What is Depression?
Concerned About Your Mental Health?
In a
recent survey, gay men reported that depression was their most serious
health concern after HIV/AIDS. Lesbians reported that the issue of
depression and mental health was their number one health concern.1
There
may be some basis for this concern. Research has shown that gay men and
lesbians may have higher rates of depression when compared with the
general population.2,3 Homophobia may be part of the
reason-both internalized homophobia (directed against oneself) as well
as the homophobia many gay people encounter at school, work, home, and
in society at large. As a gay person in a homophobic society, being in
or out of the closet can carry its own set of pressures and problems.4
Understanding Depression
Depression
is more than just feeling sad. People who are clinically depressed are
not just moody or feeling "blue" for a few days. They experience long
periods of feeling very down -- or in some cases, very anxious or
extremely tired -- for several weeks or months. Drug and/or alcohol
abuse may also be signs of depression. Because depression can change
the way a person feels, thinks, and behaves, it can have negative
effects on all aspects of a person's life, from school to work to
family and social life. Read more about depression.
What Depression Isn't
Depression is not a
sign of a weak personality, nor is it something to be ashamed of. It is
a real medical illness. People with depression cannot "just snap out of
it" -- no more than it would be possible for a person with an HIV
infection, diabetes, or some other medical illness to "just snap out of
it." The good news is that depression can be treated effectively. Read more about treatments for depression.
What Causes Depression?
In
addition to external, societal factors that may contribute to
depression, there are other reasons why a person might become
depressed. These include traumatic life experiences such as the death
of a loved one, certain diseases or medications, substance abuse,
hormonal changes, or a family history of depression. Sometimes the
cause of depression is unknown.
Whatever the circumstances,
depression is caused by an imbalance of certain chemicals in the brain.
Normally, these "chemical messengers" help nerve cells communicate with
one another by sending and receiving messages, and they may also
influence a person's mood. In the case of depression, the available
supply of the chemical messengers is low, so nerve cells can't
communicate effectively.
Antidepressant medications such as LEXAPRO
work by helping to correct the imbalance of certain chemicals in the
brain. These medications may take several weeks to be effective, but
they work well and are generally safe. With just one 10 mg tablet a
day, LEXAPRO significantly improves the symptoms of depression and
anxiety for many patients beginning at week 1 or 2.5
References: 1. Depression and mental health emerge as major concerns for the community: community health survey reveals top concern of gay men and lesbians. Available at HealthyPlace Gender Community. Accessed on: November 8, 2005. 2. Cochran SD, Sullivan JG, Mays VM. Prevalence of mental disorders, psychological distress and mental services use among lesbian, gay, and bisexual adults in the United States. J Consult Clin Psychol. 2003;71:53-61. 3. Mills TC, Paul J, Stall R, et al. Distress and depression in men who have sex with men: The Urban Men's Health Study. Am J Psych. 2004;161:278-285. 4. Igartua KJ, Gill L, Montoro R. Internalized homophobia: a factor in depression, anxiety, and suicide in the gay and lesbian population. Can J Commun Ment Health. 2003;22:15-30. 5. Goodman WK, Bose A, Wang Q. Escitalopram 10 mg/day is effective in the treatment of generalized anxiety disorder. Poster presented at: 23rd Annual Conference of the Anxiety Disorders Association of America; March 27-30, 2003; Toronto, Canada.
IMPORTANT SAFETY INFORMATION: Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Antidepressants increased the risk of suicidality (suicidal thinking and behavior) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of antidepressants in children, adolescents or young adults must balance the risk to clinical need. Patients of all ages started on antidepressant therapy should be closely monitored and observed for clinical worsening, suicidality or unusual changes in behavior, especially at the beginning of therapy or at the time of dose changes. This risk may persist until significant remission occurs. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Lexapro is not approved for use in pediatric patients.
Lexapro is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), pimozide (see DRUG INTERACTIONS: Pimozide and Celexa), or in patients with hypersensitivity to escitalopram oxalate. As with other SSRIs, caution is indicated in the coadministration of tricyclic antidepressants (TCAs) with Lexapro. SSRIs and SNRIs (including Lexapro) and other psychotropic drugs that interfere with serotonin reuptake may increase the risk of bleeding events. Concomitant use of aspirin, NSAIDs, warfarin and other anticoagulants may add to the risk. Patients should be cautioned about these risks. SSRIs and SNRIs have been associated with clinically significant hyponatremia. Elderly patients or patients taking diuretics or who are otherwise volume-depleted appear to be at a greater risk. Discontinuation of Lexapro should be considered in patients with symptomatic hyponatremia and appropriate medical intervention should be instituted. The most common adverse events with Lexapro versus placebo (approximately 5% or greater and approximately 2x placebo) were nausea, insomnia, ejaculation disorder, somnolence, increased sweating, fatigue, decreased libido, and anorgasmia.
