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Headache 2008: Depression
Dr. Larry Robbins
Posted: December 2007  
Headache 2008

Depression usually profoundly affects your feelings and moods, as well as productivity and behavior. Depression often causes physical problems as well. Depression is a physical, medical illness, just like having asthma or diabetes. There is a very strong genetic basis, but not everybody has a family history of depression. Depression can occur once in a lifetime, or it may be ongoing on a chronic basis. Depression cuts across socioeconomic lines, and is a relatively common illness.

The symptoms in depression vary widely. There is usually a depressed mood, with feelings of helplessness, sadness, and hopelessness. Decreased motivation, and loss of interest in the usual pleasurable activities, often occurs. There may be sleep disturbances, sleeping too much or not enough. Easy awakening or difficulty going to sleep are common symptoms. Concentration problems are seen, with a difficult time making decisions. Often there is agitation and irritability, and fatigue is very common. Depression takes its toll on self- esteem, and people may feel that they are worthless. There may be no interest in sex, and weight can be increased (or decreased) due to appetite changes. A serious side effect of depression is suicidal thoughts, or actually committing suicide.

Along with depression, people often experience physical problems. These may include stomach cramps, diarrhea or constipation, backaches, headaches, or other pain syndromes. Depression may affect all ages. It does manifest itself somewhat differently in various age ranges.

Some people have a "major depression", where they have at least 2 weeks of serious depression, while others have ongoing mild (or moderate) chronic depression. There is also the important category of bipolar depression (for this, please see the extensive bipolar section). Depression may be worse in certain seasons, such as in winter; Seasonal Affective Disorder is depression that is primarily related to a lack of sunlight, with the incoming late fall and winter. Light boxes may be very useful in treating Season Affective Disorder.

Stressful life events may trigger depression. Or, depression may cycle in and out of people’s lives, sometimes with certain seasons, regardless of stress. Chronic medical illnesses, or sickness in one’s family, may trigger depression. Financial difficulties may be a contributing factor. Hormonal changes may play a role, particularly with postpartum depression. It is crucial to recognize and treat postpartum depression.

The 2 primary treatments are medication and psychotherapy. Exercise may help. The combination of meds plus therapy is ideal.