A person who feels sad all the time, has unexplained crying spells, or loses interest in usual activities may have major depression, a serious medical illness that should be distinguished from normal temporary feelings of sadness after a loss, such as the death of a relative or friend. The January 18, 2006, issue of JAMA includes an article about depression. This Patient Page is based on one previously published in the June 18, 2003, issue of JAMA.

SYMPTOMS OF MAJOR DEPRESSION

• Feeling sad or empty
  
• Decreased interest or pleasure in activities
  
• Appetite change with weight loss or weight gain
  
• Decreased or increased sleeping
  
• Fatigue or loss of energy
  
• Feeling worthless or guilty
  
• Being either agitated or slowed down
  
• Difficulty thinking or concentrating
  
• Recurrent thoughts of death or suicide
  

OTHER TYPES OF DEPRESSION

• Bipolar disorder (previously called manic-depressive disorder)—occurrence of episodes of major depression and episodes of abnormally elevated mood called mania (severe) or hypomania (less severe)
  
• Dysthymia—mild depression symptoms lasting for at least 2 years
  
• Postpartum depression—a mother's depression occurring after the birth of her baby
  
• Seasonal affective disorder—major depression occurring regularly in seasons with low sunlight
  

TREATMENTS FOR DEPRESSION

• Medications—Several types of antidepressant medications have been shown to be effective for depression, but they must be taken for several weeks before they begin to work.
  
• Psychotherapy—Several kinds of "talking therapies" have also been shown to be effective for depression. They involve evaluating and changing the thoughts, attitudes, and relationship problems that are associated with depression.
  
• Bright light—Daily exposure to bright light can be helpful for seasonal depression.
  
• Electroconvulsive therapy—A series of treatments involving passage of electric current through the brain while the patient is under anesthesia can often relieve even severe depression. These treatments are usually given about 3 times per week for several weeks.
  

Anyone who is experiencing symptoms of depression should be evaluated by a doctor. Although individuals with depression often feel that nothing can help them, effective treatments are available. Evaluation and treatment are particularly important to prevent suicide. Suicide usually stems from depression.

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