Depression

Everyone feels sad or low sometimes, but these feelings usually go away after a short time.

Depression – also called clinical depression or a depressive disorder –is different. It is a mood  disorder that causes ongoing symptoms that affect how you feel, think, and handle daily activities like sleeping, eating, or working.

To be diagnosed with depression, symptoms must last most of the day, nearly every day, for at least two weeks.

Types of Depression

The two common types of depression include:

• Major depression: Symptoms last most of the day, nearly every day for at least two weeks and interfere with daily life. Some people have only one episode, while others have several throughout their lives.
• Persistent depressive disorder (dysthymia): Symptoms last for at least two years. A person may have episodes of major depression along with periods of milder symptoms.

Other forms of depression include:

• Perinatal depression: Major depression during pregnancy or after delivery (postpartum depression).
• Seasonal affective disorder (SAD): Depression that begins in late fall or early winter and improves in spring or summer.
• Psychotic depression: Severe depression with symptoms of psychosis, such as delusions or hallucinations.

Depression can also occur in children and teens, with conditions like disruptive mood dysregulation disorder or premenstrual dysphoric disorder.

Depression may also be part of bipolar disorder, where people have periods of depression along with periods of high energy and extreme moods (mania or hypomania).

Causes of Depression

Researchers believe depression is caused by a combination of:

• Genetic factors
• Biological factors
• Environmental factors
• Psychological factors

Depression often occurs with serious illnesses such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions can make depression worse, and depression can make managing these conditions harder. Some medications for these illnesses may also contribute to depression symptoms.

Signs and Symptoms

Depression is more than feeling sad. People may have different symptoms, such as:

• Persistent sadness, anxiety, or an “empty” mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest in hobbies or activities
• Fatigue or low energy
• Difficulty concentrating or making decisions
• Trouble sleeping or sleeping too much
• Appetite or weight changes
• Thoughts of death or suicide
• Restlessness or irritability
• Aches, pains, headaches, or digestive problems with no clear cause

How Depression Looks in Different People

Depression affects people differently. Women are more likely to feel sadness, worthlessness, or guilt. Men are more likely to feel tired, irritable, angry, or lose interest in work or activities. Men may also have sleep problems, use alcohol or drugs, or take risks. Older adults may have less obvious symptoms or be less likely to talk about sadness or grief. They are also more likely to have medical conditions like heart disease.

Younger children may pretend to be sick, refuse school, cling to parents, or worry a parent may die. Older children and teens may be irritable, sulk, have problems at school, or show signs of anxiety, eating disorders, or substance use.

Treatment Options

The first step is to see a health care provider or mental health professional, such as a psychiatrist or psychologist. They will check for other health conditions before diagnosing depression. The treatment options for depression include:

• Medications (antidepressants): These may take 2–4 weeks to work. Side effects often improve over time, but any new symptoms should be reported to your provider right away. Antidepressants carry some risks, especially for children, teens, and young adults, so close monitoring is important.
• Psychotherapy (talk therapy): Helps you learn new ways to think, behave, and manage relationships or stress.
• Brain stimulation therapies: Electroconvulsive therapy (ECT) and other treatments may be options for severe depression when other treatments have not worked.

Helping Yourself

• Recovery takes time, but things that may help include:
• Staying active and exercising
• Breaking large tasks into small steps and setting priorities
• Spending time with supportive people
• Waiting to make big life decisions until you feel better, and talking them over with people you trust
• Avoiding alcohol or drugs not prescribed for you

Helping a Loved One With Depression

If someone you care about may be depressed:

• Encourage them to see a health care provider or mental health professional
• Offer understanding, patience, and support
• Never ignore comments about suicide—tell their health care provider right away
• Invite them to join you for walks or activities
• Help them stick to their treatment plan, including medications and therapy visits
• Remind them that depression can improve with time and treatment

If you or someone you know is in crisis, get help quickly.

• Call your or your loved one’s health professional.
• Call 911 for emergency services.
• Go to the nearest hospital emergency room.
• Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TYY: 1-800-799-4TTY (4889).