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Newsbytes - News up-dates

Why Am I Depressed? - The Shocking Truth Behind Your Depression
How To Deal With Depression - Tactics That Work Immediately
Depression Symptoms: 11 Secret Signs You're Depressed
On living with depression and suicidal feelings
6 Must Know Signs of Depression
Depression and Suicide - Pictures and facts
Depression and Suicide Awarness - I'm Not Alright
Overcoming depression | TED Talk
Andrew Solomon: Depression, the secret we share | TED Talk


Men and Depression (36 page pdf)
Real Men, Real Depression
Cause of Depression
Men Never Cry: Depression in Men and Why It’s Hard To Ask For Help
Why Men Don't Get Depressed - Humor
Depression: Why it's different for men
Depression Affects Men Differently than Women: Cultural Expectations May Explain Why
Many U.S. Men With Depression, Anxiety Don't Get Treated, CDC FindsDads Have Postpartum Depression, Too: Depression in Father Doubles Risk of Child's Later Behavior Problems
Big Boys Do Cry
Causes of Depression
The Warning Signs and Major Risk Factors of Teenage Suicide
Happy Holidaze
A comic that accurately sums up depression and anxiety — and the uphill battle of living with them
; my story isn't over
Persistent Sadness & Loss of Interest in Life
Depression and Men: Why It’s Hard to Ask For Help
Why men don't get depressed.

Take this Survey!
Takees about 15 minutes. Author is Jed DIamond

Books on Depression, Understanding Teenage Depression
Related Issue - Online Depression Screening Test Suicide
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Life is full of good times and bad, happiness and sorrow. But if you've been feeling "down" for more than a few weeks or are having difficulty functioning in daily life, you may be experiencing more than just the "blues." You may be suffering from a common yet serious medical illness called clinical depression.

The good news is clinical depression is highly treatable. Most people with depression, however, do not seek the professional help they need -- often because they don't know the symptoms, think depression will go away on its own, or are embarrassed to talk about how they're feeling.

One of the quickest and easiest ways to determine whether you have symptoms of depression is by taking a free, confidential depression-screening test. Screening tests, such as the one on this web site, are not intended to provide a diagnosis for clinical depression. But they may help identify any depressive symptoms and determine whether a further evaluation by a medical or mental health professional is necessary. As with any other illness, you should see your doctor if you think you might have symptoms of depression.

The web site is sponsored by the National Mental Health Association (NMHA) as part of NMHA's Campaign for America's Mental Health. The mission of this web site is to educate people about clinical depression, offer a confidential way for people to get screened for symptoms of the illness, and guide people toward appropriate professional help if necessary.


Most people feel depressed at some stage of their lives, but for some the feelings are more intense and last longer. This type of depression doesn’t just ‘go away’, and telling the person to ‘cheer up’ or ‘pull yourself together’ doesn’t help. It’s not that simple. But there is hope. Depression is a medical condition that can usually be treated. A doctor may prescribe medication or therapy – or a combination of the two. The important point is to seek help.

Symptoms to look out for:

  • Depressed mood – most of the day, every day
  • Mood swings – one minute high, next minute low
  • Lack of energy and loss of interest in life
  • Irritability and restlessness
  • Disturbed sleep patterns – sleeping too much or too little
  • Significant weight loss or gain
  • Feelings of worthlessness and guilt
  • Difficulty concentrating and thinking clearly
  • Loss of sex drive
  • Thoughts about death and the option of suicide

If someone you know suffers from depression that lingers encourage them to see a doctor or healthcare professional. Newsgroup: is a good source of peer support.

If you think they might be suicidal, find out how you can help.

Emotional Symptoms

Depression is a serious illness. It can skew your view of the world, making everything seem hopeless. It can make work and daily life almost impossible. It can make you feel utterly alone.

But you're not. About 19 million Americans are living with depression right now. And the good news is a lot of treatments work to reduce depression symptoms. This guide will help you recognize the symptoms of depression and learn how to treat them.

You may already know some of the emotional and psychological effects of depression. They include:

Feeling sad, empty, hopeless, or numb. These feelings are with you most of the day, every day.

Loss of interest in things you used to enjoy. You might no longer bother with hobbies that you used to love. You might not like being around friends. You might lose interest in sex.

Irritability or anxiety. You might be short-tempered and find it hard to relax.

Trouble making decisions. Depression can make it hard to think clearly or concentrate. Making a simple choice can seem overwhelming.

Feeling guilty or worthless. These feelings are often exaggerated or inappropriate to the situation. You might feel guilty for things that aren't your fault or that you have no control over. Or you may feel intense guilt for minor mistakes.

Thoughts of death and suicide. The types of thoughts vary. Some people wish that they were dead, feeling that the world would be better off without them. Others make very explicit plans to hurt themselves.

Physical Symptoms

Most of us know about the emotional symptoms of depression. But you may not know that depression can cause physical symptoms, too.

In fact, many people with depression feel pain or other physical symptoms. These include:

Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may become worse if you're depressed.

Back pain. If you already suffer with back pain, it may get worse if you become depressed.

Muscle aches and joint pain. Depression can make any kind of chronic pain worse.

Chest pain. Obviously, it's very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But chest pain is also associated with depression.

Digestive problems. You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.

Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.

Sleeping problems. Many people with depression can't sleep well anymore. They wake up too early or can't fall asleep when they go to bed. Others sleep much more than normal.

Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods -- like carbohydrates -- and weigh more.

Dizziness or lightheadedness.

Many depressed people never get help, because they don't know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too.

These physical symptoms aren't "all in your head." Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.

Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.

Treating Physical Symptoms

In some cases, treating your depression -- with therapy or medicine or both -- will resolve your physical symptoms.

But make sure to tell your health care provider about any physical symptoms. Don't assume they'll go away on their own. They may need additional treatment. For instance, your doctor may suggest an antianxiety medicine if you have insomnia. Those drugs help you relax and may allow you to sleep better.

Since pain and depression go together, sometimes easing your pain may help with your depression. Some antidepressants, such as Cymbalta and Effexor, may help with chronic pain, too.

Other treatments can also help with painful symptoms. Certain types of focused therapy -- like cognitive behavioral -- can teach you ways to cope better with the pain.

Causes of Depression

Health experts' understanding of depression has come a long way in the last few decades. In many cases, depression doesn't have only one cause. It often results from a mix of biology, psychology, and stressful or traumatic events.

Reasons for depression include:

Biology. Researchers still have a lot to learn about exactly why people become depressed. But some experts say depression often results from an imbalance of certain chemicals in the brain. These chemicals are called neurotransmitters. Antidepressants work by affecting the levels of these chemicals -- bringing them back into balance.

There's also a genetic connection. If depression runs in your family, you have a higher chance of becoming depressed.

Having other health conditions or diseases can increase your risk of depression. For instance, if you have a heart attack, you have a 65% risk of becoming depressed afterwards. Conditions such as cancer, heart disease, thyroid problems, and many others increase your risk of becoming depressed.

Your gender makes a difference, too. Women are about twice as likely as men to become depressed. No one's sure why. But the hormonal changes that women go through at different times of their lives may be a factor.

Psychology. Studies show that people who have a pessimistic personality are more likely to become depressed. This doesn't mean that getting a "better attitude" will resolve your depression.

