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  3. Facts about Depression In any given one-year period, 9.5% of the population, or about 18.8 million American adults, suffer f

Facts about Depression In any given one-year period, 9.5% of the population, or about 18.8 million American adults, suffer f

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问题                                 Facts about Depression
    In any given one-year period, 9.5% of the population, or about 18.8 million American adults, suffer from a depressive illness. The economic cost for this disorder is high, but the cost in human suffering cannot be estimated. Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them. Serious depression can destroy family life as well as the life of the ill person. But much of this suffering is unnecessary.
    Most with a depressive illness do not seek treatment, although the great majority — even those whose depression is extremely severe — can be helped. Thanks to years of fruitful research, there are now medications and psychosocial therapies such as cognitive/behavioral "talk" or interpersonal that ease the pain of depression.
What’s Depressive Disorder?
    A depressive disorder is an illness that involves the body, mood, and thoughts, ft affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. Propel with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression
Types of Depression
    Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. Brief descriptions of the most common types of depressive disorders are given below.  However, within these types there are variations in the number of symptoms, their severity, and persistence.
    Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
    A less severe type depression, dysthymia, involves long-term, chronic (慢性的) symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
    Another type of depression is bipolar disorder. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual.
    When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, over-talkative, and have a great deal of energy.  Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase (状态) may feel elated, full to grand schemes that might range from unwise business decisions to romantic sprees(放纵). Mania, left untreated, may worsen to a psychotic state.
Symptoms of Depression and Mania
    Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.
    Depression
    • Feelings of hopelessness, pessimism
    • Feelings of guilt, worthlessness, helplessness
    • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
    • Decreased energy, fatigue, being "slowed down"
    • Difficulty concentrating, remembering, making decisions
    • Insomnia, early morning awakening, or oversleeping
    • Appetite and/or weight loss or overeating and weight gain
    • Thoughts of death or suicide; suicide attempts
   Mania
    • Unusual irritability
    • Decreased need for sleep
    • Grandiose (夸大的) notions
    • Increased talking
    • Increased sexual desire
    • Markedly increased energy
    • Poor judgment
Causes of Depression
    Some types of depression run in families, suggesting that a biological vulnerability (弱点) can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get iii. However, the reverse is not true: Not everybody with the genetic makeup that cause vulnerability to bipolar disorder will have the illness. Apparently, additional factors, possibly stresses at home, work, or school, are involved in its onset.
    In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression.  Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.
    People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.
    In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson’s disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically begin from mild stresses, or none at all.
Evaluation and Treatment
    A good diagnostic (诊断的) evaluation will include a complete history of symptoms, i. e. , when they started, how long they have lasted, how severe they are, whether the patient had them before and,  if so,  whether they symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have bad a depressive illness and, if treated, what treatments they may have received and which were effective.
    Lasts a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.
    Treatment choice will depend on the outcome of the evaluation. There are a variety of medications and psychotherapies (心理疗法) that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants (抗抑郁药). Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life’s problems, including depression. Depending on the patient’s diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.
Mania often involves thinking, ______ , and social behavior in ways that cause serious problems and embarrassment.
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