Causes of depression : Some types of depression run in families, indicating that a biological vulnerability to depression can be inherited. This seems to be the case especially with bipolar disorder. Studies have been done of families in which members of each generation develop bipolar disorder. The investigators found that those with the illness have a somewhat different genetic makeup than those who do not become ill. However, the reverse is not true. That is, not everybody with the genetic makeup that causes vulnerability to bipolar disorder has the illness. Apparently, additional factors, possibly a stressful environment, are involved in its onset. Major depression also seems to occur in generation after generation in some families, although not as strongly as in Bipolar I or II. Indeed, major depression can also occur in people who have no family history of depression. An external event often seems to initiate an episode of depression. Thus, a serious loss, chronic illness, difficult relationship, financial problem, or any unwelcome 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. Nothing in the universe is as complex and fascinating as the human brain. The over 100 chemicals that circulate in the brain are known as neurochemicals or neurotransmitters. Much of our research and knowledge, however, has focused on four of these neurochemical systems: norepinephrine, serotonin, dopamine, and acetycholine. In the new millennium, after new discoveries are made, it is possible that these four neurochemicals will be viewed as the "black bile, yellow bile, phlegm, and blood" of the twentieth century. Different neuropsychiatric illnesses seem to be associated with an over-abundance or a lack of some of these neurochemicals in certain parts of the brain. For example, a lack of dopamine at the base of the brain causes Parkinson disease. Alzheimer dementia seems to be related to lower acetylcholine levels in the brain. The addictive disorders are under the influence of the neurochemical dopamine. That is to say, drugs and alcohol work by releasing dopamine in the brain. The dopamine causes euphoria, which is a pleasant sensation. Repeated use of drugs or alcohol, however, desensitizes the dopamine system, which means that the system gets used to the drugs and alcohol. Therefore, a person needs more drugs or alcohol to achieve the same high feeling. Thus, the addicted person takes more and more to feel less and less high. The different types of schizophrenia are associated with an imbalance of dopamine (too much) and serotonin (poorly regulated) in certain areas of the brain. Finally, the depressive disorders appear to be associated with altered brain serotonin and norepinephrine systems. Both of these neurochemicals are lower in depressed people. Please note that I specified, "associated with" instead of, "caused by." I made this distinction because we really don't know whether low levels of neurochemicals in the brain cause depression or whether depression causes low levels of neurochemicals in the brain.

Postpartum Depression : Postpartum depression (PPD) is a condition that describes a range of physical and emotional changes that many mothers can have after having a baby. PPD can be treated with medication and counseling. Talk with your health care provider right away if you think you have PPD. There are three types of PPD women can have after giving birth: The so called "baby blues" happen in many women in the days right after childbirth. A new mother can have sudden mood swings, such as feeling very happy and then feeling very sad. She may cry for no reason and can feel impatient, irritable, restless, anxious, lonely, and sad. The baby blues may last only a few hours or as long as 1 to 2 weeks after delivery. The baby blues do not always require treatment from a health care provider. Often, joining a support group of new moms or talking with other moms helps. Postpartum depression (PPD) can happen a few days or even months after childbirth. PPD can happen after the birth of any child, not just the first child. A woman can have feelings similar to the baby blues - sadness, despair, anxiety, irritability - but she feels them much more strongly than she would with the baby blues. PPD often keeps a woman from doing the things she needs to do every day. When a woman's ability to function is affected, this is a sure sign that she needs to see her health care provider right away. If a woman does not get treatment for PPD, symptoms can get worse and last for as long as 1 year. While PPD is a serious condition, it can be treated with medication and counseling. Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first 3 months after childbirth. Women can lose touch with reality, often having auditory hallucinations (hearing things that aren't actually happening, like a person talking) and delusions (seeing things differently from what they are). Visual hallucinations (seeing things that aren't there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes women are put into the hospital because they are at risk for hurting themselves or someone else.

Depression diagnosis : The first step to obtaining appropriate treatment is a complete physical and psychological evaluation to determine whether the person may have a depressive illness, and if so, what type. Certain medications, as well as some medical conditions, can cause symptoms of depression. Therefore, the examining physician should rule out (exclude) these possibilities through an interview, physical examination, and laboratory tests. A thorough diagnostic evaluation includes a complete history of the patient's symptoms: (1) When did the symptoms start? (2) How long have they lasted? (3) How severe are they? and (4) Have the symptoms occurred before, and, if so, were they treated and what treatment was received? The doctor should ask about alcohol and drug use, and whether the patient has had thoughts about death or suicide. Further, the history should include questions about whether other family members have had a depressive illness, and if treated, what treatments they received and which were effective. A diagnostic evaluation also includes a mental status examination to determine if the patient's speech, thought pattern, or memory has been affected, as often happens in the case of a depressive or manic-depressive illness. As of today, there is no laboratory test, blood test, or X-ray that can diagnose a mental disorder.

Symptoms of depression and mania : Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms and some many symptoms. The severity of symptoms also varies with individuals. Depression Symptoms of Manic Depression : Persistently 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. Insomnia, early-morning awakening, or oversleeping. Decreased appetite and/or weight loss, or overeating and weight gain. Fatigue, decreased energy, being "slowed down." Thoughts of death or suicide, suicide attempts. Restlessness, irritability.