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Johns Hopkins Health - A Hopeful View on Depression

Spring 2014
Issue No. 24

A Hopeful View on Depression

Date: April 1, 2014

If you or someone you love struggles with this common illness, the right treatment technique can turn things around


Everyone is susceptible to periods of sadness, frustration or hopelessness in the face of a challenging life event, such as the loss of a loved one or a job. But when those feelings persist for a few weeks, or they are accompanied by certain physical symptoms, it is cause for concern.

“Looking and feeling sad, tearful or irritable are all signs of depression,” says Margaret Chisolm, M.D., a psychiatrist at Johns Hopkins. “But we also look for changes in appetite, sleep patterns, energy, concentration and interest in activities. Excessive worrying, feelings of worthlessness or thoughts of suicide are also symptoms of depression.”

Most people first seek treatment from their primary care physician, whether he or she is a gynecologist, a pediatrician, a family practitioner or an internist, which Chisolm says is a good place to start. That person is in the best position to rule out any medical conditions that might be causing depression and, if needed, recommend a mental health professional.

For many people, a mix of medication and psychotherapy holds the key. More people than ever are seeking mental health treatment, but many people are being treated with medication alone, Chisolm says. She and her Johns Hopkins colleagues know that isn’t enough.

“People think that they can get better with one or the other—and they may be able to,” Chisolm says, “but they’ll be much more likely to get better with that combination.” For example, she adds, when treatment for moderate to severe depression involves both antidepressant medication and psychotherapy, a successful result is more likely.

“The relationship with a psychotherapist can help people understand their illness,” Chisolm says, “and, most importantly, inspire hope.”

Heart Attack Patients, Take Note
After a heart attack, depression is the biggest cause of death in the year after surgery. People who are depressed are less likely to adhere to the regimen their doctors prescribe.

The American Heart Association recommends that all heart patients be screened for depression and treated as necessary.

If you have suffered a heart attack, talk to your doctor if you (or a loved one) notice signs of depression. Also, make sure all your doctors, including mental health professionals, collaborate in your ongoing care.

Expert Information on Thousands of Conditions
Johns Hopkins Health Library features basic information about depression and other diseases, conditions, tests and procedures—plus links to physicians with relevant expertise, multimedia and videos, and additional in-depth resources from faculty. Visit

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