Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 11/24/2020
Major depressive order, more commonly referred to as clinical depression or simply depression, is a mood disorder that can negatively affect your feelings, thoughts and daily life.
While it’s normal to feel unhappy from time to time, persistent negative feelings may signal that you have depression. Unlike a bad mood, which will typically pass on its own, the symptoms of depression can continue for a long time and affect almost every aspect of your life.
Millions of adults are affected by depression every year. According to the American Psychiatric Association, an estimated one out of every six people will experience depression at some point in their life.
Depression is treatable. If you’re worried that you may suffer from depression, it’s important to talk to a healthcare professional. Most of the time, treatment for depression involves the use of medication and/or psychotherapy.
Below, we’ve explained the forms, symptoms and causes of depression. We’ve also explained how healthcare professionals diagnose depression, as well as the treatments that are available to improve depression symptoms and facilitate recovery.
There are several different forms of depression, each with slightly different causes, symptoms and treatments. The most common forms of depression include:
Major depressive disorder (MDD). Commonly referred to simply as depression, major depressive is a mood disorder that can cause negative changes to your mood, thoughts, loss of interest in certain activities and other symptoms.
To be diagnosed with major depressive disorder, these symptoms must be present for at least two weeks.
Persistent depressive disorder (Dysthymia). This is a chronic form of depression that lasts for two years or longer. People with persistent depressive disorder often feel as if they are constantly going in and out of depression.
Seasonal affective disorder (SAD). This is a form of depression that only occurs during certain seasons, typically fall and winter. People with SAD may develop depression on a recurring seasonal basis but feel mentally healthy during other periods of the year.
Psychotic depression. Also referred to as depression with psychotic features, this form of depression is accompanied by psychosis, or loss of touch with reality. People with this form of depression may experience delusions or hallucinations.
Bipolar disorder. People with bipolar disorder often experience periods of poor moods that match the symptoms of depression. But they also experience periods of high or euphoric moods (mania). Bipolar disorder was previously referred to as manic depressive illness or manic depression.
Unlike the other forms of depression, bipolar disorder is typically treated using different medications and forms of therapy.
Postpartum depression. This is a common form of depression that can develop in new mothers after childbirth. While it’s quite normal to feel the “baby blues” after giving birth, symptoms that persist for several weeks may indicate postpartum depression.
Premenstrual dysphoric disorder (PMDD). Another form of depression that’s unique to women, premenstrual dysphoric disorder is a severe form of premenstrual syndrome that can cause depression shortly before ovulation.
Atypical depression. Sometimes, depression can be considered atypical. People with atypical depression experience common depression symptoms, but may experience an improved mood after certain positive events.
Adjustment disorders. Some types of adjustment disorder — emotional and behavioral reactions to stressful events or changes — can involve depressive symptoms. This type of disorder may occur after a stressful event such as death, divorce or separation.
Adjustment disorders that involve depression symptoms are sometimes referred to as situational depression.
The symptoms of depression can vary based on the form of depression that you have. They can also vary from person to person. For example, some people with depression find it difficult to fall and stay asleep, whereas others oversleep and find it difficult to wake up at a normal time.
Common symptoms of depression include:
Persistent feelings of sadness, tearfulness, anxiety, hopelessness and/or an “empty” mood
A loss of interest in activities that are normally pleasurable, such as sex and hobbies
Irritability and anger, frustrated outbursts over minor issues
Reduced appetite and weight loss
Increased appetite, food cravings and weight gain
Lack of energy or fatigue
Insomnia, including difficulty falling asleep and early-morning awakening
Oversleeping and struggling to wake up
Feelings of restlessness, anxiety and agitation
Physical pain and other physical symptoms, including headaches, joint and/or muscle pain and digestive problems
Difficulty focusing, making decisions and recalling information
Noticeably slower speech and movement
Recurrent thoughts of death, suicidal thoughts and suicide attempts
The symptoms of depression can vary in severity. Some people with depression may develop symptoms that come and go, while others may have severe, persistent symptoms that do not change over time.
