Depression 抑郁症
In any given one-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness.在任何特定的一年内，百分之九点五的人口，即大约1880万美国成年人，患抑郁症的疾病。 The economic cost for this disorder is high, but the cost in human suffering cannot be estimated.经济成本的这种疾病是高，但成本在人类的痛苦无法估计。 Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them.抑郁症的疾病常常干扰正常运作，并造成痛苦和苦难不仅是为了那些谁有一个障碍，而且也向那些谁关心他们。 Serious depression can destroy family life as well as the life of the ill person.严重的抑郁症会破坏家庭生活以及生命的病人。 But much of this suffering is unnecessary.但是，这种痛苦是不必要的。
Most people with a depressive illness do not seek treatment, although the great majority -even those whose depression is extremely severe - can be helped.大多数人的抑郁症患病不求医，但绝大多数，甚至那些抑郁症是极为严重的-能够得到帮助。 Thanks to years of research, there are now many medications and psychosocial therapies, such as cognitive/behavioral, "talk," or interpersonal therapies, which ease the pain of depression.经过多年的研究，现在有许多药物和心理治疗，如认知/行为， “交谈” ，或人际疗法，它缓解疼痛的抑郁症。
Unfortunately, many people do not recognize that depression is a treatable illness.不幸的是，很多人不承认，抑郁症是一种可治疗的疾病。 If you feel that you or someone you care about is one of the many undiagnosed depressed people in this country, the information presented here may help you take the steps that may save your own or someone else's life.如果您认为您或您关心的是其中一个确诊抑郁的人在这个国家，提交的资料在这里可以帮助您采取的步骤，可以节省你自己或别人的生命。
What is a Depressive Disorder? 什么是抑郁症？
A depressive disorder is an illness that involves the body, mood, and thoughts.阿抑郁症是一种疾病，涉及身体，情绪，思想。 It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things.它影响了道路的人吃和睡的方式，感觉对自己，以及如何想想的事情。 A depressive disorder is not the same as a passing blue mood.阿抑郁症是不一样的路过的蓝色心情。 It is not a sign of personal weakness or a condition that can be willed or wished away.这不是一个象征个人的弱点或条件，可意志或愿望而消失。 People with a depressive illness cannot merely "pull themselves together" and get better.人与抑郁症的患病不能仅仅“振作精神” ，并变得更好。 Without treatment, symptoms can last for weeks, months, or years.如果不治疗，症状可以持续数周，数月或数年。 Appropriate treatment, however, can help most people who suffer from depression.适当的治疗，不过，能帮助大多数人谁遭受抑郁症。
Types of Depression 类型的抑郁症
Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease.抑郁症有不同的形式，就像是这种情况与其他疾病，如心脏病。 This pamphlet briefly describes three of the most common types of depressive disorders.本小册子，简要介绍了三种最常见的抑郁症。 However, within these types there are variations in the number of symptoms, their severity, and persistence.然而，在这些类型有不同的一些症状，其严重程度和持久性。
Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities.抑郁症表现的综合症状（见症状清单）干扰的能力，工作，学习，睡觉，吃饭，并享受一次愉快的活动。 Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.这种停用的抑郁症发作，可能会出现只有一次，但更常见的发生数次一生。
A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good.一个不太严重类型的抑郁症，恶劣心境，涉及长期，慢性症状，不要停用，但保持一个良好运作或从感觉很好。 Many people with dysthymia also experience major depressive episodes at some time in their lives.许多人与恶劣心境也遇到严重抑郁发作在一段时间内他们的生活。
Another type of depression is bipolar disorder, also called manic-depressive illness.另一种类型的抑郁症是双相情感障碍，又称躁狂抑郁症的疾病。 Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression).并不像流行的其他形式的抑郁症，双相情感障碍的特点是自行车的情绪变化：严重的高点（躁狂症）和低点（抑郁症） 。 Sometimes the mood switches are dramatic and rapid, but most often they are gradual.有时情绪交换机是戏剧性的和迅速的，但往往他们是渐进的。 When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder.当不景气周期，一个人可以有任何或所有症状的抑郁症。 When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy.当在躁狂周期，个人可过， overtalkative ，并有大量的能源。 Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment.疯狂往往会影响思维，判断和社会行为方式，导致严重的问题和尴尬。 For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees.例如，个人在一个疯狂的阶段可能会感到欢欣鼓舞，充分展现了宏伟的计划有可能从不明智的商业决策，以浪漫的热潮。 Mania, left untreated, may worsen to a psychotic state.癫狂，不及时治疗，可能恶化的精神状态。
Symptoms of Depression and Mania 症状的抑郁和躁狂
Not everyone who is depressed or manic experiences every symptom.不是每个人都谁是躁狂抑郁症或经验，每一个症状。 Some people experience a few symptoms, some many.有些人经历一些症状，有些许多。 Severity of symptoms varies with individuals and also varies over time.严重的症状与个人差异，也随着时间的推移而异。