Stressful events. Many people become depressed during difficult times. Losing a family member or close friend, being diagnosed with a serious illness, going through a divorce, or any other traumatic event may trigger depression.

Medications and substances. Many prescription drugs can cause the symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.

Some people have a clear sense of why they become depressed. Others don't. The most important thing to remember is that depression is not your fault. It's not a flaw in your character. It's a disease that can affect anyone. Source:

Real Men, Real Depression

What makes depression different from the blues?

Depression is a serious medical condition that nvolves the body, mood, and thoughts. It affects how you eat and sleep. It alters your self-perception.

It changes the way you think and feel. Men with a depressive illness can’t just “snap out of it” or “pull themselves together,” because depression isn’t the same as a passing mood. Left untreated, depression may last for weeks, months, or years at a time.

Depressive illnesses can make routine tasks unbearably difficult. Pleasures that make life worth living—watching a football game, playing with children, even making love—can be drained of joy.

Depression brings pain and disruption not only to the person who has it, but also to his family and others who care about him.

If you are experiencing some of the following symptoms, you may have a depressive illness.

Ask yourself if you are feeling: sad or “empty”; irritable or angry; guilty or worthless; pessimistic or hopeless; tired or “slowed down”; restless or agitated; like no one cares about you; or like life is not worth living. You may also: sleep more or less than usual; eat more or less than usual; have persistent headaches, stomachaches or chronic pain; have trouble concentrating, remembering things or making

If these symptoms are familiar, it’s time to talk with your doctor. Depression is a real, medical illness that can be successfully treated, most often with medication, psychotherapy (“talk” therapy), or a combination of both. Support from family and friends plays an important role as well

An estimated six million men in the United States have a depressive disorder—major depression, dysthymia (chronic, less severe depression), or bipolar disorder (manic-depressive illness)—every year Although these illnesses are highly treatable, many men do not recognize, acknowledge, or seek help for their depression.

While both men and women may develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping. Men may be more willing to report fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances rather than feelings of sadness, worthlessness, and excessive guilt, which are commonly associated with depression in women. Also, tragically, four times as many men as women die by suicide, even though women make more suicide attempts during their lives.

The truth is, depression is a real and treatable illness. It can strike at any age, from childhood into late life. With proper diagnosis and treatment, the vast majority of men with depression can be helped.

It takes courage to ask for help

The feelings and behaviors that are part of depression can hinder a person’s ability to seek help. In addition, men in particular may find it difficult to admit depressive symptoms and ask for help. It’s important to remember, however, that depression is a real, treatable illness and is nothing to be ashamed about.

Thanks to years of research, a variety of effective treatments including medications and short-term psychotherapies are available for depressive disorders. Treatment choice will depend on the patient’s diagnosis, severity of symptoms, and preference. In general, severe depressive illnesses, particularly those that are recurrent, will require a combination of treatments for the best outcome.

If you are feeling depressed, tell someone about your symptoms. Speak with a doctor, nurse, psychologist, social worker, or employee assistance professional. Asking for help takes courage, but it can make all the difference.

Depression: Why it's different for men.

Every year, depression affects more that 19 million Americans, but men account for only about one in 10 diagnosed cases. Because of this, depression was once considered a "woman's disease," linked to hormones and premenstrual syndrome. The lingering stereotype of depression being a female condition may prevent some men from recognizing its symptoms and seeking appropriate treatment.

In reality, depression affects both sexes, disrupting relationships and interfering with work and daily activities. The symptoms of depression are similar for both men and women, but they tend to be expressed differently. The most common symptoms of depression include low self-esteem, suicidal thoughts, loss of interest in usually pleasurable activities, fatigue, changes in appetite, sleep disturbances, apathy and sexual problems, including reduced sex drive.

There are several reasons why the symptoms of depression in men are not commonly recognized:

  • Men tend to deny having problems because they are supposed to "be strong."
  • American culture suggests that expressing emotion is largely a feminine trait. As a result, men who are depressed are more likely to talk about the physical symptoms of their depression, such as feeling tired, rather than those related to emotions.
  • Depression can affect sexual desire and performance. Men often are unwilling to admit to problems with their sexuality -- mistakenly feeling that the problems are related to their manhood, when in fact they are caused by a medical problem such as depression.
  • The observable symptoms of male depression are not as well understood as those in women. Men are less likely to show "typical" signs of depression, such as crying, sadness, loss of interest in previously enjoyable activities, or verbally expressing thoughts of suicide. Instead, men are more likely to keep their feelings hidden, but may become more irritable and aggressive.

For these reasons, many men -- as well as doctors and other healthcare professionals -- fail to recognize the problem as depression. Some mental healthcare professionals suggest that if the symptoms of depression were expanded to include anger, blame, lashing out and abuse of alcohol, more men might be diagnosed with depression and treated appropriately.

Depression in men can have devastating consequences. The Centers for Disease Control and Prevention report that men in the U.S. are about four times more likely than women to commit suicide. A staggering 75-80% of all people who commit suicide in the U.S. are men. Though more women attempt suicide, more men are successful at actually ending their lives. This may be due to the fact that men tend to use more lethal methods of committing suicide, for example using a gun rather than taking an overdose.

Why is Depression Different in Men?

Understanding how men in our society are brought up to behave is particularly important in identifying and treating their depression. Depression in men often can be traced to cultural expectations. Men are supposed to be successful. They should restrain their emotions. They must be in control. These cultural expectations can mask some of the true symptoms of depression, forcing men to express aggression and anger (viewed as more acceptable "tough guy" behavior) instead.

In addition, men generally have a harder time dealing with the stigma of depression. They tend to deal with their symptoms with a macho attitude or by drinking alcohol. This attitude still pervades many male-dominated institutions, such as the military and athletics, where men are taught that "toughness" means putting up with physical pain and admitting to emotional distress is taboo. Rather than seek help, which means admitting to what they perceive as a weakness, men are more likely to deal with their depression by drinking heavily or committing suicide.

Special Consideration -- Bereavement

Men also tend to deal with the loss of a loved one differently than women. This may also be related to their belief that men must be strong in the face of adversity, and that showing emotion is a sign of weakness. Men tend to assume full responsibility for their bereavement and suppress their grief. Studies show that this suppression can increase the time it takes to grieve and lead to complications such as escalating anger, aggressiveness and substance abuse. Physical symptoms may include increased cholesterol levels, ulcers, high blood pressure, and pain.

Because they feel unable to openly express their feelings, many men deal with grief by taking on more activities -- such as working overtime or going on business trips -- to occupy their time. They may become involved in risk-taking behavior, such as dangerous sports or compulsive sexual activity. Some addictive behaviors, such as over consumption of alcohol or other drug abuse, can escalate as the result of suppressed grief.

Can Depression in Men Be Treated?

More than 80% of people with depression -- both men and women -- can be treated successfully with antidepressant medication, psychotherapy or a combination of both.

Depression Affects Men Differently than Women: Cultural Expectations May Explain Why

Henry gets so agitated in traffic that his face turns red and he punches the steering wheel. Marc comes home from a hard day's work and drinks a six-pack of Budweiser -- every night. Ken, who has been on disability for six months, watches television all day long, barely speaking to anyone. Bill smokes more marijuana now than he did when he was in high school 20 years ago. What these men have in common was once thought of as almost exclusively a women's problem, but depression affects both sexes. It can just manifest itself differently in men, according to a California psychologist and author. While women may cry, become withdrawn, and gain or lose weight, men may abuse alcohol or drugs, work or eat excessively, and/or become violent to themselves or others, among other things.

