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The first thing to know about depression is that it is not just in your head. Depression is, in fact, a
whole body disease that affects multiple systems.
In addition to feeling sad, hopeless, or helpless, a person may suffer from extreme fatigue,
decreased motor (muscle) coordination, changes in appetite and weight, and a loss of interest in
activities that are usually pleasurable--just to name a few of the more common symptoms.
Anxiety, which is commonly understood to consist of fear without any direct cause, is highly
correlated with depression. Anxiety is an imbalance not just of brain chemicals, but of the entire
nervous system, which is over-responding throughout the body as if a physical threat is
impending. This can often cause the depressed person to feel very jittery, and some people
experience extra clumsiness as they go about their day.
Only a doctor can diagnose depression, and if you are suffering from what you believe to be
depression, you should make an appointment immediately. (If you need help sooner, please dial
9-1-1.) When you speak to a doctor during a formal assessment, he/she will ask you questions
like the following, which are adapted from the Diagnostic and Statistical Manual of Mental
Disorders IV:
1. Are you experiencing a depressed mood?
2. Have you lost interest in most or all of your normal activities, including normally pleasurable
ones?
3. Have you experienced a dramatic change in your appetite, leading to noticeable weight gain or
weight loss in the last month?
4. Have your sleep habits changed? Do you sleep much more or much less than normal, or do you
have trouble getting to sleep or waking up?
5. Do you feel agitated or jumpy, or have others noticed that you are more irritable than normal?
6. Have you had trouble concentrating or thinking clearly?
7. Do you feel abnormally tired throughout the day?
8. Do you have overwhelming feelings of worthlessness, guilt, or hopelessness that things

2. won&#146;t improve?
9. Have you been thinking about death or suicide more than usual, or have you tried to commit
suicide?
If you answered &#147;yes&#148; to questions 1 and/or 2, plus any four of the other questions,
and these symptoms have persisted for at least two weeks with little change, you may be suffering
from clinical depression.
Your doctor will also want to make sure that these symptoms are not due to what would be
considered a normal reaction to a life situation, like a death in the family. It is completely normal to
feel those things after a traumatic life event, unless those feelings persist for longer than two
months without seeming to become easier to handle.
Additionally, the doctor will want to know whether these symptoms are causing you great difficulty
in completing your normal daily activities. Depression is serious enough that it can cause a
person to miss work and be unable to fulfill family obligations.
Risk Factors
People who suffer from depression are much more likely to suffer from other life threatening
diseases, including diabetes, cancer, and heart disease. Much focus has been put on discovering
why depressed patients are about four times as likely as their peers to suffer a heart attack within
14 years of their first depressive episode.
Underscoring the whole body effect of depression is the research finding that depressed patients
have lower heart rate variability (HRV) than normal. HRV is lowered when the parasympathetic
branch of the nervous system is not fully functioning, and people with low HRH are at high risk for
suffering heart attacks.
The malfunctioning of the parasympathetic branch may be a key in understanding how mental
perception of events that lead to depression affect the entire body.
Causes of Depression
Depression can be caused by any number of circumstances. For some, genetics may play a role
(this is especially true for bipolar disorder, or manic depression, which is not covered in this
article). For others, it could be the result of their life situation, such as an overly stressful stretch of
time or a disease.
Many times, depression can be caused by &#147;uncontrollable stress&#148;. In this case, a
person is going through a negative event in which they perceive their efforts will not affect the
outcome. Caregivers are especially prone to this. With the advent of disease such as
Alzheimer&#146;s, a patient may need constant attention from a family member for years, causing
great disruption in the caregiver&#146;s life.
In cases of stress, it should be repeated that the effects will be on the whole body, not just the
mind. Stress can cause the secretion of excess cortisol, which in turn can damage tissues in the

3. brain and body. Stress hormones can also cause the nervous system to become overworked in
trying to maintain balance, eventually causing it to shut down due to exhaustion.
Depression Treatment Options
Anti-Depressants
One of the great advances in pharmaceutical medicine was the advent of the SSRI class of anti-
depressants. Depression can cause an imbalance in the brain chemical called serotonin.
Serotonin is a neurotransmitter that helps us feel calm and relaxed with a sense of wellbeing.
In people who are depressed, serotonin production may be lowered, or it may not be utilized most
effectively in the brain.
Neurotransmitters are secreted into the spaces between the brain cells. SSRIs, or Selective
Serotonin Reuptake Inhibitors, prevent the serotonin from being absorbed back into brain cells as
quickly, and brain researchers believe that leaving more of the serotonin in between the cells has
a mood-enhancing effect.
Examples of SSRI class anti-depressant drugs include Prozac, Zoloft, and Paxil. They have been
shown to be highly effective for alleviating depression and anxiety in a wide range of people,
though their safety in children has recently been questioned.
Counseling
In addition to medication, patients are usually also referred to a counselor for what is often referred
to as &#147;talk therapy&#148;, or more formally as cognitive behavior therapy. With this type of
counseling, the depressed person learns to notice their negative thinking patterns and challenge
them. Over time, patients are able to prevent negative moods by intervening in their own to reflect
a more positive outlook.
Exercise
Research has shown that consistent aerobic exercise in a specific heart rate zone has very
beneficial effects in fighting depression in both the short- and long-term.
While it may be difficult for someone experiencing a major depressive episode to rally the energy
necessary to exercise, most people who do experience at least some relief from depression within
just 10 minutes of starting.
Though not widely publicized, the effects of exercise have been repeatedly shown to result in
decreases in depression that are on par with both drug and counseling therapies. For more
information on an exercise program that may help alleviate depression symptoms, please go to
http://www.hrh-for-depression.com.
Herbal Therapies
Interest in herbal therapies for depression has always been high, and in some countries, such as

4. Germany, herbal therapies are preferred over medicinal therapies, according to the National
Institute of Mental Health. Many people prefer herbal therapies in general, because they believe
the side effects of anti-depressants may affect them negatively.
Herbs such as ginseng and gingko biloba have been used to treat depression, but the only herb to
be tested in a large scale study is St. John&#146;s wort. Patients who were followed for 26 weeks
of St. John&#146;s Wort use did experience a reduction in depression that was nearly comparable
to sertraline, an SSRI.
Researchers warned, however, that St. John&#146;s wort may utilize the same metabolic
pathways as other drugs for depression, heart disease, seizures, and some cancers. As a result,
patients need to be certain to consult their doctors on the use of St. John&#146;s wort with other
medications.
Getting Help
Nearly 10% of Americans will experience a depressive illness in any given year. If you feel you
are in the throes of depression, please understand that there are very effective treatments
available to you. Modern SSRI medications, which are the most commonly prescribed anti-
depressants, can start working within 2 weeks of taking the first dose. By engaging in some
moderate exercise, you might even feel somewhat better by the end of today.
Though doing anything while suffering from depression is difficult, please do make it a priority to
seek some sort of help. If you need others to intervene on your behalf, please communicate that
to them.
If you are feeling depressed, chances are that people around you have noticed, but they may not
want to say anything about it to you. With a small overture on your part, they will likely jump at the
opportunity to help you seek treatment.
If you would like more information on depression, you can go to the National Institute of Mental
Health web site at [http://www.nimh.nih.gov/publicat/depression.cfm]. There you can download
information about depression and search for topics related to depression and depression
treatment.
Craig D. Wilcox is the author of The Heart Rate Health Program, which could help people suffering
from depression ease their symptoms. Information about the Heart Rate Health Program for
depression can be found at http://www.hrh-for-depression.com He also maintains the sites
http://www.heartratehealth.com and [http://www.hrhprogram.com].
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