Feelings such as sadness, anxiety and hopelessness, which are commonly associated with depression, can also occur in other situations. For example, it’s common and very normal to experience feelings of sadness after losing a loved one.
Other situations that may cause you to feel sad include losing a job, missing out on a major opportunity or ending a relationship.
While these feelings are similar to those experienced by people with depression, there is a difference between being sad and having a depressive disorder.
If you experience any of the symptoms above and believe that you’re depressed, it’s best to contact a healthcare professional. Depression, whether long term or as part of an adjustment disorder, is treatable, and reaching out for help is the first step towards recovery.
It’s particularly important to seek help if your depression is starting to interfere with your daily life. Make sure to talk to a professional as soon as you can if:
You experience depression symptoms daily and your symptoms have lasted for two weeks or longer.
You find it difficult to maintain your daily routine, from your career to socializing and maintaining relationships.
You don’t have anyone close or trustworthy to talk to and confide in, such as a close friend, family member or romantic partner.
You have suicidal thoughts or feelings.
Currently, experts aren’t completely sure about what causes depression. Research indicates that a variety of factors may play a role in depression, including the following:
Changes in brain chemistry. Depression may be caused by changes in certain brain chemicals called neurotransmitters. These chemicals are responsible for transmitting information between nerve cells.
Although there’s some debate as to the precise neurotransmitters that may play major roles in depression, research indicates that serotonin — a hormone that’s often linked to mood — may have a significant role in the development of depression.
Hormones. Changes in the levels of certain hormones may affect mood and contribute to depression. Events that can affect hormone production include use of certain types of medication, thyroid issues and, for women, pregnancy, childbirth and menopause.
Genetic factors. Depression occurs more frequently in people with family members who have also had depression. Although research is still ongoing, genetic factors may play a role in depression and other mood disorders.
Physical changes in the brain. Depression may occur alongside physical changes to the brain. For example, some research shows that certain parts of the brain may shrink in people affected by depression.
Some people may have a higher risk of developing depression than others. Factors that may affect your risk of developing depression include your age, your family history of depression, your physical health and several others:
Family history and genetics. Your genetics may play a role in your risk of developing depression. For example, research of identical twins has found that if one twin suffers from depression, the other has a 70 percent chance of developing it at some point.
Environmental factors. Environmental factors, such as being exposed to abuse, living in a stressful environment, a stressful work environment or poverty may affect your risk of developing depression.
Personality. Depression may be more common in people with certain personality traits, such as low self-esteem or a significant response to stress. People who are pessimistic may also be more likely to develop depression.
Physical health. Depression is closely linked to certain physical health conditions, such as cardiovascular disease. Research shows that up to 20 percent of people who suffer a myocardial infarction (heart attack) develop symptoms that meet the diagnostic criteria for depression.
Although it’s possible for children and teenagers to become depressed, depression often starts to develop in adulthood. In middle-aged and elderly adults, depression is often accompanied by conditions such as cancer, heart disease, Parkinson’s disease and diabetes.
Certain types of depression, such as seasonal affective disorder (SAD), have their own unique risk factors. For example, SAD is four times more common in women than in men and tends to affect people who live far from the equator.
If you’re worried that you could be depressed, it’s important to talk to your healthcare provider as soon as you can.
Healthcare professionals use a variety of tests to determine if you have depression. Your healthcare provider may ask you to undergo a physical exam, get one or several lab tests and request that you undergo a psychiatric evaluation with a mental health professional.
Many cases of depression are diagnosed using the criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM) — a handbook that contains information on mental disorders.
To be diagnosed with depression, you’ll typically need to have symptoms that have persisted for two weeks or longer.
Depression is a treatable condition. A range of safe, effective treatments are available for both mild and severe depression. Many of the leading treatments for depression are most effective when they’re started early, making it important that you seek out help if you feel depressed.
Common treatments for depression include the use of medication, psychotherapy and a range of other therapies. Severe cases of depression may require a hospital stay and treatment with brain stimulation therapies.
Depression is commonly treated using medications called antidepressants. Most medications in this category work by changing the levels of certain neurotransmitters in your brain that control your mood, appetite, sleep habits and other behaviors.