Depression Symptoms 抑郁症状
• Persistent sad, anxious, or "empty" mood •持续悲伤，焦虑，或“空”的情绪
• Feelings of hopelessness, pessimism •感到失望，悲观
• Feelings of guilt, worthlessness, helplessness •的内疚感， worthlessness ，无助
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex •失去兴趣或乐趣的爱好和活动，一旦得到，包括性
• Decreased energy, fatigue, being "slowed down" •减少能源，疲劳，是“放慢”
• Difficulty concentrating, remembering, making decisions •难集中，记忆，决策
• Insomnia, early-morning awakening, or oversleeping •失眠，早晨醒来， oversleeping或
• Appetite and/or weight loss or overeating and weight gain •食欲和/或体重减轻或暴食和体重增加
• Thoughts of death or suicide; suicide attempts •思考死亡或自杀，自杀未遂
• Restlessness, irritability •不安，烦躁
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain •持久的身体症状不回应的待遇，如头痛，消化道疾病，和慢性疼痛
Mania Symptoms 躁狂症状
• Abnormal or excessive elation •异常或过度兴奋
• Unusual irritability •异常烦躁
• Decreased need for sleep •减少必要的睡眠
• Grandiose notions •宏伟的概念
• Increased talking •增加说话
• Racing thoughts •赛车的想法
• Increased sexual desire •提高性欲
• Markedly increased energy •显着增加能源
• Poor judgment •可怜的判决
• Inappropriate social behavior •不适当的社会行为
Causes of Depression 抑郁症的原因
Some types of depression run in families, suggesting that a biological vulnerability can be inherited.某些类型的抑郁症在家庭中运行，表明生物脆弱性可以继承。 This seems to be the case with bipolar disorder.这似乎是如此躁郁症。 Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill.研究家庭中每个成员的代开发躁郁症发现，那些与这种疾病有一个略为不同的基因构成比谁不会生病。 However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness.然而，反向是不正确的：不是每个人都与遗传造成的脆弱性躁郁症将有疾病。 Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.显然还有其他因素，可能强调在家庭，工作，或上学，参与其发病。
In some families, major depression also seems to occur generation after generation.在一些家庭，抑郁症似乎也出现了一代又一代。 However, it can also occur in people who have no family history of depression.然而，它也可能发生在人们谁没有家族病史的抑郁症。 Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function.无论是继承与否，抑郁症通常伴随着变化的脑结构或大脑功能。
People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression.人们谁低自尊，谁始终认为自己和世界的悲观或谁很容易受到压力，很容易抑郁症。 Whether this represents a psychological predisposition or an early form of the illness is not clear.这是否是一个心理倾向或早期形成的疾病并不清楚。
In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well.近年来，研究人员已经证明，物理变化在体内可能会伴随着心理变化。 Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period.医学疾病，如中风，心脏病，癌症，帕金森氏症，内分泌紊乱，并可能会导致抑郁症的疾病，使有病的人冷漠，不愿照料他或她的身体的需要，从而延长了恢复期。 Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode.此外，一个严重的损失，困难的关系，财政问题，或任何压力（不受欢迎的，甚至期望）改变生活方式可引发抑郁发作。 Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder.很多时候，结合遗传，心理和环境因素参与发病的抑郁症。 Later episodes of illness typically are precipitated by only mild stresses, or none at all.后来发生的疾病通常是沉淀只有轻微压力，或根本没有。
Depression in Women 抑郁症的妇女
Women experience depression about twice as often as men.1 Many hormonal factors may contribute to the increased rate of depression in women-particularly such factors as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause.妇女患抑郁症的两倍左右经常men.1许多荷尔蒙因素可能有助于上升抑郁症的妇女，尤其是等因素，月经周期的变化，怀孕，流产，产后期，前更年期和绝经期。 Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.许多妇女还面临着更多的压力，如责任在工作和家庭，单亲家庭，以及照顾子女和衰老的父母。
A recent NIMH study showed that in the case of severe premenstrual syndrome (PMS), women with a preexisting vulnerability to PMS experienced relief from mood and physical symptoms when their sex hormones were suppressed.最近的镍氢电池的研究表明，在严重的情况下月经前期综合征（经前综合症） ，妇女与存在的脆弱性管理系统经历了从救济的情绪和身体症状时，性激素被压制。 Shortly after the hormones were re-introduced, they again developed symptoms of PMS.不久后，荷尔蒙被重新介绍，他们再次开发的经前期综合征的症状。 Women without a history of PMS reported no effects of the hormonal manipulation.6,7没有妇女的历史，经前期综合征报告没有影响荷尔蒙manipulation.6 ， 7
