What It Is, Symptoms, Causes, Treatment, and More

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.

It’s also fairly common. The Centers for Disease Control and Prevention data estimates that 18.5 per cent of American adults suffered from depression within a 2-week period.

While depression and grieving share certain features, depression is not the same as grief. It can be caused by loss of a loved or from sadness after a traumatizing life event. Depression can lead to self-loathing, loss of self-esteem and self-loathing. Grief is more common.

Positive emotions and happy memories of the deceased are often associated with feelings of emotional pain. Major depressive disorder sufferers feel constant sadness.

People experience depression in different ways. It can affect your daily work and cause you to lose time. It can also affect relationships and chronic health conditions.

Depression can lead to worsening of conditions like:

It’s important to realize that feeling down at times is a normal part of life. Everyone experiences sad and distressing events. But if you’re feeling down or hopeless on a regular basis, you could be dealing with depression.

Depression is a serious medical condition that can worsen if not treated.

Depression can be more than a constant state of sadness or feeling “blue.”

Multiple symptoms can be caused by major depression. Some can affect your mood while others affect your body. You may experience symptoms that are persistent or intermittent.

Signs and symptoms

Different symptoms may be experienced by everyone who has depression. It is possible to experience different symptoms depending on how severe they are, how frequently they occur, and how long they persist.

You may have depression if you are experiencing the following symptoms and signs for depression almost every day for at most 2 weeks.

  • feeling sad, anxious, or “empty”
  • Feeling helpless, worthless and pessimistic
  • Crying a lot
  • Feeling annoyed, angry, or bothered
  • You lose interest in hobbies and other interests that you once loved
  • You may feel less energy or fatigue
  • Trouble concentrating, remembering or making decisions
  • Talking or moving slower
  • Trouble sleeping, insomnia, morning wake-ups, or sleep deprivation
  • Weight or appetite changes
  • Chronic physical pain without a clear cause that doesn’t improve with treatment (headaches/aches or pains and digestive problems, cramps).
  • Suicide, self-harm, and thoughts about death are all possibilities

Different symptoms of depression may be experienced by males, women, teens, and children.

Males may feel symptoms related to their:

  • Anger, aggression, irritability and restlessness are all examples of mood
  • Emotional well-being is characterized by feeling empty, sad or hopeless.
  • Behaviors that are not in your best interests, like losing interest, not feeling pleasure from favorite activities, feeling tired easily or thoughts of suicidal, drinking excessively, using drug, or engaging in high risk activities
  • Sexual interest is characterized by a decreased sexual desire or insufficient sexual performance.
  • Cognitive abilities include inability to focus, difficulty completing tasks or delayed responses during conversations.
  • Sleep patterns include insomnia, restlessness, excessive sleepiness or not sleeping through the night.
  • Physical well-being can include fatigue, headaches, pains and digestive problems.

Some symptoms that may affect females include:

  • A mood such as irritability
  • Feeling sad, empty, anxious, hopeless, or helpless is an indicator of emotional well-being.
  • Behaviors such as losing interest in activities, withdrawal from social engagements or thoughts about suicide
  • Cognitive abilities include thinking and talking slower, as well as cognitive skills like slow thinking.
  • Sleep patterns such as difficulty falling asleep, difficulty getting up in the morning, and sleeping too much
  • Physical well-being can include decreased energy and fatigue, increased appetite, weight changes or aches, pains, headaches, and an increased rate of cramps.

Children might experience symptoms that are related to:

  • moods such as anger, irritability or crying
  • emotional well-being, such as feelings of incompetence (e.g., “I can’t do anything right”) or despair, crying, or intense sadness
  • Behaviors such as refusing to attend school, getting in trouble at school, and avoiding siblings or friends, thoughts of suicide or death, or self-harm
  • Cognitive impairments, such as difficulties concentrating, decrease in school performance or changes in grades, can impact cognitive abilities.
  • Sleep patterns such as difficulty or excessive sleeping can be described as sleep disorders.
  • Physical well-being includes energy loss, digestive problems or changes in appetite.

There are many possible causes of depression. They can be biological, or even circumstantial.

These are some common causes:

  • Brain chemistry. Depression patients may experience a chemical imbalance in the brain’s parts that control mood, thoughts and behavior.
  • Hormone levels. Changes in female hormones estrogen and progesterone during different periods of time like during the menstrual cycle, postpartum period, perimenopause, or menopause may all raise a person’s risk for depression.
  • The family history You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.
  • Childhood trauma. Your body’s response to fear and stressful situations can be affected by certain events.
  • Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.
  • Medical conditions Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, Parkinson’s disease, stroke, heart attack, and cancer.
  • Substance use Risk factors include a history or abuse of substances.
  • Pain.Depression is significantly more common for those who suffer from emotional or chronic physical pain over a prolonged period of time.

