What is Depression?

Depression is the most common psychiatric disorder manifested by feeling sad, low, blue, hopeless, helpless, worthless, losing interest in enjoyable activities and changes in sleep, appetite, energy, concentration, sex drive and sometimes thoughts of ending his/her life. Clinical diagnosis is made when symptoms are present everyday most of the day for two weeks.

Who is affected?

Unfortunately females are more affected than males. The cause of females being more affected is not well understood but changes in hormonal balance throughout life may be one of the contributing factors. Interestingly it affects all ages , all socio-economics, ethnicities, races, communities and cultures around the world. How people present to doctor may be different, to give few examples like Asians presents more with bodily symptoms (lack of sleep, tiredness, stomach pin/discomfort) , westerners may present more with emotional symptoms (sad feeling, irritability, boredom) and kids with behaviors (lying, talking back to parents, using/abusing drugs) and last but not least elderly with feelings of dependency, despair, loneliness and spontaneous crying to mention few.

Why do people get depressed?

Not easy to explain. Most of the affected patients have combination of genetic loading, some chemical imbalance (neurotransmitters), abnormal receptors ( sites where chemicals work in normal people) and/or we call psycho-social stressors and triggers.


Generally people have family (mother/grandmother and/or father/grandfather) history of some psychological disorder/s. As a normal human being we all have stresses in our lives but people who have genetic predisposition are on higher risk for having depressive episode/s. Main stressors are immigration from one country to another, move from one town to another, death of loved one, stress at school/college/work, relationship deficits/conflicts, financial strain and new baby or divorce. Usually people have some stresses before they have trigger which means something happens suddenly (loss of loved one or some debilitating disease) cause the first episode of depression.

Why should I seek help?

If you have symptoms of depression mentioned in the first question and it is causing distress and/or impairment in personal (relationship with family), Social (not able to make/maintain friends) and/or unable to perform well at school, college or work, you should seek help immediately.
What is the best treatment?


There are several treatment options. Studies have shown that combined treatment of safe and effective medications (anti-depressants), talk therapy (psychotherapy/ies) , exercise, good nutrition and some spiritual rituals are more effective than one treatment alone.

How long do I need treatment?

Recommendations by experts and national/local organizations is that patient should take medication/s for 9-12 months with/without talk therapy. Please visit NAMI.ORG for more information. For questions email me at
haresh.tharwani@dm.duke.eduIMG952689