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【憂鬱症】
1. 面對憂鬱要處之泰然，因為悲傷是必經的常態
2. 找些事情做，轉移注意力，例如散步、下棋、騎腳踏車、閱讀等
3. 從記憶中尋找快樂
4. 找朋友頃訴，加以發洩
5. 大哭一場，盡情的流淚
6. 冷靜的分析情況
7. 凡事只求盡力，結果的呈現並非自己可以決定
8. 運動有助於克服憂鬱症，如果平日就有運\動的習慣，不妨試著耗盡全
身力氣
9. 塗鴨，以寫字或畫畫來抒發感受
10. 直接的問清楚懷疑的事情
11. 找些很乏味的事情做以分散注意力
12. 放骭自己，慢下腳步
13. 憂鬱時避免做重大決定，以免決策錯誤使憂鬱更嚴重
14. 即使情緒低落，還是要尊重他人，不可遷怒他人
15. 遠離百貨公司，避免不理性的購物
16. 關緊冰箱，避免以吃東西扺抗憂鬱的衝動
17. 營養能控制情緒，維他命 B 群可以幫助扺抗憂鬱
[加入收藏夾] [列印此頁] [關閉視窗] the article above is from:
http://www.yowa.com.tw/shenghou(mingjian%2014).asp 2004年12月17日
走出憂鬱的泥沼
朋友的父親因為年近退休,對生命感到惶惑不安,而有嚴重的憂鬱症傾向
體重降到四十多公斤
朋友極為擔心
因有感於他父親對自我要求太高
才會想不開
因此鼓勵她父親讀"寬恕十二招"這本小書
沒想到這本書
帶領他父親走出憂鬱的泥沼
體重增加了
心情開朗了
能跟太太一齊出遊玩樂
我最近又重讀寬恕十二招
感覺其中句句是璣珠
茲抄錄一段分享
我若想要得到你的愛，就必須放你自由。
即使得不到，我也必須心甘情願地釋放你。
我必須願意往心內尋找愛，而不是向外找。
這說起來容易，但實際去做時卻很困難，
因為我必須走入內心的黑洞，去尋找隱藏在那裡的光明，
我必須穿越所有陳舊創傷的陰森洞穴，
去尋找在身內隱隱燃燒的「自我肯定」這一微光。 測測你的憂郁指數
美國新一代心理治療專家、賓夕法尼亞大學的David D·Burns博士曾設計出一套憂郁症的自我診斷表“伯恩斯憂郁症清單（BDC）”，這個自我診斷表可幫助你快速診\斷出你是否存在著抑郁症，且省去你不少用於診斷的費用。\r
請在符合你情緒的項上打分：
沒有 0
輕度 1
中度 2
嚴重 3
1、悲傷：你是否一直感到傷心或悲哀？
2、泄氣：你是否感到前景渺茫？
3、缺乏自尊：你是否覺得自己沒有價值或自以為是一個失敗者？
4、自卑：你是否覺得力不從心或自嘆比不上別人？
5、內疚：你是否對任何事都自責？
6、猶豫：你是否在做決定時猶豫不決？
7、焦躁不安：這段時間你是否一直處於憤怒和不滿狀態？
8、對生活喪失興趣：你對事業、家庭、愛好或朋友是否喪失了興趣？
9、喪失動機：你是否感到一蹶不振做事情毫無動力？
10、自我印象可憐：你是否以為自己已衰老或失去魅力？
11、食欲變化：你是否感到食欲不振？或情不自禁的暴飲暴食？
12、睡眠變化：你是否患有失眠症？或整天感到體力不支，昏昏欲睡？
13、喪失性欲：你是否喪失了對性的興趣？
14、臆想症：你是否經常擔心自己的健康？
15、自殺沖動：你是否認為生存沒有價值，或生不如死？
總分：????
測試完之后，請算出您的總分並評出你的憂郁程度。
抑郁自測答案：
0—4分沒有憂郁症
5—10分偶爾有憂郁情緒
11—20分有輕度憂郁症
21—30分有中度憂郁症
31—45分有嚴重憂郁症並需要立即治療
假如你通過BDC憂郁症清單測試表測出你患有中度或嚴重的憂郁症，我們建議你趕緊去接受專業幫助，因為當你需要援助而沒有及時地尋求援助時，你可能被你的問題擊毀。
生活時報
（責任編輯：虞兮）
性格和壓力測試
“網絡奴隸”一測便知
看看你的偏執度
測測您的飲食是否合理
你今天情緒低落嗎？
社交焦慮障礙自測 November 9, 2005
認 識 憂 鬱 症
認 識 憂 鬱 症
)
二十一世紀的三大疾病之一
有人說現代是憂鬱症的時代，根據世界衛生組織的研究中發現，平均每一百人中就有三人罹患憂鬱症，其盛行率不可不謂不高，所以憂鬱症已經繼癌症和愛滋病後成為本世紀的三大疾病之一。
憂鬱症值得注意的除了患者本身精神上的極度痛苦，例如感到悲哀、孤獨、虛無、強烈的無助等情緒外，患者身體上也常常經歷到疲憊、睡不著、起不來、吃不下等症狀，此時若無積極治療介入，患者往往會感到絕望、想死，甚至付諸實際的自殺行動，這也就是為什麼憂鬱症患者的自殺率可以達到一般人的八倍之多。
為什麼會得憂鬱症？
引起憂鬱症的原因複雜而多變，但基本上可以視為是由三大因素共同作用的結果：
1、 生物因素：大腦中的神經化學物質失去平衡。主要是血清素和正腎上腺素兩種。
2、 心理因素：人格特質以完美主義和依賴性的人格特質較易罹患憂鬱症­有負面悲觀的思考習慣。
3、 社會因素：創傷經驗，如921大地震、911世貿中心撞機事件….等；負面的生活事件，例如失業、負債、失去親人、身體重大疾病….等­挫折的人際關係，例如婆媳不合、夫妻衝突、情侶分手、被朋友背叛出賣等各種環境中所發生足以影響個人的重大事件。
如何發現憂鬱症？
每個人因為外在的環境事件或內在的主觀經驗，都會有情勢鬱悶低落的時候，大多數的人的這類負面情緒在數日之內多會有所改善，如果鬱悶低落的情緒持續兩週以上未獲改善，或是對於日常生活中原有的各種活動嗜好或交朋友都失去了興趣，並且出現下列憂鬱症的徵兆四項以上，就該尋求精神科醫師診斷評估：
1、 暴飲暴食或沒有食慾，使得一個月內體重改變5%以上。
2、 每天都嗜睡或失眠。
3、 行為變的譟動不安或呆滯遲緩。
4、 每天都覺得疲倦、虛弱無力、沒有精神。
5、 過多的罪惡感，覺得自己是無用、沒有價值的人。
