Depression is a mood disorder that causes a persistent feeling of sadness accompanied by a loss of energy and interest in activities once enjoyed. Depression affects how a person feels, thinks and behaves and can interfere with school, work and relationships. A person may be diagnosed with depression if they experience several symptoms across emotional, cognitive, behavioral and physiological domains. It’s important to recognize that everyone experiences some of these symptoms from time to time and it may not necessarily mean a person is depressed. Also, not every person who is experiencing depression will have all of these symptoms. If a person experiences symptoms across multiple areas that impact daily functioning for at least two weeks, however, clinical assessment and possible treatment are merited.
Symptoms of Depression
Emotional - People experiencing depression may feel:
sad
miserable
unhappy
irritable
overwhelmed
guilty
frustrated
lacking in confidence
indecisive
unable to concentrate
disappointed.
Cognitive - People experiencing depression may think:
‘I’m a failure.’
‘It’s my fault.’
‘Nothing good ever happens to me.’
‘I’m worthless.’
‘There is nothing good in my life.’
‘Things will never change.’
‘Life’s not worth living.’
‘People would be better off without me.
Behavioral - People experiencing depression may:
withdraw from close family and friends
stop going out
stop their usual enjoyable activities
not get things done at work or school
rely on alcohol and sedatives.
Physiological - People experiencing depression may:
feel tired all the time
feel sick and ‘run down’
have frequent headaches, stomach or muscle pains
have a churning gut
experience sleep problems
have a loss or change of appetite
experience significant weight loss or gain.
Depression has been linked to a combination of biological, psychological, social and lifestyle factors.
Research suggests that ongoing, emotionally depleting difficulties, such as long-term unemployment, living in an abusive or uncaring relationship, long-term isolation or loneliness or prolonged exposure to stress at work can increase the risk of depression. Significant adverse life events, such as losing a job, going through a separation or divorce, or being diagnosed with a serious illness, may also trigger depression, particularly among people who are already at risk because of genetic, developmental or other personal factors.
Personal/biological factors that increase risk of depression include:
family history – depression can run in families and some people will be at an increased genetic risk. However, this doesn’t mean that a person will automatically experience depression if a parent or close relative has had the condition.
habitual thoughts and responses that impact personality– people are often at risk if they they tend to worry a lot, are perfectionists, are sensitive to personal criticism, or are self-critical and negative in their thought patterns. These behaviors typically develop in reaction to unpleasant, stressful or traumatic events and over time, without intervention, can shape a person's core beliefs, values and personality.
serious medical conditions – these can trigger depression in two ways. Serious conditions can bring about depression directly or can contribute to depression through the associated stress and worry, especially if it involves long-term management of a condition or chronic pain.
drug and alcohol use – can both lead to and result from depression. Many people with depression also have drug and alcohol problems.
Although there has been a lot of research in this complex area, there is still much that we do not know. We do know that depression is not simply the result of a chemical imbalance. The interaction between our thoughts, emotions, behaviors, our physiological stress response and hormones can result in disturbances in normal chemical messaging processes between nerve cells in the brain. These disturbances are believed to contribute to depression, which in turn can impact all of the above factors.
Depression is treatable
Depression is often not recognized and can go on for months or even years if left untreated. It’s important to seek support as early as possible, as the sooner a person gets treatment, the sooner and easier they can recover. Untreated depression can have many negative effects on a person’s life, including serious relationship and family problems, difficulty finding and holding down a job, and drug and alcohol problems. Fortunately, effective treatments are available. Cognitive behavioral therapy (CBT) and second generation antidepressants have been found to be equally effective for the treatment of major depression. CBT aims to reduce negative or unhelpful thoughts and behaviors common in those with depression through practical problem-solving and action-oriented assignments. Research indicates CBT helps build skills and habits that enable individuals to effectively cope with subsequent life stressors and therefore avoid relapse or development of chronic, treatment-resistant forms of depression for which additional interventions may be necessary.
Depression often begins in the teens, 20s or 30s, but it can happen at any age. Factors that seem to increase the risk of developing or triggering depression include:
Certain traits, such as low self-esteem and/or being self-critical or pessimistic
Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation
History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
Abuse of alcohol or recreational drugs
Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)
Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.
In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.
Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:
Memory difficulties or personality changes
Physical aches or pain
Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
Often wanting to stay at home, rather than going out to socialize or doing new things
Suicidal thinking or feelings, especially in older men
Call your doctor or your mental health professional.
Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Use that same number and press "1" to reach the Veterans Crisis Line. Caring, trained, attentive counselors are available 24 hours a day to help anyone who is struggling with suicidal thoughts or significant emotional crisis.
Reach out to a close friend or loved one.
Contact a minister, spiritual leader or someone else in your faith community.
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.