让我们来谈谈抑郁症

How are you feeling today? If you’ve found yourself reading this, probably pretty crappy. Maybe you’ve been feeling listless and down for a lot longer than you expected, and it’s making you worry that you might have depression. Maybe you’ve just received a diagnosis of clinical depression and you’re looking for answers. We get it. So many contributors to HealthCentral have felt just like you do now. But we won’t let depression swallow you up. We also won’t bombard you with a bunch of false promises and inaccurate information (that’s what your Facebook feed is for). Here, we share the reality of coping with depression, as well as expert advice from top doctors, the most successful treatments, and mood-lifting lifestyle changes.

什么是抑郁症，真的吗？

It’s normal to experience sadness. (Who没有cry when Simba couldn’t wake up Mufasa?) But unlike typical sadness or grief, time can’t and won’t healMajor Depressive Disorder (MDD)，期限为临床抑郁症，其中大部分人只是所谓的“洼地”。这是一种常见的精神健康状况昭示着像一个不必要的房客，并拒绝离开。这个扩展的悲伤和空虚的时期自带的其他症状群，如疲劳，睡眠困难，萎缩食欲，暴饮暴食，突然哭了法术，有时自杀的念头。症状范围的严重程度和必须持续两周以上，以接收MDD诊断，虽然它比一个小插曲罕见只能维持这么短的时间。大多数人有六个月的症状到一年，有时，他们可以持续数年。

Without treatment, depression won’t fade away on its own. Even if you do white-knuckle it through your first episode of depression,你的另一复发的机会is more than 50 percent. If you’ve had two episodes, that chance shoots up to80％。Meaning, you’re going to want to deal with this sooner rather than later.

抑郁症的一个特点是不能体验到快感，这实际上是没有乐趣。失去你曾经喜欢事物的兴趣往往意味着你的能力，功能在工作和家庭需要潜水。事实上，抑郁症是残疾的在美国的主要原因之一，是美国人，1770万的人体验抑郁症，每年7.2％。

Other Types of Depression

我们谈到MDD（又名抑郁症），但还有其他类型的抑郁症。他们include:

• 持久的抑郁症。这是抑郁症的一种慢性形式，旧称精神抑郁症。Sometimes people call it “high functioning” or “smiling” depression. While symptoms aren’t as severe as MDD, they last for two years or长。People with PDD might feel like they’ve always been depressed. (In cases of “double depression”人们自己平时慢性抑郁症的状态中体验MDD的严重发作。）
• 季节性情感障碍（SAD）。抑郁症状开始，每年结束季节，同样的时间左右。大多数人感到沮丧在寒冷，黑暗的冬天，但在夏天有些人的情绪悬锤。
• 经前烦躁症（PMDD）。在这里，抑郁症状绑在月经周期的黄体期，开始一周左右的时间段之前，只是你的时间后结束。虽然许多症状镜的PMS-irritability,high anxiety，经常哭泣-they're严重得多。他们打断your ability to work, destroy personal relationships, and can lead to thoughts of self-harm and suicide. This condition was added in 2013 as a form of depression to the DSM-5, the official guide of mental disorders.
• Peripartum Depression.这种疾病的新妈妈通常开发生下几周内抑郁症和精神病，甚至症状。它曾经被称为产后抑郁症许多人仍沿用互换。（在某些情况下，症状在怀孕期间开始;其他时间，当宝宝几个月老故名变化。）
• Perimenopausal Depression.在中年（具体而言，多年领导到绝经), people experiencing this disorder have typical depressive symptoms plus更年期症状like hot flashes and night sweats.
• 物质/药物诱发抑郁症。物质滥用（alcohol, opiates, sedatives, amphetamines, cocaine, hallucinogens,等），或服用某些药物，如糖皮质激素or他汀类药物，可以引发抑郁症的症状。如果物质使用（或使用撤军）是引起你的症状，你可能有这个版本的抑郁症。
• 破坏性情绪调节紊乱。A孩子这个少年障碍isgrumpyandbad-tempered大多数时候。他们have severe, explosive outbursts with parents, teachers, and peers several times a week. Their overreactions are extreme and inconsistent with their developmental level.

萧条打击的人在32中位数年龄，但要记住，抑郁症可发生在任何人，在任何年龄，任何种族，性别或政治倾向是很重要的。每六个成年人一出将在其人生的某个时间出现抑郁症。幸运的是，抑郁症是可以治疗的。这就是为什么，在症状第一次暗示，它做一个心理健康专家预约，谁可以帮助确定是否有抑郁症是很重要的，如果是的话，哪种类型，以及最重要的是，它的治疗是适合您。

What Causes Depression?

你是not going to like this answer, but no one knows for sure. That said, for the past few decades, the prevailing theory is that depressed people have an imbalance in their brain chemistry—more specifically, low levels of神经递质like norepinephrine, epinephrine, and dopamine, which help regulate mood, sleep, and metabolism. We now know it's a little more complicated than that.

