What is depression?

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.

It’s also fairly common. 

People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It can also influence relationships and some chronic health conditions.

Conditions that can get worse due to depression include:

arthritis

asthma

cardiovascular disease

cancer

diabetes

obesity

It’s important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But, if you’re feeling down or hopeless on a regular basis, you could be dealing with depression.

Depression is considered a serious medical condition that can get worse without proper treatment. Those who seek treatment often see improvements in symptoms in just a few weeks.

Depression symptoms

Depression can be more than a constant state of sadness or feeling “blue.”

Major depression can cause a variety of symptoms. Some affect your mood, and others affect your body. Symptoms may also be ongoing, or come and go.

The symptoms of depression can be experienced differently among men, women, and children differently.

Men may experience symptoms related to their:

mood, such as anger, aggressiveness, irritability, anxiousness, restlessness

emotional well-being, such as feeling empty, sad, hopeless

behaviour, such as loss of interest, no longer finding pleasure in favorite activities, feeling tired easily, thoughts of suicide, drinking excessively, using drugs, engaging in high-risk activities

sexual interest, such as reduced sexual desire, lack of sexual performance

cognitive abilities, such as inability to concentrate, difficulty completing tasks, delayed responses during conversations

sleep patterns, such as insomnia, restless sleep, excessive sleepiness, not sleeping through the night

physical well-being, such as fatigue, pains, headache, digestive problems

Women may experience symptoms related to their:

mood, such as irritability

emotional well-being, such as feeling sad or empty, anxious or hopeless

behaviour, such as loss of interest in activities, withdrawing from social engagements, thoughts of suicide

cognitive abilities, such as thinking or talking more slowly

sleep patterns, such as difficulty sleeping through the night, waking early, sleeping too much

physical well-being, such as decreased energy, greater fatigue, changes in appetite, weight changes, aches, pain, headaches, increased cramps

Children may experience symptoms related to their:

mood, such as irritability, anger, mood swings, crying

emotional well-being, such as feelings of incompetence (e.g. “I can’t do anything right”) or despair, crying, intense sadness

behaviour, such as getting into trouble at school or refusing to go to school, avoiding friends or siblings, thoughts of death or suicide

cognitive abilities, such as difficulty concentrating, decline in school performance, changes in grades

sleep patterns, such as difficulty sleeping or sleeping too much

physical well-being, such as loss of energy, digestive problems, changes in appetite, weight loss or gain

The symptoms can extend beyond your mind.

These seven physical symptoms of depression prove that depression isn’t just all in your head.

Depression causes

There are several possible causes of depression. They can range from biological to circumstantial.

Common causes include:

Family history. You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.

Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.

Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.

Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, or attention-deficit hyperactivity disorder (ADHD).

Drug use. A history of drug or alcohol misuse can affect your risk.

About 21 percent of people who have a substance use problem also experience depression. In addition to these causes, other risk factors for depression include:

low self-esteem or being self-critical

personal history of mental illness

certain medications

stressful events, such as loss of a loved one, economic problems, or a divorce

Many factors can influence feelings of depression, as well as who develops the condition and who doesn’t.

The causes of depression are often tied to other elements of your health.

However, in many cases, healthcare providers are unable to determine what’s causing depression.

Depression test

There isn’t a single test to diagnose depression. But your healthcare provider can make a diagnosis based on your symptoms and a psychological evaluation.

In most cases, they’ll ask a series of questions about your:

Moods

Appetite

Sleep pattern

Activity level

Thoughts

Because depression can be linked to other health problems, your healthcare provider may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.

Don’t ignore symptoms of depression. If your mood doesn’t improve or gets worse, seek medical help. Depression is a serious mental health illness with the potential for complications.

If left untreated, complications can include:

Weight gain or loss

Physical pain

Substance use problems

Panic attacks

Relationship problems

Social isolation

Thoughts of suicide

Self-harm

Types of depression

Depression can be broken into categories depending on the severity of symptoms. Some people experience mild and temporary episodes, while others experience severe and ongoing depressive episodes.

There are two main types: major depressive disorder and persistent depressive disorder.

Major depressive disorder

Major depressive disorder is the more severe form of depression. It’s characterized by persistent feelings of sadness, hopelessness, and worthlessness that don’t go away on their own.

