Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.

US Hispanics, currently the largest minority group in the country, face disparities in the recognition and treatment of major depression.   Under-recognition of depression in adult Hispanic Americans may be related to language differences, health literacy barriers, somatic presentations, and use of cultural idioms of distress. Hispanic patients are often agreeable to treatment but as a group may tend to prefer psychotherapy or combined counseling and medication to pharmacotherapy alone. Recent studies have found both psychological and pharmacologic treatment options are efficacious in this minority group.

US Hispanics are heterogeneous, and differences among subgroups are important to recognize in assessing mental health needs. Most Latinos have a common ancestry in people speaking the Spanish language or emigrating from Latin America.
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Alternative Names
Blues; Gloom; Sadness; Melancholy

Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters—chemicals that brain cells use to communicate—are out of balance in depression. But it has been difficult to prove this.

Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.

Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too. Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.

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People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Signs and symptoms include:

•    Persistent sad, anxious, or “empty” feelings
•    Feelings of hopelessness or pessimism
•    Feelings of guilt, worthlessness, or helplessness
•    Irritability, restlessness
•    Loss of interest in activities or hobbies once pleasurable, including sex
•    Fatigue and decreased energy
•    Difficulty concentrating, remembering details, and making decisions
•    Insomnia, early-morning wakefulness, or excessive sleeping
•    Overeating, or appetite loss
•    Thoughts of suicide, suicide attempts
•    Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

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Exams and Tests
The first step to getting appropriate treatment is to visit a doctor or mental health specialist. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by doing a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation.

The doctor may refer you to a mental health professional, who should discuss with you any family history of depression or other mental disorder, and get a complete history of your symptoms. You should discuss when your symptoms started, how long they have lasted, how severe they are, and whether they have occurred before and if so, how they were treated. The mental health professional may also ask if you are using alcohol or drugs, and if you are thinking about death or suicide.

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As with any chronic illness, getting an early medical diagnosis and medical treatment may help reduce the intensity and duration of depression symptoms. It will also reduce the likelihood of a relapse.

To treat depression effectively, your doctor may use psychotherapy (counseling), medications such as antidepressants, or a combination of these therapies. It may take weeks for an antidepressant to fully work to ease depression symptoms. So it’s important to trust your doctor and stay on the medication.

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Possible Complications
Other illnesses may come on before depression, cause it, or be a consequence of it. But depression and other illnesses interact differently in different people. In any case, co-occurring illnesses need to be diagnosed and treated.

Anxiety disorders, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder, often accompany depression. PTSD can occur after a person experiences a terrifying event or ordeal, such as a violent assault, a natural disaster, an accident, terrorism or military combat. People experiencing PTSD are especially prone to having co-existing depression.

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When to Contact a Medical Professional
Call 911, a suicide hotline, or go to a nearby emergency room if you have thoughts of harming yourself or others.

Call your doctor if:
•    You hear voices that are not there
•    You cry often without cause
•    Your depression has affected your work, school, or family life for longer than 2 weeks
•    You have three or more symptoms of depression
•    You think one of your current medications may be making you feel depressed — DO NOT change or stop taking any medications without talking to your doctor
•    You think you should cut back on drinking, a family member or friend has asked you to cut back, you feel guilty about the amount of alcohol you drink, or you drink alcohol first thing in the morning

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Although depression is a highly treatable condition, some forms of depression may not be preventable. That’s because depression may be triggered by a chemical malfunctioning in the brain. However, the latest medical studies confirm that depression may often be alleviated or sometimes prevented with good health habits.

Proper diet, exercise, taking time out for fun and relaxation, not overworking, and saving time to do things you enjoy may work together to prevent a depressed mood.

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Natural Remedies
For when it’s beyond a bad day: Learn more about symptoms and what you can do to overcome depression. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

Get active

• Exercise that increases your heart rate at least three hours a week (or 30 minutes a day) may help boost your body’s natural mood-enhancers (endorphins)

Check out St. John’s wort

• Take 600 to 1,200 mg a day of a standardized herbal extract containing of 0.3% hypericin to help with mild to moderate depression—but talk to your doctor first as St. John’s wort can interact with certain medications

Get enough iron

• A lack of iron can make depression worse; check with a doctor to find out if you are iron deficient

Try B vitamins

• Take a supplement that contains folic acid and vitamins B12 and B6 to help correct deficiencies associated with depression

Seek counseling

• A mental health professional may help you make a full recovery

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full depression article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
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