Many women are also particularly vulnerable after the birth of a baby.许多妇女也特别容易受到伤害后，诞生了一个婴儿。 The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women.在荷尔蒙和物理变化，以及补充责任的新的生活，可以因素，导致产后抑郁症在一些妇女。 While transient "blues" are common in new mothers, a full-blown depressive episode is not a normal occurrence and requires active intervention.虽然短暂“蓝调”是在新的共同的母亲，一个成熟的抑郁发作不是一个正常的发生，要求采取积极的干预。 Treatment by a sympathetic physician and the family's emotional support for the new mother are prime considerations in aiding her to recover her physical and mental well-being and her ability to care for and enjoy the infant.治疗同情医生和家人的情感支持新的母亲是主要考虑在帮助她恢复她的身体和精神的福祉和她的能力照顾和享受的婴儿。
Depression in Men 抑郁症的男子
Although men are less likely to suffer from depression than women, three to four million men in the United States are affected by the illness.虽然男子不太可能患有抑郁症的女性相比， 3至4万人在美国受到疾病。 Men are less likely to admit to depression, and doctors are less likely to suspect it.男子不太可能承认抑郁症，医生不太可能怀疑。 The rate of suicide in men is four times that of women, though more women attempt it.自杀率是男性的4倍，妇女，但更多的女性尝试它。 In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85.事实上，在70岁的速度男子自杀的上升，达到高峰后， 85岁。
Depression can also affect the physical health in men differently from women.抑郁症也会影响身体健康的男性不同于女性。 A new study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.2一项新的研究表明，尽管抑郁症是与风险增加冠心病的男子和妇女中，只有男子患有高死亡rate.2
Men's depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours.男子往往是抑郁症所掩盖酒精或药物，或由社会上可以接受的习惯，工作时间过长。 Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men.抑郁症通常出现在男人的感觉不是绝望和无助，但作为急躁，愤怒，和取缔;因此，抑郁症可能很难承认这种男性。 Even if a man realizes that he is depressed, he may be less willing than a woman to seek help.即使一个人认识到，他是沮丧，他可能不太愿意比一个女人寻求帮助。 Encouragement and support from concerned family members can make a difference.鼓励和支持有关家庭成员能够有所作为。 In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment.在工作场所，雇员援助专业人员或工作场所心理健康的节目能够提供协助，在帮助男性理解和接受抑郁症成为真正的疾病，需要治疗。
Depression in the Elderly 抑郁症在老年人
Some people have the mistaken idea that it is normal for the elderly to feel depressed.一些人的错误想法，这是正常的老年人感到沮丧。 On the contrary, most older people feel satisfied with their lives.相反，大多数老年人感到满意，他们的生活。 Sometimes, though, when depression develops, it may be dismissed as a normal part of aging.有时，虽然时，抑郁症的发展，它可能会被视为正常老化的一部分。 Depression in the elderly, undiagnosed and untreated, causes needless suffering for the family and for the individual who could otherwise live a fruitful life.抑郁症在老年人，确诊和治疗，造成不必要痛苦的家庭和个人否则谁活了富有成果的生活。 When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss.当他或她不去看医生，描述的症状通常是身体，为老年人的往往是不愿讨论感情的绝望，悲伤，失去兴趣通常愉快的活动，或极为悲痛后，长期亏损。
Recognizing how depressive symptoms in older people are often missed, many health care professionals are learning to identify and treat the underlying depression.如何认识抑郁症在老年人往往错过了许多医疗专业人员正在学习识别和治疗抑郁症的根本。 They recognize that some symptoms may be side effects of medication the older person is taking for a physical problem, or they may be caused by a co-occurring illness.他们认识到，一些症状可能是副作用的药物老年人是一个身体的问题，或者他们可能是由一个共同发生的疾病。 If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life.如果诊断是抑郁症，治疗药物和/或心理治疗，将有助于抑郁症的人返回的幸福，更充实生活。 Recent research suggests that brief psychotherapy (talk therapies that help a person in day-to-day relationships or in learning to counter the distorted negative thinking that commonly accompanies depression) is effective in reducing symptoms in short-term depression in older persons who are medically ill.最近的研究表明，简短心理治疗（谈话疗法，帮助一个人在日常关系，或在学习反扭曲的消极思想，通常伴随着抑郁症）是有效地减少症状的短期抑郁症在老年人谁体检有病的。 Psychotherapy is also useful in older patients who cannot or will not take medication.心理治疗也是有益的老年患者谁可以不能或不愿吃药。 Efficacy studies show that late-life depression can be treated with psychotherapy.4药效研究表明，晚年的抑郁症可以治疗psychotherapy.4
Improved recognition and treatment of depression in late life will make those years more enjoyable and fulfilling for the depressed elderly person, the family, and caretakers.改进的认识和治疗抑郁症的晚年将这些年来更愉快和满足的抑郁症老人，家庭和照顾。
Depression in Children 抑郁症的儿童
