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Could You Be Depressed and Not Know It?

WebMD can help you recognize depression - and find relief

What Are the Causes of Depression?

Experts say that depression is caused by an interaction of genetic factors and real life triggers. Because depression often runs in families, experts believe that genetic factors make some people more vulnerable to than others, because of their individual brain chemistry.

Depression triggers can include:

* Situational factors: Major problems and life crises -- a romantic break-up, job loss, or the death of a loved one, for example -- are often the immediate, most obvious causes of depression. But ongoing life challenges like poverty, unemployment, and social isolation, as well as childhood trauma, also put people at higher risk for depression.

* Medical factors: Chronic pain or illness can lead to depression. Certain medical conditions -- including hypothyroidism, cancer, and hepatitis -- can cause depression. Nutritional deficiencies and some medications are culprits as well. Therefore, it's important that treatment for depression include a medical evaluation.

* Gender: Women are twice as likely as men to experience depression, a discrepancy likely due in part to the tremendous hormonal shifts that accompany menstruation, child birth, and menopause.

* Stress: A connection between chronic stress and depression has been established and could explain why stressful life situations, like poverty and unemployment, put people at far higher risk for depression.

Treatment for Depression

According to depression experts at the American Psychological Association, you should seek treatment for depression if it persists for more than two weeks -- particularly if your depression is severe enough to interfere with normal life activities. If you suspect that you are depressed, talk to your physician, who can rule out physical causes and refer you to a mental health professional.

Experts now understand that depression has to do with shifts in brain chemistry, so a piece of the treatment puzzle involves re-balancing chemicals, Wood says. But it doesn't have to involve medication. The best treatment for your symptoms depends on your individual story, she says; whether you've been depressed before, and whether your symptoms keep you in bed all day or simply sap your energy. So try to describe your history and symptoms as precisely as possible when you speak to your physician and psychotherapist.

Treatment for depression usually involves psychotherapy, antidepressants, or both, according to Susan G. Kornstein, MD, a professor in Virginia Commonwealth University's School of Medicine. Experts now believe that a combination of both is most effective. In a study from Vanderbilt University in Nashville, TN, researchers concluded that psychotherapy and medication together were effective for 70% of women, says Valerie E. Whiffen, PhD, professor of psychology at the University of Ottawa, Ontario, and author of A Secret Sadness.

There is evidence that in many cases, psychotherapy works as well as antidepressants do, and there are no side effects, according to Whiffen. Interpersonal Therapy (IPT) for example, focuses on improving the patient's relationships to help reduce depressive symptoms. Half of the women in the Vanderbilt study who received IPT were no longer depressed at the end of treatment -- the same result seen with antidepressants alone.

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