6、 注意力不集中、記憶力減退、判斷力變差、無法下決定。
7、 自殺念頭。
憂鬱症如何治療？
以藥物治療憂鬱症改善憂鬱症狀，再配合心理治療以修正個人人格特質及認知上的不利因素，是治療及預防憂鬱症的最佳方法。
藥物治療需要多久時間
一般來說服用抗鬱劑需2至4週才看得到療效，三個月內可達到令人滿意的療效。逐漸沒有身體心理的症狀，也開始能感受到快樂的情緒；症狀改善後，仍需繼續服藥4至6個月以預防再發，並與精神科醫師討論開始減藥的速度和方法，然後採漸進式減藥方法，不可突然停藥。
因為每個人對藥物的反應不一致，因此治療的前六週最好每一至二週就要回診一次，讓醫師針對藥物反應及療效做適當的調整，才能獲得最好的療效。一般而言，發病後愈快接受治療，復原的速度愈快，治癒率愈高。
1.如何進行心理治療？
憂鬱症的心理治療一般多採認知心理治療的方式進行，患者可以透過精神科醫師或學校輔導老師的轉介，由臨床心理師進行治療。一般來說，認知心理治療對於憂鬱症的治療和降低疾病的復發率有不錯的效果。
2.家人與朋友的支持對憂鬱症的復原非常重要！
在憂鬱症的治療過程中，除了藥物和心理治療之外，患者家人和朋友的支持也是非常重要的。因為患者在進行藥物和心理治療的同時，也需要一個具有支持性和包容性的環境，能夠接受患者在其中慢慢改變，並得到鼓勵。否則，患者的改變，很有可能在家人或朋友不經意的對待下被潑了冷水，不進反退。
結語
有一則故事是這樣說的。兩個鞋廠的推銷員到非洲做商業考察，其中一位回國後報告︰『不必去設場，因為非洲人都不穿鞋，所以不會有生意』。另一位回國後則是報告︰『趕快去設廠，因為非洲人都不穿鞋，先去先有商機』，一樣的經歷一樣的情境，卻是兩種截然不同的想法與思考模式。
年輕的你，是屬於那一種呢？
作者：蔣世光 (玉里榮民醫院 臨床心理師)
※ 本文摘自慈濟大學學輔刊物──繪心系列第五期
(http://www.guidance.tcu.edu.tw/page/pub/pub.htm) 为什么会得忧郁症？
(8/2/2001)
令人感到压力的生活事件及失落感可能诱发忧郁症。
为什么有些人会得忧郁症，有些人却不会？这的问题的答案也许不止一个，可能导致你患上忧郁症的原因包括：
⒈遗传基因：忧郁症跟家族病史有密切的关系。研究显示，在同卵双胞胎中，如果1人得病，另1人罹病机率只有50%。父母其中1人得忧郁症，子女得病机率为25%；若双亲都是忧郁症病人，子女罹病率提高至50～75%。研究发现有家族遗传忧郁症病史的患者，其第11对染色体发生异常。
⒉环境诱因：令人感到有压力的生活事件及失落感（loss）也可能诱发忧郁症，如丧偶（尤其老年丧偶，几乎八、九成的人会得病）、离婚、丢掉工作、财务危机、失去健康等。
⒊药物：对一些人而言，长期使用某些药物（如一些高血压药、治疗关节炎或帕金森症的药）会造成忧郁症状。
⒋疾病：罹患慢性疾病如心脏病、中风、糖尿病、癌症与阿兹海默症的病人，得忧郁症的机率较高。甲状腺机能亢进，即使是轻微的情况，也会患上忧郁症。
忧郁症也可能是严重疾病的前兆，如胰脏癌、脑瘤、帕金森症、阿兹海默症等。
若干研究显示，忧郁症与心脏病有关连，多达一半的心脏病患者会得忧郁症，患忧郁症的男性得心脏病的机率比一般人高3倍。
⒌个性：一些个性上的特质，如自卑、过于依赖别人、自责、悲观、容易被压力击垮等，都会使你较易患上忧郁症。
⒍抽烟、酗酒与滥用药物：过去，研究人员认为忧郁症患者借助酒精、尼古丁与药物来抒解忧郁症的低潮。但新的研究结果显示，使用这些东西实际上会引发忧郁症及焦虑症。约有30%的严重忧郁症患者酗酒与滥用药物。此外，忧郁症患者对尼古丁上瘾的机率比正常人高2倍。
⒎饮食：缺乏叶酸（folate）与维他命B-12可能引起忧郁症状。
忧郁症是多种因素引起的疾病，要预防得病，应减少不必要的压力，以乐观的态度面对生活，同时了解忧郁症的症状，及早治疗，以避免疾病恶化。
忧郁症是多种因素引起的疾病，要预防得病，应减少不必要的压力，以乐观的态度面对生活。
另一方面，挪威一项研究发现，运动有助于对抗及预防忧郁症。一些忧郁症患者在每周慢跑3天后，忧郁症的症状比没有运动的患者减轻许多。而美国加州一项长达20年的研究也发现，有运动习惯的人比较不会患上忧郁症。
不过，运动不见得对所有患者有效，医生建议病人最好又运动又吃药。
有些食物可以让你挥别忧郁的心情，如：鲑鱼、鲔鱼等富含Omega-3的深海鱼、全麦面包等。患上忧郁症也不须感到绝望，只要接受适当的治疗，有八成以上的病人可以完全复原，重获新生。
你所爱的人得忧郁症时
忧郁症没有特效药，家属“绝对急不得”，对忧郁症了解愈多，就愈能有心理准备，帮助患病家人摆脱忧郁症。有些家属因照顾忧郁症病人而心力交瘁，自己最后也有忧郁倾向，辅导员建议家属轮流照顾病人或聘请看护。在适当的时候，不妨找人诉苦，或与其他病人的家属相互沟通扶持。
英国生命线出版的《走出忧郁，生命依然灿烂》一书，提到一些不错的建议：
⒈不要试图叫忧郁症患者振作。要他们振作一点意义都没有，因为他们做不到，他们的状况身不由己。
⒉不要告诉他们：这一切都只是他们想像出来的。对他们来说，这个痛苦经验是真实存在的。
⒊不要一味批评：忧郁症患者非常敏感，一点点小批评也可能让他们陷入绝望的深渊。
⒋不要暗示他们必需为自己的心理状况负责。他们会因此有罪恶感，认为他们影响到周遭的人。
⒌不要试图强迫他们做任何事，只要不断给予鼓励与关怀。
⒍不要干扰患者的治疗方式。负面的字句像“不要吃那些药，它们对你一点好处都没有”、“你为什么要去看那个烂医生？”只会伤害患者的自信，增加他们心中的困惑。
照料者应该：
⒈鼓励患者去看医生。
⒉试着表达愿意帮助与接纳的意愿。
⒊每天提醒患者忧郁症不过是个短暂的现象，大多数人在一段时间后都会痊愈。