Only in the past two decades has depression in children been taken very seriously.仅在过去二十年儿童抑郁症已采取非常认真的态度。 The depressed child may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die.儿童的抑郁症可能会假装生病，拒绝去学校上学，抱住父母，或担心父母可能死去。 Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood.年龄较大的儿童可能会忧郁，出乱子在学校，是消极的，过敏，觉得被误解。 Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child is just going through a temporary "phase" or is suffering from depression.由于正常的行为从一个不同的童年阶段到另一个，它可能很难判断一个孩子是刚刚经历一个临时“第二阶段”或患有抑郁症。 Sometimes the parents become worried about how the child's behavior has changed, or a teacher mentions that "your child doesn't seem to be himself."有时父母成为担心孩子的行为已经发生了变化，或一名教师提到， “您的孩子似乎没有自己。 ” In such a case, if a visit to the child's pediatrician rules out physical symptoms, the doctor will probably suggest that the child be evaluated, preferably by a psychiatrist who specializes in the treatment of children.在这种情况下，如果访问了孩子的儿科医生排除了躯体症状，医生可能会建议，儿童进行评估，最好由专业心理医生谁在治疗儿童。 If treatment is needed, the doctor may suggest that another therapist, usually a social worker or a psychologist, provide therapy while the psychiatrist will oversee medication if it is needed.如果治疗需要，医生可能建议，另一个治疗，通常是一名社会工作者或心理医生，提供治疗，而精神科医生将监督服药，如果这是必需的。 Parents should not be afraid to ask questions: What are the therapist's qualifications?父母不应该害怕发问：什么是治疗师的资格？ What kind of therapy will the child have?什么样的治疗将孩子呢？ Will the family as a whole participate in therapy?将家庭作为一个整体参与治疗？ Will my child's therapy include an antidepressant?将我孩子的治疗包括抗抑郁药？ If so, what might the side effects be?如果是的话，什么可能的副作用是什么？
The National Institute of Mental Health (NIMH) has identified the use of medications for depression in children as an important area for research.美国国家精神卫生研究所（镍氢电池）已确定使用的药物用于治疗抑郁症的儿童作为一项重要的研究领域。 The NIMH-supported Research Units on Pediatric Psychopharmacology (RUPPs) form a network of seven research sites where clinical studies on the effects of medications for mental disorders can be conducted in children and adolescents.在镍氢电池，支持科研单位的儿科精神药理学（ RUPPs ）形成一个网络研究的七个地点的临床研究影响的药物为精神障碍患者可以进行儿童和青少年。 Among the medications being studied are antidepressants, some of which have been found to be effective in treating children with depression, if properly monitored by the child's physician.8其中正在研究的药物是抗抑郁药，其中一些被认为是有效的治疗儿童抑郁症，如果得到适当的监测儿童的physician.8
Diagnostic Evaluation and Treatment 诊断和治疗评价
The first step to getting appropriate treatment for depression is a physical examination by a physician.第一步，以获得适当的治疗抑郁症是一个身体检查的医生。 Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests.某些药物，以及一些医疗条件，如病毒感染可导致相同的症状如抑郁症，和医生应排除这些可能性通过考试，面试，和实验室测试。 If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist.如果身体原因，抑郁症是排除心理评价工作应当由医生或转诊到精神科医生或心理学家。
A good diagnostic evaluation will include a complete history of symptoms, ie, when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given.一个好的诊断评估将包括一个完整的历史记录的症状，也就是说，当他们开始多久，他们已持续，严重程度，有否病人之前，如果有的话，是否症状，治疗和给予治疗。 The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide.医生应该询问有关酗酒和吸毒，如果病人有思考死亡或自杀。 Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.此外，应包括历史问题，是否还有其他的家庭成员有抑郁症的疾病，如果治疗，什么治疗，他们可能已经收到并且是有效的。
Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness.最后，一个诊断评估应当包括精神状态检查，以确定是否演讲或思维模式或记忆体已受到影响，因为有时发生的情况下，抑郁症或躁狂抑郁症的疾病。
Treatment choice will depend on the outcome of the evaluation.治疗的选择将取决于评价的结果。 There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders.有各种各样的抗抑郁药物和心理治疗，可用于治疗抑郁症。 Some people with milder forms may do well with psychotherapy alone.有些人可能会比较温和的形式做好心理就有。 People with moderate to severe depression most often benefit from antidepressants.人民与中度至重度抑郁症最常用抗抑郁药受益。 Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression.大多数做最好的综合治疗：药物来获得相对快速症状救济和心理治疗学会更有效的方式来处理生活的问题，包括抑郁症。 Depending on the patient's diagnosis and severity of symptoms, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.根据病人的诊断和严重性的症状，治疗师可订明的药物和/或一个好几种形式的心理治疗已证明有效的抑郁症。
Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication.3 ECT often is effective in cases where antidepressant medications do not provide sufficient relief of symptoms.电休克治疗（变速箱）是有用的，尤其是对个人的抑郁症是严重或危及生命或谁可以不采取抗抑郁medication.3痉挛，常常是有效的情况下，抗抑郁药物不会提供足够的救济的症状。 In recent years, ECT has been much improved.近年来，变速箱已大为改善。 A muscle relaxant is given before treatment, which is done under brief anesthesia.肌肉松弛是治疗前，这是做简短的麻醉下。 Electrodes are placed at precise locations on the head to deliver electrical impulses.电极置于确切地点的头部，提供电脉冲。 The stimulation causes a brief (about 30 seconds) seizure within the brain.刺激造成短暂（大约30秒）内检获的大脑。 The person receiving ECT does not consciously experience the electrical stimulus.该人接受变速箱不自觉地体验刺激的电力。 For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.如需完整的治疗效果，至少在几次会议的变速箱，通常考虑的速度，每周三，是必需的。
Medications 药品
There are several types of antidepressant medications used to treat depressive disorders.有几种类型的抗抑郁药用于治疗抑郁症。 These include newer medications-chiefly the selective serotonin reuptake inhibitors (SSRIs)-the tricyclics, and the monoamine oxidase inhibitors (MAOIs).这些措施包括新的药物，主要是羟色胺再摄取抑制剂（ SSRIs ）的tricyclics ，以及单胺氧化酶抑制剂（抑制剂） 。 The SSRIs-and other newer medications that affect neurotransmitters such as dopamine or norepinephrine-generally have fewer side effects than tricyclics.在SSRIs和其他新的药物，影响神经传递素，如多巴胺或去甲肾上腺素通常有副作用较少比tricyclics 。 Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications.有时医生会尝试各种抗抑郁药之前，找到最有效的药物或药物组合。 Sometimes the dosage must be increased to be effective.有时，剂量必须增加是有效的。 Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks) before the full therapeutic effect occurs.虽然一些改进可以看出在头几个星期，抗抑郁症药物必须采取定期为3至4周（在某些情况下，多达8周）之前，充分的治疗作用发生。
Patients often are tempted to stop medication too soon.患者往往是诱惑，停止服药还为时过早。 They may feel better and think they no longer need the medication.他们可能感觉更好，并认为他们不再需要药物治疗。 Or they may think the medication isn't helping at all.或者，他们可能会认为，药物是没有帮助的。 It is important to keep taking medication until it has a chance to work, though side effects may appear before antidepressant activity does.重要的是要服药，直到它有一个工作的机会，但副作用可能会出现之前没有抗抑郁活动。 Once the individual is feeling better, it is important to continue the medication for at least 4 to 9 months to prevent a recurrence of the depression.一旦个人的感觉更好，重要的是要继续用药至少4至9个月，以防止复发的抑郁症。 Some medications must be stopped gradually to give the body time to adjust.一些药品必须停止逐渐让身体一段时间来适应。 Never stop taking an antidepressant without consulting the doctor for instructions on how to safely discontinue the medication.从未停止服用抗抑郁一个未经咨询医生的指示，就如何安全地停止服药。 For individuals with bipolar disorder or chronic major depression, medication may have to be maintained indefinitely.对于个人与双相情感障碍或慢性抑郁症，药物治疗可能会无限期地保持下去。
Antidepressant drugs are not habit-forming.抗抑郁药物不会上瘾。 However, as is the case with any type of medication prescribed for more than a few days, antidepressants have to be carefully monitored to see if the correct dosage is being given.然而，如与任何类型的药物处方超过了几天，抗抑郁药，必须仔细监测，看看是否正确的用量正在考虑。 The doctor will check the dosage and its effectiveness regularly.医生将检查的剂量和其有效性定期。
For the small number of people for whom MAO inhibitors are the best treatment, it is necessary to avoid certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles, as well as medications such as decongestants.对于少数人的人毛抑制剂是最好的治疗，有必要避免某些食物含有高浓度的酪胺，如许多奶酪，葡萄酒，和腌菜，以及药物，如充血。 The interaction of tyramine with MAOIs can bring on a hypertensive crisis, a sharp increase in blood pressure that can lead to a stroke.的相互作用与酪胺能见效的高血压危象，急剧增加血压，可导致中风。 The doctor should furnish a complete list of prohibited foods that the patient should carry at all times.医生应提供的完整列表禁止的食品，病人应在任何时候都。 Other forms of antidepressants require no food restrictions.其他形式的抗抑郁药不需要食物的限制。
