Everyone experiences feelings of melancholy or hopelessness at times, but when those feelings become persistent, intense, and make it hard to function through day-to-day life, you may be experiencing depression, a common but serious mental health disorder.
Depression can make it difficult to eat, work, sleep, or take care of yourself and others. It is more than just an emotion: it can cause uncomfortable physical sensations and intrusive thoughts. Additionally, depression can be worsened by difficult life circumstances, other mental health conditions, or medical conditions.
Depression is one of the most universally experienced mental health conditions, so if you are battling it, know that you aren’t alone. Treatment for depression is usually highly effective and help is available for you.
What is Depression?
Depression, also referred to as depressive disorder or clinical depression, is typically diagnosed when a person’s symptoms have persisted for a period of two weeks and impacted their life significantly.
Depression affects as many as 1 in 15 adults, according to the American Psychological Association, and over 16% of adults will have a bout of depression in their lifetimes. Depression can be experienced as a one-time episode, but many people experience it chronically.
Anyone can be impacted by depression, regardless of socioeconomic status, race, age, or gender, but depression affects certain populations differently. For example, women are more likely to experience depression than men: a third of women experience a depressive episode during the course of their lives. Depression also tends to run in families; if you have an immediate family member with depression, you have a 40% chance of experiencing it yourself.
Depression doesn’t just affect one’s mood. According to the National Alliance on Mental Illness (NAMI), depression increases your risk of cardiovascular and metabolic diseases by 40%. Teens who experience depression are two times as likely to drop out of high school. Depression and mental illness increase the likelihood that people experience substance abuse, and that they become unemployed.
Hearing all of these statistics may sound … well, depressing. But probably the most important thing to understand about depression is that it’s highly treatable. Psychotherapy, medication, and lifestyle changes can be effective in treating depression and making it possible for depressed individuals to lead healthy and full lives.
Talking about depression — and reaching out for help — is often stigmatized by society, which makes it hard for people battling depression to get the help they need. This is all the more reason why educating yourself and others about what depression is — what its symptoms and causes are, and how to get treatment for it — is vital.
Depression Symptoms Overview
It’s important to understand that depression is more than just feeling down. For many, depression is experienced emotionally, physically, and might include intrusive thoughts, as well as suicidal ideation. Depression symptoms make it hard to participate in everyday life and complete basic tasks. Additionally, activities that used to be enjoyable may lose their happiness or meaning, and depression may cause individuals to distance themselves from others.
There is no one way for someone to experience depression. One might have all or some of the symptoms of depression and they might fluctuate daily or from one depressive episode to the next.
Common Symptoms Of Depression
Here are some of ways that depression may present itself and common symptoms:
- Altered Sleep: changes in sleep patterns, including sleeping more or less than usual
- Changes in Appetite: changes in appetite including overeating, losing your appetite, or losing interest in food
- Concentration & Cognition Challenges: an inability to concentrate, struggling to keep your concentration, and/or “fuzzy” thinking, trouble remembering things. This can also include slowed thoughts or speech.
- Low Energy Levels: feeling sluggish or having low energy
- Loss of Interest: feeling less interested or not interested at all in activities that used to be pleasurable
- Low Self-Esteem: fallen self-esteem, less self-confidence and a sense of worthlessness
- Heightened Emotions: feelings of hopelessness and feeling worthless, increased agitation or anger
- Intrusive Thoughts: negative thoughts about yourself that come throughout the day, whether triggered by something in your environment or not
- Restlessness: increased pacing, hand wringing and inability to stay still
- Decision-making Issues: difficulty making decisions, both seemingly simple ones and more difficult ones
- Physical Pain or Discomfort: this can include headaches, back pain or pain in other parts of the body not resulting from injuries
- Suicidal Thoughts: having thoughts of suicide or suicidal ideation
It’s important to keep in mind that suicidal ideation is considered a medical emergency, and you shouldn’t wait to seek care. If you are experiencing suicidal thoughts, please go to the nearest emergency room or call the National Suicide Prevention Lifeline (800-273-8255).
Depression Symptoms By Age Groups
Depression symptoms may differ according to age groups as well. For example:
- Depression in children may present as refusing to go to school, being extra clingy to parents, or experiencing physical symptoms such as stomachaches.
- Older children and adolescents may experience difficulties at school, inability to complete school work, low self-esteem, lack of motivation, and ADHD symptoms. Teens may experience eating disorders and substance abuse.
- Adults may experience depression at pivotal moments in their lives or during major life changes. Young adults may experience other mental health disorders alongside their depression, such as anxiety, panic disorder, and eating disorders. Middle aged adults may experience more physical symptoms, including gastrointestinal symptoms and insomnia.
- Elderly adults with depression may experience grief, moods of generalized depression, and feelings of loneliness.
Depression: Causes And Risks
Depression can have several causes, and certain people may be at more risk than others for developing depression. People battling depression may be prone to placing blame on themselves but feeling depressed is never your fault. The circumstances and causes of depression are often out of an individual’s control. Keep this in mind as you begin the process of understanding your depression and healing from it.
