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。

如果不进行治疗，抑郁症会不会消失在自己的。即使你通过你的抑郁症首次发作白热化它，你的另一复发的机会是50％以上。如果你有两集，这样的机会拍摄到80％。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％。

抑郁症的其他类型

We talked about MDD (a.k.a. depression) but还有其他类型的抑郁症。它们包括：

• 持久的抑郁症。这是抑郁症的一种慢性形式，旧称dysthymia。Sometimes people call it “high functioning” or “smiling” depression. While symptoms aren’t as severe as MDD, they last for two years or长。与PDD的人可能会觉得自己一直被按下。（在案件“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。
• Premenstrual Dysphoric Disorder (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-易怒，高度焦虑，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.
• 围产期抑郁症。New mothers with this disorder typically develop symptoms of depression and even psychosis within a few weeks of giving birth. It used to be called产后抑郁症和many people still use the term interchangeably. (In some cases, symptoms start during pregnancy; other times, when the baby is several months old—hence the name change.)
• Perimenopausal Depression.In midlife (specifically, the years leading up to绝经), people experiencing this disorder have typical depressive symptoms plus更年期症状像潮热和盗汗。
• 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，如糖皮质激素要么他汀类药物，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。Achild with this juvenile disorderisgrumpy和脾气暴躁大多数时候。他们与父母，老师和同学每周数次严重的，爆炸性的爆发。他们的过度反应是极端的，不符合他们的发展水平。

萧条strikes people at a median age of 32, but it's important to remember that depression can happen to anyone, at any age, of any race, gender, or political affiliation. One out of every six adults will experience depression at some time in their life. Fortunately, depression is treatable. That’s why, at the first hint of symptoms, it’s important to make an appointment with a mental health professional who can help determine whether you have depression, and if so, which type—and most importantly, which treatment is appropriate for you.

是什么原因导致抑郁症？

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:

• 遗传学。研究表明，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。
• 从童年创伤性生活事件，such as abuse or neglect.
• Environmental stressors,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(e.g., underactive thyroid, chronic pain). Per science, the relationship between these physical conditions and depression is bidirectional, so there’s a chicken-or-egg thing going on because they feed each other.
• 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. The things you liked doing no longer give you joy.
3. 重大重量损失（无需节食）要么weight 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staying asleep or oversleeping.
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。你是筋疲力尽你甚至不能。
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，而无法集中精力。
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）。

How Do Doctors Diagnose Depression?

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.

不幸的是，没有简单的血液测试，可以判断，如果你有抑郁症，虽然这将使诊断容易得多。（得到它，科学！）的DSM-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

This doesn’t mean you’ll find yourself reclined on a couch, complaining about your relationship with your mother (though it might). A psychiatrist, psychologist, therapist, or licensed clinical social worker might use a variety of techniques to help change the negative thinking, beliefs, or behaviors that exacerbate your depression and make your world seem hopeless. Types of therapy includepsychodynamic therapy,认知行为疗法（CBT）, andinterpersonal therapy。

药物

你的抑郁症可能需要超过执教。医生可以开药，包括抗抑郁药,情绪稳定, and/or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like Zyban or Wellbutrin (bupropion) or Remeron (mirtazapine) that affect serotonin, norepinephrine, and dopamine levels in ways unique from other anti-depression drugs. Or they may add非典型抗精神病药物, a.k.a. second-generation antipsychotics like Seroquel (quetiapine) or Abilify (aripiprazole). They’re “atypical” in that they affect dopamine and other neurotransmitters without the physical side effects, such as tics and tremors, that first-generation antipsychotics can cause.

脑刺激

Fortreatment-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。Fear not—modern ECT is safe, performed under anesthesia, and much less aggressive than you see in the movies.

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vagus nerve stimulation (VNS), a surgical implant that works kind of like a pacemaker, sending electric pulses to the brain.

其他的治疗方法

These may include:

• For severe,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。专家说，它的工作原理是惹得生产glutamate神经递质，有助于提示大脑形成新的神经连接。
• Sadness duringseasonal depression (SAD)可以与褪黑激素调节的能够减轻light therapy。
• Postpartum depression may be treated withBrexanolone(Zulresso), an IV version of the body’s own neurosteroid allopregnanolone.
• 研究表明，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.

在哪里可以找到抑郁症相关的社区？

关于抑郁症的事情是，它让你想自己擀成毯卷饼，并没有活着出来的。但闭关锁国可以给你自由支配时间去照顾自己的需求，玩味你的感知缺陷，并销毁的前进的动力，任何机会，使已经坏情况变得更糟。随着治疗和药物治疗，寻找支持的人，并与他们在线连接，并在现实生活中，是照顾自己的重要组成部分。下面是从哪里开始。

Top Depression Instagrammers and Bloggers

• 汤妮雅英格拉姆，@tonyainstagram,tonyaingram.com

Follow because: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

Follow because: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

Follow because: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

Follow because:Sometimes the only way to come out of a deep dark hole is with the universal language of laughter. These girls (mostly family or like family) create endless hilarious memes that represent the real trials and tribulations of living in today’s social media-infested world. The point of it all? So you know that, as they put it, “you’re never alone and never as batshit as you think.”

• 伤心女孩俱乐部,@sadgirlsclub

Follow because: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

Follow because: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。

• The Sad Ghost Club,@theofficialsadghostclub,thesadghostclub.com

Follow because:弥敦道，丽泽，和海伦都是死党，或者，ghosties，因为他们把自己，谁走到一起，分享生活与精神疾病从电脑屏幕后面。这些鬼不糖衣的事情，但他们也不能悲观失望。你会沉迷于自己的图形和积极的（但不是过于认真的）消息。

Top Depression-Related Podcasts

• 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。作者诺拉McInerny，谁处理的抑郁症，是不是怕问了尴尬的问题，因为真正的听众分享自己的悲伤，绝望和焦虑应对的故事。
• 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 Times畅销书幸福工程拥有吨的建议，以帮助您从悲伤的洞穴出现，建立良好的习惯，营造一个快乐的前景。她有点怀疑妹妹伊丽莎白工艺保留所有阳光检查。
• 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here—it’s为什么you’re here. This podcast dives even deeper into that “why” and tries to bring that to the forefront of your mind instead of the other garbage trying to pull you down. Host Rick Osowski, who has battled depression, brings a variety of guests into the fold to talk about their why.

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）。这个非盈利性心理健康宣传组提供免费的教育和支持计划，例如NAMI对等网络（为特定的心理健康状况的成年人购物休闲会话）。您也可以与谁对这个组织的网上留言板，并通过抑郁症外乡亲连接NAMI连接(use the site to find a weekly or monthly recovery group near you).
• Reddit, r/depression。reddit的是对匿名用户提供了坏名声吸引“incels”和可怕下设计的社会网站“neckbeards。”自称为“互联网的头版”有模因，阴谋论，和社区的称为十万subreddits，其中一些是非常可爱的。例如，R /抑郁版（Subreddit）是十多年的老有超过50万用户。在这里，盛传是所有关于同情，支持和帮助的反馈。（一个recent 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?