Affecting approximately 19 million Americans, depression clearly takes its toll on both sexes. The toll is physical as well as mental: A recent study of Johns Hopkins medical students found that depressed men were twice as likely as their nondepressed counterparts to develop heart disease or die suddenly because of heart problems.

But even though 80% of people who seek help will get relief from medication, therapy, or a combination of the two, just one in three people actually seek help, according to the National Institute of Mental Health in Bethesda, Md. And most of them are women. Because many men are brought up to believe that expressing emotions is largely a feminine trait, half as many men as women seek psychotherapy or are diagnosed with depression. This may be one of the reasons that, according to unpublished CDC findings, men in the U.S. are about four times more likely than women to commit suicide.

"We are brought up with a code that says if one shows these feelings or acts in a vulnerable way, then he is weak, a sissy, or a girl," Fred Rabinowitz, PhD, professor of psychology at the University of Redlands in Redlands, Calif., tells WebMD. The stigma associated with male depression must be removed so men can get the help they need, Rabinowitz says. He and Sam Cochran, PhD, the director of clinical services at the University of Iowa in Iowa City, are the authors of the book Men and Depression: Clinical and Empirical Perspectives.

"Some researchers believe that women are more prone to depression biologically, more oppressed in society, and thus experience more depression," Rabinowitz tells WebMD. This same thinking, he says, holds that women "tend to be more ruminating than men, and thus more likely to focus on and talk about depressing ideas, and are permitted by society to express feelings like sadness and emotional pain -- unlike men, who must keep it hidden. "Our take on why men show up less depressed is that men are not likely to show typical depression symptoms like crying, sadness, loss of will, verbalization of suicide intent. Instead, men are likely to keep it hidden, like they do most of the time with most feelings. Thus, others are unable to tell if a man is depressed or not."

Men at risk for depression and/or suicide include those who are feeling like they aren't measuring up any more, who feel physically weaker, sense that their lives no longer have outlets for pleasure, or who have experienced a personal loss.

"One of the biggest triggers is loss, especially of a relationship that has been supportive and sustaining," Rabinowitz tells WebMD. "Many men, when they lose their fathers or partners, experience a grief that is more debilitating than expected." For example, a man going through a divorce may feel sorry for himself, drink too much, and feel isolated from friends and family. At work, he may do his job, crack jokes, and be one of the guys. But "when he gets home, he sits in front of a television, drinks and eats too much, and harbors private thoughts of anger that he can not fully express," Rabinowitz says.

Another trigger of depression is physical illness such as cancer or heart disease, he says, because illness is a direct attack on a man's sense of virility, strength, and self-definition. Unfortunately, like depression, therapy also is often seen as feminine, he says. "It involves verbalizing emotions and talking about problems, which is more common for women to do with same-gender friends," Rabinowitz says. "On the other hand, boys and men tend to be less verbal and more uncomfortable in deep relationships."

Redford Williams, MD, director of the Behavioral Medicine Research Center at Duke University Medical School in Durham, N.C., and the author of Anger Kills and Life Skills, puts it this way: "Men are taught to be in control from the very beginning and are more likely than women to express anger, while women are more likely to hold anger in and get depressed."

It's harder for men to admit they are depressed because to do so would be to admit they were out of control, Williams tells WebMD. Anyone who thinks a man they're close to may be depressed should "provide a safe place and encourage the man to talk about his feelings and be more constructive and less destructive," he suggests. Rabinowitz agrees, adding that men must learn to live with their limitations. "Too often, we compare ourselves to the best in whatever we are doing. If I always compare myself to Tiger Woods, I am likely to never feel good about my golf game," he says. "It is also important for men to realize that it is normal to feel down or low, and rather than run from it by using distraction, alcohol, or some addictive substance or activity, try to listen to what the emotion is telling you." If men learn to accept that they are human beings with strengths, weaknesses, and doubts, they are likely to be more accepting of themselves and others, and less prone to depression, he says.

Many U.S. Men With Depression, Anxiety Don't Get Treated, CDC Finds

Young minority males less likely than whites to access mental health care.

Close to one in 10 American men suffers from depression or anxiety, but fewer than half get treatment, a new survey reveals.

The nationwide poll of more than 21,000 men also found that among younger males, blacks and Hispanics are less likely than whites to report mental health symptoms. And when they do acknowledge psychiatric troubles, they are less likely to seek professional help than whites, according to the U.S. Centers for Disease Control and Prevention report.

"We suspect that there are several social and cultural pressures that lead black and Hispanic men to be less likely than white men to seek mental health treatments," said report lead author Stephen Blumberg, an associate director for science with the CDC's National Center for Health Statistics (NCHS).

"These pressures, which include ideas about masculinity and the stigma of mental illness, may be more pronounced for men of color," he said. "And these same forces may lead men of color to be more likely to deny or hide feelings of anxiety or depression."

If this is true, Blumberg added, "then the (racial) disparities we observed could be even greater."

The survey was conducted between 2010 and 2013. The results were published June 11 in the NCHS Data Brief.

Across all ages, survey results indicate almost 9 percent of U.S. men suffer from depression or anxiety on a daily basis, although only 41 percent of these men actually sought treatment.

More than 39 percent of the men under 45 years of age said they had either taken medication or visited a mental health professional for daily anxiety or depression during the prior year. This put these younger men roughly on a par with the estimated 42 percent of "older men" (those 45 and up) who said they had done the same.

But racial differences in terms of mental health care patterns became apparent when the study authors focused on those 18 to 44 years old.

Just 6 percent of younger black and Hispanic men said they experience daily anxiety or depression, compared with over 8 percent of younger white men, the findings showed.

And younger black and Hispanic men who experienced daily depression or anxiety were less likely to have accessed mental health treatment in the prior year than their white peers (about 26 percent versus 45 percent, respectively). This racial divide was not seen among men aged 45 and up.

Health insurance status appeared to be a major factor. While no significant racial differences in the use of mental health treatment services were seen among insured men, uninsured white men between 18 and 44 with daily anxiety or depression were three times more likely to access mental health care than their uninsured black or Hispanic peers.

While the survey doesn't explain this discrepancy, the authors said that in focus groups they found having health insurance coverage seemed to reduce the stigma associated with needing mental health treatment for blacks and Hispanics. Expansion of health insurance coverage as a result of the Affordable Care Act (sometimes called "Obamacare") could therefore reduce these racial and ethnic disparities, they said.

Jill Kiecolt, an associate professor of sociology at Virginia Tech University, said she wasn't surprised by the findings.

"But they need to be unpacked a bit," she added. Kiecolt said, for example, that while a lot of prior research has also identified relatively lower rates of anxiety and depression among blacks, rates among Hispanic men have generally been pegged as on par with their white peers.

"Consequently, African Americans' mental health advantage on these indicators is larger than it appears," Kiecolt said, "whereas Hispanics may not have a mental health advantage."

As for what might drive the better mental health numbers among black men, Kiecolt said the dynamic remains puzzling. "We don't know why," she noted.

Her own research has not found support for the often-floated notion that black Americans generally benefit from stronger social support structures relative to whites.

