Physician Specialist Glossary

What Are the Symptoms of Depression?

For major depression, you may experience five or more of the following for at least a two-week period:

• Persistent sadness, pessimism
• Feelings of guilt, worthlessness, helplessness, or hopelessness
• Loss of interest or pleasure in usual activities, including sex
• Difficulty concentrating and complaints of poor memory
• Worsening of co-existing chronic disease, such as rheumatoid arthritis or diabetes
• Insomnia or oversleeping
• Weight gain or loss
• Fatigue, lack of energy
• Anxiety, agitation, irritability
• Thoughts of suicide or death
• Slow speech; slow movements
• Headache, stomachache, and digestive problems

In children and adolescents, symptoms of depression may include:

• Insomnia, fatigue, headache, stomachache, dizziness
• Apathy, social withdrawal, weight loss
• Drug abuse or alcohol abuse, a drop in school performance, difficulty concentrating
• Isolation from family and friends
• For dysthymia (minor, but long-term depression), symptoms are less intense and fewer in number, but long-lasting

Call Your Doctor About Depression If:

• You or a loved one have suicidal thoughts, or have other signs of either major depression or dysthymia; help is available.
• You are considering alternative or complementary treatments for depression. It's important that your doctor be aware of all aspects of your treatment.

NOTE: There is a distinct difference between feeling "depressed" and having a depressive illness. If you have low spirits for a while, don't be concerned. However, if you feel you can't lift yourself out of your misery, seek help.

Panic Attack Symptoms

Panic attacks involve sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms:

• "Racing" heart
• Feeling weak, faint, or dizzy
• Tingling or numbness in the hands and fingers
• Sense of terror, or impending doom or death
• Feeling sweaty or having chills
• Chest pains
• Breathing difficulties
• Feeling a loss of control

Panic attacks are generally brief, lasting less than 10 minutes, although some of the symptoms may persist for a longer time. People who have had one panic attack are at greater risk for having subsequent panic attacks than those who have never experienced a panic attack. When the attacks occur repeatedly, a person is considered to have a condition known as panic disorder.

People with panic disorder may be extremely anxious and fearful, since they are unable to predict when the next episode will occur. Panic disorder is fairly common and affects about 2.4 million people in the U.S., or 1.7% of the adult population between the ages of 18 and 54. Women are twice as likely as men to develop the condition, and its symptoms usually begin in early adulthood.

It is not clear what causes panic disorder. In many people who have the biological vulnerability to panic attacks, they may develop in association with major life changes (such as getting married, having a child, starting a first job, etc.) and major lifestyle stressors. There is also some evidence that suggests that the tendency to develop panic disorder may run in families. People who suffer from panic disorder are also more likely than others to suffer from depression, attempt suicide, or to abuse alcohol or drugs.

Luckily for sufferers of frequent panic attacks, panic disorder is a treatable condition. Psychotherapy and medications have both been used, either singly or in combination, for successful treatment of panic disorder. If medication is necessary, your doctor may prescribe antianxiety medications, antidepressants that also have antianxiety properties, or a class of heart medications known as beta-blockers to help control the episodes in panic disorder.