In order to be diagnosed with clinical depression, you must experience 5 or more of the following symptoms over a 2-week period:

Feeling depressed most of the day

Loss of interest in most regular activities

Significant weight loss or gain

Sleeping a lot or not being able to sleep

Slowed thinking or movement

Fatigue or low energy most days

Feelings of worthlessness or guilt

Loss of concentration or indecisiveness

Recurring thoughts of death or suicide

There are different subtypes of major depressive disorder, which the American Psychiatric Association refers to as “specifiers.”

These include:

Atypical features

Anxious distress

Mixed features

peripartum onset, during pregnancy or right after giving birth

Seasonal patterns

Melancholic features

Psychotic features

Catatonia

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It’s a milder, but chronic, form of depression.

In order for the diagnosis to be made, symptoms must last for at least 2 years. PDD can affect your life more than major depression because it lasts for a longer period.

It’s common for people with PDD to:

Lose interest in normal daily activities

Feel hopeless

Lack productivity

Have low self-esteem

Depression can be treated successfully, but it’s important to stick to your treatment plan.

Read more about why depression treatment is important.

Treatment for depression

Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your healthcare provider about possible options.

You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best.

It’s common to combine medical treatments and lifestyle therapies, including the following:

Medications

Your healthcare provider may prescribe:

Antidepressants

Antianxiety

Antipsychotic medications

Each type of medication that’s used to treat depression has benefits and potential risks.

Psychotherapy

Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light therapy

Exposure to doses of white light can help regulate your mood and improve symptoms of depression. Light therapy is commonly used in seasonal affective disorder, which is now called major depressive disorder with seasonal pattern.

Alternative therapies

Ask your healthcare provider about acupuncture or meditation. Some herbal supplements are also used to treat depression, like St. John’s wort, SAMe, and fish oil.

Talk with your healthcare provider before taking a supplement or combining a supplement with prescription medication because some supplements can react with certain medications. Some supplements may also worsen depression or reduce the effectiveness of medication.

Exercise

Aim for 30 minutes of physical activity 3 to 5 days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid alcohol and drugs

Drinking or misusing drugs may make you feel better for a little bit. But in the long run, these substances can make depression and anxiety symptoms worse.

Learn how to say no

Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take care of yourself

You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleepeating a healthy diet, avoiding negative people, and participating in enjoyable activities.

Sometimes depression doesn’t respond to medication. Your healthcare provider may recommend other treatment options if your symptoms don’t improve.

These include electroconvulsive therapy (ECT), or repetitive transcranial magnetic stimulation (rTMS) to treat depression and improve your mood.

Natural treatment for depression

Traditional depression treatment uses a combination of prescription medication and counseling. But there are also alternative or complementary treatments you can try.

It’s important to remember that many of these natural treatments have few studies showing their effects on depression, good or bad.

Likewise, the U.S. Food and Drug Administration (FDA) doesn’t approve many of the dietary supplements on the market in the United States, so you want to make sure you’re buying products from a trustworthy brand.

Talk to your healthcare provider before adding supplements to your treatment plan.

Supplements

Several types of supplements are thought to have some positive effect on depression symptoms.

St. John’s wort

Studies are mixed, but this natural treatment is used in Europe as an antidepressant medication. In the United States, it hasn’t received the same approval.

S-adenosyl-L-methionine (SAMe)

This compound has shown in limited studies to possibly ease symptoms of depression. The effects were best seen in people taking selective serotonin reuptake inhibitors (SSRIs), a type of traditional antidepressant.

5-hydroxytryptophan (5-HTP)

5-HTP may raise serotonin levels in the brain, which could ease symptoms. Your body makes this chemical when you consume tryptophan, a protein building block.

Omega-3 fatty acids

These essential fats are important to neurological development and brain health. Adding omega-3 supplements to your diet may help reduce depression symptoms.

Essential oils

Essential oils are a popular natural remedy for many conditions, but research into their effects on depression is limited.

People with depression may find symptom relief with the following essential oils:

Wild ginger: Inhaling this strong scent may activate serotonin receptors in your brain. This may slow the release of stress-inducing hormones.

Bergamot: This citrusy essential oil has been shown to reduce anxiety in patients awaiting surgery. The same benefit may help individuals who experience anxiety as a result of depression, but there’s no research to support that claim.

Other oils, such as chamomile or rose oil, may have a calming effect when they’re inhaled. Those oils may be beneficial during short-term use.

Vitamins

Vitamins are important to many bodily functions. Research suggests two vitamins are especially useful for easing symptoms of depression:

Vitamin B: B-12 and B-6 are vital to brain health. When your vitamin B levels are low, your risk for developing depression may be higher.

