Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It is a mental health condition that requires understanding and care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan many people can and do get better.

Some will only experience one depressive episode in a lifetime, but for many, depressive disorder recurs. Without treatment, episodes may last a few months to several years. People of all ages and all racial, ethnic, and socioeconomic backgrounds experience depression.

Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:

• Changes in sleep
• Changes in appetite
• Lack of concentration
• Loss of energy
• Lack of interest in activities
• Hopelessness or guilty thoughts
• Changes in movement (less activity or agitation)
• Physical aches and pains
• Suicidal thoughts

Treatments

Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment, a client-centered treatment plan can include any or a combination of the following:

• Therapy includes cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
• Medications including antidepressants, mood stabilizers and antipsychotic medications.
• Exercise can help with prevention and mild-to-moderate symptoms.
• Light therapy uses a light box to expose a person to full spectrum light to regulate the hormone melatonin.

Bipolar Depression

Symptoms

Symptoms and their severity can vary. A person with bipolar disorder may have distinct manic or depressed states but may also have extended periods—sometimes years—without symptoms. A person can also experience both extremes simultaneously or in rapid sequence.

Mania. To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. Hypomania is a milder form of mania that does not include psychotic episodes. People with hypomania can often function well in social situations or at work. Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; others may experience them only rarely.

Although someone with bipolar may find an elevated mood of mania appealing—especially if it occurs after depression—the “high” does not stop at a comfortable or controllable level. Moods can rapidly become more irritable, behavior more unpredictable and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions, and take unusual risks.

Depression.The lows of bipolar depression are often so debilitating that people may be unable to get out of bed. Typically, people experiencing a depressive episode have difficulty falling and staying asleep, while others sleep far more than usual. When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt, or helplessness; this negative thinking can lead to thoughts of suicide.

The depressive symptoms that obstruct a person’s function must be present nearly every day for at least two weeks for a diagnosis. Depression associated with bipolar disorder may be more difficult to treat and require a customized treatment plan.

Treatment

Bipolar disorder is treated and managed in several ways:

• Therapy, such as cognitive behavioral therapy and family-focused therapy.
• Medications, such as mood stabilizers, antipsychotic medications and, to a lesser extent, antidepressants.
• Self-management strategies, like education and recognition of an episode’s early symptoms.
• Complementary health approaches, such as aerobic exercise meditation, faith and prayer can support, but not replace, treatment.