Medications of any kind - prescribed, over-the counter, or borrowed - should never be mixed without consulting the doctor.药物的任何一种-明，过柜台，或借用-绝不应混合未经咨询医生。 Other health professionals who may prescribe a drug-such as a dentist or other medical specialist-should be told of the medications the patient is taking.其他卫生专业人员谁订明的药物，如牙医或其他医学专家，应告知病人的药物是。 Some drugs, although safe when taken alone can, if taken with others, cause severe and dangerous side effects.有些药物，但安全时，可以采取单独，如果采取与他人，造成严重和危险的副作用。 Some drugs, like alcohol or street drugs, may reduce the effectiveness of antidepressants and should be avoided.某些药物，如酒精或街道药物，可减少效力的抗抑郁药物，应该避免。 This includes wine, beer, and hard liquor.这包括葡萄酒，啤酒，烈性酒。 Some people who have not had a problem with alcohol use may be permitted by their doctor to use a modest amount of alcohol while taking one of the newer antidepressants.有些人谁没有问题，使用酒精可允许他们的医生使用少量酒精，同时考虑一个新的抗抑郁药。
Antianxiety drugs or sedatives are not antidepressants.抗焦虑药物或镇静剂是不是抗抑郁药。 They are sometimes prescribed along with antidepressants; however, they are not effective when taken alone for a depressive disorder.他们有时一起抗抑郁药，但他们没有采取有效时，就有一个抑郁症。 Stimulants, such as amphetamines, are not effective antidepressants, but they are used occasionally under close supervision in medically ill depressed patients.兴奋剂，如安非他明，没有有效的抗抑郁药物，但他们偶尔用密切监督下在医学虐待抑郁症患者。
Questions about any antidepressant prescribed, or problems that may be related to the medication, should be discussed with the doctor.问题的任何抗抑郁药处方，或问题，可能与药物，应该讨论的医生。
Lithium has for many years been the treatment of choice for bipolar disorder, as it can be effective in smoothing out the mood swings common to this disorder.锂多年来一直治疗的首选躁郁症，因为它可以有效地理顺了情绪波动共同对这一疾病。 Its use must be carefully monitored, as the range between an effective dose and a toxic one is small.其使用必须仔细监测，如之间的有效剂量和毒性是小。 If a person has preexisting thyroid, kidney, or heart disorders or epilepsy, lithium may not be recommended.如果一个人存在的甲状腺，肾脏，或心脏疾病或癫痫，锂不得推荐。 Fortunately, other medications have been found to be of benefit in controlling mood swings.幸运的是，其他药物被认为是有利于在控制情绪波动。 Among these are two mood-stabilizing anticonvulsants, carbamazepine (Tegretol(r)) and valproate (Depakote(r)).其中有两个情绪稳定抗癫痫药，卡马西平（得理多（ R ） ）和丙戊酸钠（丙戊酸钠（ r ）段） 。 Both of these medications have gained wide acceptance in clinical practice, and valproate has been approved by the Food and Drug Administration for first-line treatment of acute mania.这两种药物已获得广泛接受的临床实践，并丙戊酸钠已通过美国食品和药物管理局的第一线治疗急性躁狂症。 Other anticonvulsants that are being used now include lamotrigine (Lamictal(r)) and gabapentin (Neurontin(r)): their role in the treatment hierarchy of bipolar disorder remains under study.其他抗正在使用现在包括拉莫三嗪（ Lamictal （ R ） ）和加巴喷丁（加巴（ r ）段） ：其作用在治疗等级躁郁症仍然在研究。
Most people who have bipolar disorder take more than one medication including, along with lithium and/or an anticonvulsant, a medication for accompanying agitation, anxiety, depression, or insomnia.大多数人谁也躁郁症采取一个以上的药物包括，随着锂和/或抗惊厥的药物随同激动，焦虑，抑郁，或失眠。 Finding the best possible combination of these medications is of utmost importance to the patient and requires close monitoring by the physician.寻找可能的最佳结合，这些药物的最重要的是病人和需要密切监测的医生。
Side Effects of Antidepressant Medications 副作用的抗抑郁药物
Antidepressants may cause mild and, usually, temporary side effects (sometimes referred to as adverse effects) in some people.抗抑郁药可能会导致轻度和，通常情况下，暂时的副作用（有时称作不利影响）在一些人。 Typically these are annoying, but not serious.通常这些烦人的，但并不严重。 However, any unusual reactions or side effects or those that interfere with functioning should be reported to the doctor immediately.但是，任何不寻常的反应或副作用或那些干扰运作，应当报医生立即。 The most common side effects of tricyclic antidepressants, and ways to deal with them, are:最常见的副作用的三环抗抑郁药，以及如何处理这些问题，它们是：
• Dry mouth - it is helpful to drink sips of water; chew sugarless gum; clean teeth daily. •口干-它是帮助小口喝的水;咀嚼无糖口香糖;每天清洁牙齿。
• Constipation - bran cereals, prunes, fruit, and vegetables should be in the diet. •便秘-麸谷物，梅干，水果和蔬菜应在饮食。
• Bladder problems - emptying the bladder may be trouble-some, and the urine stream may not be as strong as usual; the doctor should be notified if there is marked difficulty or pain. •膀胱问题-排空膀胱可能会麻烦一些，尿液流可能不强像往常一样，医生应通知是否有显着困难或疼痛。
• Sexual problems - sexual functioning may change; if worrisome, it should be discussed with the doctor. •性问题-性功能可能会改变，如果令人担忧，应该讨论的医生。
