1. Is depression a mental illness?
Yes, depression is a serious, but treatable, mental problem. It is a medical problem, not a personal weakness. It also is very common, affecting 10 percent of the U.S. population at any given time. Everybody at one point or another will feel sadness as a reaction to loss, grief or injured self-esteem, but clinical depression, called "major depressive disorder" by doctors, is a serious medical illness that needs professional diagnosis and treatment.

2. Do children get depression?
Yes. Children are subject to the same factors that cause depression in adults. These include: changes in physical health, life events, heredity (inheritance), environment and chemical disturbances in the brain. It is estimated that 2.5 percent of children in the U.S. suffer from depression.

Depression in children is different from the "normal" blues and everyday emotions that are typical in children of various ages. Children who are depressed experience changes in their behavior that are persistent and disruptive to their normal lifestyles, usually interfering with relationships with friends, schoolwork, special interests, and family life. It may also occur at the same time as (or be hidden by) attention deficit hyperactivity disorder (ADHD) obsessive-compulsive disorder (OCD), or conduct disorder (CD).

3. Can lack of sleep cause depression?
No. Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep resulting from another medical illness or the presence of personal problems can intensify depression. Chronic inability to sleep also is an important clue that someone may be depressed.

Common triggers of depression include:

• Family history of depression.
• Grief over the loss of a loved one through death, divorce, or separation.
• Interpersonal disputes.
• Physical, sexual, or emotional abuse.
• Major life events such as moving, graduating, or retiring, etc.
• Serious illness — major, chronic, and terminal illnesses often contribute to depression. These include cancer, heart disease, stroke, HIV, Parkinson’s disease, and others.
• Substance abuse — almost 30% of people with substance abuse problems also have major depression.
• Being socially isolated or excluded from family, friends, or other social groups.

4. Are there any alternatives to the traditional treatments for depression that I can try?
Alternative therapy describes any treatment or technique that has not been scientifically documented or identified as safe or effective for a specific condition. Alternative therapy involves a variety of disciplines that include everything from diet and exercise to mental conditioning and lifestyle changes. Some of these have been found to be effective for treating depression. Examples of alternative therapies include acupuncture, guided imagery, chiropractic, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others. If you are interested in trying any of these options, talk with your doctor.

5. How can you determine if an illness is causing depression or depression is causing an illness?
Illnesses that can lead to depression are usually major, chronic, and/or terminal. When an illness is causing depression, there often is long-term pain present or a sudden change in lifestyle.

Depression causes illness in a different way. Like psychological stress, it can weaken the immune system (cells involved in fighting disease and keeping you healthy), allowing a person to get more colds or the flu. There often is a notable presence of "aches and pains" with no particular cause. Having depression also may cause an illness to last longer and intensify its symptoms, but the true relationship of depression-induced illness, in terms of major disease, has not been thoroughly defined.

It is important to seek the advice of your doctor if your think you or someone you know may have depression.

6. I’ve heard lots of warnings about drug interactions with certain depression medicines. What are they?
MAOIs, or monoamine oxidase inhibitors, are effective antidepressant medicines that have been used for years. Typically prescribed for people with severe depression, MAOIs improve mood by increasing the number of chemicals in the brain that pass messages between brain cells. MAOIs have been proven to work just as well as other antidepressant drugs, but they have more possible food and drug interactions.

Medicines to avoid when taking MAOIs include all SSRIs (a group of antidepressants that includes Prozac and Paxil) and certain pain medicines including Demerol. There also are some cough medicines and blood pressure medicines that must not be taken with MAOIs. Foods to avoid when taking MAOIs include aged cheeses and meats, avocado, pickled or smoked foods like sauerkraut or meat, and foods that include yeast extracts like beer and wine. It is important to tell your doctor about any medicines you are currently taking. Be sure to discuss the limitations, interactions, and possible side effects of MAOIs.

7. Why are women more likely to get depression?
Women develop depression twice as often as men. One reason may be the various changes in hormone levels that women experience. For example, depression is common during pregnancy and menopause, as well as after giving birth, suffering a miscarriage, or having a hysterectomy. These are all times when women experience huge fluctuations in hormones. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), an extreme form of PMS, also may cause depression.

8. Do most people with depression commit suicide?
No. Most people who suffer from depression do not attempt suicide, but according to the National Mental Health Association, 30 percent to 70 percent of suicide victims have suffered from some form of depression. This figure demonstrates the importance of seeking professional treatment for yourself or someone you love if you suspect depression.

9. Will someone who has had depression get it again?
Having experienced an episode of depression does put a person at greater risk for future episodes, but not everyone who has recovered from depression will experience it again. Sometimes depression is triggered by a major life event or illness or a combination of factors particular to a certain place and time. Getting the proper treatment for the correct amount of time is crucial to recovery and in helping prevent or identify any future depression.

10. How long does depression last?
If left untreated, various types of depressive disorders can last for years. A major depressive episode is characterized by a set of symptoms that last for more than two weeks and may last for months. Seasonal depression, or SAD, usually extends throughout the winter months and continues to improve during spring and summer. Bipolar disorder is characterized as "ups" (periods of mania) and "downs" (periods of extreme depression). Although these phases may change rapidly or slowly, bipolar depression may last until an effective treatment is found. Dysthymia is mild and more difficult to identify, and may last for years if left untreated.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771 or visit www.clevelandclinic.org/health/.

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