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What is Depression?

Everyone gets the blues from time to time. But when those feelings of sadness don’t go away on their own after a couple of days, it may be something more serious - depression.

At a basic level, depression is a mood disorder that causes an ongoing feeling of sadness, hopelessness and loss of interest in daily activities. These mood changes are usually accompanied by physical and cognitive symptoms as well.

Also called major depressive disorder or clinical depression, depression affects how people feel, think and behave. At its worst, depression can cause sufferers to feel as though life simply isn't worth living.

Although depression can be a serious illness, fortunately, it is also treatable. The right treatment can help sufferers regain their joy and optimism in life, and be able to cope with the demands of daily life once more.

Symptoms of Depression

Some people have a single bout of depression during their lives. However, most people go through multiple episodes. Going through depression takes a major toll on sufferers, their friends, families and other relationships.

When a person is experiencing a bout of depression, they will likely have some or all of the following symptoms:

Feelings of sadness, emptiness or hopelessness
Feeling ‘on the edge of tears’ a lot of the time
Angry outbursts, even over small or unimportant things
Feeling highly irritable or frustrated and not knowing why
Loss of interest in activities such as sex, hobbies or sports
Changes to sleep patterns such as insomnia or sleeping many more hours than usual
General tiredness and extreme lack of energy
Changes to appetite, either not wanting food or overeating
Slowed thinking and ‘brain fog’
Feelings of worthlessness or guilt
Fixating on thoughts of self-blame
Difficulties with thinking, concentrating, making decisions and remembering
Thoughts about death, or even planning suicide
Feeling unhappy without knowing why

For many people with depression, going through these symptoms causes problems in day-to-day activities such as school or work and can also lead to issues with relationships.

Many depressed people do not understand what they are going through, or why. They cannot explain how they feel to others, or explain the cause to themselves. In other words, they feel generally miserable or unhappy without really knowing why.

Definition of clinical depression

Depression ranges in severity from mild, short episodes of sadness to severe, persistent and debilitating symptoms. Clinical depression is the more severe type of depression. It is also known as major depression or major depressive disorder.

Treatment of Depression

Fortunately, depression is among the most treatable of mental disorders. Almost all patients gain some relief from their symptoms through the right combination of treatments.

Diagnosis

The first step to treating depression is receiving a diagnosis. A health professional should conduct a complete evaluation, which will include an interview and a physical examination.

In some cases, a health professional may also choose to perform a blood test in order to confirm that the depression is not due to a medical condition like a thyroid problem or a vitamin deficiency.

Treatments

There are a number of different approaches to treating depression. Some involve medication, whereas others involve psychological therapies such as talk therapy. Many treatments use a combination of both approaches to see the best results.

Medication

People whose brain chemistry becomes imbalanced can experience depression. For this reason antidepressants might be prescribed to help modify the brain chemistry of someone suffering from depression.

Antidepressants may produce some improvement within the first week or two but full benefits may not be seen for two to three months. Some patients receive other medications, such as anti-anxiety medications, together with antidepressants. It is important to let your doctor know if a medication does not work or if you experience side effects.

Healthcare professionals recommend that patients continue to take antidepressants for six or more months after the symptoms have improved. This is to help prevent a relapse.

Psychotherapy

Psychotherapy is also known as “talk therapy”. It involves sitting and talking to a healthcare professional about life, problems, relationships, feelings and anything else that is relevant to mental health.

There are many different types of psychotherapy but cognitive behavioral therapy (CBT) has been found to be particularly effective in treating depression. It is focused on helping people recognize issues with negative or obsessive thoughts and respond to challenges in a more positive manner.

ECT

Electroconvulsive therapy (ECT) is a medical treatment only used on patients with severe depression who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia.

Newer treatments

Within the past decade, there have been some therapies developed that sometimes work when other treatments have failed to produce a full response. These include transcranial magnetic stimulation, vagal nerve stimulation, ketamine injections, and esketamine nasal inhalation.

Self-care for depression

In addition to the treatments above, it is also important for people suffering from depression to take care of themselves and perform positive, mood-elevating activities such as:

Performing regular exercise
Getting enough sleep
Eating well
Spending time outdoors
Ending damaging relationships
Avoiding alcohol and drugs

While it can feel debilitating to suffer with depression, the good news is that it is easy to seek help, get the right treatment, and start the journey to recovery

FAQs

How to know if you are depressed?

Depressed people often experience some or all of the following symptoms:

Continual feelings of sadness, emptiness or hopelessness
Crying often, or feeling on the edge of tears a lot of the time
Angry outbursts, even over unimportant things
Feeling highly irritable or frustrated and not knowing why
Loss of interest in regular activities
Changes to sleep patterns such as insomnia or sleeping many more hours than usual
General tiredness and extreme lack of energy

If you are experiencing some or all of these symptoms, you may be depressed.

Is depression genetic?