⒋鼓励患者从事某种运动。
⒌千万不要轻言放弃。不断提醒自己，你的努力绝不会白费。
《新明日报》
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<<< 回保健网 香港：30万人患有抑郁症 医生呼吁及早求医
类型：认识抑郁 作者：转载
人民网香港11月7日电香港两名据说都患有抑郁症的少女，相约到大屿山租住度假屋共进“最后晚餐”，至昨晨被发现双双“烧炭”（俗称煤气中毒）身亡。据统计，全港约30万人患有抑郁症。
对于两名患抑郁症女子同时烧炭死亡，中文大学精神科学系教授李诚医生指出，抑郁症（Depression）可分重、中及轻三类病情，当中七至八成患者有自杀意念、三成会有自杀行动，至于重性抑郁症患者的自杀率则高达一成半，这类患者可能因病情反覆经常病发，可能多次自杀最后死亡。根据一项调查发现，全港约有30万名抑郁症患者，但当中只有三成人愿意求医。
李医生又称，根据研究发现，八成自杀死亡人士，在自杀前四至六周内均曾出现情绪问题，所以若能及早发现病情，对治疗患者十分重要。他称，患者亲人、朋友应多多关注留意他们，及早就医；欢迎有需要人士致电“香港健康情绪中心”求助。（陈晓钟）来源：人民网
注：林紫心理咨询中心义工热线62442318 63591025 随时接受你的求助。
日期：2004-11-08
把文章推荐给朋友＞＞： 美国新一代心理治疗专家、宾夕法尼亚大学的David D·Burns博士曾设计出一套忧郁症的自我诊断表“伯恩斯忧郁症清单（BDC）”，这个自我诊断表可帮助你快速诊断出你是否存在着抑郁症，且省去你不少用于诊断的费用。
请在符合你情绪的项上打分：
没有 0
轻度 1
中度 2
严重 3
1、悲伤：你是否一直感到伤心或悲哀？
2、泄气：你是否感到前景渺茫？
3、缺乏自尊：你是否觉得自己没有价值或自以为是一个失败者？
4、自卑：你是否觉得力不从心或自叹比不上别人？
5、内疚：你是否对任何事都自责？
6、犹豫：你是否在做决定时犹豫不决？
7、焦躁不安：这段时间你是否一直处于愤怒和不满状态？
8、对生活丧失兴趣：你对事业、家庭、爱好或朋友是否丧失了兴趣？
9、丧失动机：你是否感到一蹶不振做事情毫无动力？
10、自我印象可怜：你是否以为自己已衰老或失去魅力？
11、食欲变化：你是否感到食欲不振？或情不自禁的暴饮暴食？
12、睡眠变化：你是否患有失眠症？或整天感到体力不支，昏昏欲睡？
13、丧失性欲：你是否丧失了对性的兴趣？
14、臆想症：你是否经常担心自己的健康？
15、自杀冲动：你是否认为生存没有价值，或生不如死？
总分：＿＿＿＿
测试完之后，请算出您的总分并评出你的忧郁程度。
抑郁自测答案：
0—4分没有忧郁症
5—10分偶尔有忧郁情绪
11—20分有轻度忧郁症
21—30分有中度忧郁症
31—45分有严重忧郁症并需要立即治疗
假如你通过BDC忧郁症清单测试表测出你患有中度或严重的忧郁症，我们建议你赶紧去接受专业帮助，因为当你需要援助而没有及时地寻求援助时，你可能被你的问题击毁。
http://www.isitreallydepression.com/mini_c/isitreallydepression/righttreatment.asp
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Antidepressants in bipolar disorder
Treatments for bipolar disorder
The professionals who treat bipolar disorder
Antidepressants in bipolar disorder
For people who are correctly diagnosed with depression (major depressive disorder), antidepressant medications are often highly effective. But in individuals who have bipolar disorder, antidepressants can sometimes do more harm than good when they are not used appropriately.* That’s one reason why getting a correct diagnosis is so important.
A few facts:
Antidepressants may trigger manic episodes in people with bipolar disorder
Antidepressants may not work well (or at all) in bipolar individuals. Poor response to antidepressants could be a sign that the diagnosis of major depressive disorder is incorrect
Important: For people with major depressive disorder, antidepressants must be taken regularly for three to four weeks (sometimes longer) before the full response is seen. It is important to give the medication a chance to work.
