Adapted, in part, from the University Health Services of UC Berkley and the
National Institute of Mental Health
It is estimated that 6.7% of the US population over the age of 18 suffer from clinical depression, often called major depression . Overall, between
20% and 25% may suffer an episode of major depression at some point during their lifetime. Major depression affects adults, teens, children, and the elderly alike. Major depression frequently goes undiagnosed and untreated in children and the elderly.
What is Major or Clinical Depression?
Clinical depression is a serious medical illness that negatively affects how you feel, the way you think and how you act. Individuals with clinical depression are unable to function as they used to. Often they have lost interest in activities that were once enjoyable to them, and feel sad and hopeless for extended periods of time.
Clinical depression is not the same as feeling sad or depressed for a few days and then feeling better. It can affect your body, mood, thoughts, and behavior. Most people feel sad or low at some point in life, but clinical depression is marked by a depressed mood most of the day, particularly in the morning. In addition, according to the DSM-IV -- a manual used to diagnose mental health conditions – there may be other symptoms with major depression. Those symptoms might include:
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Fatigue or loss of energy almost every day
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Feelings of worthlessness or guilt almost every day
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Impaired concentration, indecisiveness
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Insomnia or hypersomnia (excessive sleeping) almost every day
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Markedly diminished interest or pleasure in almost all activities nearly every day (called anhedonia, this symptom can be indicated by reports from significant others.)
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Psychomotor agitation or retardation (restlessness or being slowed down)
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Recurring thoughts of death or suicide (not just fearing death)
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Significant weight loss or gain (a change of more than 5% of body weight in a month)
To distinguish the condition as major depression, one of the symptoms must be either depressed mood or loss of interest. Also, the symptoms must be present for most of the day every day or nearly every day for at least two weeks. For some people, depression symptoms are so severe that it's obvious something isn't right.
Others people feel generally miserable or unhappy without really knowing why. Depression affects each person in different ways, so depression symptoms vary from person to person. Inherited traits, age, gender and cultural background all play a role in how depression may affect a person.
Depression in Women and Men, How Might it Differ?
About twice as many women as men have major depression. It's thought that hormonal changes in women during puberty, menstruation, pregnancy, miscarriage, and menopause may increase the risk of major depression. Among other factors that increase the risk of major or clinical depression are increased responsibilities at home or at work. Juggling kids, careers, commitments, and caring for an aging parent may increase the risk of major depression. Raising a child alone will also increase the risk.
Depression in men is significantly underreported. Men who suffer from clinical depression are less likely to seek help or even talk about their experience. Signs of depression in men may include irritability, anger, or drug and alcohol abuse. Repressing their feelings can result in violent behavior directed both inwardly and outwardly. It can also result in an increase in illness, suicide, and homicide.
There are different types and levels of clinical depression. Mental health professionals and psychiatrists are trained to diagnose and treat clinical depression.

Types of Depression:
Clinical depression can come in different forms, often called mood disorders. Mood disorders affect approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year. The median age of onset for mood disorders is 30 years and often co-occurs with anxiety disorders and substance abuse. It may start suddenly or build up over a period of weeks, months, or years. The following are descriptions of the three most prevalent forms of mood disorders, though for an individual, the number, severity and duration of the symptoms may vary.
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Major Depression: a combination of symptoms (described above) that interfere with one's ability to work, sleep, eat and enjoy once pleasurable activities. These episodes can occur once, twice or several times in a lifetime.
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Dysthymia: a less intense type of depression that involves long-term, chronic symptoms that are less severe, but keep one from functioning at full ability and from feeling good.
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Bipolar Disorder (also known as manic-depressive illness): periods of depression alternate with periods of elation and increased activity, known as mania.
Clinical depression is not a sign of personal weakness, or a condition that can be willed away. Clinically depressed people cannot "pull themselves together" and get better. In fact, clinical depression often interferes with a person's ability or wish to get help. Clinical depression is a serious illness that lasts for weeks, months and sometimes years. It may even influence someone to contemplate or attempt suicide.
The causes of depression are quite complex. Very often it is a combination of genetic, psychological, and environmental factors. Regardless of the cause, depression is almost always treatable. You do not need to determine the cause of your depression to get help.
Depression symptoms may not get better on their own, and depression may get worse if it isn't treated.
Untreated depression can lead to other mental and physical health problems or problems in other areas of your life. Feelings of depression can also lead to suicide. With the right treatment, most people who seek help get better within several months. Many people begin to feel better in just a few weeks.
Treatments for Depression:
Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.
The first step to getting appropriate treatment is to visit a doctor. Some medical conditions such as viruses or a thyroid disorder, and certain medications can cause the same symptoms as depression. A doctor can rule out these possibilities by conducting a physical examination, interview and lab tests. If the doctor can eliminate a medical condition as a cause, he or she should conduct a psychological evaluation or refer the patient to a mental health professional.
The doctor or mental health professional will conduct a complete diagnostic evaluation.
He or she should discuss any family history of depression, and get a complete history of symptoms, e.g., when they started, how long they have lasted, their severity, and whether they have occurred before and if so, how they were treated. Once diagnosed, a person with depression can be treated with a number of methods. The most common treatments are medication and psychotherapy.
Antidepressants work to normalize naturally occurring brain chemicals called neurotransmitters, notably serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists studying depression have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways in which they work. Again, a good evaluation will help to know if these are right for each individual.