It may be. Recent studies revealed a certain gene that appears to be prevalent in multiple family members with depression. Scientists believe that a large proportion of those with depression can trace it to a genetic link. Research has shown that people with parents or siblings who have depression are up to three times more likely to have the condition.

When should I see a doctor if I am feeling depressed?

It is never wise to wait when you are experiencing feelings of depression. If symptoms persist for more than a few days, or you feel that what you are experiencing is more than the blues, make an appointment to see your doctor or mental health professional as soon as you can.

Many people are hesitant to talk to a doctor about depression, because they think they may have difficulty expressing how they feel or their problem will not seem very serious. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, or someone else you trust. From there, consider going to speak to a mental health professional.

When should a depressed person seek emergency help?

It is important to remember that there are many caring people out there who can help with feelings of depression.

If you ever think you are at risk of hurting yourself or even attempting suicide, call 911 or your local emergency number immediately.

In the U.S., the National Suicide Prevention Lifeline is 1-800-273-TALK (1-800-273-8255).

Samaritans is a nonprofit organization offering emotional support to anyone who has feelings of depression or loneliness or who is considering suicide. Call or text 877-870-4673 (HOPE) to contact them.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with them. Then 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.

Are there different kinds of depression?

Yes. There are many different kinds of depression. Two of the main ones are major depression and persistent depressive disorder. Major depression happens when a person experiences a constant state of extreme sadness, lethargy and hopelessness. They lose interest in everyday activities and may have difficulty caring for themselves. Persistent depressive disorder, also known as dysthymia, is an goinging disorder that causes symptoms for at least two years. A person with this disorder may have episodes of major depression as well as milder symptoms.

Other types of depression include:

Peripartum depression (previously known as postpartum depression)
Seasonal depression (also called seasonal affective disorder)
Premenstrual dysphoric disorder
Disruptive mood dysregulation disorder

Are there any natural treatments for depression?

It is important for people who suffer with depression to get the correct treatment, which may include psychotherapy, medication or both. But there are also alternative or complementary treatments that can be tried.

It is however important to remember that these natural treatments only have a few studies on their effects on depression, good or bad. That means it is important to discuss their use with your doctor. The doctor can also advise on any drug interactions with other medications you may be taking.

S-adenosyl-L-methionine (SAMe): This compound has some possibility of easing the symptoms of depression but studies are limited.
5-hydroxytryptophan (5-HTP): 5-HTP may raise serotonin levels in the brain, which could ease the symptoms of depression. Your body makes this chemical itself when you eat foods containing tryptophan, a protein building block.
Omega-3 fatty acids: These essential fats are important for neurological functioning and brain health. Adding omega-3 supplements to your diet may help reduce depression symptoms.
Vitamin B: B-12 and B-6: When your levels of these crucial vitamins are low, your risk for developing depression may be increased.
Vitamin D: Vitamin D is important for brain, heart, and bone health. People who are depressed are more likely to have low levels of this vitamin.

What can trigger depression?

When it comes to depression, there are many possible causes. Sometimes, different factors combine to trigger symptoms.

Factors that are likely to play a role include:

Genetics. People who have blood relatives who have suffered with depression are more likely to experience symptoms.
Psychological and social factors such as childhood deprivation or abuse, stress, pressure or bullying.
Underlying medical disorders.

Are there different kinds of antidepressants?

There are several different kinds of antidepressants. Based on factors such as your age, severity of your depression, lifestyle factors and more, your doctor will decide which choice is best for you. Some people experience better results with some types of antidepressants than others.

Types of antidepressants include:

selective serotonin reuptake inhibitors (SSRIs)
monoamine oxidase inhibitors (MAOIs)
tricyclic antidepressants
atypical antidepressants
selective serotonin and norepinephrine reuptake inhibitors (SNRIs)

Each type of antidepressant acts on a different neurotransmitter or combination of neurotransmitters.

A person should only take medication as their doctor prescribes it for them. It is also important to remember that antidepressants can take a while to take effect - from weeks to months - and that they should not be stopped without a doctor’s advice.

Can eating well help depression?

Eating a good diet is an important part of overall mental and physical health. While eating a poor diet, for example a diet high in sugary or processed foods, can lead to various health problems.

Some studies point to the fact that increasing your intake of foods such as these can help improve depression symptoms:

fruit
vegetables
fish
olive oil

What are some of the risk factors for depression?

Some people have a higher risk of depression than others. Risk factors for developing depression include:

Going through traumatic life events, such as loss/death, changes in relationships, financial problems, and medical issues
Experiencing acute stress from, for example, work
Not having the kind of coping strategies that allow you to deal with difficulties
Having a close relative with depression (genetic link)
Having a head injury
Use of certain prescription drugs, such as corticosteroids
Using recreational drugs, such as alcohol or amphetamines
Having a chronic health condition
Living with persistent pain

The information provided is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of a doctor with any questions you may have regarding a medical condition. Never delay seeking or disregard professional medical advice because of something you have read here.