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by Scholten A

(Major Depressive Affective Disorder; Unipolar Disorder; Unipolar Mood Disorder)


Risk Factors

Depression is more common in females. There are a range of factors that may increase your risk of depression. Examples include:


There is no blood test or diagnostic test for depression. You will be asked about your symptoms and medical history, giving special attention to:
  • Alcohol and drug use
  • Thoughts of death or suicide
  • Family members who have or have had depression
  • Sleep patterns
  • Previous episodes of depression
Specific mental health exams may be done. This will help the doctor get detailed information about your speech, thoughts, memory, and mood. A physical exam and other tests can help rule out other causes.


Treatment may involve the use of medication and/or psychotherapy.
Severe depression can require hospital care, especially if you are at risk of hurting yourself or others.


Psychotherapy for depression consists of various types of counseling. These include cognitive-behavior therapy (CBT) , interpersonal therapy, psychodynamic therapy, or a combination of these. Therapy is designed to help you cope with difficulties in relationships, change negative thinking and behavior patterns, and resolve difficult feelings.

Diet and Exercise

Dietary Changes
Research suggests that diets high in tryptophan and certain B vitamins may be helpful. There is also mixed evidence that omega-3 fatty acids may reduce symptoms.
If you want to take supplements or change your diet, talk to your doctor first.
Dietary Supplements and Herbal Therapy
The herb St. John's wort may be an effective alternative to standard medications with fewer side effects. However, St. John's wort may reduce the effectiveness of many drugs, such as antidepressants, birth control pills, blood thinners, and other medications. It is important that you talk to your doctor before trying any herb.
There is also some evidence that dehydroepiandrosterone (DHEA) , a hormone that is available as a dietary supplement, may help some people.
A regular exercise program has been shown to relieve some of the symptoms. It should play a large role in the overall management of depression.


Electroconvulsive Therapy (ECT)
ECT is the use of an electric stimulus to produce a generalized seizure. It may be used in people with severe or life-threatening depression. ECT is also used for people who cannot take or do not respond to medication. It is considered a safe and effective procedure.
Vagus Nerve Stimulation (VNS)
VNS is used as therapy for depression when multiple trials of medication do not work. A pacemaker-like device stimulates the vagus nerve in the neck.
Vagus Nerve
Vagus Nerve
Stimulation of the vagus nerve (yellow) at the neck is a depression therapy option.
Copyright © Nucleus Medical Media, Inc.
Transcranial Magnetic Stimulation (TMS)
TMS involves the application of low-frequency magnetic pulses to the brain. The change in electrical field stimulates nerves. There are a number of studies that show the benefits of TMS for the treatment of depression. It may be used if you have not gotten better with medications and psychotherapy.

Other Treatment Options

Bright Light Therapy
Your doctor may recommend bright light therapy. This involves being exposed to high levels of light from a special light box that has a screen on it.
Meditation may help to improve the symptoms of depression.


Depression and Bipolar Support Alliance

Mental Health America



Canadian Mental Health Association

Canadian Psychiatric Association



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Columbia University. Q&A on bright light therapy. Columbia University website. Available at: Accessed September 18, 2014.

Depression. EBSCO DynaMed website. Available at: Updated September 15, 2014. Accessed September 18, 2014.

Depression. Mental Health America website. Available at: Accessed September 18, 2014.

Depression (mild to moderate). EBSCO Natural and Alternative Treatments website. Available at: Updated August 2013. Accessed September 18, 2014.

Groves DA, Brown VJ. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neurosci Biobehav Rev. 2005;29:493-500.

St. John's wort. EBSCO Natural and Alternative Treatments website. Available at: Updated August 2013. Accessed September 18, 2014.

St. John's wort and depression. National Center for Complementary and Alternative Medicine website. Available at: Updated September 2013. Accessed September 18, 2014.

St. John's wort for depression. EBSCO DynaMed website. Available at: Updated April 26, 2012. Accessed September 18, 2014.

What is depression? National Institute of Mental Health website. Available at: Accessed September 18, 2014.

12/16/2008 DynaMed's Systematic Literature Surveillance. Linde K, Berner M, Kriston L. St. John's wort for major depression. Cochrane Database Syst Rev. 2008;CD000448.

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