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Depression

Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being.

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(Source: Wikipedia)

About Depression

We all feel unhappy and listless every now and then. And we have all felt down or even desperate at some point in our lives. These phases are a normal part of life, and people usually feel better again after a while. Things are different for people who have depression. Their sadness and negative thoughts last longer and overshadow all of their thoughts and actions. Depression can arise without any triggering events or for no apparent reasons. People often feel like they are stuck in a deep pit. They feel cheerless, lack motivation and self-confidence, and perceive themselves to be worthless. They find it hard to do everyday things, go to work or study. Friends, family and hobbies are neglected. They do not sleep well.

Depression can also make family and friends feel worried, anxious and helpless. They often would like to help but do not know how. It is not always easy for them to tell whether it is a passing phase or a serious illness... Read more about Depression

What works? Research summarized

Evidence reviews

Depression: The Treatment and Management of Depression in Adults (Updated Edition)

This clinical guideline on depression is an updated edition of the previous guidance (published in 2004). It was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage depression in adults.

Depression in Children and Young People: Identification and Management in Primary, Community and Secondary Care

This guideline has been developed to advise on the identification and management of depression in children and young people in primary, community and secondary care. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, carers, and guideline methodologists after careful consideration of the best available evidence. It is intended that the guidelines will be useful to clinicians and service commissioners in providing and planning high-quality care for children and young people with depression while also emphasising the importance of the experience of care for patients and their families.

Low frequency repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder: a systematic review

Bibliographic details: Lin JB, Liao WJ, Wang P, Li HG, Guo Y.  Low frequency repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder: a systematic review. Chinese Journal of Evidence-Based Medicine 2011; 11(10): 1192-1198 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=201110017

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Summaries for consumers

Second‐generation antipsychotic drugs for major depressive disorder 

This review found 28 studies on five second‐generation antipsychotic drugs (amisulpride, aripiprazole, olanzapine, quetiapine and risperidone) comparing the effects of the drugs alone or adding them or placebo to antidepressants for major depressive disorder and dysthymia. There is evidence that amisulpride might lead to symptom reduction in dysthymia, while no important differences were seen for major depression. There is limited evidence that aripiprazole leads to symptom reduction when added to antidepressants. Olanzapine had no beneficial effects for treatment of depression when compared to antidepressants or compared to placebo but there was limited evidence for the benefits of olanzapine as additional treatment. Data on quetiapine indicated beneficial effects for quetiapine alone or as additional treatment when compared to placebo; data on quetiapine versus duloxetine did not show beneficial effects in terms of symptom reduction for either group, but quetiapine treatment was less well tolerated. The data, however, are very limited. Slight benefits of risperidone as additional treatment, in terms of symptom reduction, are also based on a rather small number of randomised participants. Generally, treatment with second‐generation antipsychotic drugs was associated with worse tolerability, mainly due to sedation, weight gain or laboratory values such as prolactin increase.

Fluvoxamine versus other anti‐depressive agents for depression

Major depression is a severe mental illness characterised by a persistent and unreactive low mood and loss of all interest and pleasure, usually accompanied by a range of symptoms including appetite change, sleep disturbance, fatigue, loss of energy, poor concentration, psychomotor symptoms, inappropriate guilt and morbid thoughts of death. Although pharmacological and psychological interventions are both effective for major depression, antidepressant (AD) drugs remain the mainstay for treatment of moderate or severe depression. Fluvoxamine is one of the oldest selective serotonin reuptake inhibitors (SSRIs) and is prescribed to patients with major depression in many countries. This review reports trials comparing fluvoxamine with other antidepressants for treatment of major depression. We found no strong evidence that fluvoxamine was either superior or inferior to any other antidepressants in terms of efficacy and tolerability in the acute phase treatment of depression. However, there is evidence of differing side‐effect profiles, especially when comparing gastrointestinal side effects between fluvoxamine and tricyclic antidepressants (TCAs). Based on these findings, we conclude that clinicians should focus on practical or clinically relevant considerations including these differences in side effect profiles.

Paroxetine versus other anti‐depressive agents for depression

Major depression is a severe mental illness characterised by a persistent and unreactive low mood and loss of all interest and pleasure, usually accompanied by a range of symptoms such as appetite change, sleep disturbance, fatigue, loss of energy, poor concentration, inappropriate guilt and morbid thoughts of death. Although medication and psychological treatments are both effective for major depression, antidepressant drugs remain the mainstay of treatment in moderate to severe major depression. However, head‐to‐head comparisons of such drugs provide contrasting findings as to whether they are effective.

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Terms to know

Anxiety
Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat.
Bipolar Disorder
A psychiatric diagnostic category, previously called manic depression, characterised by mood swings between great energy (manic) and clinical depression.
Dysthymia (Chronic Depression)
A mood disorder consisting of the same cognitive and physical problems as in depression, with less severe but longer-lasting symptoms.
Major Depression (Major Depressive Disorder)
A pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities.
Postnatal Depression (Postpartum Depression)
A type of clinical depression that occurs after childbirth.
Sleep Disorders
A disturbance of normal sleep patterns.

More about Depression

Photo of an adult

Also called: Depressed, Depressive disorder, Depressive episode, Depressive illness

Other terms to know: See all 6
Anxiety, Bipolar Disorder, Dysthymia (Chronic Depression)

Related articles:
Signs of Depression
Types of Depression
Depression: Strategies for Family and Friends

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