These items stress the importance of open communication with your doctor; be sure to discuss concerns you may have about your treatment plan during your next visit.
*Note that in some people with diagnosed bipolar disorder, antidepressants are sometimes used in combination with bipolar medications.
Treatments for bipolar disorder
Treatment for bipolar disorder often involves a two-part plan of both medication and psychotherapy.
Medications. There are different types of medications used to treat bipolar disorder, including medicines for controlling manic symptoms, depressive symptoms, or medications that help stabilize the patient's mood
Psychotherapy. Several types of “talk therapy” are used in bipolar disorder treatment. Cognitive behavioral therapy focuses on changing inappropriate or negative thought patterns that can affect the illness. Psychoeducation aims to help the patient and family understand the illness and recognize signs of relapse. Interpersonal and social rhythm therapy, focuses on daily routines that can promote emotional stability. The type of therapy used depends on the individual’s needs
The professionals who treat bipolar disorder
Bipolar disorder patients work with a team of health care professionals that supervise the patients' care. For medication management, patients usually work with their psychiatrist. For psychotherapy, patients typically work with a licensed therapist or social worker and their psychiatrist. The health care team maintains close contact with each other to help ensure the patients' continued progress.
Not sure where to find help? Start with your primary care provider. He or she can discuss symptoms, give you guidance and recommend psychiatrists and/or therapists in your area.
Important: Even if you think you may not be diagnosed correctly it is extremely important to follow your current medication plan as prescribed by your doctor. If you have concerns about your medicine—or if you feel you are doing better—don’t stop treatment on your own. Instead, communicate openly with your doctor and discuss your diagnosis and possible adjustments to your treatment plan. Translated by Kathy: thanks a lot!!!
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躁郁症
抗抑郁药物在躁郁症中的作用 对于被正确诊断为抑郁症的人来说，抗抑郁药物能起到非常好的作用。但是对于躁郁症患者，抗抑郁药物如果使用不当，它对病人带来的危害要比益处大。这也就是为什么正确的诊断尤为重要。 以下是一些事实： 抗抑郁药物会引起躁郁症患者的躁狂相 抗抑郁药物也许或根本在躁郁患者上不起作用。对所服抗抑郁药物的反应不佳也许是对抑郁症诊断不正确的一个标志。重要的是：对于抑郁症患者，抗抑郁药物必须定期服用3-4周左右，有时会更长，才会看到药效。必须给药物时间让其发挥作用。 以上这些说明了患者和医生之间沟通的重要性；记得在下次看医生之前想好应向医生咨询哪些关于治疗方案方面的问题。 注意：被诊断为躁郁症的人来说，抗抑郁药有时要连同抗躁郁药一起服用。 对躁郁症的治疗 对躁郁症的治疗经常要包括药物和心理两方面的治疗。 药物治疗：有多种的药物治疗用来医治躁郁症，包括控制躁狂症状，抑郁症|状，或帮助患者稳定情绪。 心理治疗：有多种的“谈话疗法”被应用于躁郁症的治疗。认知行为疗法注重改变会对疾病产生影响的不当的或是负面的思维模式。心理学方法教育在于帮助患者和家属了解疾病以及更好的认识疾病的复发。人际关系与社会节律疗法侧重于患者每日的日常活动，从而增进他们的情感稳定性。这种治疗取决于个人的需求。 治疗躁郁症的专业人士躁郁症患者要在专业人士的指导下进行治疗。对于药物方面，患者应配合精神科医师，在心理治疗方面，患者通常应在有行医执照的心理治疗师或精神科医生的指导下进行治疗。健康指导工作小组应和患者保持紧密的联系并注意患者病情的进展。 不知道去哪里寻找帮助吗？从你身边最初级的健康保健人士那里可以获得一些相关信息。他们会告诉你一些病情的基本特征，给你一些最初级的指导，并会向你推荐一些精神科医生或心理治疗师。 重要的是：即使你认为自己被诊断得并不正确，也一定要遵循医生给你制定的治疗方案。如果你对你所服用的药物有所担心-或是觉得你在渐渐好转—不要停止对自己的治疗。反之，要及时和你的医生沟通，并做出相应的调整。 Dear All who know English:
Please translate the fllowing article into Chinese, i will publish ALL of the translations, people will learn English as well as the knowledge, thanks!!!!!!!!!!!!!!!!!!!!!!!!!!!
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Depression Introduction
What is a Depressive Disorder?
Types of Depression
Symptoms of Depression and Mania
Causes of Depression
Diagnostic Evaluation and Treatment
Psychotherapies
How to Help Yourself If You Are Depressed
Where to Get Help
Further Information
References
In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness5 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 people 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.
Unfortunately, many people do not recognize that depression is a treatable illness. If you feel that you or someone you care about is one of the many undiagnosed depressed people in this country, the information presented here may help you take the steps that may save your own or someone else's life.
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WHAT IS A DEPRESSIVE DISORDER?
A depressive disorder is an illness that involves the body, mood, and thoughts. It 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. People 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. This pamphlet briefly describes three of the most common types of depressive disorders. 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 of depression, dysthymia, involves long-term, chronic 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, also called manic-depressive illness. 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, overtalkative, 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 may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. 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
Persistent sad, anxious, or "empty" mood
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
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Mania
Abnormal or excessive elation
Unusual irritability
Decreased need for sleep
Grandiose notions
Increased talking
Racing thoughts
Increased sexual desire
Markedly increased energy
Poor judgment
Inappropriate social behavior
CAUSES OF DEPRESSION
Some types of depression run in families, suggesting that a biological vulnerability 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 ill. However, the reverse is not true: Not everybody with the genetic makeup that causes 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 are precipitated by only mild stresses, or none at all.
Depression in Women
Women experience depression about twice as often as men.1 Many hormonal factors may contribute to the increased rate of depression in women—particularly such factors as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.
