Photo of depressed woman
Studies indicate that African-American women have even higher rates of depression than Caucasian women and are less likely to get adequate help. 

The cloudy gray skies of fall and winter are arriving with each passing week. The sun shines less frequently and the days end earlier in darkness. These seasonal changes certainly can affect a person's mood, and many people might suffer a case of the blues as they adjust to the waning months of the year.

However, when those few days of feeling down stretch into weeks and affect so many aspects of a person's life, then it's time to get help.

“Most people think of depression as a feeling of overwhelming sadness,” says Robert Hales, chair of the UC Davis Department of Psychiatry and Behavioral Sciences. “While that's often the case, psychiatrists know that depression easily can be found in other forms. Often depressed individuals simply lose interest in normal activities or become withdrawn from work, hobbies, socializing with friends and being with family.”

Sleeping patterns are often disturbed as well, notes Hales. Some feel lethargic and sleep a lot during the day. Many have insomnia with early morning wakening. There may be a slowing down of thoughts, with problems concentrating and making decisions. Some people become restless and agitated. Many people have frequent thoughts of death and suicide.

A common disorder, too often ignored

Depression is a common disorder that is too often ignored and left untreated. About 15 percent of the population experiences depression some time in their lives, with women affected about twice as often as men. Untreated, an episode of depression may last for months, and even years. And people who are prone to depression are likely to experience recurrent episodes throughout their lifetime.

Studies indicate that African-American women have even higher rates than Caucasian women and are less likely to get adequate help. Studies indicate that many African-Americans don't report the typical feelings of depression, and are more likely to experience weight gain as a predominant symptom. In addition, many African-Americans distrust the medical system for helping with emotional problems and turn instead to the family and church during times of distress.

“Traditional systems of support, as good as they might be, are not always up to the task of helping with true clinical depression,” said Hales. “And sometimes people regard depression as a personality characteristic that one just has to live with. But this isn't true and is a dangerous point of view.”

Untreated, depression has a significant mortality rate. Studies have shown that heart attack patients who are depressed are more likely to die than heart attack patients who don't exhibit depression. And of elderly people admitted to nursing homes, those who were depressed had higher death rates. Suicide, of course, also increases the mortality from this disorder.

The suicide danger

Suicide is a real danger for depressed individuals, and it is important that family members and close friends assess the risk. Some people are afraid that asking about suicidal intention puts ideas in people's heads. But for most people who are considering suicide, it can actually be a relief to unburden these terrible feelings. Individuals who have an actual plan to commit suicide, such as a set date, and a means of doing it such as using a weapon or a stash of pills, are most likely to be in immediate danger. In these cases, professional help must be sought without delay.

Effective treatments are available

“I always advise people to work with their doctor until they find what works best for them,” says Hales. “Some people, especially those with mild to moderate depression, may wish to talk through problems. A good counselor can help an individual develop a more positive self-image and learn how to better cope with stress and relationships.”

Experts like Hales also say that getting more exercise has been shown repeatedly to be helpful in alleviating symptoms of depression.

For some people, these steps aren't enough. Depression is associated with disturbances in levels of neurotransmitters in the brain, and a variety of drugs take specific action to target this problem. Medications may take a few weeks for improvement to start being felt.

The right medication

It's important that each individual finds the right medication. Some people need to test a few different ones before they find one that works well and has the fewest side effects. Some medications may not be combined with other medications or be used if certain conditions are present. It's also important not to mix prescription antidepressant medications with herbal antidepressant remedies, such as St. John's wort.

Antidepressant medications are usually taken for at least six months for a first episode of depression. For people who have an ongoing problem, taking the medications indefinitely is indicated. Antidepressants should only be discontinued with the advice of a doctor and should not be stopped abruptly. Some types need to have their dosage tapered off slowly in order to avoid a rebound reaction with even more intense depressive symptoms.