Nevertheless, she stressed that the lower rates of depression and anxiety seen among black men "most likely are real."

The Warning Signs and Major Risk Factors of Teenage Suicide

Each year, thousands of American teenagers are diagnosed with clinical depression. If ignored or poorly treated, it can be a devastating illness for adolescents and their families. A new book, Understanding Teenage Depression, provides the latest scientific research on this serious condition and the most up-to-date information on its treatment. Drawing on her many years of experience as a psychiatrist working with teenagers, Dr. Maureen Empfield answers the questions parents and teens have about depression. Maureen Empfield, M.D., is director of psychiatry at Northern Westchester Hospital Center in Mt. Kisco, New York, and assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons. She is the author or coauthor of more than a dozen publications for the professional market. Nicholas Bakalar is a New York-based writer and editor.

Although it is almost impossible to predict precisely which teenager will attempt suicide, there are warning signs that parents can look for. The American Academy of Child and Adolescent Psychiatry has assembled this list of indications. If one or more of these signs occur, parents should talk to their teenager and seek professional help.

  • Unusual changes in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent actions, rebellious behavior, or running away
  • Excessive drug and alcohol abuse
  • Unusual neglect of personal appearance
  • Marked personality change
  • Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Loss of interest in pleasurable activities
  • Not tolerating praise or rewards
  • Complaints of feeling “rotten inside”
  • Giving verbal hints such as “Nothing matters,” “It’s no use,” or “I won’t be a problem for you much longer”
  • Putting his or her affairs in order by giving or throwing away favorite possessions or belongings
  • Becoming suddenly cheerful after an episode of depression

In high-risk patients—that is patients who have threatened or attempted suicide—there are four risk factors that account for more than 80% of the risk for suicide: major depression, bipolar disorder, a lack of previous mental health treatment, and the availability of firearms in the home. If these four problems were solved, most suicides would be prevented.
© 2001 Maureen Empfield, M.D., and Nicholas Bakalar. See also Teen Suicide

Depression in the elderly


An emotional state marked by sadness, discouragement, and loss of self-worth that occurs in the elderly.

Causes, incidence, and risk factors:

Detecting depression in the elderly may be complicated by several factors. Often the symptoms of depression such as fatigue, loss of appetite, and sleeping difficulties are associated with the aging process or a medical condition rather than with depression. Contributing factors include the loss of a spouse or close friends, chronic pain and illness, difficulty with mobility, frustration with memory loss, difficulty adapting to changing circumstances such as moving from a home to a retirement facility, or changes within the family. Depression can also be a sign of a medical problem. It may be complicated by brain disorders associated with the aging process such as Alzheimer's disease or organic brain syndrome. Risk factors are related to contributing factors. Depression in the elderly is a widespread problem.


Prevention is related to the contributing factors. Social supports the help deal with losses, mobility changes, and so on can be helpful. In many cases, there is no effective prevention.


  • depressed or irritable mood
  • loss of interest or pleasure in daily activities
  • temper, agitation
  • change in appetite, usually a loss of appetite
  • change in weight
  • weight loss (unintentional)
  • weight gain (unintentional)
  • difficulty sleeping
  • daytime sleepiness
  • difficulty falling asleep or staying asleep (insomnia)
  • fatigue (tiredness or weariness)
  • difficulty concentrating
  • feelings of worthlessness or sadness
  • memory loss
  • abnormal thoughts, excessive or inappropriate guilt
  • abnormal thoughts about death
  • excessively irresponsible behavior pattern
  • thoughts about suicide
  • plans to commit suicide or actual suicide attempts

Note: Symptoms often last for weeks to months.

Signs and tests:

physical examination to rule out medical causes of depression

psychological evaluation

a variety of tests may be indicated


Sometimes depression can be alleviated by social interventions to help with isolation or loneliness such as group outings, volunteer work for the healthy elderly, or regular visits from concerned people.

Treatment of underlying medical conditions or the discontinuation of certain medications may alleviate symptoms.

Antidepressant drug therapy or electroconvulsive therapy may be indicated in the severely depressed if other measures are unsuccessful. Neuroleptic medications may help treat agitation but in some individuals they make symptoms worse. Antidepressants must be carefully monitored for side effects in the elderly.

Expectations (prognosis):

If detected, depression may respond to medical treatment. Undetected it may lead to complications. The outcome is usually worse for those who have limited access to social services or family or friends who can help promote an interest in activities.


Depression may cause or be complicated by Alzheimer's disease, organic brain syndrome, dementia, or other medical conditions in the elderly.

Calling your health care provider:

Call your health care provider if you are feeling worthless or hopeless or you are crying frequently. Also call if you feel that you are having difficulty coping with stresses in your life and want a referral for counseling.

Go to the emergency room or call your local emergency number (such as 911) if you feel like you might end your life.


Depression More Dangerous For Elderly Men Than Women

Depression is more dangerous for elderly men than women, with depression starting in old age representing the greatest risk for men, according to a long-term study.
Source: Center for the Advancement of Health ,

Can Caviar Cure Depression?

It might sound a little fishy, but there is growing evidence that caviar can help chase away the blues. Early research suggests that people suffering from depression, bipolar disorder, and other mental health problems can benefit from diets rich in omega-3 fatty acids -- found in abundance in certain types of fish.

In one study, people with bipolar disorder -- previously known as manic depression -- had significantly fewer depressive episodes when their diets were supplemented with omega-3. And earlier research comparing 10 countries found that depression was much lower in areas where fish is a dietary staple.

Omega-3 -- abundant in cold-water fish (such as salmon and mackerel), some nuts, and flaxseed -- has already been shown to protect against heart disease. The evidence is so strong that the American Heart Association now recommends eating salmon or tuna at least twice a week. Studies also indicate that the fatty acid may benefit people with rheumatoid arthritis, stomach or intestinal diseases, and even certain cancers.

"We know that omega-3 is good for your body, and there is certainly enough evidence to suggest there is at least something there to improve mood," says Andrew Stoll, MD, who directs the psychopharmacology research lab at McLean Hospital in Belmont, Mass. "Almost every patient in my practice has tried [fish oil] supplements, and most are still on them."

In a 1999 study, Stoll and colleagues gave 30 patients with bipolar disorder either 10 grams of omega-3-rich fish oil capsules a day (the equivalent of 30 cans of tuna), or placebo capsules containing olive oil. All of the participants had experienced bipolar episodes within the previous year, and all but eight were on medication during the study. People with bipolar disorder have episodes of depression alternating with times of mania -- when their bodies are so revved up and hyper that they can't even sleep.

After four months, half of the patients given placebo capsules had relapsed into depression, compared to just two of the 15 patients taking fish oil supplements. Stoll is now conducting a four-year study involving 120 patients in an effort to confirm the results. And he says several other studies examining fish oil and depression should be published soon.

"Our earliest study used very high doses, but it looks like 1 to 2 grams per day of EPA, which is the active ingredient in fish oil, is all you need," Stoll tells WebMD. "But all fish oil supplements are not equal, so you have to read the labels to find out how much EPA [one type of fish oil] you are getting."

Salmon, mackerel, sardines, and anchovies are the fish with the highest amounts of omega-3, Stoll says.

A serving of salmon contains about a gram of omega-3. Certain brands of eggs are also rich in omega-3, and flaxseed and walnuts are also good dietary sources.