• Blurred vision - this will pass soon and will not usually necessitate new glasses. •视力模糊-这将很快通过通常不会需要新的眼镜。
• Dizziness - rising from the bed or chair slowly is helpful. •眩晕-增加从床上或椅子慢是很有帮助的。
• Drowsiness as a daytime problem - this usually passes soon. •嗜睡作为一个白天的问题-这通常很快通行证。 A person feeling drowsy or sedated should not drive or operate heavy equipment.一个人的感觉昏昏欲睡或镇静剂不应驾驶或操作重型设备。 The more sedating antidepressants are generally taken at bedtime to help sleep and minimize daytime drowsiness.更镇静药，一般采取在睡前来帮助睡眠和尽量减少日间嗜睡。
The newer antidepressants have different types of side effects:较新的抗抑郁药物具有不同类型的副作用：
• Headache - this will usually go away. •头痛-这通常会消失。
• Nausea - this is also temporary, but even when it occurs, it is transient after each dose. •恶心-这也是暂时的，但即使发生时，这是在每一瞬间剂量。
• Nervousness and insomnia (trouble falling asleep or waking often during the night) - these may occur during the first few weeks; dosage reductions or time will usually resolve them. •紧张和失眠（入睡困难或醒来常常在晚上） -这些可能发生在头几个星期;剂量减少或时间会解决这些问题。
• Agitation (feeling jittery) - if this happens for the first time after the drug is taken and is more than transient, the doctor should be notified. •搅拌（感觉不安） -如果发生这种情况后首次药物是采取多短暂，医生应当通知。
• Sexual problems - the doctor should be consulted if the problem is persistent or worrisome. •性问题-医生应征求问题是否存在，或令人担忧。
Herbal Therapy 草药疗法
In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety.在过去的几年中，很大的兴趣增加在使用草药治疗的抑郁和焦虑。 St. John's wort (Hypericum perforatum), an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest in the United States.圣约翰麦汁（贯叶连翘） ，一个药草广泛用于治疗轻，中度抑郁症在欧洲，最近已引起兴趣在美国。 St. John's wort, an attractive bushy, low-growing plant covered with yellow flowers in summer, has been used for centuries in many folk and herbal remedies.圣约翰麦汁，有吸引力的灌木丛，低增长的植物覆盖着黄色的花朵在夏天，已用于世纪以及许多民间草药。 Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant.今天，在德国，贯叶连翘是用来治疗抑郁症比任何其他抗抑郁药。 However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.然而，科学的研究，已进行了其使用已短期和使用了几个不同的剂量。
Because of the widespread interest in St. John's wort, the National Institutes of Health (NIH) conducted a 3-year study, sponsored by three NIH components-the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, and the Office of Dietary Supplements.由于广泛的兴趣圣约翰麦汁，国家卫生研究院（ NIH ）进行了3年的研究，由美国国立卫生研究院三个组成部分，在国立精神卫生研究所，全国中心的补充和替代医学，以及办公室的膳食补充剂。 The study was designed to include 336 patients with major depression of moderate severity, randomly assigned to an 8-week trial with one-third of patients receiving a uniform dose of St. John's wort, another third sertraline, a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, and the final third a placebo (a pill that looks exactly like the SSRI and the St. John's wort, but has no active ingredients).这项研究的目的是要包括336抑郁症患者中度严重性，随机分派到了8周的审判有三分之一的患者接受一个统一的剂量圣约翰麦汁，另外三分之一舍曲林，一个羟色胺再摄取抑制剂（再摄取抑制剂）常用的抑郁症，最后第三安慰剂（一丸看起来完全一样再摄取抑制剂和圣约翰麦汁，但没有活性成分） 。 The study participants who responded positively were followed for an additional 18 weeks.该研究参与者谁作出了积极反应后额外的18个星期。 At the end of the first phase of the study, participants were measured on two scales, one for depression and one for overall functioning.在结束第一阶段的学习，学员们在两个衡量尺度，一个是抑郁症和一个整体运作。 There was no significant difference in rate of response for depression, but the scale for overall functioning was better for the antidepressant than for either St. John's wort or placebo.没有显着差异的答复率为抑郁症，但大规模的整体运作较好的抗抑郁药相比，无论圣约翰麦汁或安慰剂。 While this study did not support the use of St. John's wort in the treatment of major depression, ongoing NIH-supported research is examining a possible role for St. John's wort in the treatment of milder forms of depression.虽然这项研究并不支持使用圣约翰麦汁在治疗抑郁症，目前美国国立卫生研究院的研究支持，正在研究可能发挥的作用圣约翰麦汁治疗轻形式的抑郁症。
