Depression is a common mental health condition that can impact how you feel, think, and act (American Psychiatric Association, 2013). Depression can disrupt everyday activities, like work, school, and self-care. Understanding depression and getting a diagnosis from a trained mental health clinician is an important step in obtaining treatment.
What is depression?
It’s normal to feel down sometimes. However, people with depression often experience extended periods of extreme and debilitating sadness, aimlessness, hopelessness, and despair, among other symptoms. Depression is a serious mental health issue that can negatively impact how a person may feel, act, think, and relate to the world.
What causes depression?
While every individual is unique and causes vary, there are factors that can increase the chances of experiencing depression. These include differences in biology and brain chemistry, hormone levels, having a family history of depression, and undergoing extreme stress, trauma, or illness (Monroe et al., 2014).
Depression has also been linked to ailments like arthritis and irritable bowel syndrome and can increase a person’s likelihood of developing cardiovascular issues. People who have multiple physical or chronic health conditions may also be at greater risk of depression.
Symptoms of depression
There are many symptoms that can help determine whether a person is experiencing depression. These symptoms include:
- Feelings of extreme sadness, anxiousness, or hopelessness
- Irritability, restlessness, or frustration
- Losing interest in favorite hobbies, activities, or other pleasurable things
- Feeling tired, fatigued, or noticeably low energy, even when getting regular sleep
- Increased or decreased appetite and weight gain or weight loss
- Trouble concentrating or completing everyday tasks
- Persistent body or headaches that do not respond to standard treatments
- Suicidal thoughts or attempts of suicide
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Types of depression
A person may be experiencing clinical depression when symptoms have lasted for at least two weeks. While it is normal to feel sad or down sometimes, clinical depression is disruptive in mental, physical, and emotional ways. There are different types of depression that come with a range of symptoms. These include:
Major depressive disorder
Major depressive disorder (MDD) occurs when symptoms last for at least two weeks and significantly disrupt daily habits, life, and routines. Symptoms of MDD can include extreme sadness or anxiety, fatigue, diminished or increased appetite, difficulty concentrating, body aches, and suicidal thoughts.
Seasonal affective disorder
Seasonal affective disorder (SAD) is tied to seasonal changes. It often peaks during fall and winter and recedes during spring and summer, although some people experience it during warmer months. In addition to standard depressive signs, symptoms of fall/winter SAD can include oversleeping, weight gain or overeating, hibernating, or withdrawing from social settings. Symptoms of spring/summer SAD can include trouble sleeping, weight loss, and restlessness.
Persistent depressive disorder
Persistent depressive disorder (PDD) is a type of chronic depression that often lasts for two years or more. Symptoms can include fatigue, difficulty concentrating, low energy, and changes in appetite. These symptoms are typically not as severe as with MDD. PDD may be related to low levels of serotonin in the body.
Depression with symptoms of psychosis
Depression with symptoms of psychosis can include symptoms of MDD along with episodes of psychosis or psychotic behavior. People may experience delusions or hallucinations (like hearing voices or sensing scents, tastes, or visions) that they perceive as real. Restlessness, fidgeting, or slowness in speech, movement, or thinking may be present. People experiencing this type of depression are also at a greater risk of suicidal thoughts.
Postpartum (peripartum) depression
Postpartum depression (also known as peripartum depression) is experienced either during pregnancy or after giving birth. It may be caused by life stress, the stress of pregnancy and childbirth, or adjusting to being a parent. In addition to standard depression symptoms, people can experience feelings of emptiness, difficulty sleeping (even when their baby is asleep), challenges in bonding or emotionally attaching to their baby, doubts about their ability to care for their baby, or thoughts of harming themself or their baby.
Situational depression symptoms are similar to MDD symptoms. However, situational depression is generally triggered by a traumatic life event. These can include fighting or conflict in a relationship, having a near-death experience, enduring a job loss or financial problems, struggling with an illness, or losing a loved one. People with ongoing mental health issues or who grew up with a high level of stress may be at a greater risk for situational depression.
Other types of depression
Other types of depression include premenstrual dysphoric disorder (typically experienced at the start of menstrual periods), atypical depression, and treatment-resistant depression. People with bipolar disorder may experience both depressive and energized manic episodes.
Common comorbid conditions with depression include anxiety, substance abuse, and panic disorders. People with other medical conditions, like diabetes, heart disease, arthritis, and cancer, may also be at a greater risk of depression (Bisschop et al., 2004).
How is depression diagnosed?
To diagnose depression, a therapist might ask about your symptoms and how long they have been present. They may ask you to rate the intensity of your symptoms. You may also be referred to a general practitioner for a physical examination to rule out other potential causes.
The U.S. Preventative Task Force recommends early screening for depression to mitigate symptoms and combat the ongoing effects of the COVID-19 pandemic.
Treatments for depression
Depression can be managed with therapy, medication, or a combination of both. Your clinician will work with you to develop a treatment plan that considers the type and severity of your depression, symptoms, and personal preferences.
When to seek treatment for depression
It is important to seek treatment when depressive symptoms are recurring, persistent, and disruptive to daily life and routine. Consulting a doctor or licensed mental health professional can be an essential step in treating depression.
When to seek immediate help
If you are having a psychiatric or medical emergency, please call 911 or go to the nearest emergency department. To reach the Suicide and Crisis Lifeline, please call or text 988.
Therapy for depression
Therapy, also called talk therapy or psychotherapy, can help you explore the root causes of your depression, identify and replace negative beliefs, and develop healthy coping tools. This type of therapy is conducted with a therapist or other licensed mental health professional. It may involve different therapy modalities, including cognitive behavioral therapy and interpersonal therapy.
Medication for depression
Antidepressant medication is another treatment option for depression. While not everyone experiencing depression takes medication, it can provide relief for some. Common types of medications include selective serotonin reuptake inhibitors (SSRIs), which generally have fewer side effects. Doctors may prescribe other oral medications if SSRIs are not as effective as hoped.
TMS for depression
Transcranial magnetic stimulation (TMS) is an option for people who have not found relief from antidepressant medications and therapy. TMS is a non-invasive treatment that uses short, magnetic pulses to stimulate underactive nerve cells in brain regions known to regulate mood.
Spravato® for depression
Spravato® is another option for treatment. It is a nasal spray that is self-administered by a patient under the supervision of a trained medical assistant. Taken in addition to other treatments, it is used to help decrease depression and restore stability to a patient’s mood.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Monroe, Scott M., Slavich, George M., Gotlib, Ian. H. (2014), Life stress and family history for depression: The moderating role of past depressive episodes. Journal of Psychiatric Research, 49, 90-95. https://doi.org/10.1016/j.jpsychires.2013.11.005
- Bisschop, M. Isabella., Kriegsman, Didi M.W., Deeg, Dorly J.H., Beekman., Aartjan, T.F., van Tilburg, Willem. (2004), The longitudinal relation between chronic diseases and depression in older persons in the community: the Longitudinal Aging Study Amsterdam. Journal of Clinical Epidemiology, 57 (2), 187-184. https://doi.org/10.1016/j.jclinepi.2003.01.001
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