让我们来谈谈抑郁症

你今天感觉怎么样？如果您发现自己读这篇文章，可能很糟糕。也许你已经感觉无精打采，下来了很多的时间比你预期的，而且它让你担心，你可能有抑郁症。也许你刚刚收到了临床抑郁症的诊断和你正在寻找的答案。我们懂了。因此，许多贡献者HealthCentral感到就像你现在要做的。但是，我们不会让抑郁症你吞没。我们也不会与一堆虚假的承诺和不准确的信息（这是你的Facebook饲料是）的轰炸你。在这里，我们分享应对抑郁症的现实，以及来自顶尖的医生，最成功的治疗和情绪提升生活方式的改变，专家的意见。

什么是抑郁症，真的吗？

这是正常的经验悲伤。（WHOdidn’t想哭的时候辛巴不能醒木法沙？）但是，与典型的悲伤或悲痛，时间也不会痊愈Major 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是more than 50 percent. If you’ve had two episodes, that chance shoots up to80％。意思是，你将要处理这个宜早不宜迟。

One hallmark of depression is an inability to experience pleasure, which is literally no fun. Losing interest in things you once enjoyed often means that your capacity to function at work and home takes a dive. In fact, depression is one of the leading causes of disability in the U.S., as 7.2% of Americans—17.7 million people—experience Major Depressive Disorder, each year.

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。They 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。有时，人们把它称为“高功能”或“微笑”抑郁症。虽然症状并不严重的抑郁症，但持续两年longer。People with PDD might feel like they’ve always been depressed. (In cases of “双抑郁症”人们自己平时慢性抑郁症的状态中体验MDD的严重发作。）
• Seasonal Affective Disorder (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, frequent crying—they’re much more severe. They打断你的工作能力，破坏人际关系，并可能导致自我伤害和自杀的念头。在2013年加入这个条件如抑郁症的DSM-5，精神障碍的官方指南的形式。
• 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postpartum depression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.
• Substance/Medication-Induced Depressive Disorder.Substance abuse (酒精，鸦片制剂，镇静剂，安非他明，可卡因，迷幻剂，etc.) or taking some medications, like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孩子这个少年障碍是grumpyandbad-tempered大多数时候。They 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?

你不会喜欢这个答案，但没有人确切知道。也就是说，在过去的几十年里，当时的说法是，抑郁的人在他们的大脑失衡化学，更具体地说，水平低neurotransmitterslike 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,如虐待或忽视。
• 环境压力，就像一个爱的人的死亡，杂乱离婚，或财务问题。
• Some medical conditions（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。
• 荷尔蒙的变化，like those that come with childbirth and menopause.
• Gut bacteria.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feel down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 hungrierthan usual.
4. Having a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 exhaustedyou can’t even.
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thoughts of death or suicide（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？

当你有一个抑郁症发作，它可能觉得你注定要觉得可怕永远。这不是真的。这是你的郁闷大脑要你想什么。最难的步骤是忽略的感觉，使与医生和/或心理健康专家，预约比如心理医生或精神科医生。心理健康专家，是唯一的专家，可以帮助你计算出，如果你抑郁。

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.

即使你的症状匹配到MDD，不过，你的医生应首先排除任何潜在的医学原因。一些条件，如甲状腺疾病和维生素缺乏症，抑郁症可以模仿的症状。其次，考虑你目前服用任何药物。
如果这听起来像你或你认识的人，做一个心理健康专家预约。现在。不要等待！什么是可能发生的最坏的事情？如果你觉得由当时的任命来临时更好的，你可以随时取消。如果不这样做，你已经采取措施来管理你的心理健康保存自己宝贵的时间（和不必要的痛苦）。

什么是抑郁症最好的治疗？

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。治疗的类型包括心理动力学疗法,Cognitive Behavioral Therapy (CBT)和人际关系治疗。

Medication

您r depression might require more than coaching.Doctors may prescribe medication includingantidepressants,情绪稳定和/或antipsychotic pillsin order to decrease the symptoms of depression. These include:

• SSRIs的（选择性血清素再摄取抑制剂）像百忧解（氟西汀），帕罗西汀（帕罗西汀），和左洛复（舍曲林）和SNRIs (serotonin and norepinephrine reuptake inhibitors)like Cymbalta (duloxetine) and Effexor XR (venlafaxine) make neuro-transmitters serotonin and norepinephrine already existing in the brain more available.
• TCAs (tricyclic antidepressants)like Tofranil (imipramine) and Norpramin (desipramine) andMAOIs (monoamine oxidase inhibitors)like Emsam (selegiline) and Marplan (isocarboxazid) are first-generation antidepressants that work similarly on neuro-transmitters, but they’re used less often because of unpleasant side effects.
• 医生也可以使用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

对于难治性抑郁症that 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。

There is alsorepetitive transcranial magnetic stimulation (rTMS)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。

Other Treatment Approaches

These may include:

• 对于严重的，难治性抑郁症，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, a neurotransmitter that helps prompt the brain to form new neural connections.
• 在悲伤seasonal depression (SAD)可以与褪黑激素调节的能够减轻光疗。
• 产后抑郁症可与治疗Brexanolone（Zulresso），人体自身的神经类固醇四氢孕酮的IV版本。
• Research shows that生活方式的改变像合并行使and mindfulnesscan 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。

• Kevin Hines,@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.

• 萝拉，吉娜和诺拉塔什和妮可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你如何应对抑郁症，特别是在现代的情况下，如在工作中讨论了心理健康咨询的实际（包括hashtagawkward）。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“professionally depressed” host John Moe.
• Terrible, Thanks for Asking。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.
• Jen Gotch is OK...Sometimes。Ladyboss CEO and ban.do founder Jen Gotch gets vulnerable and real every week, sharing her struggles with mental health.
• Happier with Gretchen Rubin。这是毫不奇怪，笔者纽约时报bestsellerThe Happiness Projecthas 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。你在这里，你正在读这篇文章，让本身就证明你还没有放弃希望。但它不只是你are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。

Top Depression Support Groups and Non-Profits

• 美国的焦虑和抑郁协会(ADAA). This nonprofit is dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders. Come here for new research, monthly webinars from mental health experts, educational infographics and stats, and a Find-a-Therapist database you can search by disorder. You can always find (free) support on the ADAA Online Peer-to-Peer Support Group orsupport groupiOS app for iPhone.
• 全国精神疾病联盟(NAMI). This nonprofit mental health advocacy group 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（使用本网站找到一个每周或每月的恢复组你附近）。
• reddit的，R /抑郁症。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. (A最近的研究甚至发现，逛版（Subreddit）造成用户“积极情感变化”。）
• Talkspace。More like “safe space.” It’s online, it’s private, and it’s “open” 24/7. Over 1 million people use Talkspace to get matched up with one of their 5,000+ licensed therapists and then message them...as much and as often as they’d like. There are different packages depending on your needs, but the instant feedback and comfort is pretty much priceless.
• Sad Girls Club。这是一个非营利组织,一个在线社区,一个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.
• 写情在她的胳膊（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?