What is depression?
Depression is a whole-body illness. It involves the body, mood, and thoughts. Depression
affects the way you eat and sleep. It also can affect the way you feel about yourself
and things. It is not the same as being unhappy or in a “blue” mood. It is not a sign
of personal weakness or a condition that can be willed or wished away. When you have
depression, you can’t “pull yourself together” and get better. Treatment is often
needed and many times crucial to recovery.
Depression has different forms, just like many other illnesses. Three of the most
common types of depressive disorders include:
- Major depression. This is a mixture of symptoms that affect your ability to work, sleep, eat, and enjoy
life. This can put you out of action for awhile. These episodes of depression can
happen once, twice, or several times in a lifetime.
- Dysthymia. This is a long-term, ongoing depressed mood and other symptoms that are not as severe
or extensive as those in major depression. These symptoms can still keep you from
functioning at "full steam" or from feeling good. Sometimes, people with dysthymia
also experience major depressive episodes.
- Bipolar disorder. A chronic, recurring condition that includes cycles of extreme lows (or depression)
and extreme highs (called hypomania or mania).
What causes depression?
There is no clear cause of depression. Experts think it happens because of chemical
imbalances in the brain. Many factors can play a role in depression, including environmental,
psychological, biological, and genetic factors.
Some types of depression seem to run in families. However, no genes have yet been
linked to depression.
Women have depression about twice as often as men. Many hormonal factors may add to
the increased rate of depression in women. This includes menstrual cycle changes,
premenstrual syndrome (PMS), pregnancy, miscarriage, postpartum period, perimenopause,
and menopause. Many women also deal with additional stresses such as responsibilities
both at work and home, single parenthood, and caring for both children and aging parents.
Many women are especially at risk after giving birth to a baby. Women experience hormonal
and physical changes on top of the added responsibility of caring for a baby. These
can be factors that lead to postpartum depression in some women. While the “baby blues"
are common in new mothers (lasting a week or two), a full-blown depressive episode
is not normal and treatment is needed.
What are the symptoms of depression?
The following are the most common symptoms of depression. However, each person may
experience symptoms differently. Symptoms may include:
- Lasting sad, anxious, or “empty” mood
- Weight and/or appetite changes due to eating too much or eating too little
- Changes in sleeping patterns, such as fitful sleep, inability to sleep, early morning
awakening, or sleeping too much
- Loss of interest and pleasure in activities formerly enjoyed, including sex
- Increased restlessness and/or irritability
- Decreased energy, fatigue, being "slowed down"
- Feeling of worthless and/or helpless
- Lasting feelings of hopelessness
- Feelings of inappropriate guilt
- Not being able to concentrate, think, and/or make decisions
- Frequent thoughts of death or suicide, wishing to die, or attempting suicide (Note: People with this symptom should get treatment right away!)
- Physical symptoms, such as headaches, digestive problems, and/or chronic pain that
don’t get better with treatment
Without treatment, symptoms can last for weeks, months, or even years. Appropriate
treatment, however, can help most people who suffer from depression.
How is depression diagnosed?
Depression often happens along with other medical problems, such as heart disease,
cancer, or diabetes. It can also happen with other psychiatric disorders, such as
substance abuse or anxiety disorders. Getting an early diagnosis and treatment is
crucial to recovery.
A diagnosis is made after a careful psychiatric exam and medical history done by a
psychiatrist or other mental health professional.
How is depression treated?
Generally, based on the outcome of evaluations, treatment of depressive disorders
may include one or a combination of the following:
- Medicine. Many different medicines are available, but it often takes 4 to 6 weeks to feel the
full effects of anti-depressants. It’s important to keep taking the medicine, even
if it doesn’t seem to be working at first. It’s also important to talk to the healthcare
provider before stopping. Some people have to switch medicines or add medicines to
- Psychotherapy. This is most often cognitive-behavioral and/or interpersonal therapy. It focuses on
changing the distorted views you have of yourself and your environment. It helps you
work to improve your interpersonal relationship skills, and how to identify and manage
stressors in your life.
- Electroconvulsive therapy (ECT). This treatment may be used in people with severe, life-threatening depression that
has not responded to medicines. An electrical current is passed through the brain,
triggering a seizure. For unknown reasons, the seizures help to restore the normal
balance of chemicals in the brain and ease symptoms.
You can also do things to help yourself. Depressive disorders can make you feel exhausted,
worthless, helpless, and hopeless. Such negative thoughts and feelings may make you
feel like giving up. It is important to realize that these negative views are part
of the depression and typically do not accurately reflect the actual circumstances.
Negative thinking fades as treatment begins to take effect. In the meantime, if you
think you have depression, consider the following:
- Get help. If you think you may be depressed, see a healthcare provider as soon as
- Set realistic goals in light of the depression. Take on only what you reasonably think
- Break large tasks into small ones and set priorities. Do what you can as you can.
- Try to be with other people and confide in someone. It is usually better than being
alone and secretive.
- Do things that make you feel better. Going to a movie, gardening, or taking part in
religious, social, or other activities may help. Doing something nice for someone
else can also help you feel better.
- Get regular exercise.
- Expect your mood to get better slowly, not right away. Feeling better takes time.
- Eat healthy, well-balanced meals.
- Stay away from alcohol and drugs, which can make depression worse.
- It is best to put off important decisions until the depression has lifted. Before
deciding to make a major life change—change jobs, get married, or divorced—discuss
it with others who know you well. They will have a more objective view of your situation.
- Remember, people rarely “snap out of” a depression. But with treatment they can feel
a little better day-by-day.
- Try to be patient and focus on the positives. This may help replace the negative thinking
that is part of the depression. The negative thoughts will disappear as your depression
responds to treatment.
- Let your family and friends help you.
Key points about depression
- Depression is a whole-body illness. This means that it involves the body, mood, and
thoughts. It is not the same as being unhappy or in a “blue” mood. Treatment is often
needed and many times crucial to recovery.
- There is no clear cause of depression, but healthcare providers think it’s a result
of chemical imbalances in the brain. Some types of depression seem to run in families,
but no genes have yet been linked to depression.
- Women experience depression about twice as often as men. Many hormonal factors may
play a role in the increased rate of depression in women. These factors may include
menstrual cycle changes, premenstrual syndrome (PMS), pregnancy, miscarriage, postpartum
period, perimenopause, and menopause.
- In general, nearly everyone suffering from depression has ongoing feelings of sadness.
They may feel helpless, hopeless, and irritable. Without treatment, symptoms can last
for weeks, months, or years.
- Depression may be diagnosed after a careful psychiatric exam. A medical history will
be done by a psychiatrist or other mental health professional.
- Depression is most often treated with medicine, psychotherapy, or cognitive behavioral
therapy. It can also be a combination of medicine and therapy.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that
- Know how you can contact your provider if you have questions.