Depression and Mood Disorders

It is common to feel sad or discouraged after having a heart attack, receiving a cancer diagnosis, or when trying to manage a chronic condition such as pain. You may be facing new limits on what you can do and may feel stressed or concerned about treatment outcomes and the future.

What is Depression?

Depression is often colloquially used to describe someone who appears sad. Sadness is a human emotion people experience in response to stressful events, such as losing a loved one or dealing with unexpected medical problems like being diagnosed with cancer or having a heart attack or stroke. Transient periods of sadness would be anticipated in those circumstances, but if it persists, it can make it difficult to get everyday tasks done and even cause a person to no longer enjoy their favorite pastimes.

Generally, "depression" can be categorized as one of two types: unipolar depression or bipolar depression. Unipolar depression is associated with depressive episodes seen with a diagnosis of major depression disorder (MDD). Bipolar depression is associated with depressive episodes seen with a diagnosis of bipolar disorder.

Depressive symptoms are common among those with chronic medical problems, such as those who have had a stroke, have diabetes, heart disease, cancer, thyroid disease, dementia, HIV/AIDS, epilepsy, and an autoimmune disease. It is also worth noting there are some depression risk factors that are directly related to a chronic medical problem, specifically those that may change brain structure, such as Parkinson's disease or multiple sclerosis.

The presence of a chronic medical problem can increase a person's risk of depression as well as if there is a family history of depression or if family members have contemplated suicide. MDD is a serious disorder that not only affects mood but also can cause physical symptoms. MDD is characterized by persistently sad mood lasting longer than a couple of weeks often with other symptoms like difficulty sleeping, loss of energy, and changes in appetite.

MDD can occur in children, adolescents, adults, and older patients but most commonly occurs in younger adults and older patients. If someone believes they have symptoms of depression, especially those with chronic medical problems, their symptoms should be evaluated by a health care provider.

Treatment-Resistant Depression Program Brochure

What are the symptoms of major depressive disorder?

Some symptoms include:

• Feeling persistently sad, down, or depressed
• Loss of interest in favorite activities or hobbies
• Trouble falling or staying asleep
• Changes in appetite or weight
• Difficulty concentrating or trouble remembering or making decisions
• Feeling restless or feeling keyed up
• Loss of energy or fatigue
• Feelings of worthlessness or excessive guilt
• Feelings of hopelessness
• Thoughts of death or suicide or attempting suicide

How is major depressive disorder treated?

If a person believes they are experiencing symptoms of MDD, they should speak with a health care provider. After discussion with their health care provider, they may be referred to a mental health professional, such as a clinical social worker, counselor, psychologist, or psychiatrist. This is an important step as the mental health professional can help identify a diagnosis and recommend a targeted treatment.

MDD can be effectively treated with medication or psychotherapy or both, even if someone has been diagnosed with another chronic medical problem. There are many available options to treat depression, but the most common medication used to treat depression and anxiety are called antidepressants, which are further classified as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

If symptoms continue despite treatment, there are other interventions, including brain stimulation therapies and different classes of medication, that research has shown to be effective. Psychotherapy is another way MDD can be treated and is often referred to as "talk therapy." Cognitive behavioral therapy (CBT) is a type of psychotherapy supported by research to be an effective treatment for depression and anxiety. During CBT, the therapist and patient work together towards the primary goal of modifying different patterns of the patient's thinking as well as their reactions to stressful situations in efforts to develop more effective ways of coping and reducing depressive symptoms long-term.

It is important for a person to tell their health care provider what other treatment or medication they are currently taking, including prescription medications, dietary supplements, and over-the-counter medications. Their health care provider can then help determine which treatment would be the most helpful for their mood symptoms while not interfering with their current medications. With treatment, depressive symptoms can gradually improve and even be helped along if other chronic medical problems are appropriately treated as well.