WHAT IS A DEPRESSIVE DISORDER?
A depressive disorder is an illness that
involves the body, mood, and thoughts. It
affects the way a person eats and sleeps,
the way one feels about oneself, and the
way one thinks about things. A depressive
disorder is not the same as a passing blue
mood. It is not a sign of personal
weakness or a condition that can be willed
or wished away. People with a depressive
illness cannot merely "pull themselves
together" and get better. Without
treatment, symptoms can last for weeks,
months, or years. Appropriate treatment,
however, can help most people who suffer
from depression.
TYPES OF DEPRESSION

Depressive disorders come in different forms, just as is the case with
other illnesses such as heart disease. This pamphlet briefly describes
three of the most common types of depressive disorders. However,
within these types there are variations in the number of symptoms, their
severity, and persistence.

Major depression is manifested by a combination of symptoms (see
symptom list) that interfere with the ability to work, study, sleep, eat, and
enjoy once pleasurable activities. Such a disabling episode of
depression may occur only once but more commonly occurs several
times in a lifetime.

A less severe type of depression, dysthymia, involves long-term,
chronic symptoms that do not disable, but keep one from functioning
well or from feeling good. Many people with dysthymia also experience
major depressive episodes at some time in their lives.

Another type of depression is bipolar disorder, also called
manic-depressive illness. Not nearly as prevalent as other forms of
depressive disorders, bipolar disorder is characterized by cycling mood
changes: severe highs (mania) and lows (depression). Sometimes the
mood switches are dramatic and rapid, but most often they are gradual.
When in the depressed cycle, an individual can have any or all of the
symptoms of a depressive disorder. When in the manic cycle, the
individual may be overactive, overtalkative, and have a great deal of
energy. Mania often affects thinking, judgment, and social behavior in
ways that cause serious problems and embarrassment. For example,
the individual in a manic phase may feel elated, full of grand schemes
that might range from unwise business decisions to romantic sprees.
Mania, left untreated, may worsen to a psychotic state.
Bipolar Disorder
Bipolar disorder, also known as
manic-depressive illness, is a brain disorder
that causes unusual shifts in a person's
mood, energy, and ability to function.
Different from the normal ups and downs
that everyone goes through, the symptoms
of bipolar disorder are severe. They can
result in damaged relationships, poor job or
school performance, and even suicide. But
there is good news: bipolar disorder can be
treated, and people with this illness can
lead full and productive lives.

About 5.7 million American adults or about
2.6 percent of the population age 18 and
older in any given year,1 have bipolar
disorder. Bipolar disorder typically
develops in late adolescence or early
adulthood. However, some people have
their first symptoms during childhood, and
some develop them late in life. It is often not
recognized as an illness, and people may
suffer for years before it is properly
diagnosed and treated. Like diabetes or
heart disease, bipolar disorder is a
long-term illness that must be carefully
managed throughout a person's life.
What Are the Symptoms of Bipolar Disorder?

Bipolar disorder causes dramatic mood
swings—from overly "high" and/or irritable to
sad and hopeless, and then back again, often
with periods of normal mood in between. Severe
changes in energy and behavior go along with
these changes in mood. The periods of highs
and lows are called episodes of mania and
depression.

Signs and symptoms of mania (or a manic
episode) include:
Increased energy, activity, and restlessness
Excessively "high," overly good, euphoric mood
Extreme irritability
Racing thoughts and talking very fast, jumping
from one idea to another
Distractibility, can't concentrate well
Little sleep needed
Unrealistic beliefs in one's abilities and powers
Poor judgment
Spending sprees
A lasting period of behavior that is different from
usual
Increased sexual drive
Abuse of drugs, particularly cocaine, alcohol,
and sleeping medications
Provocative, intrusive, or aggressive behavior
Denial that anything is wrong
A manic episode is diagnosed if elevated mood
occurs with three or more of the other
symptoms most of the day, nearly every day, for
1 week or longer. If the mood is irritable, four
additional symptoms must be present.

Signs and symptoms of depression (or a
depressive episode) include:
Lasting sad, anxious, or empty mood
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in activities once
enjoyed, including sex
Decreased energy, a feeling of fatigue or of
being "slowed down"
Difficulty concentrating, remembering, making
decisions
Restlessness or irritability
Sleeping too much, or can't sleep
Change in appetite and/or unintended weight
loss or gain
Chronic pain or other persistent bodily
symptoms that are not caused by physical
illness or injury
Thoughts of death or suicide, or suicide
attempts
A depressive episode is diagnosed if five or
more of these symptoms last most of the day,
nearly every day, for a period of 2 weeks or
longer.

A mild to moderate level of mania is called
hypomania. Hypomania may feel good to the
person who experiences it and may even be
associated with good functioning and enhanced
productivity. Thus even when family and friends
learn to recognize the mood swings as possible
bipolar disorder, the person may deny that
anything is wrong. Without proper treatment,
however, hypomania can become severe mania
in some people or can switch into depression.
Anxiety Disorders
Anxiety Disorders affect about 40 million
American adults age 18 years and older
(about 18%) in a given year,1causing them to
be filled with fearfulness and uncertainty.
Unlike the relatively mild, brief anxiety
caused by a stressful event (such as
speaking in public or a first date), anxiety
disorders last at least 6 months and can get
worse if they are not treated. Anxiety
disorders commonly occur along with other
mental or physical illnesses, including
alcohol or substance abuse, which may
mask anxiety symptoms or make them
worse. In some cases, these other illnesses
need to be treated before a person will
respond to treatment for the anxiety disorder.

Effective therapies for anxiety disorders are
available, and research is uncovering new
treatments that can help most people with
anxiety disorders lead productive, fulfilling
lives. If you think you have an anxiety
disorder, you should seek information and
treatment right away.
Depression, Bipolar, Anxiety