A recent NIMH study showed that in the case of severe premenstrual syndrome (PMS), women with a preexisting vulnerability to PMS experienced relief from mood and physical symptoms when their sex hormones were suppressed. Shortly after the hormones were re-introduced, they again developed symptoms of PMS. Women without a history of PMS reported no effects of the hormonal manipulation.6,7
Many women are also particularly vulnerable after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. While transient "blues" are common in new mothers, a full-blown depressive episode is not a normal occurrence and requires active intervention. Treatment by a sympathetic physician and the family's emotional support for the new mother are prime considerations in aiding her to recover her physical and mental well-being and her ability to care for and enjoy the infant.
Depression in Men
Although men are less likely to suffer from depression than women, 3 to 4 million men in the United States are affected by the illness. Men are less likely to admit to depression, and doctors are less likely to suspect it. The rate of suicide in men is four times that of women, though more women attempt it. In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85.
Depression can also affect the physical health in men differently from women. A new study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.2
Men's depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment.
Depression in the Elderly
Some people have the mistaken idea that it is normal for the elderly to feel depressed. On the contrary, most older people feel satisfied with their lives. Sometimes, though, when depression develops, it may be dismissed as a normal part of aging. Depression in the elderly, undiagnosed and untreated, causes needless suffering for the family and for the individual who could otherwise live a fruitful life. When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss.
Recognizing how depressive symptoms in older people are often missed, many health care professionals are learning to identify and treat the underlying depression. They recognize that some symptoms may be side effects of medication the older person is taking for a physical problem, or they may be caused by a co-occurring illness. If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Recent research suggests that brief psychotherapy (talk therapies that help a person in day-to-day relationships or in learning to counter the distorted negative thinking that commonly accompanies depression) is effective in reducing symptoms in short-term depression in older persons who are medically ill. Psychotherapy is also useful in older patients who cannot or will not take medication. Efficacy studies show that late-life depression can be treated with psychotherapy.4
Improved recognition and treatment of depression in late life will make those years more enjoyable and fulfilling for the depressed elderly person, the family, and caretakers.
Depression in Children
Only in the past two decades has depression in children been taken very seriously. The depressed child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood. Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child is just going through a temporary "phase" or is suffering from depression. Sometimes the parents become worried about how the child's behavior has changed, or a teacher mentions that "your child doesn't seem to be himself." In such a case, if a visit to the child's pediatrician rules out physical symptoms, the doctor will probably suggest that the child be evaluated, preferably by a psychiatrist who specializes in the treatment of children. If treatment is needed, the doctor may suggest that another therapist, usually a social worker or a psychologist, provide therapy while the psychiatrist will oversee medication if it is needed. Parents should not be afraid to ask questions: What are the therapist's qualifications? What kind of therapy will the child have? Will the family as a whole participate in therapy? Will my child's therapy include an antidepressant? If so, what might the side effects be?
The National Institute of Mental Health (NIMH) has identified the use of medications for depression in children as an important area for research. The NIMH-supported Research Units on Pediatric Psychopharmacology (RUPPs) form a network of seven research sites where clinical studies on the effects of medications for mental disorders can be conducted in children and adolescents. Among the medications being studied are antidepressants, some of which have been found to be effective in treating children with depression, if properly monitored by the child's physician.8
DIAGNOSTIC EVALUATION AND TREATMENT
The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.
A good diagnostic 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 the 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 had a depressive illness and, if treated, what treatments they may have received and which were effective.
Last, 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 antidepressant medications and psychotherapies 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. 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.
Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication.3 ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms. In recent years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.
Medications
There are several types of antidepressant medications used to treat depressive disorders. These include newer medications—chiefly the selective serotonin reuptake inhibitors (SSRIs)—the tricyclics, and the monoamine oxidase inhibitors (MAOIs). The SSRIs—and other newer medications that affect neurotransmitters such as dopamine or norepinephrine—generally have fewer side effects than tricyclics. Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks) before the full therapeutic effect occurs.
Patients often are tempted to stop medication too soon. They may feel better and think they no longer need the medication. Or they may think the medication isn't helping at all. It is important to keep taking medication until it has a chance to work, though side effects (see section on Side Effects on page 13) may appear before antidepressant activity does. Once the individual is feeling better, it is important to continue the medication for at least 4 to 9 months to prevent a recurrence of the depression. Some medications must be stopped gradually to give the body time to adjust. Never stop taking an antidepressant without consulting the doctor for instructions on how to safely discontinue the medication. For individuals with bipolar disorder or chronic major depression, medication may have to be maintained indefinitely.
Antidepressant drugs are not habit-forming. However, as is the case with any type of medication prescribed for more than a few days, antidepressants have to be carefully monitored to see if the correct dosage is being given. The doctor will check the dosage and its effectiveness regularly.
For the small number of people for whom MAO inhibitors are the best treatment, it is necessary to avoid certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles, as well as medications such as decongestants. The interaction of tyramine with MAOIs can bring on a hypertensive crisis, a sharp increase in blood pressure that can lead to a stroke. The doctor should furnish a complete list of prohibited foods that the patient should carry at all times. Other forms of antidepressants require no food restrictions.
Medications of any kind—prescribed, over-the counter, or borrowed—should never be mixed without consulting the doctor. Other health professionals who may prescribe a drug—such as a dentist or other medical specialist—should be told of the medications the patient is taking. Some drugs, although safe when taken alone can, if taken with others, cause severe and dangerous side effects. Some drugs, like alcohol or street drugs, may reduce the effectiveness of antidepressants and should be avoided. This includes wine, beer, and hard liquor. Some people who have not had a problem with alcohol use may be permitted by their doctor to use a modest amount of alcohol while taking one of the newer antidepressants.
Antianxiety drugs or sedatives are not antidepressants. They are sometimes prescribed along with antidepressants; however, they are not effective when taken alone for a depressive disorder. Stimulants, such as amphetamines, are not effective antidepressants, but they are used occasionally under close supervision in medically ill depressed patients.
Questions about any antidepressant prescribed, or problems that may be related to the medication, should be discussed with the doctor.