While some heart studies suggest that food sources are more protective than supplements, most people in this country get very little omega-3 in their daily diets. In that case, Stoll favors supplements and recommends that people take vitamin E and C as well. He has written a book on the health benefits of fish oil titled The Omega-3 Connection.

"Omega-3 is not intended to replace other medications for depression," Stoll says. "But the evidence is mounting that it can play a role in treatment. And there is no downside to eating an omega-3-rich diet."
Source: Salynn Boyles,

New Resources Now Available at

A recording of an interview of Terrence Real and Kevin Roth, from WHYY radio. Articles and commentary about depression in men, after the births of their children. A mother's poignant story of the suicide of her son--a college student who suffered from undiagnosed and untreated depression. A multi-lingual site (French, German, and Italian) from Switzerland. A brief commentary about depression in African-American men. Several articles discussing the differences in depression and stress, as experienced by men and women.

St. John's Wort Not Effective In Treating Depression

St. John's wort, a popular herbal supplement touted as a remedy for depression, did no better than dummy pills in a long-awaited government-backed study.

Women And Depression

More than 19 million Americans suffer from depression yearly and women are twice as likely as men to experience a major depressive episode. Depression may occur at any age during a woman's life with certain events like puberty, pregnancy, perimenopause, trauma, substance abuse and quality of relationships increasing the risk, according to the leading authorities on the etiologies and treatments for depression.
Source: American Psychological Association,

Depressed People More Likely To Develop Parkinson's

People with depression are three times more likely to develop Parkinson's disease than people who are not depressed, according to a study published in the 5/28/02 issue of Neurology, the scientific journal of the American Academy of Neurology.
Source: American Academy of Neurology,

Nicotine Shows Anti-Depressant Effects In An Animal Model Of Depression

Investigators at Howard University have recently observed the antidepressant effect of nicotine in Wistar-Kyoto (WKY) rats, a putative behavioral model of depression. Drs. Youssef Tizabi and K. Y. Tyler will present their findings at the Experimental Biology meeting in New Orleans on April 22, 2002.
Source: Federation of American Societies for Experimental Biology ,

Are you depressed?

Use our Depression Assessment interactive tool to find out. Take your time, answer the questions as honestly as you can, and carefully read the report at the end.

The New Depression

Welcome to the New Depression "Gripe Vine": Click here to air your personal frustrations, or ask other men for advice on dealing with covert depressions. Some of the experts quoted in this story will be checking in periodically and lending their wisdom.

David Ramsey just built a new house – 3,100 square feet of custom living space set on an acre of land in the North Carolina woods. He has a pretty young wife with long, brown hair, and the money she makes as an attorney pushes their annual income well into six figures. They travel a lot together, vacationing in Puerto Vallarta, Maui, and the Cayman Islands.

David Ramsey also has two blond sons, ages 7 and 2, who consider Dad their hero. There’s a full-time nanny to take care of them when he and his wife aren’t around. And although he often works long hours, it’s for no one but himself. As the owner of a distributing business, he’s his own boss.

Yes, David Ramsey has it all. Yet in his bedroom, locked in a nightstand, is a black Glock 9 millimeter that he can’t seem to chase from his thoughts. Although he’s never slipped in the magazine and put the barrel to his head, he’s thought about it – more than once.

And David Ramsey has just one question: Why?

From his car phone, Ramsey, 39, calls to ask a question that tens of thousands of men like him are asking: "Why aren’t I happy?"

"From the outside looking in, my life is unbelievably great," he says. "Right now, for instance, I’m driving through Fayetteville, North Carolina, and it’s an absolutely beautiful afternoon. Not one soul has said an unkind word to me all day, and I’m heading home to spend the evening with my family. Yet I’m not happy. I never am. And I can’t understand why."

Ramsey is not alone. After we heard similar complaints from dozens of friends, coworkers, and relatives – and finally were unable to dismiss their grumblings as so many midlife crises – we posted a small ad on the Men’s Health Web site that read, "We’re looking for unhappy guys with perfect lives. If you have a great job, a great family, a great house full of great stuff, but you’re still feeling unfulfilled and, at times, even miserable, then we’d like to hear from you."

It was a tiny baited hook, but the attention it drew was remarkable.

"I’m definitely in a rut," wrote Dennis, 30, a regional vice president, new homeowner, and proud father. "I have every reason to be happy with my life, yet I feel lost."

"I’m an anesthesiologist," wrote Andrew, 39. "Been married for 9 years, couple of houses, dog, snowboard, kayak, just spent 3 weeks vacationing in Australia. But I’d chuck it all to be as happy as I was in medical school. It seems when I had less, I felt better."

The e-mails go on and on, stacks of them. Evidently, there are a lot of dissatisfied men out there, guys who you’d never guess were unhappy, men who would otherwise evoke feelings of admiration and even jealousy. They come forward tentatively, ashamed about complaining. Not all of these men are suicidal, of course, but they can’t see themselves continuing like this indefinitely. Happiness is a reward they’ve earned, and they’re tired of waiting to claim it.

The Problem No One's Treating

Most of us understand the symptoms of depression: the lack of energy, of appetite, of sheer will; the manic moments of confusion; the retreat into drugs, alcohol, or isolation. But that’s overt depression, says Terrence Real, a psychotherapist and author of

I Don’t Want to Talk About It. There’s a second type, one that even many psychologists don’t recognize. It’s called covert depression or, as it’s known clinically, dysthymia.

Overt depression is what we expect from a mood disorder. It’s "a state of profound impairment, utter despair, thorough debilitation," Real explains. "A truly depressed man would lie in bed in the morning, staring at the ceiling, too apathetic to drag himself off to another meaningless day."

First identified in 1974, yet seldom reported on afterward, dysthymia is far less obvious--both to the sufferers and to the people around them. "It’s the life of quiet desperation that Thoreau wrote about," says Real. "Most men don’t view it as a disease but as a weakness. It is a disorder of selfesteem." Its textbook symptoms include at least 2 years of depressed mood, plus at least two of the following: poor appetite or overeating, insomnia or oversleeping, fatigue, low self-esteem, poor concentration or difficulty making decisions, and hopelessness.

"Any person with a chronic sense of unhappiness or dissatisfaction in spite of the success and happiness in his life almost always has a mood disorder and often has dysthymia," says Richard C. Shelton, M.D., professor of pharmacology and psychiatry at Vanderbilt University. "The condition is grossly underrecognized and undertreated, especially among men."

The reason it has received so little popular attention is because of the shame men feel about it. Not only are we far less likely than women to seek professional help for depression, but for reasons of pride and/or simple embarrassment we won’t even discuss it.

"It’s hard to talk to friends about this, because they don’t understand how I could have anything to complain about," admits Tony, 34, a debt-free, college-educated newlywed with a prestigious job in San Francisco. "In fact, I’ve gone to therapists, and even they just sort of look at me as if to say, ‘What’s your problem?’"

Although men like these may tell themselves they’re just a little down, that nobody can be happy all of the time, such rationalization is inaccurate.

"Humans are, by nature, a happy breed," says David Lykken, Ph.D., a professor emeritus of psychology at the University of Minnesota and author of the book Happiness. "That’s because happiness is protective. Happy people get sick less often and get well sooner than unhappy people. It’s an adaptive trait. The typical person has above-neutral feelings of well-being most of the time."