Certain circumstances put people at a higher risk of depression, including childhood trauma, other types of mental illness and chronic pain conditions, or a family history of depression, but anyone can get depressed.

Scientists informed by decades of research believe that the following factors also up your risk of becoming depressed, but they can’t prove causality. Still, they can play heavily in the development of depression, so it’s important to be aware of them:

• Genetics.Research shows that具有一级亲属患有抑郁症（父母，兄弟姐妹或子女）让你两到三次更可能有抑郁症的倾向。
• Traumatic life events from childhood,such as abuse or neglect.
• 环境压力，就像一个爱的人的死亡，杂乱离婚，或财务问题。
• 一些医疗条件（例如，甲状腺功能低下，慢性疼痛）。每学，这些物理条件和抑郁症之间的关系是双向的，所以有鸡还是先有蛋的事怎么回事，因为他们互相喂对方。
• 某些药物，包括一些镇静剂和血压药。
• Hormonal changes,like those that come with childbirth and menopause.
• 肠道细菌。There has been a链接established between the microbiome and the gut-brain axis, but it’s only just starting to be studied.

我有抑郁症的症状？

想知道是否your feelings qualify for clinical depression? Those with MDD experience five or more of the below symptoms during the same two-week period, and at least one must be depressed mood or loss of pleasure. The symptoms would be distressing or affect daily functioning.

1. 您情绪低落大多数时候。
2. 你喜欢做的不再是东西给你带来快乐。
3. Significantweight loss (without dieting)orweight gain感觉还是一贯多少less hungry or hungrier比平常。
4. 有一个很难入睡和保持睡眠或睡过头。
5. A molasses-like slowdown of thought, becoming a couch potato, or spending days in bed. (This should be noticeable to others, not just subjective feelings of restlessness or slothiness.)
6. 所以。所以。累。你是so exhausted你甚至不能。
7. 感觉一文不值了大量的时间，即使你没有做错任何事。
8. Being super心烦意乱，犹豫不决，and unable to concentrate.
9. 复发死亡或自杀的念头（有或没有具体的计划，以真正做到这一点）。如果您需要为自己或别人的帮助，请与国家预防自杀生命线1-800-273-TALK（8255）。

怎么做医生诊断抑郁症？

When you’re having a depressive episode, it might feel like you’re destined to feel terrible forever. That’s not true. It’s just what your depressed brain wants you to think. The hardest step is ignoring that feeling and making an appointment with a doctor and/or mental health professional, such as a psychologist or psychiatrist. A mental health professional is the only expert that can help you figure out if you are depressed.

Unfortunately, there’s no easy blood test that can determine if you have depression, though that would make diagnosis a lot easier. (Get on it, science!) TheDSM-5helps clinicians make that call with a targeted list of common symptoms. To be diagnosed with MDD, patients must experience five or more of the above symptoms (see “Do I Have the Symptoms of Depression?”)—one must be depressed mood or loss of pleasure—during a two-week period.

Even if your symptoms match up to MDD, though, your doctor should rule out any underlying medical causes first. Some conditions, such as thyroid disease and vitamin deficiency, can mimic symptoms of depression. Next, consider any medications you’re currently taking.
If this sounds like you or someone you know, make an appointment with a mental health professional. Now. Don't wait! What's the worst thing that can happen? If you feel better by the time the appointment rolls around, you can always cancel it. If you don’t, you’ve saved yourself precious time (and unnecessary pain) by taking steps to managing your mental health.

What Are the Best Treatments for Depression?

Regardless of why you’re depressed, it’s important to get treatment before the condition starts to erode your quality of life. Studies and surveys show that most adults in the U.S. who screen positive for depression remain untreated. Don’t be one of them.

As scientists continue to hash out theories about the root causes of depression, research shows that the most effective treatment is a mix of psychotherapy, medication, and lifestyle changes. It might take a (frustratingly long) while to find the right recipe —antidepressants work differently in different people so finding the right fit often takes some trial and error. Plus, the mental health professional you’re working with will be by your side. They won’t give up and neither should you. Some of the treatment options available are:

心理治疗

这并不意味着你会发现自己斜躺在沙发上，抱怨你和母亲的关系（尽管它可能）。精神病医生，心理学家，治疗师，或许可临床社会工作者可以使用多种技术来帮助改变消极思想，信仰或加剧你的忧郁，让你的世界似乎无望的行为。治疗的类型包括psychodynamic therapy,认知行为疗法（CBT）, and人际关系治疗。

药物

你的抑郁症可能需要超过执教。Doctors may prescribe medication including抗抑郁药,情绪稳定和/或抗精神病药物丸为了减少抑郁症的症状。这些包括：