Lithium has for many years been the treatment of choice for bipolar disorder, as it can be effective in smoothing out the mood swings common to this disorder. Its use must be carefully monitored, as the range between an effective dose and a toxic one is small. If a person has preexisting thyroid, kidney, or heart disorders or epilepsy, lithium may not be recommended. Fortunately, other medications have been found to be of benefit in controlling mood swings. Among these are two mood-stabilizing anticonvulsants, carbamazepine (Tegretol&reg;) and valproate (Depakote&reg;). Both of these medications have gained wide acceptance in clinical practice, and valproate has been approved by the Food and Drug Administration for first-line treatment of acute mania. Other anticonvulsants that are being used now include lamotrigine (Lamictal&reg;) and gabapentin (Neurontin&reg;): their role in the treatment hierarchy of bipolar disorder remains under study.
Most people who have bipolar disorder take more than one medication including, along with lithium and/or an anticonvulsant, a medication for accompanying agitation, anxiety, depression, or insomnia. Finding the best possible combination of these medications is of utmost importance to the patient and requires close monitoring by the physician.
Side Effects
Antidepressants may cause mild and, usually, temporary side effects (sometimes referred to as adverse effects) in some people. Typically these are annoying, but not serious. However, any unusual reactions or side effects or those that interfere with functioning should be reported to the doctor immediately. The most common side effects of tricyclic antidepressants, and ways to deal with them, are:
Dry mouth—it is helpful to drink sips of water; chew sugarless gum; clean teeth daily.
Constipation—bran cereals, prunes, fruit, and vegetables should be in the diet.
Bladder problems—emptying the bladder may be troublesome, and the urine stream may not be as strong as usual; the doctor should be notified if there is marked difficulty or pain.
Sexual problems—sexual functioning may change; if worrisome, it should be discussed with the doctor.
Blurred vision—this will pass soon and will not usually necessitate new glasses.
Dizziness—rising from the bed or chair slowly is helpful.
Drowsiness as a daytime problem—this usually passes soon. A person feeling drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.
The newer antidepressants have different types of side effects:
Headache—this will usually go away.
Nausea—this is also temporary, but even when it occurs, it is transient after each dose.
Nervousness and insomnia (trouble falling asleep or waking often during the night)—these may occur during the first few weeks; dosage reductions or time will usually resolve them.
Agitation (feeling jittery)—if this happens for the first time after the drug is taken and is more than transient, the doctor should be notified.
Sexual problems—the doctor should be consulted if the problem is persistent or worrisome.
Herbal Therapy
In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety. St. John's wort (Hypericum perforatum), an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest in the United States. St. John's wort, an attractive bushy, low-growing plant covered with yellow flowers in summer, has been used for centuries in many folk and herbal remedies. Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.
Because of the widespread interest in St. John's wort, the National Institutes of Health (NIH) conducted a 3-year study, sponsored by three NIH components—the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, and the Office of Dietary Supplements. The study was designed to include 336 patients with major depression of moderate severity, randomly assigned to an 8-week trial with one-third of patients receiving a uniform dose of St. John's wort, another third sertraline, a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, and the final third a placebo (a pill that looks exactly like the SSRI and the St. John's wort, but has no active ingredients). The study participants who responded positively were followed for an additional 18 weeks. At the end of the first phase of the study, participants were measured on two scales, one for depression and one for overall functioning. There was no significant difference in rate of response for depression, but the scale for overall functioning was better for the antidepressant than for either St. John's wort or placebo. While this study did not support the use of St. John's wort in the treatment of major depression, ongoing NIH-supported research is examining a possible role for St. John's wort in the treatment of milder forms of depression.
The Food and Drug Administration issued a Public Health Advisory on February 10, 2000. It stated that St. John's wort appears to affect an important metabolic pathway that is used by many drugs prescribed to treat conditions such as AIDS, heart disease, depression, seizures, certain cancers, and rejection of transplants. Therefore, health care providers should alert their patients about these potential drug interactions.
Some other herbal supplements frequently used that have not been evaluated in large-scale clinical trials are ephedra, gingko biloba, echinacea, and ginseng. Any herbal supplement should be taken only after consultation with the doctor or other health care provider.
PSYCHOTHERAPIES
Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals. "Talking" therapies help patients gain insight into and resolve their problems through verbal exchange with the therapist, sometimes combined with "homework" assignments between sessions. "Behavioral" therapists help patients learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression.
Two of the short-term psychotherapies that research has shown helpful for some forms of depression are interpersonal and cognitive/behavioral therapies. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving often associated with depression.
Psychodynamic therapies, which are sometimes used to treat depressed persons, focus on resolving the patient's conflicted feelings. These therapies are often reserved until the depressive symptoms are significantly improved. In general, severe depressive illnesses, particularly those that are recurrent, will require medication (or ECT under special conditions) along with, or preceding, psychotherapy for the best outcome.
HOW TO HELP YOURSELF IF YOU ARE DEPRESSED
Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:
Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
Break large tasks into small ones, set some priorities, and do what you can as you can.
Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
Participate in activities that may make you feel better.
Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help.
Expect your mood to improve gradually, not immediately. Feeling better takes time.
It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation.
People rarely "snap out of" a depression. But they can feel a little better day-by-day.
Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment.
Let your family and friends help you.
How Family and Friends Can Help the Depressed Person
The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication. The depressed person should be encouraged to obey the doctor's orders about the use of alcoholic products while on medication. The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Report them to the depressed person's therapist. Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.
Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it." Eventually, with treatment, most people do get better. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better.
WHERE TO GET HELP
If unsure where to go for help, check the Yellow Pages under "mental health," "health," "social services," "suicide prevention," "crisis intervention services," "hotlines," "hospitals," or "physicians" for phone numbers and addresses. In times of crisis, the emergency room doctor at a hospital may be able to provide temporary help for an emotional problem, and will be able to tell you where and how to get further help.
Listed below are the types of people and places that will make a referral to, or provide, diagnostic and treatment services.