Vitamin D: Sometimes called the sunshine vitamin because exposure to the sun supplies it to your body, Vitamin D is important for brain, heart, and bone health. People who are depressed are more likely to have low levels of this vitamin.

Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven’t shown themselves to be effective in clinical research.

Learn about herbs, vitamins, and supplements that have shown some promise, and ask your healthcare provider if any are right for you.

Preventing depression

Depression isn’t generally considered to be preventable. It’s hard to recognize what causes it, which means preventing it is more difficult.

But once you’ve experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.

Techniques that may help include:

regular exercise

getting plenty of sleep

maintaining treatments

reducing stress

building strong relationships with others

Other techniques and ideas may also help you prevent depression.

Read the full list of 15 ways you may be able to avoid depression.

Bipolar depression

Bipolar depression occurs in certain types of bipolar disorder, when the person experiences a depressive episode.

People with bipolar disorder may experience significant mood swings. Episodes in bipolar 2, for instance, typically range from manic episodes of high energy to depressive episodes of low energy.

This depends on the type of bipolar disorder you have. A diagnosis of bipolar 1 only has to have the presence of manic episodes, not depression.

Symptoms of depression in people with bipolar disorder may include:

loss of interest or enjoyment from normal activities

feeling sad, worried, anxious, or empty

not having energy or struggling to complete tasks

difficulty with recall or memory

sleeping too much or insomnia

weight gain or weight loss as a result of increased or decreased appetite

contemplating death or suicide

If bipolar disorder is treated, many will experience fewer and less severe symptoms of depression, if they experience depressive episodes.

Depression and anxiety

Depression and anxiety can occur in a person at the same time. In fact, research has shown that over 70 percent Trusted Source of people with depressive disorders also have symptoms of anxiety.

Though they’re thought to be caused by different things, depression and anxiety can produce several similar symptoms, which can include:

Irritability

Difficulty with memory or concentration

Sleep problems

The two conditions also share some common treatments.

Both anxiety and depression can be treated with:

Therapy, like cognitive behavioural therapy

Medication

Alternative therapies, including hypnotherapy

If you think you’re experiencing symptoms of either of these conditions, or both of them, make an appointment to talk with your healthcare provider. You can work with them to identify coexisting symptoms of anxiety and depression and how they can be treated.

Depression and obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It causes unwanted and repeated thoughts, urges, and fears (obsessions).

These fears cause you to act out repeated behaviours or rituals (compulsions) that you hope will ease the stress caused by the obsessions.

People diagnosed with OCD frequently find themselves in a loop of obsessions and compulsions. If you have these behaviours, you may feel isolated because of them. This can lead to withdrawal from friends and social situations, which can increase your risk for depression.

It’s not uncommon for someone with OCD to also have depression. Having one anxiety disorder can increase your odds for having another. Up to 80 percent Trusted Source of people with OCD also has major depression.

This dual diagnosis is a concern with children, too. Their compulsive behaviours, which may be first developing at a young age, can make them feel unusual. That can lead to withdrawing from friends and can increase the chance of child developing depression.

Depression with psychosis

Some individuals who have been diagnosed with major depression may also have symptoms of another mental disorder called psychosis. When the two conditions occur together, it’s known as depressive psychosis.

Depressive psychosis causes people to see, hear, believe, or smell things that aren’t real. People with the condition may also experience feelings of sadness, hopelessness, and irritability.

The combination of the two conditions is particularly dangerous. That’s because someone with depressive psychosis may experience delusions that cause them to have thoughts of suicide or to take unusual risks.

It’s unclear what causes these two conditions or why they can occur together, but treatment can successfully ease symptoms. Treatments include medications and electroconvulsive therapy (ECT).

Understanding the risk factors and possible causes can help you be aware of early symptoms.

Read more about depressive psychosis, how it’s treated, and what healthcare providers understand about why it occurs.

Depression in pregnancy

Pregnancy is often an exciting time for people. However, it can still be common for a pregnant woman to experience depression.

Symptoms of depression during pregnancy include:

Changes in appetite or eating habits

Feeling hopeless

Anxiety

Losing interest in activities and things you previously enjoyed

Persistent sadness

Troubles concentrating or remembering

Sleep problems, including insomnia or sleeping too much

Thoughts of death or suicide

Treatment for depression during pregnancy may focus entirely on talk therapy and other natural treatments.