Most cases of depression are multifactorial, meaning that they have more than one cause. Depression often occurs when someone who is already vulnerable to it experiences difficult life circumstance or trauma.
The Most Common Causes of Depression Include:
Depression tends to run in families, making certain people more vulnerable to experiencing a depressive episode or chronic depression.
Traumatic events and circumstances can trigger depression. This might include older traumas, such as childhood abuse, or newer traumatic experiences, such as the sudden loss of a loved one, war, poverty, or a natural disaster. Repeated or early traumas can affect how your brain and body respond to stress.
Traumas are not the only events that can trigger depression. Major life disruptions such as job loss, moving, and divorce can trigger depression or depressive episodes.
People who experience difficult medical conditions, such as chronic pain, ADHD, or sleep disorders, are also more likely to experience depression. Some medical conditions, such as hypothyroidism, can also mimic the symptoms of depression, and certain medications taken to treat a medical condition can cause depressive symptoms.
People who have issues with substance abuse are more likely to experience depression. Certain substances, like alcohol, can make depression symptoms worse.
Major hormonal changes, including puberty, pregnancy and postpartum, as well as menopause, can trigger depression.
Brain and biological differences
People who experience depression may have brain differences. For example, people with depression may have differences in how their pituitary gland and hypothalamus interact with their hormones, or how neurotransmitters function in their brain and body.
Depression Risk Factors
Certain people and population groups may be at higher risk of developing depression than others. For example:
- Women are more likely to experience depression than men, although this may be because women are more likely to seek care for their symptoms.
- Trauma such as childhood abuse or neglect, the death of a loved one, financial hardship, or any difficult or sudden life change, may make someone more prone to depression.
- People who identify as LGBTQ are more likely to experience depression, especially if they don’t receive support for their identities or lifestyle.
Other life experiences that may make you more prone to depression include:
- Having a family history of depression or other mental health disorders
- Having a personal history of mental health issues, including anxiety, eating disorders, PTSD, bipolar disorder, or postpartum depression.
- Experiencing chronic illness, such a fibromyalgia, cancer, or heart disease
- Being someone who has a history of substance abuse
- Taking any medication that may cause depressive symptoms, such as blood pressure medication or medication to help you sleep
Types of Depression
Just as symptoms of depression may be experienced differently by different people, depression itself has many variations. Types of depression vary according to the kind of symptoms people experience, the circumstances that trigger the depression, as well as other overlapping mental health conditions that have depressive symptoms.
It’s possible to experience more than one type of depression at once. The best way to find out what type of depression you are experiencing is to visit your doctor or psychiatrist for a diagnosis. For example, you might be someone who has bipolar disorder and experiences postpartum depression after having a baby. Or you may have a persistent depressive disorder which gets exacerbated by seasonal affective disorder in the wintertime.
Most Common Types of Depression
Major Depressive Disorder
Major depressive disorder is considered the “classic” type of depression. People who experience this type of depression have persistent symptoms and may feel like there is a dark cloud around them most of the time. They may lose interest in activities that once brought them joy, and may have trouble completing everyday tasks. The most common symptoms of major depressive disorder include issues with sleeping, eating, and weight loss or gain. It is typical to experience feelings of extremely low self-esteem and worthlessness. Some people with major depressive disorder also have suicidal thoughts. Those who suffer from major depressive disorder can be treated with therapy and/or medication.
Persistent Depressive Disorder
When someone experiences symptoms of depression for two years or more, they may be diagnosed with persistent depressive disorder, also known as dysthymia. Having persistent depressive disorder doesn’t necessarily mean that that person has been intensely depressed for two years — they may have had a combination of less severe symptoms mixed with severe ones. The idea is that the symptoms were persistently present for over two years. People with persistent depressive disorder may be highly functional at times, but still experience low, depressive moods. Symptoms may also include changes in sleep patterns, appetite, energy, and low self-esteem.
Bipolar disorder is not the same as depression, but rather a condition where someone wavers between depression symptoms and symptoms of mania or euphoria. Someone with bipolar disorder usually has “high” periods (mania) followed by extremely “low” periods (hypomania). Bipolar is a serious mental health disorder that requires psychiatric care and medication.
Seasonal Affective Disorder
Seasonal affective disorder is experienced primarily during the darker, colder fall and winter months. Experts believe that the lack of natural sunlight contributes to this disorder, along with fewer social interactions, less exercise, and more time spent indoors. Treatments involve light therapy as well as psychotherapy or medication.
A person who has psychotic depression experiences severe depression symptoms alongside psychotic symptoms such as delusions or hallucinations. Delusions are beliefs that are not based in reality, and hallucinations are when someone has the experience of seeing or hearing things that do not exist. A person who experiences psychotic depression needs to seek therapy and medication for psychosis as well as depression.
Postpartum depression is something experienced by 1 in 7 new parents. Postpartum depression should be distinguished from the “baby blues,” which is a period of mild depressive symptoms that almost all new parents experience after giving birth due to hormonal and lifestyle changes. Postpartum depression involves more serious and consistent depressive symptoms and is usually diagnosed when these symptoms have persisted for more than two weeks. Parents with postpartum depression may feel that they are terrible parents, and may experience extreme sadness, guilt, and anxiety about parenting. Additionally, they may have trouble caring for themselves or their babies.