Family doctors
Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors
Health maintenance organizations
Community mental health centers
Hospital psychiatry departments and outpatient clinics
University- or medical school-affiliated programs
State hospital outpatient clinics
Family service, social agencies, or clergy
Private clinics and facilities
Employee assistance programs
Local medical and/or psychiatric societies
For More Information
Depression Information and Organizations from NLM's MedlinePlus (en Espa&ntilde;ol)
REFERENCES
1 Blehar MD, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3:3-12.
2 Ferketick AK, Schwartzbaum JA, Frid DJ, Moeschberger ML. Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. Archives of Internal Medicine, 2000; 160(9): 1261-8.
3 Frank E, Karp JF, Rush AJ (1993). Efficacy of treatments for major depression. Psychopharmacology Bulletin, 1993; 29:457-75.
4 Lebowitz BD, Pearson JL, Schneider LS, Reynolds CF, Alexopoulos GS, Bruce MI, Conwell Y, Katz IR, Meyers BS, Morrison MF, Mossey J, Niederehe G, Parmelee P. Diagnosis and treatment of depression in late life: consensus statement update. Journal of the American Medical Association, 1997; 278:1186-90.
5 Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press.
6 Rubinow DR, Schmidt PJ, Roca CA. Estrogen-serotonin interactions: Implications for affective regulation. Biological Psychiatry, 1998; 44(9):839-50.
7 Schmidt PJ, Neiman LK, Danaceau MA, Adams LF, Rubinow DR. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. Journal of the American Medical Association, 1998; 338:209-16.
8 Vitiello B, Jensen P. Medication development and testing in children and adolescents. Archives of General Psychiatry, 1997; 54:871-6.
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This brochure is a new version of the 1994 edition of Plain Talk About Depression and was written by Margaret Strock, Public Information and Communications Branch, National Institute of Mental Health (NIMH). Expert assistance was provided by Raymond DePaulo, MD, Johns Hopkins School of Medicine; Ellen Frank, MD, University of Pittsburgh School of Medicine; Jerrold F. Rosenbaum, MD, Massachusetts General Hospital; Matthew V. Rudorfer, MD, and Clarissa K. Wittenberg, NIMH staff members. Lisa D. Alberts, NIMH staff member, provided editorial assistance.
This publication is in the public domain and may be used and reprinted without permission. Citation as to source is appreciated.
NIH Publication No. 00-3561
Printed 2000
Top Dear All translators:
Sorry for that LONG article! Don't push yourself hard, IT'S FUN! YOU ARE GETTING THE FEELING THAT YOU ARE USEFUL TO OTHERS! YOU ARE LEARNING!
ENJOY THE PROCESS! NOT THE RESULT ONLY!! who finished the first part? please send it to me: SongCharle@gmail.com, i will publish it RIGHT AWAY.
again, i promise: every translation, no matter what, finished or not, good or not.....IT DOESN'T MATTHER.
The matther thing is: you are useful! you are helping others! you are helping yourself by doing that!
looking forward to hearing from you now!!! 关 于 忧 郁 症