• SSRIs的（选择性血清素再摄取抑制剂）like Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline) and的SNRI（血清素和去甲肾上腺素再摄取抑制剂）像欣百达（度洛西汀）和Effexor的XR（文拉法辛）使神经发射机羟色胺和去甲肾上腺素已经在大脑中存在更多可用。
• 三环类抗抑郁药（三环类抗抑郁药）像Tofranil（丙米嗪）和Norpramin（地昔帕明）和单胺氧化抑制剂（单胺氧化酶抑制剂）像Emsam（司来吉兰）和是marplan（异卡波）是第一代抗抑郁药对神经发射机类似的工作，但他们使用，因为令人不快的副作用较少。
• Doctors may also use非典型抗抑郁药像载班或安非他酮（安非他酮）或瑞美隆（米氮平）影响血清素，去甲肾上腺素和其他抗抑郁药物独特的方式多巴胺水平。或者，他们可能会增加非典型抗精神病药物，又名第二代抗精神病药等思瑞康（喹硫平），或阿立（阿立哌唑）。他们是“非典型”的，因为它们会影响多巴胺等神经递质没有身体的副作用，如抽搐和震颤，即第一代抗精神病药物可引起。

脑刺激

对于treatment-resistant depressionthat doesn’t get better after exhausting psychotherapy and more than two classes of antidepressants (such SSRIs and TCAs), there are more hardcore options. Severe depression may warrantelectroconvulsive therapy (ECT)，你可能还记得，从飞越疯人院。不要害怕现代ECT是安全的，在麻醉下进行的，并且比你在电影里看到更积极。

还有重复经颅磁刺激（磁刺激）其中一些文档称之为“ECT精简版”。对于严重的抑郁症，一些人收到迷走神经刺激（VNS），外科植入物的作品有点像一个心脏起搏器，发送电脉冲到大脑。

其他的治疗方法

These may include:

• 对于严重的，treatment-resistant depression，美国FDA最近批准esketamine，喷鼻剂基础上，党的药物/麻醉剂氯胺酮。Experts say it works by kicking up production ofglutamate神经递质，有助于提示大脑形成新的神经连接。
• 在悲伤seasonal depression (SAD)可以与褪黑激素调节的能够减轻光疗。
• Postpartum depression may be treated withBrexanolone(Zulresso), an IV version of the body’s own neurosteroid allopregnanolone.
• Research shows that生活方式的改变like incorporating行使和正念can amplify results of medication and therapy. Even if they aren’t foolproof mood-lifters, it never hurts to build a health-supportive routine.

Where Can I Find Depression-Related Communities?

The thing about depression is that it makes you want to roll yourself into a blanket burrito and never come out. But shutting out the world can make an already-bad situation worse by giving you free reign to neglect your needs, ruminate over your perceived flaws, and destroy any chance of forward momentum. Along with therapy and medication, finding supportive people—and connecting with them online and in real life—is a key part of taking care of yourself. Here's where to start.

Top Depression Instagrammers and Bloggers

• Tonya Ingram,@tonyainstagram,tonyaingram.com

遵循这是因为：她有一个办法一个地狱的话，毕竟她是一位诗人和作家。她还再战一些非常重的东西像抑郁症，生活的“狼疮传奇”（她的话，我们的爱），目前正在等待观望肾移植。她把它所有的天天和她股份如何得到床上了，看上去镜子里的自己，并计算出如何简单...生存。

• Scott Ste Marie,@depressiontoexpression,depressiontoexpression.com

遵循这是因为：随即，他听起来像是你想成为朋友，有人要引导其氛围的人。一位前员工的Twitter，目前的公共演说家，斯科特是不会来指导你一些道路上彻底治愈，也不是他要粉饰与抑郁症生活的现实。为了克服自己的心魔，斯科特认为你要来与生活有时很烂的事实而言，这没关系。

• 凯文·海因斯，@kevinhinesstory,kevinhinesstory.com

遵循这是因为：您know the saying “What doesn’t kill you only makes you stronger”? Kevin Hines is living proof. He is the only person ever to survive a suicide attempt from the Golden Gate Bridge. After a sea lion kept him afloat, he was reborn as someone who now devotes his life to making sure you’re here tomorrow—which is why he regularly uses the hashtag #beheretomorrow.

