Seasonal affective disorder
Depression is often chronic, with episodes of recurrence and improvement. About a third of patients with a single episode of major depression will have another episode within 1 year after discontinuing treatment, and more than half will have a recurrence at some point in their lives. Depression is more likely to recur if the first episode was severe or prolonged, or if there have been prior recurrences. To date, even newer antidepressants have failed to achieve permanent remission in most patients with major depression, although the standard medications are very effective in treating and preventing acute episodes.
Many suicides are due to treatable disorders, most commonly depression or substance abuse. Depression is the cause of up to two-thirds of all suicides. Depressed men are more likely to commit suicide than depressed women. Suicidal preoccupation or threats of suicide should always be treated seriously. In addition, antidepressant medications may increase the risk for suicidal behavior in some children and adolescents. [See “Depression in Children and Adolescents” in Risk Factors section and “Suicidal Risk and Antidepressant Medications” in Drug Treatment Guidelines section in this report.]
Major depression in the elderly or in people with serious illness may reduce survival rates, even independently of any accompanying illness. Decreased physical activity and social involvement certainly play a role in the association between depression and illness severity.
Heart Disease and Heart Attacks. Depression increases the severity of a heart attack and may even impair a patient's response to medication for heart disease. Although people with heart disease may certainly become depressed, this does not explain entirely the link between the two problems. Data suggest that depression itself may be a true risk factor for heart disease as well as its increased severity. A number of studies indicate that depression has biologic effects on the heart, including a higher risk for blood clotting, changes in heart rate, and impaired blood flow to the heart (particularly in response to mental stress). The more severe the depression, the more dangerous to the health, although even mild depression, including feelings of hopelessness, experienced over many years, may harm the heart, even in people with no early signs of heart disease.
Obesity. Both obesity and depression are increasing in Americans. Adolescents who are depressed have a high risk for obesity. Conversely, obese people are about 25% more likely than non-obese people to develop depression or other mood disorders. The conditions may have common risk factors. For example, being in a lower social and economic group increases the risk for both obesity and depression. Low physical activity may also be a common factor.
Mental Decline. Depression in the elderly is associated with a decline in mental functioning, regardless of the presence of dementia. Depression may be associated with Alzheimer's disease. Brain scans in the elderly, for example, have reported greater atrophy (shrinkage) in the brains of depressed individuals than in those of nondepressed ones.
Increasing Sensations of Pain. Depression coincides with increased pain in people with conditions such as those arthritis or fibromyalgia.
Cancer. The relationship between depression and cancer has been explored for years with few clear-cut associations. Certainly depression and anxiety can have a profound impact on quality of life in cancer patients.
Effects of Parental Depression on Children. Depression in parents can have profound effects on their children and may increase the risk for childhood depression.
Effects on Marriage.. People who suffer from psychiatric disorders tend to have higher divorce rates than healthy people. Spouses of partners with depression are themselves at higher risk for depression.
Effect on Work. Depression is well-known to adversely affect a person's work life. It significantly increases the risk for unemployment and lower income. Nearly half of the nation's excess lost productive time (in most cases because of reduced performance at work) may be a result of depression. Workers with depression also lose significantly more time due to ill health than non-depressed workers. Such lost time is estimated to cost the country billions of dollars each year.
Alcohol and Drug Abuse. Many people with major depression also have an alcohol use disorder or drug abuse problems. Studies on the connections between alcohol dependence and depression have still not resolved whether one causes the other or if they both share some common biologic factor.
Smoking. Depression is a well-known risk factor for smoking, and many people with major depression are nicotine dependent. Nicotine may stimulate receptors in the brain that improve mood in certain people with genetically induced depression.
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