The Widespread Effects Of Depression

African American woman sad depressed

( — Depression is one of the leading causes of disability
worldwide. That’s the word from NIH’s National Institute of Mental Health
(NIMH), the component of the federal government that studies depression and
other mental illnesses.

You probably know depression as a medical condition that primarily affects
the brain. Its symptoms include a persistent sad, anxious or “empty” mood,
feelings of hopelessness, pessimism and worthlessness, and a loss of interest in
hobbies and activities once enjoyed. The “Symptoms of Depression” side box
contains a more complete description.

But according to Dr. Husseini Manji, chief of NIMH’s Laboratory of
Pathophysiology, the psychological symptoms of depression are just the “tip of
the iceberg.” Because the brain is the body’s “control center,” the effects of
depression spread throughout the body, often resulting in problems with sleep,
appetite, energy level, motivation, memory, and concentration. Performing
everyday activities can be an enormous challenge for people who are

A Devastating Illness

“Depression needs to be recognized as a devastating illness,” Dr. Manji
explains. “It can occur with other diseases, but it is a very real medical
condition in its own right.”

Research shows that depression increases the risk of death for people of all
ages. For those with other illnesses such as type 2 diabetes and certain
infections, depression can make their symptoms worse. Elderly people with
depression may be at higher risk for Alzheimer’s disease, and depression may
increase their chance of being admitted into a nursing home.

No one knows better the ravages of depression than the estimated 20 million
Americans of every age who suffer from depression. Although women and older
people seem to have higher rates of depression, depression can strike anyone at
any time. Those who have recently experienced a traumatic event, such as a
divorce, job loss or sudden death of a loved one, may be at higher risk.

More Than Stressed Out

Dr. Manji emphasizes that depression is not a character flaw, a lack of
willpower or a sign of emotional weakness. “You can’t simply wish or will
depression away,” he says.

People who are “stressed out” may think that their current situation is to
blame, but a prolonged case of the blues that interferes with normal functioning
is usually the result of a chemical imbalance in the brain,” he explains.

That’s why treatment is so important — and the sooner the better. There are a
variety of treatments that work, including medications and psychotherapy. NIMH
researchers and others are constantly looking at new ways to treat and prevent

If you think you may be depressed, seek professional help (see “Where to Get
Help”) and learn ways to cope to help you feel better (see “Tips for Coping With
Depression”). Don’t let depression keep you down.

— a report from The NIH Word on Health, April, 2003

For more information on depression, see NIMH’s booklet on depression at
Links to other depression publications from NIH can be found at
You can also phone, fax or send e-mail to:

National Institute of Mental Health
Information Resources and Inquiries
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD
Telephone: 301-443-4513
Fax: 301-443-4279
E-mail: [email protected]

A Word to
the Wise…
Tips for Coping With Depression

Depression can make
you feel exhausted, worthless, helpless, and hopeless. Negative thoughts and
feelings can 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
reflect the actual circumstances. Negative thinking begins to fade as treatment
takes effect. In the meantime:

Break large tasks into small ones, set
some priorities, and do what you can.

Try to be with other people and
confide in someone; it is usually better than being alone.

in activities that make you feel better. Mild exercise, going to a movie, a ball
game, or participating in religious, social, or other activities may help.

Expect your mood to improve gradually. Feeling better takes time.
People rarely “snap out of” depression, but they can feel a little better

Postpone important decisions until the depression has
lifted. Before deciding to make a significant decision, such as changing jobs,
getting married or divorced, discuss it with others who know you well and have a
more objective view of your situation.

Remember, as your depression
responds to treatment, positive thinking will replace the negative thinking that
is part of the depression.

Let your family and friends help you.

Source: National Institutes of Mental Health


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Workouts Can Lighten Heavy Hearts


A man doing crunches at the gymThe millions of Americans stricken each year by debilitating depression may want
to consider running away from their problem — or walking, swimming or dancing
it away.

