填空题

Depression
In bed, you toss and turn, unable to get a good night’s sleep. You feel anxious and worried. There’s plenty to do, but the work piles up because you feel listless and tired. You don’t even want to do anything fun. Friends tell you to "pull yourself together," but you feel helpless and hopeless. You have difficulty concentrating and making decisions. When you look in the mirror, you hate yourself. You are definitely in one of life’s valleys—you are depressed.
Everyone gets the blues once in a while. Emotional lows and highs are a normal part of life. The blues become depression when you feel so sleepy and listless that you can’t function normally in everyday life.
Types of Depression
Depression can range from a mild panic to self-destructive or suicidal behavior, It’s important to understand the various types of depression so that you can recognize them.
Depression occurs at all ages, although major depressive episodes peak between the ages of 55 and 70 in men and 20 and 45 in women. About half of those who experience an episode of major depression will have another within two years. For some people, episodes of depression are separated by several years, while others suffer groups of episodes over a short time span. Between episodes, such individuals feel well.
Major depressive disorder affects approximately 14.8 million American adults —or 6.7 percent of the U.S. population aged 18 years and older—in a given year. Major depressive disorder is more common in women than in men. Although treatment can help more than 80 percent of people with severe depression, most people with depression do not seek treatment.
● Reactive depression. This type of depression is a reaction to stressful events—divorce, death of a loved one, a chronic illness, a personal tragedy, or even social isolation, which the elderly frequently experience. The person is unable to recover normally from the feelings associated with the event. Common feelings include self-pity, pessimism, and loss of interest in life. It affects people of all ages.
● Seasonal Affective Disorder (SAD). If you live in the northern latitudes and suffer depression during the winter months, you may suffer from seasonal affective disorder caused by a lack of exposure to sunlight. Doctors aren’t sure exactly what physiological mechanisms are at work in SAD, but they speculate that depressed feelings and other symptoms may be due to an increase in the release of the hormone meltonin. SAD sufferers feel lethargic and irritable. They may also suffer from chronic headaches, increased appetite, weight gain, and an increased need for sleep. For unknown reasons, SAD is truly a "woman’s depression," in that women make up 70 percent to 80 percent of those affected. Since about half of all SAD sufferers have relatives who also suffer from SAD or other emotional problems, researchers speculate that the problem may be inherited.
● Biochemical depression. Doctors aren’t sure why, but some people develop a biochemically based depression sometime during midlife. It’s likely that this type of depression is caused by biochemical problems within the brain. The problem usually responds well to antidepressant medication. You may be more likely to develop this type of chemical depression if other members of your family have also suffered from this problem.
● Disease or drug-related depression. Some diseases such as AIDS, stroke, chronic pain, and hypothyroidism (甲状腺功能减退) can cause depression. In hypothyroidism, the thyroid gland (甲状腺) malfunctions, leading to too little or no thyroid hormone circulating in the bloodstream. In addition to depression, other symptoms of hypothyroidism include fatigue, weakness, weight gain, impaired memory, and shortness of breath. Fortunately, the depression and other symptoms of hypothyroidism can be effectively treated with adequate doses of thyroid hormone.
Certain drugs such as alcohol, tranquilizers (镇定剂), and heart and blood pressure medications, as well as withdrawal from some street drugs like cocaine, can cause drug-related depression. Some women who take birth control pills find the drugs make them irritable, anxious, and depressed. And a deficiency in some nutrients has been linked to depression.
● Teenage depression. Recognizing depression in children is important. Depression in teenagers may appear somewhat different from adult depression. The teenage years are a period of complicated conflicts that lead many young people to develop negative self-esteem, anxieties, and fears about their future. Some young people become overwhelmed by peer pressures and feelings of isolation and powerlessness. Social expectations may be unrealistic, and doing poorly in school can lead to a feeling of rejection. The young person may have experienced a lack of support from family and other significant people and a decrease in his or her ability to cope effectively. (As is the case for adults, treatment for depression in teenagers may involve a combination of therapies.)
Causes of Depression
Depression may be related to many factors, including a family history of depression, medical illnesses, alcohol, drugs, gender, and age. Additionally, an individual’s self-confidence, personality traits—such as dependency on others or perfectionism—and unrealistic expectations may lead to depression. Stressful events, such as death of a spouse or loss of a job, also contribute to de pression. Many people with major depression also suffer from intense anxiety.
● Theories of Depression. There are many theories about the causes of depression. The social learning theory, suggests that lack of positive reinforcement from others may lead to negative self-evaluation and a poor outlook for the future. The psychoanalytic theory, suggests that a significant loss (such as of a parent) or a withdrawal of affection in childhood (whether real or perceived) may lead to depression in later life. Interpersonal theory emphasizes the importance of social connections for good mental health. Other theories suggest that unrealistic expectations of oneself and others and loss of sell-esteem are essential components leading to depression.
Some individuals may be biologically predisposed to depression; in other words, they may have been born with a tendency to develop depression. Researchers continue to investigate chemical reactions in the body that are controlled by these genes. Depression often runs in families. For example, if one identical twin suffers from depression, the other twin has a 70 percent chance of also having the illness.
● Environmental Influences. Researchers view depression as the result of interaction between environmental and biological factors. Depression can be endogenous (internally caused) or exogenous (related to outside events). Major changes in one’s environment, such as a move or job change, or any major loss, such as a divorce or death of a loved one, can bring on depression. Feeling depressed in response to these changes is normal, but when it becomes a severe long term condition (longer than one month) and interferes with effective functioning, it requires treatment.
Some environmental factors relating to depression include being unemployed, poor, elderly, or alone. Depression changes one’s way of looking at ordinary life circumstances. A depressed person tends to exaggerate negative aspects, which leads to feelings of hopelessness, helplessness, and being overwhelmed.
Symptoms of Depression
How do you recognize symptoms of depression in yourself and others People who suffer from depression have a number of symptoms nearly every day, all day, tor at least two weeks. De pressed people have feelings of extreme sadness, hopelessness, despair, low self-worth, and helplessness. For some people, depression is marked by anxiety, withdrawal from others, loss of sleep or excessive need for sleep, constant fatigue, loss of appetite or compulsive eating, loss of sexual desire, either lethargy or agitation, an inability to concentrate and make decisions, and possibly exaggerated feelings of guilt.
Many depressed individuals have mental and physical symptoms that seem endless and do not get better with happy events or good news. Some depressed people are so disabled by their condition that they don’t have enough energy to call a friend, relative, or medical professional for help. If another person calls for them. these people may refuse to go because they have no hope that they can be helped. However, family and friends should keep trying to get the depressed person to seek help, because up to 15 percent of those who suffer from severe clinical depression commit suicide.
Major depressive episodes happen to women earlier than men.