After extensive research, Lykken has concluded that each of us has a "happiness set point" that is genetically predetermined. Our mood may occasionally rise above or fall below this point, but eventually we all return to it. And in most cases, it’s well above neutral. When someone feels chronically unhappy, there’s something wrong.

What’s perplexing is why so many young, successful men are suddenly noticing their unhappiness.

"Let me give you an analogy," says Stephen Braun, a dysthymia sufferer and author of The Science of Happiness. "Before the invention of eyeglasses, what was considered normal eyesight was probably on the blurry side. But as soon as glasses were invented, normal vision became 20/20. I think we’re at the same stage with happiness. With so many new and effective antidepressants available, any mood that’s the least fuzzy is being viewed as abnormal."

Add to this such social factors as a booming economy, record-low unemployment, and a relatively peaceful world, and the result is less for men to worry about and strive for. When the living is so easy, happiness should be an affordable commodity. Its continued slipperiness is disconcerting.

"I took a psychology class in college in which the professor had us write a letter to ourselves listing all our goals," says Jon, a teacher with two advanced degrees. "He told us to call him in 10 years, and he’d mail the list to us. Well, I did, and I’d nailed every one--the degree, the job, the marriage, the kids, the house, the car. I’m 36. So, now what?"

And there’s another factor: pop culture. "The degree of upbeatness on television, for instance, is incredible," says Steven Treistman, Ph.D., a professor of pharmacology at the University of Massachusetts medical center. "Every other commercial has people singing and dancing, as though that’s the way everyone lives." Against such a yardstick, even mild happiness can seem negative.

"I’ve had a certain level of dissatisfaction for the past 6 years," says Dale, 42, a wealthy insurance agent. "But it has only started getting to me recently. It’s a slow burn of increasing intensity."

A Blurry Gray Zone

Dysthymia isn’t something you can typically conquer on your own. Although it’s relatively easy to treat with the right kind of professional help, it’s very difficult to recognize and manage by yourself. Unlike classic, overt depression, which barges into life and usually lasts between 1 and 2 years, dysthymia sneaks in and lingers for 10 to 20 years, says Dr. Shelton. In some instances, it never goes away. Although it does not always lead to more serious depression, he says that under stressful circumstances it makes depressive episodes more likely to occur. In fact, it’s usually when a person seeks help for one of these episodes that the underlying dysthymia is detected.

Unfortunately, when men do muster the courage to seek help, their trouble isn’t always pinpointed. One study found that 67 percent of overtly and covertly depressed men were misdiagnosed by their doctors. William Pollack, Ph.D., director of the Center for Men and Young Men at McLean Hospital/Harvard Medical School, blames this on biased assessment criteria that miss common male symptoms ("Women get weepy, men get busy") and on stubborn macho stereotypes that incline physicians to prescribe fortitude rather than psychiatric care.

Real’s theory, drawn from more than 20 years of practicing family therapy, is that men cope with covert depression by masking its symptoms. Typically, they use work, exercise, spending, and drinking. Because it’s considered unmanly to admit sadness, Real says men try to distract themselves from it with behaviors that bolster self-esteem.

"The less time I have to think about how I feel, the better," says Dennis, the regional vice president. "So I keep busy and immerse myself in my work. The more down I feel, the harder I drive myself."

"I go to the gym," says Andrew. "Exercise makes me feel dramatically better and gives me a sense that I can control my mood."

Coping strategies such as these are effective in the short term, but they eventually backfire, says Real. Either the behavior itself becomes addictive and destructive (alcoholism, bankruptcy), or one of the crutches unexpectedly snaps (athletic injury, loss of job). With no support left for the ego, overt depression can result.

The danger of masking persistent feelings of unhappiness is that it can become life-threatening. According to Dr. Shelton, suicide rates for long-term covert depression and short-term overt depression are similar (about 10 percent of untreated cases).

The thought of suicide is what finally prompted Braun, the 43-year-old author, to recognize and treat his dysthymia. "I was driving along one evening, and I had this sudden feeling of pointlessness," he recalls. "I had no reason to be sad. And yet, I had this powerful sense of meaninglessness. And as I eased onto the exit ramp, a black thought bubbled up: I could just kill myself. That’s when I knew something was wrong."

Braun sought psychiatric help, experimented with various antidepressants, and eventually came to an important realization. "Mood disorders are like an eclipse. The center is totally black, then there is a much bigger area, a penumbra, around that black center. If the center is depression, then that surrounding area is dysthymia. The tricky thing is, there’s no sharp boundary between normal and dysthymic. It’s a blurry, gray zone."

This Way Out

If you’ve read this far, you’re probably either nodding your head in self-recognition or thinking of someone you know who has all these symptoms. The problem is, the way out of dysthymia can be just as labyrinthine as the way in. Here’s where to begin:

Take a quick emotional inventory. As we’ve seen, men often cover up their depression by working longer, training harder, or drinking lots of beer. If you find yourself constantly doing one of these and not deriving any pleasure from it, there could be an underlying problem, says Pollack.

Find someone to spill your guts to. If your wife or girlfriend is the supportive type--meaning she’s not the kind who’ll either (a) tell you to grow up, or (b) blame herself – she can probably help. But you should also seek out men whose integrity you trust. You just might find someone who’s feeling exactly the same way. If you don’t have anyone you can talk to, see "The Gripe Vine" for a way to get in touch with other men who feel the way you do.

Define what has real meaning for you. Write down three goals you’d like to realize by this time next year. But here’s the catch. Don’t make them materialistic. Not a higher salary, not a nicer car, not a boob job for the missus. Instead, stay away from fickle, performance-based self-esteem and pick three goals with inherent meaning, such as spending more time with your kids, getting to know your parents better before they die, or developing a closer relationship with your wife.

Get help if you need it. Eighty percent of people who are treated for depression, regardless of type, report substantial relief. "I’ve had men say to me, ‘I can’t believe I lived my whole life that way,’" says Real. "They never knew what being happy felt like." The best treatment, studies show, is a mix of psychotherapy and antidepressants.

Real says men require a different kind of therapy than women--not the sappy, stereotypical, "tell-me-everything-you’re-feeling" brand, but a more dynamic, opinionated style of coaching. To find a therapist like this, he recommends interviewing candidates. Call around and ask two questions: Do you have experience helping men reconnect, and do you have an active or passive style? And demand progress. "If you’re in therapy for 6 months and you feel 5 percent better, that’s not good enough," he says.

Speak to your doctor about St. John’s wort. Some claim that this herb is useful for treating depression. Studies are not conclusive, but side effects are minor, so it may be a good first step for those hesitant to take antidepressants. Frank Dattilio, Ph.D., a clinical psychologist and faculty member at the University of Pennsylvania school of medicine, points out that you need to take it for 2 to 4 weeks (300 mg doses three times daily) before you see any improvement.

Don’t be afraid of antidepressants. Most of the men we spoke to were hesitant about resorting to drugs, but Real says they’re worth a shot. "This isn’t heroin," he says. "If you try it and either it doesn’t do much for you or the side effects are awful, then stop. But at least you’ll have given it a try."

Stay challenged. Men are not maintainers, we are builders. (That’s why vacuuming holds no allure for us.) We are happiest when we’re creating something – a career, a home, a family. Make sure there’s always a project on your workbench, something new you’re trying to accomplish.

