Depression is a medical condition that affects nearly 21 million American adults each year, according to the National Institute of Mental Health. Mood, thoughts, physical health, and behavior all may be affected. Symptoms of depression commonly include: * Persistent sad, anxious, or "empty" feelings * Feelings of hopelessness and/or pessimism * Feelings of guilt, worthlessness, and/or helplessness * Restlessness or irritability * Loss of interest or pleasure in activities that the person once enjoyed * Fatigue and decreased energy * Difficulty concentrating, remembering details, and/or making decisions * Insomnia, early–morning wakefulness, or excessive sleeping * Overeating, or appetite loss * Thoughts of suicide, suicide attempts * Persistent aches or pains, headaches, cramps, or digestive problems that do not ease with treatment. Depression comes in several forms and its symptoms and severity can vary from person to person. For example: * In major depression (also called major depressive disorder), people experience symptoms that interfere with their ability to work, study, sleep, eat, and take pleasure in activities they once enjoyed. Symptoms last for at least 2 weeks but frequently last for several months or longer. * In dysthymia (also called dysthymic disorder), a less severe, but more chronic form of depression, people experience symptoms that are not as disabling but keep them from functioning well or feeling good. Symptoms last at least 2 years. Many people with dysthymia also have episodes of major depression. * In bipolar disorder (also called manic–depressive illness), people have periods of depressive symptoms that alternate or may co-exist with periods of mania. Symptoms of mania include abnormally high levels of excitement and energy, racing thoughts, and behavior that is impulsive and inappropriate. In addition, milder forms of depression exist that fall into the category of minor depression. In minor depression, people experience the same symptoms as major depression, but they are fewer in number and are less disabling. Symptoms last at least 6 months but less than 2 years continuously. Depression can be treated effectively with conventional medicineMedicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals such as physical therapists, psychologists, and registered nurses., including antidepressants and certain types of psychotherapy. Top What the Science Says About St. John's Wort for Depression Scientific evidence regarding the effectiveness of St. John's wort for depression is inconsistent. An analysis of the results of 37 clinical trials concluded that St. John's wort may have only minimal beneficial effects on major depression. However, the analysis also found that St. John's wort may benefit people with minor depression; these benefits may be similar to those from standard antidepressants. Overall, St. John's wort appeared to produce fewer side effects than some standard antidepressants. One of the studies included in the analysis was cofunded by NCCAM and two other components of the National Institutes of Health (NIH)—the National Institute of Mental Health and the Office of Dietary Supplements. This study found that St. John's wort was no more effective than placebo in treating major depression of moderate severity. However, the antidepressant sertraline, used in one arm of the study, also showed little difference from placebo. Top Side Effects and Risks The most common side effects of St. John's wort include dry mouth, dizziness, diarrhea, nausea, increased sensitivity to sunlight, and fatigue. Research has shown that taking St. John's wort can limit the effectiveness of some prescription medicines, including: * Antidepressant medicines * Birth control pills * Cyclosporine, a medicine that helps prevent the body from rejecting transplanted organs * Digoxin, a medicine used to strengthen heart muscle contractions * Indinavir and other medicines used to control HIV infection * Irinotecan and other anticancer medicines * Warfarin and related medicines used to thin the blood (known as anticoagulants) When combined with certain antidepressants, St. John's wort also may increase side effects such as nausea, anxiety, headache, and confusion.
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