Unipolar Depression

What is unipolar depression?

Depression is a serious medical illness.  It's more than just a feeling of being sad or "blue" for a few days.  If you are one of the more than 19 million teens and adults in the United States who have depression, the feelings do not go away.  They persist and interfere with your everyday life.  Symptoms can include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness

  • Angry outbursts, irritability or frustration, even over small matters

  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

  • Sleep disturbances, including insomnia or sleeping too much

  • Tiredness and lack of energy, so even small tasks take extra effort

  • Reduced appetite and weight loss or increased cravings for food and weight gain

  • Anxiety, agitation or restlessness

  • Slowed thinking, speaking or body movements

  • Feelings of worthlessness or guilt, fixating on past failures or self-blame

  • Trouble thinking, concentrating, making decisions and remembering things

  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

  • Unexplained physical problems, such as back pain or headaches                                                                                                                                                              

Depression across the life-span

 

Depression is a disorder of the brain.  There are a variety of causes including genetic, familial, environmental, and psycho-social factors that can influence the development of depression.  Unipolar depression can happen at any age, but it more likely to occur in later adult years as opposed to an onset in teen years.  It is much more common in women than in men.  Women can also get postpartum depression after the birth of a baby.  Some people get seasonal affective disorder, which is depression that occurs in the winter months.  Depression is also one part of bipolar disorder.  Depression can affect people differently, depending on their age.

Children with depression may be anxious, cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.

Older children and teens with depression may get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem.  They also may have other disorders, such as anxiety and eating disorders, attention-deficit hyperactivity disorder, or substance use disorder.  Older children and teens are more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia).  In adolescence, females begin to experience depression more often than males, likely due to the biological, life cycle, and hormonal factors unique to women.

Younger adults with depression are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, and substance use disorders.

Middle-aged adults with depression may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning awakening.  They also may more frequently report having gastrointestinal symptoms such as diarrhea or constipation.

Older adults with depression commonly experience sadness or grief or may have other less obvious symptoms.  They may report a lack of emotions rather than a depressed mood.  Older adults also are more likely to have other medical conditions or pain that may cause or contribute to depression.  In severe cases, memory and thinking problems (called pseudodementia) may be prominent.

                                                                                                                       

 

Treatments for depression

 
The mainstay of treatment is usually medication, talk therapy, or a combination of the two.  Increasingly, research suggests these treatments may normalize brain changes associated with depression.

Medications used to treat depression include: SSRIs and other antidepressants, mood stabilizers, anxiolytics and antipsychotics.  

 

Psychotherapies (talk therapy) include: Cognitive behavioral therapy (CBT) which is a form of talk therapy focused on modifying negative thoughts, behaviors, and emotional responses associated with psychological distress.  Dialectical behavior therapy (DBT) is focused on modifying harmful behaviors associated with psychological distress.  There are also many other forms of therapy.