What is depression?
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, this mental disorder affects how you feel, think and behave and can lead to a variety of emotional and physical problems.
It is a common mental disorder worldwide with more than 264 million people of all ages affected, as per WHO.
Depression may require long-term treatment. But it can be treated successfully with therapy and medication.
It’s also important to note that feeling down at times is a normal part of life. Sad and upsetting events happen to each one of us. However, if you’re feeling down or hopeless on a regular basis, there is a huge possibility that you could be experiencing depression.
Major depression can cause a variety of symptoms. Some affect your mood, and others affect your body. Although this major depressive disorder may happen only once in your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
The symptoms of depression can be experienced differently among men, women, and children.
Several signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.
Men may experience symptoms related to their:
- Mood, such as anger, aggressiveness, irritability, anxiousness, restlessness
- Emotional well-being, such as feeling empty, sad, hopeless
- Behavior, 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
- Behavior, 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
- Behavior, 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
- Brain chemistry: Abnormalities in brain chemical levels may lead to depression.
- Genetics: If you have a relative with depression, you may be more likely to become depressed.
- Life events: Stress, the death of a loved one, upsetting events (trauma), isolation, divorce and lack of support can cause depression.
- Medical conditions: Ongoing physical pain and illnesses can cause depression. People often have depression along with conditions like diabetes, cancer and Parkinson’s disease.
- Medication: Some medications have depression as a side effect. Recreational drugs and alcohol can also cause depression or make it worse.
- Personality: People who are easily overwhelmed or have trouble coping may be prone to depression.
- Gender. Women are about twice as likely as men to become depressed. No one’s sure why. The hormonal changes that women go through at different times of their lives may play a role.
In addition to the above causes, other risk factors for depression include:
- Low self-esteem or being self-critical
- Substance misuse
Types of depression
Healthcare providers name depression types according to symptoms and causes.
Major Depressive Disorder (MDD)
To be diagnosed with MDD, you must have either (a) an intense and persistent low (or irritable) mood or (b) a lack of interest or pleasure in the things you usually like, every day for at least 2 weeks. You also must have at least 5 of the symptoms listed below. These symptoms need to significantly interfere with your ability to live a normal life. Sometimes people with this kind of depression experience psychosis, which means their thinking is detached from reality. The symptoms are:
- Gaining or losing a significant amount of weight
- Sleeping much more or much less than usual
- Extreme restlessness or lack of movement noticed by others
- Feeling really tired or lacking energy
- Feeling worthless or inappropriately guilty (i.e., when you haven’t done anything wrong)
- Extreme difficulty concentrating or making decisions
- Frequent thoughts of death or suicide, suicide plan, attempted suicide
- Feeling hopeless
This is very similar to MDD except that it is less severe and may last years without being diagnosed. The person may be able to get through daily functioning (with some struggle) but still has problems with his or her mood. The symptoms are:
- Depressed mood most of the day, more days than not, for at least 1 to 2 years
- Many of the additional symptoms listed above
Seasonal Affective Disorder (SAD), A.K.A. MDD With Seasonal Pattern
This is a type of depression that usually occurs at certain times of the year, often in fall and winter when there is less sunlight. The symptoms are:
- Same symptoms as above, but person has periods without any symptoms at characteristic times of year (often spring and summer).
- Needs to happen for more than one year to be diagnosed (otherwise, it’s not a pattern).
When to see a doctor
If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you’re reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.
There isn’t a single test designed to diagnose depression. However, your healthcare provider will make a diagnosis based on your symptoms and a psychological evaluation.
Usually, they’ll ask questions about your:
- Sleep pattern
- Activity level
Your healthcare provider may also perform an exam or order lab tests to see if you have another medical condition.
In case Depression is left untreated, complications may include:
- Weight gain or loss
- Physical pain
- Substance use problems
- Panic attacks
- Relationship problems
- Social isolation
- Thoughts of suicide
Depression can be serious, but it’s also treatable. Treatment for depression includes:
- Self-help: Regular exercise, getting enough sleep, and spending time with people you care about can improve depression symptoms.
- Counseling: Counseling or psychotherapy is talking with a mental health professional. Your counselor helps you address your problems and develop coping skills. Sometimes brief therapy is all you need. Other people continue therapy longer.
- Alternative medicine: People with mild depression or ongoing symptoms can improve their well-being with complementary therapy. Therapy may include massage, acupuncture, hypnosis and biofeedback.
- Medication: Prescription medicine called antidepressants can help change brain chemistry that causes depression. Antidepressants can take a few weeks to have an effect. Some antidepressants have side effects, which often improve with time. If they don’t, talk to your provider. A different medications may work better for you.
- Brain stimulation therapy: Brain stimulation therapy can help people who have severe depression or depression with psychosis. Types of brain stimulation therapy include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS).
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.
Tips for helping others
If someone you care about has depression, the best and most important thing you can do is support them. In order to support someone else, you also need to look after yourself. Here are a few pointers:
- Educate yourself – Understanding what depression is and how it affects the person you care about will help you be less frustrated and more supportive.
- Encourage your friend to seek help – Having someone he/she can trust, like you, is so important. But someone trying to cope with a mental disorder also needs treatment. Encourage them to see a doctor or psychologist to get the help he/she needs. Even if the problems don’t seem that bad yet, seeking help early can prevent problems from getting worse.
- Listen – When you listen to and acknowledge their feelings, it sends the message that you care. Knowing that you have people who care about you is an important part of recovering from a mental disorder.
- Be positive – Positive moods can be contagious! It’s really easy for someone with a mental disorder to focus only on the negative aspects of his/her life. Sharing your positive mood may help them see things from a different perspective.
- Be patient – Sometimes it can be frustrating when they start acting differently and may not want to do anything they used to like. Take a deep breath and remember that depression is making them feel this way. He/she can’t just “snap out of it.” Getting impatient will only make the situation worse. Stay positive and be patient. Encourage them to participate in social events. He/she may feel like it’s too much work or effort, but will probably feel better afterwards.
- Don’t blame yourself – It is not your fault that they have depression. Many different factors, including his/her genetic background, environment, and life experiences are involved. No one can “make” another person have depression.
- Put yourself first – On an airplane, they tell you to always put your oxygen mask on first in an emergency before you assist someone else. You’ll be no help to anyone if you’re passed out. With someone with a mental illness, if you burn yourself out by always putting him or her first, you won’t be able to help anyone. It’s absolutely okay (and important) to take time away to take care of yourself.
- Don’t try to change your friend – You don’t have to solve all of their problems or turn him/her into a different kind of person. Just be present and supportive.
- Have fun together – They need someone who can have fun, relax, and laugh with him/her. These are all important parts of their mental health (and yours!).
- Be aware of suicide risk – If they talk about death or suicide, don’t ignore it or keep it a secret. Talk to a responsible adult who they also trust (e.g., residence assistant, counsellor, coach, professor). Let them know that you care about him/her and his/her life. If they are talking about suicide, it may be his or her way of indirectly asking for help.