Clinical depression is more than just feeling sad or unhappy. Doctors define clinical depression as a persistent, severe depression without any physical or environmental attributable causes. This means that those who suffer from depression feel exceptionally sad for a long time, and they have no reason for this a feeling, such as a serious injury or the death of a loved one.

Doctors have a medical checklist to decide whether or not a person is suffering from clinical depression. They must have one (or possibly both) of the following: depressed mood or loss of interest in pleasure. In conjunction with this feeling, they must also have four of the ten following symptoms. Emotional abnormality: feelings of extreme sadness or fear, or the opposite, the complete lack of emotion. Disinterest: A loss of interest in pleasurable or normal activities. Change in weight: a significant weight gain or weight loss. Disturbed sleep: inability to sleep normally (insomnia), or sleeping more than usual. Change in physical activity: being nervous, restless or fidgety, or the opposite, being lethargic and slow moving. Fatigue: either physical exhaustion or mental tiredness. Unusual emotions: feeling emotions like guilt, fear, anxiety or helplessness when there seems to be no direct cause for those feelings. Low self esteem: feeling worthless and not self confident. Loss of concentration: the inability to concentrate, focus or make decisions. Morbid fixation: frequently thinking about death or suicide.

It is believed that approximately 15% of Americans will suffer from depression at some point in their lives. Although more women that men have been diagnosed and treated for this illness, the gap is closing as more men feel that it is socially acceptable to admit depression and seek medical care. Doctors have linked depression to increased rates of morbidity (illness and health problems like coronary artery disease) and increased rates of mortality (death). Depression also affects the level of the ability to function normally in home and work environments and causes the loss of economic productivity due to absenteeism and under-performance.

Depression can affect children, teens, adults and the elderly. There are documented triggers that can cause depression. Some of the most frequent causes are death of a loved one, divorce, emotional relationship stress, moving to a new home, work stress, changing jobs, unemployment, retirement, and physical, sexual or emotional abuse. There are also many instances where depression seems to run in families. Particularly in bipolar disorder, it is believed that heredity can predispose a person to become clinically depressed.

There are many treatments available for those who suffer from depression. These range from psychological counseling, to medications, to a medical treatment called electro shock therapy. Most doctors believe that anti-depressant drugs are the best treatment for depression.

There are many different drugs used to treat clinical depression. Sometimes, doctor try a variety of antidepressants before finding the medication or combination of medications that is most effective. In order to choose an antidepressant, the patient’s age and medical condition(s) must be taken into account. Selective serotonin reuptake inhibitors (SSRIs) have lower severity of side effects than other classes of antidepressants. Side effects of SSRI medications can be minimized by starting them at low doses and gradually increasing the dosage to achieve full benefits. For those patients who do not respond after taking an SSRI, the doctors can switch to a different SSRI, or combine the drug with another SSRI, or try another class of antidepressants. Some doctors believe that antidepressants with dual action (action on both serotonin and norepinephrine), like duloxetine (Cymbalta), mirtazapine (Remeron), and venlafaxine (Effexor), may work in treating patients with severe depression. Other options include bupropion (Zyban, Wellbutrin, Wellbutrin SR, and Wellbutrin XL). Sometimes doctors use a combination of antidepressants from different classes.

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