Editors' note: Depression is a serious illness, and these classes are designed to be used in addition to -- not instead of -- medical treatment. If you think you are depressed, particularly if you feel suicidal, please seek help immediately.

Everyone feels sad occasionally. That's normal. But if the sadness goes on for weeks or months, and if none of your usual techniques for dealing with a bad mood seem to work, you might be depressed. Depression saps your energy, making it difficult to get through the day. Previously enjoyable activities become dull and uninteresting, and relationships with friends and family begin to suffer.

Depression affects your whole being -- the way you eat, sleep, and think. It is not a sign of personal weakness, and it can't be wished away. The condition takes the joy out of living, and depressed people can't just "snap out of it." Without treatment, serious symptoms can last weeks, months, or years.

The symptoms vary from person to person, but there are many common warning signs. The National Institute of Mental Health lists these red flags:

•Persistent sad, anxious, or "empty" feelings

•Feelings of hopelessness and/or pessimism

•Feelings of guilt, worthlessness, and helplessness

•Irritability and restlessness

•Loss of interest in hobbies or activities that once were pleasurable (including sex)

•Fatigue and decreased energy

•Difficulty concentrating, remembering details, and making decisions

•Insomnia, early morning wakefulness, or excessive sleeping

•Overeating or loss of appetite

•Thoughts of suicide or suicide attempts

•Persistent aches or pains, headaches, cramps, or digestive problems that do not get better even with treatment.

If you experience five or more of these symptoms lasting for two weeks or longer, it's time to make an appointment to see your doctor. Depression can almost always be successfully treated, but unfortunately fewer than half of people with depression seek help. It may help to understand that depression is an illness. You would likely talk to your doctor if you suffered from migraines, ulcers, or another ailment, and you should take depression just as seriously.

There are other reasons you should not try battling this on your own. Some physical illnesses -- and even some medications -- can cause symptoms similar to depression, so you'll need a doctor's expertise to rule those out. (Talk to your doctor before you stop taking medications on your own.) If you have heart disease, diabetes, cancer, or another chronic illness, getting depression under control can be an important part of your overall treatment.

Depression is not a sign of personal weakness -- you don't become depressed because you're weak-willed or soft. A number of things may contribute to depression, and not all of them are well understood. For instance, when people are depressed they have a distinct brain chemistry, although the reason is unknown. Some types of depression tend to run in families, suggesting a possible genetic link. Statistically, women are more likely to be depressed, and so are people with low self-esteem. Traumatic life events, including divorce, job layoffs, or a death in the family can all trigger enduring depression.

If you make an appointment to be evaluated for depression, your doctor will review your medical history, give you a physical examination, and perhaps run some lab tests to rule out physical problems. Depending on the results, you may then be referred to a mental-health professional for further evaluation, or the doctor may suggest therapy, possibly including antidepressant medication. (You'll find a list of links at the end of this article with more information about treatment options, as well as a handy checklist of questions to ask your doctor.)

You can also help yourself, and that's where this class comes in. All of the tips and techniques in this class can be used along with counseling or antidepressant medications -- nothing here will interfere with other treatments. (Of course, it's always a good idea to keep your doctor or therapist informed about all the things you are doing to manage your depression.)

Depression can make you feel exhausted and helpless, but remember that those feelings are a part of the condition. The negative thoughts that go along with depression are often unrealistic. Working to replace negative thinking with a more optimistic and realistic approach can help you move toward recovery. In his book SOS Help for Emotions, psychologist Lynn Clark suggests changing negative or unrealistic thoughts in specific ways. The following examples may help you get going.

If you find yourself thinking this:

"It's easier to avoid facing certain responsibilities than to deal with them right now."

Try substituting this more constructive thought:

"Dealing with difficulties and responsibilities may be unpleasant, but it's a part of life and I can handle it."

If you find yourself thinking this:

"I should wait to (call my doctor, go to the gym, whatever you want to avoid) until I feel more like doing it."

Try substituting this more constructive thought:

"I can begin this task even though I don't feel like it."

We'll dig deeper into the role of negative or unrealistic thinking and how to counter it in our next class. For now, try tackling the following tasks.

•Take our depression assessment quiz /

•Call your doctor for an appointment if you think you might be depressed

•Before your appointment, print this list of questions to ask your doctor about depression

•Research the different types of psychotherapists

•Learn how to choose the right therapist for you

Future Classes:

Managing Depression 101, Part 2: Changing Negative Thinking

Managing Depression 101, Part 3: The Exercise Prescription

Managing Depression 101, Part 4: What Role Does Diet Play?

Managing Depression 101, Part 5: Complementary Treatments

References

First published December 18, 2009
Copyright © 2009 Consumer Health Interactive

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