The Food and Drug Administration issued a Public Health Advisory on February 10, 2000.美国食品和药物管理局发表了一份公众健康咨询2月10日， 2000年。 It stated that St. John's wort appears to affect an important metabolic pathway that is used by many drugs prescribed to treat conditions such as AIDS, heart disease, depression, seizures, certain cancers, and rejection of transplants.它指出，圣约翰麦汁似乎影响到一个重要的代谢途径所使用的许多药物处方治疗的条件，如艾滋病，心脏病，抑郁症，癫痫，某些癌症，并拒绝接受移植。 Therefore, health care providers should alert their patients about these potential drug interactions.因此，卫生保健提供者应提醒患者对这些潜在的药物相互作用。
Some other herbal supplements frequently used that have not been evaluated in large-scale clinical trials are ephedra, gingko biloba, echinacea, and ginseng.其他一些草药补充经常使用，但没有进行大规模的临床试验麻黄，银杏叶，紫锥花，和人参。 Any herbal supplement should be taken only after consultation with the doctor or other health care provider.任何草药补充应采取协商后，不仅与医生或其他保健提供者。
Psychotherapies 心理治疗
Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals.许多形式的心理，包括一些短期（ 10-20周）的疗法，可以帮助抑制个人。 "Talking" therapies help patients gain insight into and resolve their problems through verbal exchange with the therapist, sometimes combined with "homework" assignments between sessions. “谈”疗法帮助患者深入了解和解决他们的问题通过口头交流的治疗，有时加上“家庭作业”的任务之间的会议。 "Behavioral" therapists help patients learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression. “行为”治疗师帮助患者了解如何获得更多的满意和奖励通过自己的行动，以及如何忘掉的行为模式，有助于或结果从他们的抑郁症。
Two of the short-term psychotherapies that research has shown helpful for some forms of depression are interpersonal and cognitive/behavioral therapies.两年的短期心理治疗的研究表明有益的某种形式的抑郁症的人际和认知/行为疗法。 Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression.人际治疗重点放在病人的不安个人的关系，既造成和加剧（或增加）的抑郁症。 Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving often associated with depression.认知/行为治疗师帮助患者改变不良作风的思想和行为往往与抑郁症。
Psychodynamic therapies, which are sometimes used to treat depressed persons, focus on resolving the patient's conflicted feelings.心理疗法，这是有时用来治疗抑郁症的人，着眼于解决病人的抵触情绪。 These therapies are often reserved until the depressive symptoms are significantly improved.这些疗法往往保留，直到抑郁症状显着改善。 In general, severe depressive illnesses, particularly those that are recurrent, will require medication (or ECT under special conditions) along with, or preceding, psychotherapy for the best outcome.一般来说，严重的抑郁症的疾病，尤其是那些经常性的，将需要药物治疗（或变速箱在特殊条件下）一起，或前，心理治疗的最佳结果。
How to Help Yourself if You are Depressed 如何帮助自己，如果你感到沮丧
Depressive disorders make one feel exhausted, worthless, helpless, and hopeless.抑郁症作一次感到疲惫，毫无价值，无助和绝望。 Such negative thoughts and feelings make some people feel like giving up.这种消极的思想和感情使一些人觉得放弃。 It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances.重要的是要认识到，这些负面看法一部分的抑郁症和通常不准确地反映实际情况。 Negative thinking fades as treatment begins to take effect.消极思维消失治疗开始生效。 In the meantime:与此同时：
• Set realistic goals in light of the depression and assume a reasonable amount of responsibility. •设置现实的目标是鉴于抑郁症，并承担合理的责任。
• Break large tasks into small ones, set some priorities, and do what you can as you can. •突破大任务分成小的，设定一些优先事项，并做您可以您可以。
• Try to be with other people and to confide in someone; it is usually better than being alone and secretive. •尽量与其他人并信任的人;通常是优于独处和秘密。
• Participate in activities that may make you feel better. •参加活动，可能使你感觉更好。
• Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help. •轻度运动，将一部电影，一个球，或参与宗教，社会，或其他活动可能的帮助。
• Expect your mood to improve gradually, not immediately. •期待你的情绪逐步改善，而不是立即。 Feeling better takes time.感觉好需要时间。
• It is advisable to postpone important decisions until the depression has lifted. •最好推迟作出重要决定之前，抑郁症已经取消。 Before deciding to make a significant transition-change jobs, get married or divorced-discuss it with others who know you well and have a more objective view of your situation.在决定作出重大的转型，改变工作，结婚或离婚，讨论它与其他谁知道你也有一个更客观的看法您的状况。
• People rarely "snap out of" a depression. •人们很少“管理单元的”一个抑郁症。 But they can feel a little better day-by-day.但是，他们却可以感觉好一点每天。
• Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment. •请记住，正面思考将取代消极的思想，是抑郁症和将消失，您的回应抑郁症的治疗。
• Let your family and friends help y |
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Depression 抑郁症