Stuff You Might Not Have Wondered About Depression Quiz

Answer: False

A sad mood is usually associated with depression, but irritability, anxiety, feeling guilty, and an empty "who cares?" feeling are also common.

Answer: Yes

Before recommending treatment, a good psychiatrist should assess the individual patient's history, symptoms, and the severity of illness. No treatment is effective for all cases of depression.

Answer: No

Depression impairs memory and thinking in predictable ways which can be seen in performance testing. Decreased activity in the nerve centers responsible for mood control corresponds to a visible drop in glucose consumption on PET scanning. Serum levels of stress-related hormones such as corticosteroids are elevated in some types of depression, and these can be measured and shown to respond abnormally. Why does your doctor not use these tests regularly? Several reasons: they're expensive and not covered by insurance; the difference distinct enough to count as "positive" is not clearly defined in some age groups; and (most importantly) the tests have not yet shown which treatment is likely to be most useful in a particular case.

As more is discovered through research, new applications of the tests can be developed.

Answer: Yes

Yes! Based on data reported before modern treatments were discovered, the average length of an episode of severe depression is 2-4 years. Many episodes recur, and tend to become more severe and last longer each time. About 80% resolve, but some cases never clear completely and leave chronic sleep and energy problems.

The decision whether to treat or not is not always a clear-cut one, but if the symptoms are severe enough to make the person's life miserable or to pose a risk of suicide, most specialists will strongly encourage treatment.

Answer: False

Unfortunately, the consequences of depression can be deadly. Especially in adolescents, the hopelessness of depression makes risky behavior like taking drugs, driving recklessly, or carrying weapons seem less unreasonable. Deliberate suicide is more common in depressed people of all ages, but most dramatically so in adolescents and the elderly. Depressed elderly people may also stop getting up, stop caring for themselves, withdraw and stop eating. All of these people can end up just as dead as if they'd been hit by a truck.

Answer: No

Depression, by medical definition, is an abnormal condition. Specialists would like to restrict the use of the name to the mood and biological changes that are clearly out of proportion to life events. This can be confusing because nonprofessionals also use the term to mean the painful reaction that is appropriate to loss.

Everyone has distressing events in life, and the natural response can feel very much like depression. Two things that are signs of normal grieving are a clear reason for feeling bad (e.g., somebody died) and acute bursts of anger, tears, or sadness that gradually become less frequent as the person starts to feel interest in life again. Medications are often not appropriate in this situation, but understanding and support can be helpful.

"Life seems pointless since my brother died six months ago." might not be an exaggerated response, but few people would agree with "You'd want to kill yourself too if you lost your job and had to move 45 miles away from your brother and his family."

Many terms have more than one meaning, but confusion about this point can lead to belief that normal feelings need to be treated away. Another risk is that of dismissing a serious illness that really deserves treatment.

There should be separate names for the two conditions, but since this isn't the case it's necessary to be clear about what is meant.

Answer: No

No - you can self refer, but make sure you've done your research and checked the therapist's qualifications. If you don't feel comfortable with the first therapist you see, you can always change to another. If the therapist suspects there may be underlying medical issues, he or she will recommend seeing you medical practitioner.

Answer: Yes

Yes, when you have four or five of these symptoms, and you have them most of the time for several weeks, without an obvious reason, then your doctor should probably diagnose depression. One or two symptoms, especially when you just had a stressful day, are more likely to be a normal reaction.

Answer: Yes

Before you panic, please remember that movie was filmed many years ago, based on a book written ten years before that, describing the author's recollections of being treated another decade or so before that! Modern treatments are done under anesthesia and tracked by EEG.

The big advantages of electroconvulsive therapy are the speed with which it works (often within a week!), the power of the treatment (it's known to work in cases where all other treatments have failed), and the desirability of avoiding medication side effects in patients who are elderly and may be taking medications for several medical problems. On the other hand, it does cause confusion and memory problems, even though most of these do clear up.

It does require general anesthesia and so must be performed under medical supervision with the use of monitors. And, well, it scares people. Nearly everybody has seen the movie! But it saves lives on a regular basis, so if the psychiatrist recommends it, ask more about her reasons for that decision.

In some cases it's the only appropriate treatment available.

Answer: No

Some of the symptoms are the same, but it's a different disease causing them. Bipolar disorder (formerly called manic depression) also tends to respond poorly to many depression treatments, but to be helped by other treatments. It's quite important to have a definite diagnosis when choosing treatment!
Well, time's up for tonight's depression review. We can look at other psychiatric diseases another time. Have a good day!