that leads to risk-taking behavior
• Inappropriate social behavior

Effective Treatments are Available
Treatment Is Needed. When four or more of these symptoms last longer than 2 weeks or interfere with ordinary functioning, professional treatment is needed. Research Has Improved Treatments. There are effective medications and psychological treatments that often are used in combination. A number of short-term talk therapies to treat clinical depression have been developed in recent years.

Several types of medications are available. People with severe depression respond more rapidly and more consistently to treatment with medication. Those with recurring forms of depression, particularly bipolar disorder, may need to stay on medication to prevent or lessen further episodes.

Many patients need psychotherapy to deal with the psychological or interpersonal problems typically associated with their illness. Electroconvulsive treatment (ECT) may also be a very effective treatment for the most severe depressions. Research is being done on light therapy, as an adjunct to other treatments.

Nearly Everyone can be Helped Quickly
Depression often co-occurs with medical, psychiatric, and substance abuse disorders, though it is frequently unrecognized and untreated. This can lead to unnecessary suffering since depression is usually treatable, even when it co-occurs with other disorders.

Individuals or family members with concerns about the co-occurence of depression with another illness should discuss these issues with the physician.

Symptoms Can Be Relieved in Weeks. With available treatment, 80 percent of the people with serious depression can improve and return to daily activities, usually in a matter of weeks.

Encourage Anyone Who is Depressed to Get Help
Depressive Illnesses Sap Energy. The very nature of a depressive illness can interfere with a person's ability or wish to get help. Depression makes a person feel tired, worthless, helpless, and hopeless.

People with serious depression need encouragement from family and friends to get an accurate diagnosis and to seek the treatment that can ease their pain. Some people need even more help; they become so depressed that they must be taken for treatment.

Seek Treatment or Referral
You Can Get Help From:

• Physicians
• Mental health specialists
• Employee Assistance Programs (EAP's)
• Health maintenance organizations
• Community mental health centers
• Hospital departments of psychiatry or outpatient psychiatric clinics
• University- or medical school-affiliated programs
• State hospital outpatient clinics
• Family service/social agencies
• Private clinics and facilities

In addition to treatment, joining a support group may be helpful.

Mutual and Family Support Groups
In addition to professional treatment, many people benefit from joining mutual and family support groups. For a list of groups in your local area, contact:

• National Alliance for the Mentally Ill
  Colonial Place Three
  2107 Wilson Blvd., Suite 300
  Arlington, VA 22201-3042
  1-800-950-NAMI (6264)
• National Depressive and Manic Depressive Association
  730 North Franklin Street, Suite 501
  Chicago, IL 60610
  1-800-826-DMDA (3632)
• National Mental Health Association
  1021 Prince Street
  Alexandria, VA 22314-2971
  1-800-969-NMHA (6942)
• U.S. Department of Health and Human Services
• Public Health Service
• National Institutes of Health
• National Institute of Mental Health

Do you need help? If you, or someone you love is depressed and contemplating suicide, PLEASE get some HELP! If you need help NOW, call the National Hopeline Network Suicide Hotline at: 1-800-SUICIDE (1-800-784-2433) - National Hotline -