"Here’s my best advice, as someone who’s been through it," says Braun. "First, do everything you can to eliminate stress and conflict in your life. If you have a bad relationship, try to make it better. Second, if you’re still not feeling very good, then get yourself to a doctor. But don’t just accept the first drug he gives you. Try different ones. Be open to the idea that happiness can have something to do with chemistry."

"Men like these often see themselves as inadequate or as losers," concludes Real. "But I consider them pioneers. Their unhappiness is not a personal failing but a thirst. By their very dissatisfaction, they’re saying the old male roles no longer work. They’re eventually going to help us move beyond those old ideas to healthier values. In that respect, I think they’re heroes."

Welcome to the New Depression "Gripe Vine": Click here to air your personal frustrations, or ask other men for advice on dealing with covert depressions. Some of the experts quoted in this story will be checking in periodically and lending their wisdom.

Drug can help compulsive shoppers

A corporate-funded study said an antidepressant can help compulsive shoppers. People with the disorder who took the drug--a member of the class of antidepressants called selective serotonin reuptake inhibitors--showed marked improvement in their condition, said Dr. Kim Bullock and colleagues at Stanford University in California.

Antidepressants promote brain cell growth in rats

New research may help explain, at least in part, how antidepressant medications work. In a study conducted in rats, regular use of antidepressants promoted the growth of new cells in the hippocampus, an area of the brain where cells are known to waste away in people who are depressed.

Children need help to cope with depression

It may seem like the first 12 years of life are all child's play but for many young people, the world can be a sad and frightening place. A normally happy child can become depressed after a family move or the death of a pet, friend or family member or separation from a birth parent.

Death wish in terminally ill linked to depression

Terminally ill patients with cancer who also show signs of depression or hopelessness are much more likely to wish for an early death than are similar patients who are not depressed or hopeless, researchers report.

Hardened arteries may cause depression

While depression in old age has been linked to the risk of heart disease and stroke, new research suggests there is a role-reversal in some cases--artery disease may trigger depression in some elderly people.

Smaller doses of Prozac just as effective

Patients who take a relatively low dose of Prozac have fewer side effects than those given higher doses of the antidepressant drug, according to an analysis of three studies conducted in the past.

Depression--is medication the only treatment?

Dr. Joseph Glenmullen will explore the reasons why the popular pharmaceutical "solutions" may not be the best choice for every patient.

Do antidepressants affect weight?

"I'm 34 years old, and my children are one and three. I started taking Prozac six years ago and have gained 100 pounds. I never realized there might be a connection. Do all antidepressants cause weight gain?"

Can Zoloft cause weight gain, agitation and high cholesterol?

"My husband has been taking Zoloft and has experienced strange behavior. His doctor says side effects are rare with this drug and does not want to take him off it."

Can a folic acid deficiency cause depression?

"I met someone who told me she'd had no desire to go on living. When she started taking folic acid, there was a complete change in her attitude, mental state and energy. Why isn't this better known?"

Seniors prone to loneliness, depression during holidays

Divorced and with most of his family in England, John Loader is reminded each holiday season how alone he is. His feelings of isolation have deepened since last year, when he suffered a stroke that forced him into a Pasadena retirement home.

How Much Is Stress Or Depression A Factor In Sleep Problems In The Elderly? (10/30/00)

These are pretty big factors. Depression at any age can interfere with sleep and there’s a lot of research about changes in sleep structure with depression.

This also occurs in older people who become depressed. Stress is an important cause, particularly for transient or short-term insomnia -- loss of a loved one, for example, or a change in life such as retirement.

In general, life transitions tend to occur more as people get older and these transitions, such as changes in living location, can be stressful. Good stress also can interfere with sleep. It’s not just bad stress.

Job stress can cause depression

If your boss doesn't listen to you and the work keeps piling up, you may be on a collision course with depression, according to a new report from the Johns Hopkins University School of Public Health, in Baltimore, Maryland.

Mother's depression impacts child's health

Mothers who are depressed are more likely to smoke around their youngsters and less likely to place their children in car seats or give them vitamins, results of a study indicate.

One in five Americans depressed or unhappy

A surpris!ing number of Americans report high levels of stress, anxiety and sadness, according to new survey results. Even though their symptoms don't meet the definition of clinical depression, they can have a significant negative impact on quality of life, according to Dr. Michael Seidman of the Henry Ford Hospital in Detroit, Michigan.

Researchers test implant used to ease depression

Many patients with the kind of depression that sabotages the ability to form relationships or keep a job have long thought that medicines or shock therapy were their only hope. But doctors at 20 research centers around the country are studying how a surgically implanted stopwatch-sized device could offer an alternative treatment for profound depression.

Therapy helps new moms deal with depression

For women who experience major depression after having a baby, psychotherapy can help, according to results of a study. For some women, the demands of taking care of a baby, as well as the changes motherhood can bring to social and work relationships, are enough to cause major depression.

Depression not linked to early signs of heart disease

Even though depression!, anxiety, hostility and stress have been linked to an increased risk of coronary artery disease, these psychological factors do not appear to affect the risk of developing calcium deposits in heart vessels, an early sign of heart disease, according to new study findings.

Preschoolers can be depressed, study says

Not every four year old is a happy-go-lucky youngster - some preschoolers can exhibit signs of depression, according to research presented during the 47th annual meeting of the American Academy of Child and Adolescent Psychiatrists.

Anxiety doesn't make the heart grow sicker

If you suffer from stress, anxiety or depression, here is some good news -- your risk of coronary artery disease is not going up. Such emotional attitudes show no correlation with coronary-artery calcification, which can lead to heart problems.

Job stress can bring on the blues

In a finding that probably surprises no one who works, Baltimore researchers have concluded that high levels of stress on the job can results in depressive symptoms. Call it the "Working Man's (or Woman's) Blues."!

How can I beat the winter blues?

If the winter blues have gotten you down, you need to know that you are not alone. Seasonal affective disorder, or SAD, affects many people during the winter months with lethargy and depression. Several reasons have been suggested: lack of sunlight, lack of exercise, poor diet and disruption of natural body rhythms. Luckily there are solutions. Have a look at these tips.

Depressed teens at risk for adult depression

Four out of five depressed adolescents do not receive treatment for their depression, according to a new study. This lack of treatment may consequently put these teenagers at risk for recurrence of the condition in their adult years, study findings suggest.

"Almost 70% of adolescents who had experienced an episode of major depressive disorder (MDD) by age 18 suffered another episode of mental disorder between (ages) 19 to 24--that is, in a relatively short period of time," lead author Dr. Peter M. Lewinsohn, a senior research scientist with the Oregon Research Institute in Eugene, told Reuters Health.

In addition, many of the teenagers were diagnosed with other psychiatric problems in their later years, Lewinsohn and his colleagues report in the October issue of the American Journal of Psychiatry.

A follow-up study of 24-year-olds who were depressed in adolescence revealed that of 274 patients, "21.2%...suffered another episode of ('pure') MDD; 24.5% had another episode of MDD that was associated with another mental disorder; and 22.1% did not have a recurrence of depression, but developed a substance use disorder," Lewinsohn said.

The investigators found that girls who engaged in conflict with their parents were more likely than boys to have recurrent major depression.

A family or personal history of the condition, and borderline personality disorder symptoms were also predictive of major depressive disorder recurrence in young adulthood, the authors point out.

