Depression

Mental health is vital to our overall health and well-being. And just like our physical health, various conditions can throw us way off course.

Continue reading as we explore depression in more detail. We’ll go over topics like what depression is, what causes it, and how it’s diagnosed and treated.

What is Depression?

Depression is a type of mood disorder. These are mental health disorders that significantly impact our emotional state.

 People living with depression can have persistently low moods and a loss of interest in activities that used to bring them joy. The effects of depression can greatly impact our thoughts, feelings, and daily activities.

 While we may think of depression as one single entity, there are actually many different types of depression. Different types of depression can have variations in symptoms, diagnostic criteria, and treatments.

 One of the most common types of depression is major depressive disorder (MDD). This is what typically comes to mind when we think about depression.

 MDD is characterized by having a low mood or loss of interest that interferes with your daily life most days, for at least two weeks.

 Other types of depression include:

• Persistent depressive disorder

• Bipolar depression

• Seasonal affective disorder

• Perinatal depression

• Premenstrual dysphoric disorder

• Disruptive mood dysregulation disorder

• Depression with symptoms of psychosis

• Atypical depression

Depression is more than just feeling sad all the time. There are many different signs and symptoms of depression to be aware of.

 Additionally, the effects of depression aren’t just mental. Depression can also cause physical symptoms and can impact us socially and behaviorally.

Psychological Symptoms of Depression

One of the main psychological symptoms of depression is a persistent low mood, which can encompass the following feelings:

• Sadness

• Tearfulness

• Hopelessness

• Emptiness

• Pessimism

• Helplessness

• Worthlessness

• Guilt

 Depression is associated with other types of emotions as well. Some examples include frustration, irritability, and restlessness.

 Additional psychological symptoms of depression include: 

• Reduced interest in activities, especially those that were previously enjoyed

• Difficulty thinking, including trouble concentrating, making decisions, or remembering things

• Thoughts of death or suicide

Physical Symptoms of Depression

The potential physical symptoms of depression can include:

• Reduced energy levels or fatigue

• Noticeable changes in appetite, which can lead to unintended weight gain or weight loss

• Difficulty sleeping or sleeping too much

• Aches and pains, including headaches and digestive issues that don’t have a clear cause

Social and Behavioral Effects of Depression

Depression can also lead to changes in our social lives and behaviors. This may include: 

• Reducing contact with friends and family

• Neglecting favorite hobbies or pastimes

• Not meeting responsibilities at home or at work

• Acting more impulsively or engaging in risky activities

• Increasing use of alcohol or drugs

The exact cause of depression isn’t known. It’s generally accepted that the causes of depression are multifactorial. This means it can happen when certain factors or events combine in a vulnerable person. 

Causes of Depression

According to researchers, some factors that may lead to depression are: 

• Genetics

• Changes in the levels of certain neurotransmitters, which are chemical messengers in the nervous system

• Differences in the hypothalamic–pituitary–adrenal (HPA) axis, a pathway that’s involved in how we perceive and respond to stress

• Inflammation affecting the nervous system

• Changes in the structure of certain brain regions

• Alterations in the gut microbiome

• Extreme stress or traumatic events

Experiencing some of the signs and symptoms we’ve been discussing on most days for at least two weeks could signal depression. Making an appointment with your primary care provider to discuss concerns about depression is a great place to start.

 As with a physical health condition, they’ll ask you questions about your symptoms, when they started, and how they impact your daily life. Based on your discussion, they may refer you to a mental health professional for further evaluation.

Diagnosing Depression

Depression is diagnosed using criteria from the fifth volume of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 for short. This is a handbook that healthcare professionals use to diagnose mental health disorders like depression.

 Your provider will compare your symptoms and experiences to the criteria in the DSM-5 to help them reach a diagnosis. 

