Are you experiencing crying spells, changes in sleep habits or appetite, loss of interest in activities, poor concentration, or reduced sexual drive? These symptoms and others—such as thoughts of suicide or feelings of worthlessness—can be significant signs of depression.

Are there different kinds of depression?

"Depression varies in intensity," says adult psychiatrist O.B. Towery, M.D., medical director of the John Muir Behavioral Health Center. "In some cases it is mild, experienced as a lowered mood or sadness. After identifying the stressors causing these feelings, an individual may be motivated to make positive changes. Some people feel ’down’ for no apparent reason. Others experience mood swings between euphoria and depression, such as in bipolar disorder. At its worst, depression may be so severe that a person is unable to function."

What causes depression?

Depression may be caused by a number of factors, including:

• Loss of a significant relationship
• Loss of job or position
• Feeling trapped and powerless in adverse life situations
• A genetic predisposition to depression
• Imbalance of brain neuro-transmitters

Depression is generally thought to be related to an imbalance of certain brain chemicals, or neurotransmitters, especially serotonin. These allow nerve cells (neurons) to pass messages to each other. When these chemicals are released they attach to receptor sites on neighboring neurons, thereby causing a reaction. Changes that occur in the receptor sites are also probably an important factor in the devel-opment of depression.

How can depression be treated?

The two most common treatments are psychotherapy and antidepressant medication (or mood-stabilizing medication for bipolar disorder). Psychotherapy techniques include cognitive behavioral therapy, insight-oriented psychotherapy and interpersonal therapy. Licensed mental health professionals in California include psychiatrists; licensed clinical social workers; marriage, family and child counselors; and clinical nurse specialists. These professionals may use one or a combination of treatment approaches. In many cases, using talk therapy in conjunction with medications has proven highly effective.

Antidepressant medication is believed to work primarily by altering the neurotransmitter systems of the brain. Among the newer commonly used antidepressants are Paxil, Prozac, Zoloft, and Wellbutrin. Still effective for many are the older medications such as Elavil, Tofranil, and Pamelor. Medications are usually taken for six months to a year after a depressive episode. In severe depression, antidepressants may be taken for prolonged periods.

When should I seek treatment?

First, consider whether you are making significant progress without help in altering upsetting situations. If your answer is "no," ask yourself the following questions: Do you feel helpless and hopeless? Is depression interfering with your functioning in relationships, at work, or at school? Is the quality of your life affected by low moods? Do you think about suicide?

"If you answer ’yes’ to any of these questions, you could benefit from professional assistance," Dr. Towery says. "Remember, depression is not a sign of weakness or moral failure. Don’t hesitate to seek help."

How can I find help?

"Today, with our recent discoveries about the human brain, depression is more treatable than ever," Dr. Towery says, "The Bay Area has an abundance of psychotherapists and psychiatrists with expertise in nearly every specialty area. You might talk with your family physician about help or a referral to a specialist."

Located in Concord, the John Muir Behavioral Health Center provides inpatient and outpatient behavioral health programs and services including psychiatry, geriatric psychiatry, alcohol and drug treatment, inpatient/partial hospitalization, aftercare and other treatment options.