"We think that the findings emphasize the importance of efforts to identify adolescents and young adults who are at high risk for depression, in order to provide treatment to those who are depressed and preventative help to those who are at elevated risk," Lewinsohn stated.

These efforts should be a high public health priority that may involve periodic--perhaps annual--monitoring of such individuals, he suggested.

In a related editorial, Drs. Andres Martin and Donald J. Cohen note that only 20% of the adolescents in the study received some form of treatment. This, they write, "strongly suggests that in community settings, the adolescent window of therapeutic opportunity is, more likely than not, missed.

Further research is needed "to lead toward a sharper definition of that window of opportunity that the timely identification and effective treatment of adolescent depression promises to be," Martin and Cohen conclude.

Smoking may lead to teen depression

Contrary to the notion that depressed teenagers were more likely to take up smoking, a study found that young people who became smokers were more likely to become depressed, researchers said on Monday.

Cigarette smoking was the "strongest predictor" of developing depressive symptoms among a group of 8,704 teenagers who were not depressed a year earlier, said study author Elizabeth Goodman of Children's Hospital Medical Center and the University of Cincinnati College of Medicine.

The adolescents who were not depressed at the start of the study--and may or may not have been experimenting with cigarettes--were four times more likely to have depressive symptoms if they were moderate or heavy smokers a year later.

The impact of nicotine or other cigarette additives on certain brain receptors could be to blame for the onset of depressive symptoms, Goodman said.

There has been some success in using anti-depressants to help smokers stop, suggesting a close link between the effects of cigarettes and the brain's chemistry that dictates mood.

Smoking prevalence among American teenagers remained high despite drops in adult smoking rates, Goodman reports in the journal Pediatrics, and researchers have been trying to figure out why.

Previous research has produced conflicting results, and the common belief was that smoking was a sought-after if temporary relief from depression.

"Typically, increased likelihood of smoking initiation and progression have been viewed as consequences of depression," Goodman wrote. But "high depressive symptoms were not predictive of smoking progression in this study."

A comic that accurately sums up depression and anxiety — and the uphill battle of living with them

Sarah Flanigan has been fighting depression since she was 10 years old and anxiety since she was 16. "I wish everyone knew that depression is not something that people can just 'snap out of,'" she explains. "I mean, if I could 'snap out of it,' I would have by now."

Depression and anxiety disorders are real illnesses. Mental illnesses are not "in someone's head," they're not something a person can "just get over," and they affect so many of us — over 40 million people in the U.S. alone.

Despite how common they are, it's still really difficult to explain to people who may have never experienced a mental illness.

Enter: cute, clever illustrations that get the job done.

Nick Seluk, who creates the amazing comics at The Awkward Yeti, heard from reader Sarah Flanigan. She shared her story of depression and anxiety with him. If it could help even one person, she said, it would be worth it.

Nick turned her story into a fantastic comic that perfectly captures the reality of living with depression and anxiety. (Go to the web site to see the actual cartoon.)

"The hardest part of living with depression and anxiety for me is feeling like I have to hide it," Sarah said. "I've always been known as the happy one in my group of friends. Everyone's always so shocked when I tell them I have depression or they see the self-harm scars."

"It's much harder than it should be to say, 'Hey, I have depression and I've been struggling with self-harm since I was 10 and I just really need your support to get me through tonight,'" Sarah explained.

Let's all keep working to make it easier for our friends, family members, and ourselves to get support. Let's keep talking about it.


These comics were created by Nick Seluk of The Awkward Yeti, published on Tapastic. I'm sharing them with Nick's express permission. He's a really cool guy who has an entire "Medical Tales Retold" series that, until recently, focused on physical conditions. He covers a lot there and makes the difficult reality of living with certain conditions a little lighter. You can follow him on Facebook, Twitter, Tumblr, and Instagram.

Huge props to Sarah for bravely sharing her story with Nick and, in turn, thousands and thousands of people. She was hoping for just one person to see the comic and know they weren't fighting the battle alone. She more than accomplished that, and we're all better for it!

Men Never Cry: Depression in Men and Why It’s Hard To Ask For Help

Depression is real. Even more so in men. It is said that men suffer from the worst forms of depression. This is more likely to be true because, unlike women, men don’t like to talk about it. Being sad and depressed is almost a taboo for men around the world. When depressed, a man is more likely to get angry, irritated and frustrated instead of showing the sadness and tackling the problem or talking about it. Most of the time, men channel the sadness and depression out through reckless and violent behavior or try to fix it using liquor and other forms of drug, instead of coming face-to-face with the problem.

Depression is a form of illness which causes continuous feelings of sadness that shadow over a person. It also causes a loss of interest and appetite. The thing is that a lot of people out there still believe that depression is not a real problem. But it is and it gets worse if not fixed in early stages. Depressed people have a tendency to harm themselves, and the people around them, both physically and mentally.

Men are three times more likely to kill themselves than women.

The main problem lies in the social stigma that men don’t cry, or rather men SHOULDN’T cry! While crying and reaching out helps in these situations, men around the world are taught to not do so, as it will be UNMANLY! Even though crying helps to prevent sadness. Research suggests that on average men cry fewer times a year than women. It also states that crying relives us from stress and anxiety. It helps reduce distress and tension and also lowers blood pressure. While the world treats crying as girly, we forget that it only means that we are human and we have emotions.

Recognizing the problem

The first step to resolve any problem is to recognize that problem. It is imperative to start acknowledging that depression is not just a teenage or feminine problem. Men often suffer from depression clinical depression can lead to dangerous life choices, such as suicide and drug abuse. General consciousness of the fact that depression is a common problem that remains unaddressed would be the first step towards resolving it.

Starting a Conversation

At times it is really hard to figure out how bad the situation is, especially when it comes to men. While women tend to be more talkative and share and talk about what is bothering them, men tend to keep emotions to themselves and keep the signs of depression repressed.

In these situations, talking in numbers is the only way to figure out how bad it is. Asking someone to rate the sadness level might help. For example you can ask, how happy is he on a scale of 0 to 10, 0 being the “The lowest I could ever be” and 10 being “I love my life.”

Even if someone doesn’t say they are at 0, but answers that they are at less than 5, it’s an indication that things might be really bad. But the first step is to make the person realize that there is a problem. Most of the time guys avoid the situation and don’t dig deep and eventually things start to get worse.

While women focus on both understanding and solving the problem, men tend to start fixing it before they even understand what depression really is. In general, men don’t like talking or they don’t want to go through the whole process. Rather they move to the more practical steps and focus more on improving habits, such as eating right, exercising, getting proper sleep etc.

Suicide Tendencies and Drug Abuse

Men start drinking or abusing drugs when depressed, and this is one of the main reasons why it is harder to help them recover. Suicidal tendencies get stronger when you are not in your senses and you cannot express your emotions.

Choosing alcohol or any kind of drug is the worst decision one can make, both for himself and the people around him. Misuse of drugs to help oneself to forget the bad things will eventually cause worse problems in life. Facing problems is the only way to get rid of them. Running away from them is not. When you see someone trying to do something reckless, know that they are either seeking thrills or are trying to run away from distress.

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Depression is the lid you keep on a geyser of feeling you fear to express. - Don Jones

"Women seek help—men die.” Jed Diamond

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