 To diagnose depression, your provider may also: 

• Ask about your and your family’s medical history, especially as it relates to mental health disorders

• Inquire about your personal history, including any significant stressors, life events, or substance use or abuse

• Assess your risk for suicide or self-harm

• Do a physical exam and order lab tests to see if your symptoms may be explained by another health condition

• Review your current medications to make sure they aren’t contributing to your symptoms

First off, it’s important to know that depression is very common. In fact, according to the Centers for Disease Control and Prevention (CDC), about five percent of adults in the United States report regular feelings of depression.

 Further, the results of a survey of U.S. adults estimated that the lifetime prevalence of MDD is over 20 percent. That means that just over one in five adults may experience MDD at some point in their life.

Risk Factors for Depression

While anyone can develop depression, some factors that can increase risk are: 

• Being a woman. Compared to men, women are at least twice as likely to experience depression.

• Being in the LGBT community. Research has found that individuals in the LGBT community tend to have higher rates of depression and other mental health challenges.

• Having close family members with depression. Compared to the general population, people with a parent, sibling, or child with depression are about three times as likely to develop it themselves.

• Having certain personality traits. Depression risk is increased in those with low self-esteem or high levels of pessimism. Other research finds that things like introversion and unhealthy coping mechanisms were also linked with depression risk.

• Experiencing negative life events. The risk of depression can increase in people who’ve had negative life experiences, such as physical or emotional trauma, the death of a loved one, or unemployment.

• Living with a chronic illness. Individuals living with a chronic illness are of developing depression. A few examples of chronic illnesses include diabetes, heart and lung diseases, HIV/AIDS, autoimmune disorders, and cancer.

Depression is typically treated with medication, therapy, or a combination of both. 

Medications for Depression

To treat depression, providers typically prescribe one or more antidepressants. These drugs work by affecting the way the brain makes or utilizes neurotransmitters, the chemical messengers that play a role in mood.

 There are many types of antidepressants. Common types include:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin/norepinephrine reuptake inhibitors (SNRIs)

• Monoamine oxidase inhibitors (MAOIs)

• Tricyclic antidepressants (TCAs)

 No matter the condition, we all want to feel better as quickly as possible. However, it’s important to be patient when starting a new antidepressant. According to the National Institute of Mental Health (NIMH), these drugs can take four to eight weeks to work.

 Additionally, everyone responds to antidepressants differently. That means what works well for one person may not work well for another. You may need to try more than one antidepressant before you find one that works for you.

Talk Therapy for Depression

Therapy for depression involves talking with a mental health professional about your thoughts, emotions, and behaviors. Talk therapy helps you identify negative thought patterns that are causing you distress. It helps you reframe your thinking and teaches you to employ healthier coping mechanisms to help reduce your depression.

 Different types of therapy can be used to treat depression. Two examples of evidence-based therapy approaches that are effective at treating depression are cognitive-behavioral therapy and interpersonal therapy.

Other Treatments for Depression

Some people with depression, about 30 percent, have what’s known as treatment-resistant depression. This means they haven’t found sustained relief from conventional treatments. 

Now that we’ve covered a lot about depression, you may be wondering if there’s a good way to prevent it. Unfortunately, there’s no tried-and-true way to prevent depression.

This is simply because we can’t control many of the factors that contribute to depression. These include things like our genetics, the levels of chemical messengers in our brains, and our significant negative life experiences.

Depression Prevention Tips

We can all do things to promote our overall mental well-being. For example: 

• Taking part in hobbies and activities that we enjoy

• Maintaining connections with our friends and family

• Finding effective ways to reduce our stress levels, such as through relaxation techniques, yoga, or meditation

• Getting enough good-quality sleep each night 

• Engaging in regular physical activity

• Eating a healthy, balanced diet

• Limiting our alcohol consumption

• Reducing our media use when possible, such as our use of social media

Get Help Right Away

If you find that you or a loved one is struggling with symptoms of depression or thoughts of suicide and need someone to talk to right away, help is available. Check out the resources below:

• Call or text the National Suicide Prevention Lifeline using 988

• Call the Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline by dialing 1-800-662-HELP (4357)

• Contact the National Alliance on Mental Illness (NAMI) Helpline by dialing 1-800-950-NAMI (6264) or texting “HelpLine” to 62640