Psychotherapy
Several types of psychotherapy –or "talk therapy"–can help people with depression. The National Institute of
Mental Health (NIMH) research has shown that certain types of psychotherapy, particularly cognitivebehavioral therapy (CBT) and interpersonal therapy (IPT), can help relieve depression. CBT helps patients change the negative styles of thinking and behaving often associated with depression. IPT focuses on working through disturbed personal relationships that may contribute to depression. Other types of psychotherapy and alternative treatments continued to be studied for effectiveness.
In District 11, there is an Employees Assistance Program (EAP) in which a staff member may receive five free therapy sessions, aimed to help guide their healing. EAP is a sponsored benefit that provides confidential assessment, short-term counseling, referral, and follow-up services for employees and their immediate family members......and so much more. It's free! Check out: http://www.d11.org/risk/employee_benefits_employee_assist.htm
Herbal Remedies/Saint John’s Wort:
Today in Europe, St. John’s Wort is used extensively to treat mild to moderate depression. In the United
States, it is one of the top-selling botanical products. However, the National Institute of Health conducted a clinical trial to determine the effectiveness of treating adults who have major depression with St. John
’s Wort.
Their results suggest that St. Johns Wort was no more effective than the placebo in treating major depression.
In addition the NIH advises that, because there are potential interactions with other medications, patients should always consult with their doctors before taking any herbal supplement.
The Effects of Diet and Healthy Lifestyles on Depression:
Unfortunately, there's no specific diet that works for depression. Certain diets or foods may not ease depression (or put you instantly in a better mood), but they may help as part of an overall treatment for depression. There's more and more research indicating that, in some ways, food and mood are connected.
Dietary changes can bring about changes in your brain structure, both chemically and physiologically. Those changes can improve mood and mental outlook. Here are some tips if you have clinical depression.
1. Eat a Diet High in Nutrients
Nutrients in foods support the body's repair, growth, and wellness. Nutrients we all need include vitamins, minerals, carbohydrates, protein, and even a small amount of fat. A deficiency in any of these nutrients can lead to our bodies not working at full capacity -- and can even cause illness.
2. Fill Your Plate with Essential Antioxidants
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Sources of beta-carotene: apricots, broccoli, cantaloupe, carrots, collards, peaches, pumpkin, spinach, sweet potato.
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Sources of vitamin C: blueberries, broccoli, grapefruit, kiwi, oranges, peppers, potatoes, strawberries, tomato.
 Sources of vitamin E: margarine, nuts and seeds, vegetable oils, wheat germ.
3. Eat "Smart" Carbohydrates for a Calming Effect
We know that eating foods high in carbohydrates (breads, cereal, pasta) raises the level of serotonin in the brain. When serotonin levels rise, we feel a calming effect with less anxiety. Make smart carbohydrate choices by: limiting sugary foods, and increasing your whole grains, fruits, vegetables, and legumes.
4. Eat Protein-Rich Foods to Boost Alertness
Foods rich in protein help to boosts levels of the brain chemicals dopamine and norepinephrine. This boost helps you feel alert and makes it easier to concentrate. Try to include a protein source in your diet several times a day, especially first thing in the morning and when taking tests.
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Good sources of healthy proteins: beans and peas, lean beef, low-fat cheese, fish, milk, poultry, eggs, soy products, yogurt.

5. Watch Your Lifestyle Habits
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Drinks: Many people who are depressed also have problems with alcohol and/or drugs. Not only can alcohol and drugs interfere with mood, sleep, and motivation, they can also affect the effectiveness of medications. In addition, drinks and foods containing caffeine can trigger anxiety and make it difficult to sleep at night. Cutting out caffeine or stopping caffeine after noon each day can also help you get a better night's sleep.
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Sleep: Studies show that children and teens that do not get enough sleep are more likely to show signs of depression.
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Exercise: Regular exercise has been proven to help: reduce stress, ward off anxiety, depression, boost self-esteem and improve mood and sleep.
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Weight: People who are obese may be more likely to become depressed, and people who are depressed are more likely to become obese. Researchers believe the link between obesity and depression may result from physiological changes that occur in the immune system and hormones with depression. If you have a weight problem, look into healthy ways to manage it with diet and exercise.
There are times that diet, sleep, and exercise alone will not be enough to improve your mood. At those times you may want to speak to a mental health professional, a friend or loved one, a health care professional, a faith leader, or someone else you trust. If your thoughts turn to violence towards self or others, get help. This is a strong indicator that help is necessary now.