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关于忧郁症，现在有种倾向是把它看成是一种身体上的疾病，就是身体缺少某些东西，然后就会忧郁了，然后吃点药，比如百忧解等，就可以解决问题了，把心理问题简单化，比较符合现代人求快求简单的愿望，但是是否真的吃药之后就可以了呢？那么是不是要一直吃呢？那些悲伤，空虚，没有兴趣，自杀倾向等情况，就仅仅是身体缺少某种物质吗？其实个人性格，心理上的原因是不容忽略的，怎么样去帮助咨客了解自己的内心问题，并尝试一些药物以外的方式是很重要的，药物毕竟只是控制了一下情绪的强度，问题的根源并没有解决的，当然药物帮助控制情绪之后，结合心理治疗会更加容易一些，也是很有帮助的。
面对以下的症状，首先要考虑的是：
1 原因是什么呢？一般都是有原因的，虽然有的人会强调自己是没有原因的，无缘无故的，但其实是自己不了解，这是需要心理咨询是帮助去了解的；
2 怎么解决这些问题呢？药物是一种方式，但是心理咨询和治疗恐怕是更加重要的，有很多的心理治疗的方法，大家可以去详细了解。
我的解决方案
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相关资料：
忧郁症，也被称为「心的感冒」，近年来，在高压力社会中，几乎已成为最流行的精神文明病，而世界卫生组织将其与癌症并列为下个世纪，最需要卫教预防，也最盛行的疾病之一。世界卫生组织等的研究表明，平均每一百人中就有三人患有忧郁症，其中因为忧郁症所带来的身体疾病，甚至自我毁灭的例子更是比比皆是。
忧郁症是一种涉及生理、心理、情绪和思想的疾病。不仅影响正常的生活，也会影响人与人之间的感情和对事情的看法。忧郁症不同于暂时性的心情沮丧，如没有有效治疗，症状会持续数周、数月，乃至数年之久，其症状包括：
(1) 感到悲伤和空虚。
(2) 对各种活动提不起劲或兴趣。
(3) 感觉没有价值或有罪恶感。
(4) 没有食欲，体重减轻。
(5) 失眠或嗜睡。
(6) 容易疲劳。
(7) 无法集中注意力。
(8) 有死亡或自杀的念头。
忧郁症病例并不一定同时符合上述的所有症状。
成因：
造成忧郁症的原因很多，如失去挚爱或遭受失败等；但是在很多病例中，大脑显像技术指出，忧郁症患者负责情绪、思考、睡眠、食欲和行为调节的中枢神经回路无法正常运作，而必要的神经传送素（沟通神经细胞的化学元素）亦失去平衡。一般认为血清素和正肾上腺素均扮演着导致忧郁症的关键角色。研究指出，这两种化学元素都会影响一个人的情绪。
容易感到忧郁的原因可能是基因引起的，与心理因素和外在环境（如，失去挚爱或生活状态的重大改变）相互影响，心脏病、中风或癌症等疾病也可能引发忧郁症的症状。
忧郁症并不专属任何特定人群，并有可能发生在任何人身上，不管是什么地区、国家或民族，都可能会有精神及行为失常的人。精神失常亦有可能出现在生命周期的任何时侯，不管男女，贫富，乡村或城市，都有可能发生。关于精神失常易出现在工业化国家或富有的人中的观点是错误的。同样有些说法关于，在现代化步伐落后的农村生活中不易产生精神失常也是不正确的。
世界上大约有四亿万人有过精神或神经失常的问题，而之中就有约一亿两千一百万人患有忧郁症的问题，这些失常类疾病被列为了世界十大残疾病的第五名，造成了个人、家庭和政府莫大的社会经济压力。到2020年时，如果目前人口统计数字和流行病发病趋势顺势发展，忧郁症的比例将会在总体疾病中增至5.7％，跃居成为造成DALYs（burden of disease in Disability-Adjusted Life Years，失能校正生命人年数）中的第二位，仅次于贫血症，在发达地区将会跃居首位。
诊断：
治疗忧郁症的第一步就是做全身健康检查。全身健康检查应包括查看个人和家族成员的病史，以及完整的身体和心理状况检查，以确定语言和思维模式有没有受到影响。
忧郁症是难以诊断出的疾病。患有忧郁症的人多半很少求助于医生，因为人们普遍认为忧郁症是一种个人缺点，而患者也认为随时间流逝，忧郁症的症状便会消失，或者他们无助得无法向他人求助。甚至当他们求助于医生时，也常常无法被诊断出患有忧郁症。因此，只有少数忧郁症患者能得到适当的治疗。忧郁症是真正的疾病，并不是个性软弱，也不会自己消逝。辨别忧郁症非常重要，同时也要鼓励患者寻求治疗。
负面影响：
忧郁症的不利影响，不仅发生在患者身上，也会波及患者的家属和朋友。严重的可能会让受害者无法过正常生活，对工作、学习、饮食和睡眠造成障碍，无法享受任何一种快乐的活动。的确，忧郁症会让人感觉提不起劲，根据记录有将近12％的患者有无力感。另一方面，忧郁症也会加重个人、家庭或整个社区的经济负担，部分经济负担是明显的，可以被计算出来，然而有些则无法估算。可被估算出来的经济负担包括健康和社会服务的需求、失业、生产力的降低、对家人及照护者的影响、不同程度的犯罪和公共安全隐患及轻生的负面影响。
忧郁症与其它疾病的关联：
除了一些生理疾病，如：中风、癌症等，会造成忧虑症外，也有一些心理疾病会并发忧郁症，如：一般性忧虑症（GAD）、创伤后压力症候群（PTSD），早期诊治患者有无其它病症，对于整体健康状况的恢复有很大的帮助。
治疗：
治疗目的是缓解忧郁症症状，有效治疗减缓症状持续六个月以上，并恢复到原有的正常生活功能。依据治疗成效病症会有不同程度的缓解，有的可能也只是部分症状上的减轻而已。
忧郁症患者会因为病情轻重而有相当大程度的差异和治疗效果的不同，根据不同患者的需求，采用抗忧郁剂药物治疗、精神疗法或综合治疗，都会有不同的效果。
抗忧郁剂
抗忧郁剂是可以凭处方签购买的舒缓忧郁症症状的药物。研究人员估计约有50％～60％的忧郁症患者可以透过药物治疗获得控制和缓解。
非药物疗法
精神/心理疗法或“谈话”治疗方法，包括认知/行为治疗、个人疗法、精神分析治疗和支持性心理治疗，都常被用来治疗忧郁症。电气痉挛治疗（ECT）和近来开发出来的另一种ECT替代方式的跨颅磁头刺激（TMS，一种脑外无创伤性的磁性刺激），都可以提供给严重患者作为有效的治疗方式。 准妈妈们，小心产后忧郁症！
2004-8-5 10:08:05
千禧龙年接近尾声，许多在年初怀孕、赶搭最后一班龙宝宝列车的准妈妈即将陆续分娩。万芳医院精神科邓惠文医师，提醒准妈妈和准爸爸注意产后忧郁症的发生，及早预防及治疗，为母亲及宝宝的身心健康把关。
邓医师表示，大约半数妇女在产后会经历心情低落、情绪起伏、疲倦、焦虑、失眠等症状，这就是最明显可以自我察觉的产后忧郁症，这些症状最常出现在产后第四、第五天左右，而且通常会在两周内恢复，一般不需特别治疗。
但少数产妇症状较严重，包括忧郁、无法感受快乐、食欲大幅减退、倦怠、即使宝宝不吵仍然失眠、悲观、自卑、无望无助感，甚至出现自杀或伤害宝宝的焦虑。
但是准爸爸准妈妈也不必太过紧张，因为并不是每一对父母都会经历，医师解释，曾经患过忧郁症、经前症候群严重的人（每次月经来前会出现严重情绪困扰）、和配偶相处不睦、婚姻有问题、怀孕期间或产后生活有压力事件者，才是高危险群。
而如果经过诊断，确定发生了产后忧郁症情况，医师也建议，可以采用心理治疗、团体治疗或药物治疗的方式，以免忧郁症慢性化或将来复发，如果严重到出现伤害自己或宝宝的念头，一定要紧急寻求精神科医师的协助。
另一方面，预防产后忧郁症恶化，邓惠文医师建议：
(一)找家人或朋友倾吐心情，寻求支持。
(二)处理好与配偶的关系，切忌只顾宝宝而忽略与伴侣沟通。
(三)每天至少半小时，请家人帮忙看顾小孩，做自己喜欢的事。
(四)给自己适应新宝宝的时间，不需要求自己马上做到「一百分妈妈」。
(五)如果想坐月子、请产假但公司借故刁难，可以寻求申诉。
(六)如果怀疑自己有忧郁症，不要害怕找精神科医师或心理专业人员协助。
医师强调，忧郁的原因有许多是来自于环境，并不代表自己不是好妈妈。
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