While some women do take antidepressants during their pregnancy, it’s not clear which ones are the safest. Your healthcare provider may encourage you to try an alternative option until after the birth of your baby.

The risks for depression can continue after the baby arrives. Postpartum depression, which is also called major depressive disorder with per partum onset, is a serious concern for new mothers.

Recognizing the symptoms may help you spot a problem and seek help before it becomes overwhelming.

Depression and alcohol

Research has established a link between alcohol use and depression. People who have depression are more likely to misuse alcohol.

Out of the 20.2 million U.S. adults who experienced a substance use disorder, about 40 percent had a co-occurring mental illness.

According to a 2012 study, 63.8 percent Trusted Source of people who are alcohol dependent have depression.

Drinking alcohol frequently can make symptoms of depression worse, and people who have depression are more likely to misuse alcohol or become dependent on it.

Outlook for depression

Depression can be temporary, or it can be a long-term challenge. Treatment doesn’t always make your depression go away completely.

However, treatment often makes symptoms more manageable. Managing symptoms of depression involves finding the right combination of medications and therapies.

If one treatment doesn’t work, talk with your healthcare provider. They can help you create a different treatment plan that may work better in helping you manage your condition.

Depression Treatment Tips

To get better, you need to take an active role in your treatment. You can’t be passive as a patient. You and your doctor have to work as a team.

Of course, you might not feel up to taking an active role in anything. You might have doubts that treatment will help. But push yourself. Depression can make you feel helpless. Taking charge of your treatment is one way to feel in control again.

Stick with it. Treatment usually won’t work right away. Antidepressants may not take effect for four to six weeks. In some cases, a medication may not work and you’ll need to try another, or possibly a combination of medicines. Therapy can take a while, too. But don’t despair. If you give them time, these treatments are very likely to help. When a depressed person gets the right medicine, at the right dose, and takes it long enough, treatment succeeds about 70% of the time. But you and your doctor may sometimes need to try quite a few treatments before landing on the right therapy for you.

Take your medicine as prescribed. Get into good habits. Take your medicine at the same time every day. It’s easier to remember if you do it along with another activity, like brushing your teeth, eating breakfast, or getting into bed. Get a weekly pillbox, which will make it easy to see if you’ve missed a dose.

Never stop taking your medicine without your doctor’s OK. If you need to stop taking a medicine for some reason, your doctor may reduce your dose gradually. If you stop suddenly, you may have side effects. Stopping medication abruptly may also cause depression to return. Don’t assume that you can stop taking your medicine when you feel better. Many people need ongoing treatment even when they’re feeling well. This can prevent them from getting depressed again. Remember, if you’re feeling well now, it might be because your medicine is working. So why stop?

Make lifestyle changes. There’s a lot you can do on your own to supplement your treatment. Eat healthy foods, high in fruits and vegetables and low in sugars and fats. Avoid alcohol and illicit drugs, which can cause or worsen depression and interfere with the effects of the medicines that treat depression. Make sure to get a good night’s sleep. Follow a regular daily structured routine. Don’t lie in bed during the day or allow yourself to take naps. Several studies show that physical activity can help with the symptoms of depression. Start slowly. Try taking walks around the neighbourhood with a friend. Gradually, work up to exercising on most days of the week.

Reduce stress at home and at work. Ask for help with some of the stressful things in your life. See if your friends or family will take care of some of the daily hassles, like housework. If your job is stressing you out, figure out ways to scale back some of your duties.

Be honest. Opening up to a therapist or other mental health professional isn’t easy. But if you’re not truthful, therapy is less likely to help. People are sometimes uncomfortable talking about sensitive topics such as sexual functioning, side effects, substance use, missing medication doses, or suicidal thoughts – but sharing such concerns openly with your doctor or therapist can only help. If you have doubts about therapy or your therapist’s approach, don’t hide them. Instead, talk about them openly with your therapist. He or she will be happy to have your feedback. Together, you might be able to work out a new approach that works better.

Be open to new ideas. Your therapist may have suggestions that sound strange. He or she may push you to do things that feel awkward or uncomfortable. But try to stay open. Give new approaches a try. You may find them more helpful than you expected.

Don’t give up. You may feel hopeless right now. You may feel like you’re never going to get better. But feeling that way is a symptom of your condition. If you give yourself some time and allow your treatment to take effect, you will feel better again.

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