• Lola, Gina, and Nora Tash, and Nicole Argiris,@mytherapistsays,mytherapistsays.ca

遵循这是因为：有时来了深刻的暗洞的唯一出路是欢笑的通用语言。这些女孩（主要是家庭或像家人一样）创建表示真正的考验和生活在今天的社会化媒体出没的世界的苦难无尽的热闹模因。这一切的呢？所以，你知道，就像他们所说的那样，“你永远不会孤独，从来没有为batshit像你想象的。”

• 伤心女孩俱乐部，@sadgirlsclub

遵循这是因为：It’s not your typical reel of inspirational quotes and nod-worthy memes — though, those are sprinkled in, too. Mostly, this feed—run by women of color (including founder@elyse.fox)—gives you actual advice on how to cope with depression, especially in modern-day situations, like discussing mental health at work (hashtag尴尬）。该饲料为您提供您需要关闭耻辱的弹药。

• 凯特·阿伦，@thelatestkate

遵循这是因为：动物让一切变得更加美好 - 尤其是当他们与一个古怪的图纸和所有太熟悉的感觉配对。这充分说明你的灵魂狼;狐狸，让你所有的感觉;和鸟谁告诉它喜欢它。艺术家，作家，急得人凯特运行，此页面（以及生活在那里的可爱的动物）是一个自我感觉良好的必须遵循的。

• 哀伤的鬼俱乐部，@theofficialsadghostclub,thesadghostclub.com

遵循这是因为：Nathan, Lize, and Helen are besties—or, ghosties, as they refer to themselves—who came together to share life with mental illness from behind the computer screen. These ghosts don’t sugarcoat things, but they’re also not gloom and doom. You’ll be hooked on their graphics and positive (but not overly earnest) messages.

顶级抑郁症相关的播客

• 抑郁症的热闹世界。单口相声满足斗志约会时，演员和喜剧演员与沮丧斗争告诉他们的（令人惊讶的搞笑）心理健康故事“专业郁闷” host John Moe.
• 可怕的是，谢谢你的邀请。Author Nora McInerny, who has dealt with depression, isn’t afraid to ask the awkward questions, as real listeners share their own tales of coping with grief, despair, and anxiety.
• 仁Gotch是OK ......有时。Ladyboss CEO和创始人ban.do仁Gotch变得脆弱，真正的每周，有心理健康分享她的斗争。
• Happier with Gretchen Rubin。这是毫不奇怪，笔者The New York Timesbestseller幸福工程has tons of suggestions to help you emerge from your sad cave, build positive habits, and create a happier outlook. Her slightly skeptical sister Elizabeth Craft keeps all that sunshine in check.
• 希望之文集。你是here, and you’re reading this, so that in itself proves that you haven’t given up hope. But it’s not just that you是在这里，它是为什么你在这里。该播客下潜更深成“为什么”，并试图把那个你的脑海里，而不是其他垃圾试图拉你下来。主持人里克Osowski，谁作战了抑郁症，带来了各种各样的客人进折谈谈自己的原因。

顶级萧条支持团体和非营利组织

• 美国的焦虑和抑郁协会（ADAA）。这个非盈利性的专门用于预防，治疗和焦虑，抑郁，强迫症，创伤后应激障碍，以及共同发生疾病治愈。来这里的新的研究，从心理卫生专家，教育信息图表和统计信息，并可以通过障碍搜索查找-A-治疗师数据库每月的网络研讨会。你总是可以找到在ADAA网上对等网络支持小组或（免费）支持支援团队iOS app for iPhone.
• National Alliance on Mental Illness(NAMI)。这个非营利组织心理健康宣传组织p offering free education and support programs such as NAMI Peer-to-Peer (eight free sessions for adults with specific mental health conditions). You can also connect with other folks who have depression on this org’s online message boards and viaNAMI连接(用这个网站找到一个每周或每月的复苏group near you).
• Reddit, r/depression。Reddit is the hideously under-designed social website for anonymous users with a bad rep for attracting “incels” and “neckbeards.” The self-proclaimed “Front Page of the Internet” has memes, conspiracy theories, and thousands of communities called subreddits—and some of them are quite lovely. For example, the r/depression subreddit is over a decade old with more than half a million subscribers. In here, the vibe is all about empathy, support, and helpful feedback. (Arecent study甚至发现，逛版（Subreddit）造成用户“积极情感变化”。）
• Talkspace。更喜欢“安全空间”。这是在网上，它是私有的，而且它的“开放” 24/7。超过1亿人使用Talkspace得到匹配了他们的5000多名持牌治疗师之一，然后他们的消息...尽可能多和尽可能经常想。有根据您的需要不同的包，但即时反馈和舒适是非常宝贵的。
• 伤心女孩俱乐部。This is a nonprofit, an online community, and an Instagram handle (see above) focused on the millennial and Gen Z experience of mental illness (depression, anxiety, or something undiagnosed all count). They host meetups IRL where you can connect with similar people and try a cool twist on art therapy like a poetry slam or embroidery class.
• To Write Love on Her Arms (TWLOHA)。It’s not just a nonprofit — it’s a movement. Online, at in-person events, through social media and blogs, TWLOHA creates a place for hope and healing through depression, addiction, self-injury, and suicide. People who attend their events and join this community have said they’ve felt transformed. Worth a try, yea?