Premenstrual Dysphoric Disorder
Premenstrual Dysphoric Disorder (PMDD) is a severe version of premenstrual syndrome (PMS). This usually affects women during the week before their period, but it may start soon after ovulation and last for approximately two weeks until an expected period. Medication, including selective serotonin reuptake inhibitors (SSRIs), may relieve some PMDD symptoms. Lifestyle changes, including stress reduction and exercise, can also help PMDD symptoms.
When you experience situational depression, you may experience many of the same symptoms as major depressive disorder, but your depression may be triggered by a specific situation or major life event, and may not be as long lasting a major depressive disorder. Triggers may include the death of a loved one, a divorce or breakup, or any sudden or major life change.
A person who experiences atypical depression may experience many of the same symptoms as someone who has major depressive disorder, but they are also able to experience moments of happiness and a lifting of the depression symptoms. This may happen when they receive good news or are otherwise cheered up in some way. However, when these feelings die down, this person is still likely to slip into an intense and all encompassing depression.
Treatment For Depression
There is hope for even the most severe cases of depression. According to the American Psychiatric Association (APA), 80-90% of people who seek treatment for their depression respond positively. Almost all people treated find relief or reduced symptoms.
Before being treated for depression, it’s important that you receive a proper diagnosis. Since certain medical conditions — like thyroid issues, hormonal issues, or vitamin deficiencies — can have similar symptoms to depression, most experts recommend that you get a full medical workup before being diagnosed with depression. If everything else is ruled out, you may be diagnosed with depression by your doctor or by a psychiatrist.
There are several different ways to treat depression and treatment can work better if different methods are combined. For example, lifestyle changes may not be effective alone, but when combined with therapy and medication, they can propel you faster toward healing from depression.
Therapy for Depression
Psychotherapy is one of the most effective ways to manage your depression. Having an experienced, licensed therapist or counselor to talk to — someone who will listen and advise without judgement — can make a huge difference as you begin the journey of recovery. A therapist can help understand the origins of your depressive feelings, offer a safe place to express your thoughts and feelings, and can help you come up with effective ways to cope. These days, therapists work both in-person and virtually; there is a way to fit therapy into almost any lifestyle.
The types of therapy most often used to treat depression include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Psychodynamic Therapy, and Interpersonal Therapy. In some cases, therapy alone can treat depression, but often severe cases of depression are best treated with a combination of psychotherapy and medication.
Medication For Depression
Many cases of depression are treated with antidepressants. These medications affect the neurotransmitters in your brain — serotonin, norepinephrine, and dopamine — that control your mood and how you react to stress. The most common types of antidepressants prescribed are selective serotonin reuptake inhibitors (SSRIs). Other antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).
Choosing the right antidepressant will include considerations like medication side effects, what particular type of depression you are experiencing, and what medication works best for your body. It can take 2 – 4 weeks for an antidepressant to work, so it’s important to be patient and keep in touch with your doctor. It’s also important not to go “cold turkey” and quickly stop taking an antidepressant, as doing so can have negative physical and emotional side effects. Instead, it’s best to taper off gradually with your doctor’s advice.
Some people need to be on antidepressants consistently, while others only need them for a few months or years, depending on their life circumstances. There is no shame in needing to take antidepressants. They are life changing for many people and for some who are suicidal, medication may even save their life.
Wellness and Self-Help Strategies
Most depression treatment plans also involve lifestyle changes. What we eat, how we move, and who we interact with can have strong effects on our mood as well as our ability to manage our depression. Here are some tips:
Exercising and moving your body are great ways to boost the mood. Exercise releases endorphins and can decrease your stress levels. You don’t need to be a runner or a weightlifter to benefit from exercise. A walk around the block or an impromptu dance party works just fine.
Create healthy and mindful routines
Getting enough sleep, eating regular, healthy meals, decreasing your alcohol intake, and creating a daily routine can help get you out of the rut of depression. Additionally, incorporating regular mediation or journaling into your day can help immensely.
Talk about it
Besides routinely seeing a therapist or counselor, having a few trusted people in your life to share your feelings with can really help you process your feelings and feel supported. If you are having trouble finding these people, look for depression support groups, either online or in person. Keeping your feelings bottled up only exacerbates depression, so finding a safe space to let them out is vital.
Having realistic goals about what it will take to manage your depression can help. Keep in mind that healing from depression is a journey, one that may have setbacks along the way. Be gentle and compassionate with yourself. Simply deciding that it’s time to feel better is an enormous first step.
The Bottom Line
If you are struggling with depression — whether it’s something you’ve battled your whole life, or whether you are facing it for the first time — there is support out there for you. Depression is not something you need to just “put up” with. Everyone deserves to live a full, balanced, and happy life.
Jill E. Daino, LCSW-R
Reviewed On: June 1, 2021