Depression Due to a Medical Condition

What is depression due to a medical condition?

Depression is a condition in which you feel sad, hopeless, and uninterested in daily life. Several medical problems can cause depression. It is not that you are just upset at having a medical problem, but that the medical problem physically causes depression.

How does it occur?

The brain is made up of billions of neurons (cells) that communicate with each other. This affects other parts of the body. Neurotransmitters are chemical substances in the brain. The kinds and amounts of these substances control how neurons communicate. Too little or too much of these chemicals can cause mood problems. Many medical problems upset the balance of neurotransmitters in your body, such as:

• heart or circulatory problems (such as a stroke)
• brain problems (such as Parkinson's disease and Huntington's disease)
• hormone problems (such as thyroid problems and adrenal gland changes)
• infections (such as mononucleosis, hepatitis, and pneumonia)
• autoimmune disorders (such as AIDS)
• several types of cancer (such as brain tumors, thyroid cancer, and lymph gland cancer).

In addition to medical conditions that physically cause depression, you may also become depressed about being ill. Illness reduces your energy, sense of well-being, and social activities.

What are the symptoms?

Besides feeling somewhat sad and uninterested in things, you may also:

• Be irritable.
• Have trouble falling asleep, wake up very early, or sleep too much.
• Have little or excessive appetite.
• Be easily tired and low in energy.
• Have low sexual desire and function.
• Feel worthless and guilty.
• Have trouble concentrating or remembering things.
• Feel hopeless or just not care about anything.
• Have unexplained physical symptoms.
• Worry that you will never feel better.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and any drug or alcohol use. You will be asked about the medicines and supplements you take. You may be asked to have some lab tests to pinpoint other medical problems.

How is it treated?

Sometimes treating the medical problem helps depression. For example, treating thyroid illness may treat depressive symptoms. But sometimes depression is still a problem after the illness has been effectively treated. Sometimes treating depression helps to treat medical symptoms. For example, some medicines used to treat depression help migraines.

Do not try to overcome depression by yourself. Depression can be successfully treated with either psychotherapy, medicine, or both. Discuss this with your healthcare provider or therapist.

Medicines

Several types of medicines can help treat depression. Your healthcare provider will work with you to carefully select the best one for you. Before you take any medicine for depression, check with your healthcare provider to make sure it will not interact with the medicines you are taking for your physical condition.

You must take antidepressant medicines daily for 3 to 6 weeks to get full benefit from them. Most people benefit from taking these medicines for at least 6 months.

Psychotherapy

Seeing a mental health therapist can help with all forms of depression. Therapy may last a short time or may need to go on for many months. Cognitive behavioral therapy (CBT) is a way to help you identify and change thought processes that lead to depression. Replacing negative thoughts with more positive ones can help you with depression.

Complementary Treatments

Diets rich in fruits and vegetables are recommended for people with depression. A multivitamin and mineral supplement may also be recommended.

Eating fatty fish 2 to 3 times per week may reduce feelings of depression. Fatty fish include salmon, tuna, mackerel, herring, and sardines. You can also buy fish oil supplements. Flaxseed, pumpkin seed, walnuts, and olive oil are also sources of omega-3 fatty acids.

At 300 to 400 mg per day, St. John's wort may help mild depression. It does not help with severe depression, and may cause side effects, such as sun sensitivity, anxiety, or sleeplessness.

Other supplements that may be helpful in treating depression include SAMe, DHEA, and 5-hydroxytryptophan.

Be careful which products you use. "Natural" products are not standardized. They may have different strengths and effects. Some may be contaminated. Herbs and supplements may interact with prescription medicines. Talk to your healthcare provider or pharmacist about any supplements that you are using or considering.

Many types of complementary treatments may help depression. Some of them are:

• Biofeedback: Through biofeedback you learn to control body functions such as muscle tension or brain wave patterns. Biofeedback can help with tension, anxiety, and concentration.
• Massage Therapy: Massage therapy may help lower stress, but it does not cure the problem.
• Relaxation Therapies: Learning ways to relax can help with depression. Yoga and meditation may also be helpful.
• Art and Music Therapies: Some people find art and music therapy are helpful in treating depression.

How long will the effects last?

As your physical condition improves, your depression will usually improve. However, if your health remains poor, depression can continue. For this reason, you should seek professional help. The treatments listed above most often will help you to overcome depression or at least reduce it.

What can I do to help myself or my loved one?

Certain medicines can add to the symptoms of depression:

• benzodiazepines
• digoxin
• hormonal birth control
• isotretinoin (Accutane)
• levofloxacin (Levaquin)
• some malaria medicines
• some beta blockers.

If you are being treated for depression, check with your healthcare provider before taking any new prescription or nonprescription medicines.

Maintaining a healthy lifestyle is crucial. To help prevent depression:

• Stay focused on positives in life rather than on your illness.
• Exercise for at least 20 minutes every day, for example a brisk walk.
• Learn which activities make you feel better and do them often.
• Talk to your family and friends.
• Eat a healthy diet.
• Do not drink a lot of caffeine.
• Do not abuse alcohol or drugs.
• Learn ways to lower stress, such as breathing and muscle relaxation exercises.

When should I seek help?

Seek professional help if you believe that you or a loved one have the symptoms described here.

Get emergency help immediately if you or a loved one have serious thoughts of suicide or harming others.