Several different types of antidepressants are available. Common antidepressants used to treat major depressive disorder (MDD) and other forms of depression include:
Selective serotonin reuptake inhibitors (SSRIs). SSRIs are typically used as first-line medications for treating depression in adults. First approved in the 1980s, SSRIs tend to be safer and less likely to cause side effects than older antidepressants.
Common SSRIs include Prozac® (fluoxetine), Zoloft® (sertraline), Paxil® (paroxetine) and Lexapro® (escitalopram).
Serotonin-norepinephrine reuptake inhibitors (SNRIs). A relatively newer class of antidepressants first introduced in the 1990s, SNRIs are used to treat depression and other conditions such as certain anxiety disorders.
Common SNRIs include Cymbalta® (duloxetine) and Effexor® (venlafaxine).
Tricyclic antidepressants (TCAs). Tricyclic antidepressants, or TCAs, are an older class of antidepressants. The first TCAs were introduced in the 1950s, with some still regularly prescribed today.
TCAs typically aren’t used as a first-line treatment for depression, but may be used if other, newer antidepressants aren’t effective. Compared to newer SSRIs and SNRIs, some TCAs are more likely to cause side effects and drug interactions.
Examples of TCAs include Elavil® (amitriptyline) and Sinequan® (doxepin)
Monoamine oxidase inhibitors (MAOIs). MAOIs, which were developed in the 1950s, are another older class of antidepressants. Although they remain in use today, they are less widely used than SSRIs and SNRIs due to their side effect and interaction risk.
Examples of MAOIs include Marplan® (isocarboxazid) and Nardil® (phenelzine).
Atypical antidepressants. Certain antidepressants are referred to as atypical, as they don’t fit into any of the specific categories listed above.
Common atypical antidepressants include bupropion (Wellbutrin XL®) and mirtazapine (Remeron®).
When used over the course of several months, most antidepressants are effective at reducing the severity of depression symptoms and assisting in recovery.
Most antidepressants require several weeks to start working properly. In the first few weeks, it’s common to experience improvements in sleep and appetite before experiencing a general improvement in mood.
Sometimes, you may need to try several antidepressants before you find the medication that’s best for you. In certain cases, you may need to take more than one type of medication at the same time to properly address your symptoms.
Certain antidepressants can cause withdrawal symptoms if they’re stopped abruptly. It’s also possible for your depression symptoms to return if you stop taking your antidepressants early, even if you feel that you no longer need to use them.
If you’re prescribed any type of antidepressant and think that it isn’t working effectively, talk to your healthcare provider before making any changes to your dosage or use of your medication. They will inform you when it’s safe to adjust your dosage or discontinue use of antidepressants.
Certain other medications may also be prescribed to treat depression-related symptoms. These medications are often prescribed alongside antidepressants. The specific medications you may be prescribed can vary based on your symptoms, medical history and other factors.
Depression can often be treated via psychotherapy, often in combination with antidepressants and other medications. Also known as talk therapy, several different types of therapy are used to treat depression, including interpersonal therapy and cognitive behavioral therapy (CBT).
As part of psychotherapy, you’ll talk with a qualified mental health care professional to identify and overcome the factors that may be contributing to your depression. Psychotherapy may help you to:
Work out how to solve problems and manage difficulties.
Identify beliefs, behaviors and thought processes that are contributing to your symptoms and work on replacing them with new ones.
Improve your feelings of satisfaction and take control over your depression symptoms.
Create healthy behaviors for dealing with setbacks, difficulties and distress.
Set achievable, realistic goals that you can work towards.
Depending on the type of depression you have, your symptoms and your response to treatment, your healthcare provider may a different from of treatment for depression:
Brain stimulation therapies. Therapies such as electroconvulsive therapy (ECT) may provide relief from depression, including severe depression, when other treatments are ineffective or insufficient.
Other brain stimulation therapies include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS).
Hospital treatment. People with severe depression may require Inpatient psychiatric treatment. This type of treatment is typically only used for people at risk of self-harm, unable to take care of themselves or affected by extremely severe depression.
