Overview
It happens to everyone-feeling sad, blue or occasionally anxious.  But when it won't go away and interferes with life it probably is time to seek medical advice.  Diagnosing depression is an important step in determining treatment and it is difficult to do in people with Spina Bifida.  With this segment of the population, it is important to first rule out physical causes, such as shunt malfunction or severe infections, which can cause depression.  If there is an infection or shunt malfunction, when diagnosed, depression disappears.

Symptoms of Clinical Depression
For parents, the most telling signs of depression are their children's behavior such as changes in appetite, sleep patterns, classroom concentration, and daily functioning.  Additionally, activities that once were appealing may no longer be interesting.

Symptoms often include appetite changes, insomnia and psychomotor agitation such as pacing, hand wringing, constant general restlessness or the opposite-psychomotor retardation, which makes the person speak and think slowly, as if in slow motion. 

Causes of Depression
While the most well accepted theory is that the depletion of certain neurotransmitters causes depression, there are more theories than facts.  Some studies show increased incidence of depression in people with Spina Bifida, who are at a higher risk of depressed mood and lower self-worth.  Like depression, anxiety, that sense of dread, panic or constant worry, runs in families. 

How to Treat Depression
Many studies show that exercise alone can have a profound effect on depression.  For many people with Spina Bifida, wheelchair sports programs provide both social contact and physical activity. 

Medications and counseling may be crucial, especially if the patients have low self-esteem or learned helplessness.  While medications alone won't improve self-esteem, counseling, particularly for the entire family can be helpful. 

Selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Prozac, Zoloft, Effexor, and Serzone are medications that help lighten depression.  The duration of treatment with SSRIs depends on many factors-including the patient's history with depression.  Most doctors prefer to not medicate anyone for more than six months, although treatment can extend into years.

Conclusion
It is important to find a doctor who will be able to discuss options, but depression and anxiety are very treatable. 

This information does not constitute medical advice for any individual. As specific cases may vary from the general information presented here, SBA advises readers to consult a qualified medical or other professional on an individual basis.