“What the studies are showing is that exercise, at least when performed in a
group setting, seems to be at least as effective as standard antidepressant
medications in reducing symptoms in patients with major depression,” said
researcher James Blumenthal, a professor of medical psychology at Duke
University in Durham, N.C.

According to Blumenthal, other studies are beginning to suggest that solitary
exercise, such as workouts at the gym or a daily jog, can be just as effective
as group activities in beating the blues, and that “duration of exercise didn’t
seem to matter — what seemed to matter most was whether people were exercising
or not.”

Blumenthal was lead author on a much-publicized study released five years ago
that found that just 10 months of regular, moderate exercise outperformed a
leading antidepressant (Zoloft) in easing symptoms in young adults diagnosed
with moderate to severe depression.

And another study released earlier this year, by researchers at the
University of Texas Southwestern Medical Center at Dallas, found that 30-minute
aerobic workouts done three to five times a week cut depressive symptoms by 50
percent in young adults.

Theories abound as to how revving up the body helps uncloud the mind.

Robert E. Thayer is a professor of psychology at California State University,
Long Beach, and the author of Calm Energy: How People Regulate Mood with Food
and Exercise
. He said that while workouts probably affect key brain
chemicals like serotonin and dopamine, physical activity may also trigger
positive changes in other areas, too.

“Depression is a condition characterized by low energy and moderate tension,
something I call ‘tense tiredness,'” he said. But exercise has a clear “mood
effect” that seems to ease that anxious but lethargic state, he said.

According to Thayer, moderate exercise — a brisk 10-minute walk, for example
— results in a boosting of energy, although it may not be quite enough to
relieve stress.

“More intense exercise — the amount you’d engage in with a 45-minute aerobic
workout — does give a primary mood effect of reducing tension. It might also
leave you with a little less energy because you’d be tired, of course,” he said.
“However, there’s also some indication from the research that there’s a
‘rebound’ effect an hour or so later, in terms of [increased] energy.”

Blumenthal pointed to the more lasting psychological boost regular workouts
can bring. “People who exercise might also have better self-esteem; it may help
them feel better about themselves, having that great sense of accomplishment,”
he said.

Still, the experts acknowledged that truly depressed individuals often find
it tough to jump into an exercise routine.

“Why do people not do the thing that’s perhaps the most important
thing for them to do?” said Thayer. “It’s because a drop in energy is such a
central component of depression — you just don’t have the energy to do the

He said the key to breaking that cycle is to start small.

“Thinking about going to the gym and doing all the stuff that’s involved with
that can be overwhelming for a depressed person,” Thayer pointed out. “But if
you think ‘Hey, maybe I’ll just walk down the street 30 yards or so, at a
leisurely pace,’ that’s a start. And it turns out that your body becomes
activated then — you have more of an incentive to walk farther, to do

Loved ones can play a key role, too, urging a depressed friend or family
member to join in with them as they work out. “Social support, peer pressure,
family support — all of that can be helpful, certainly in getting people to
maintain exercise,” Blumenthal said.

No one is saying that exercise is always a substitute for drug therapy,
especially for the severely depressed. “But we also know that these drugs aren’t
effective for everyone — about a third of people aren’t going to get better
with medication,” Blumenthal said.

For those patients, exercise may prove a viable, worry-free alternative —
with one great fringe benefit.

“In addition to its mental health benefits, there are some clear
cardiovascular benefits to exercise which we don’t see with antidepressant
drugs, of course,” Blumenthal noted. So, he said, what keeps the mind fit
strengthens the body, too. “You’re killing two birds with one stone.”

More information

For more on recognizing and beating depression, head to the National Institute of Mental

SOURCES: James Blumenthal, Ph.D., professor, medical psychology, Duke
University School of Medicine, Durham, N.C.; Robert E. Thayer, Ph.D., professor,
psychology, California State University, Long Beach, and author, Calm Energy:
How People Regulate Mood with Food and Exercise

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