Depression isn’t a condition that can be fully treated using home remedies, natural products or changes to your lifestyle. If you often feel depressed and think that you may have a clinical form of depression, it’s important to talk to your healthcare provider about proven treatment options.
However, making changes to your habits and lifestyle in combination with proven treatments for depression may help you to stay focused, avoid setbacks and work towards recovery. If you are undergoing treatment for depression, try the following home remedies and lifestyle changes:
Set realistic expectations and objectives. Treating depression is an ongoing process, meaning you’re more likely to experience a gradual improvement in mood over a period of weeks and months than a sudden “I’m better” moment.
During your treatment for depression, keep your expectations realistic and try to focus on making gradual, steady progress.
Exercise. Scientific evidence indicates that exercise can help to treat depression. Try exercising daily while you’re being treated for depression, even if it’s just a short walk or bike ride.
Take care of yourself. Focus on taking care of yourself while you recover. Try eating healthy, getting more than enough nightly sleep and spending your time on things that you enjoy.
Create a daily schedule. Try planning your day with things to do, from work-related tasks to leisure and recreation. Simple things such as keeping a journal of what you accomplish each day can help to keep you focused on recovery and improvement.
Make sure not to isolate yourself. Some people with depression isolate themselves from others by falling out of touch with friends, avoiding social events and making little effort to maintain relationships.
If you’re being treated for depression, make sure that you don’t isolate yourself. Try to reach out to your friends, family members and other people to catch up, talk and assist each other as you recover.
Seek out groups that can help you. There are numerous support groups for people with depression and other mental illnesses. Seeking out a support group can give you people to talk to and a social network that can assist in your recovery.
Options include NAMI Connection Recovery Support Group, a free, peer-led network of support groups across the country, the ADAA’s network of support groups, the DBSA’s network of support groups and local support groups that may meet in your area.
Read books and other materials to help with your recovery. Your healthcare provider or therapist may be able to recommend self-help books or other resources that can assist with your recovery and help you make progress in life.
Postpone major events and decisions. If you’re planning to change jobs, get married or make other major life choices in the near future, it may be best to consider postponing these decisions until you’ve finished your treatment.
You can also talk about any major decisions or life events with trusted friends and family members.
Avoid drinking alcohol. Alcohol is a depressant, and research has shown that people who consume alcohol excessively are more likely to develop depressive disorders and symptoms than those who either drink responsibly or rarely drink.
Alcohol may also interact with medications used to treat depression, increasing your risk of experiencing side effects. If you’re currently undergoing treatment for depression, it’s best to either avoid completely or strictly limit your consumption of alcohol.
Act if you notice any depression warning signs. It’s important to be aware of warning signs that may trigger or worsen your depression symptoms. If you find your symptoms getting worse, contact your healthcare provider quickly.
If you live with or spend lots of time with your friends and family, it can also help to talk with them about your depression symptoms and ask them to help you stay aware of any changes in your symptoms.
Certain health supplements and natural products are marketed as being helpful for people with depression. For example, products such as St. John’s wort are commonly promoted as natural treatments for people with depression symptoms.
Although there’s some evidence that St. John’s wort may help to treat mild depression, it isn’t approved by the FDA as a depression treatment. There’s also a significant risk of side effects and interactions if St. John’s wort is used in combination with other depression medications.
Before using any supplements or natural products to treat depression, it’s important to talk to a healthcare or mental health professional. Take extra care before using any supplements or natural products if you are currently prescribed medication.
Depression is an alarmingly common disorder that can affect millions of American adults every year.
Although depression is a serious condition, it’s highly treatable. From medications to therapy and changes to your habits and lifestyle, there are proven steps that you can take to treat the symptoms of depression and work towards a full recovery.
If you’re worried that you might have depression, consult with a licensed health provider now to discuss your symptoms and learn more about what you can do.
If appropriate, the provider can write you a prescription on the spot and send it directly to a local pharmacy of your choice, allowing you to get the relief you need fast, all without having to go to a healthcare professional's office. You may also be able to access therapy to help with your treatment.
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