Risk factors

The risk factors for depression may be biochemical or medical. Common risk factors include:

  • Sex. Major depression is twice as common in females than in men.
  • Genetics. If you have a history of depression in your family, you are at an increased risk for developing it.
  • Socioeconomic status Your risk of developing depression can be increased by your socioeconomic status. This includes financial problems, perceived low social standing, and other factors.
  • Certain medications. Some drugs, including corticosteroids and beta-blockers, may increase the risk of depression.
  • Vitamin D deficiency. Studies show that vitamin D deficiency can lead to depression.
  • Gender identity.A 2018 study found that transgender people are nearly four times more likely to develop depression than cisgender individuals.
  • Substance misuseAround 21 percent of those who suffer from a substance abuse disorder also have depression.
  • There are many medical conditions.Depression can be associated with other chronic illnesses. People with heart disease are about twice as likely to have depression as people who don’t, while up to 1 in 4 people with cancer may also experience depression.

Many factors can contribute to depression.

It is possible to successfully manage symptoms using one type of treatment. Or, you might find that multiple treatments work best.

It’s common to combine medical treatments and lifestyle therapies, including the following:

Medications

You may be referred to your healthcare professional:

Selective serotonin reuptake inhibitors (SSRIs),

SSRIs are most frequently prescribed antidepressant medication and have very few side effects. They increase the brain’s availability of the neurotransmitter, serotonin.

SSRIs shouldn’t be taken with monoamine oxidase inhibitors (MAOIs), and in some instances thioridazine (pimozide)

Talk to your healthcare professional if you are pregnant about the potential risks of taking SSRIs while pregnant. If you have narrow-angle vision, it is important to exercise caution.

SSRIs are citalopram or Celexa, escitalopram/Lexapro, fluvoxamine/Luvox, paroxetine [Paxil, Paxil XR (Pexeva), Paxil XR], and sertraline.

SNRIs are serotonin and norepinephrine reuptake inhibiters (SNRIs).

SNRIs are used to treat depression by increasing neurotransmitters serotonin, norepinephrine, and other brain chemicals.

MAOIs and SNRIs should be avoided. Avoid SNRIs if you have kidney problems or liver disease.

Desvenlafaxine, Pristiq, Khedezla, duloxetine, Cymbalta Irenka, Cymbalta, Irenka, levomilnacipran, Fetzima, milnacipran, Savella, and venlafaxine, Effexor XR are all examples of SNRIs.

Antidepressants that are tricyclic and/or tetracyclic

Tricyclic antidepressants, (TCAs), and tetracyclic Antidepressants, (TECAs), treat depression by increasing neurotransmitters norepinephrine and serotonin in the brain.

Side effects of TCAs may be more severe than those from SSRIs and SNRIs. TCAs and TECAs should not be taken with MAOIs. If you have narrow-angle or severe glaucoma, be careful.

Tricyclic antidepressants are amitriptyline, doxepin(Sinequan), imipramine/Tofranil, trimipramine/Surmontil), desipramine/Norpramin), desipramine/Norpramin), nortriptyline (“Pamelor, Aventyl”) and protriptyline (“Vivactil”).

Antidepressants that are not typical

Dopamine reuptake inhibiters (NDRIs), are noradrenaline- and dopamine reuptake stimulators (NDRIs).

These drugs can be used to treat depression by increasing brain levels of noradrenaline and dopamine.

Bupropion (Wellbutrin), is an example of an NDRI.

Monoamine oxidase inhibitors (MAOIs)

MAOIs can be used to treat depression by increasing brain levels of dopamine, serotonin, dopamine and tyramine.

MAOIs should not be used to treat mental disorders. They are used only when other medications fail to treat depression.

MAOIs are selegiline, phenelzine and Nardil as examples.

N-methyl D–aspartate (NMDA), antagonists

N-methyl-D–aspartate antagonists (NDMA), treat depression by increasing glutamate levels in the brain. Glutamate is believed to be a neurotransmitter that plays a role in depression.

Patients who have failed to receive antidepressant therapy with their other options should not be given NMDA antagonists.

FDA approved one NDMA drug, esketamine (Spravato), to treat depression.

Esketamine is a nasal spray available through a restricted program called Spravato REMS.

After taking the medication, some patients may experience fatigue and dissociation (difficulty focusing, judgement and thinking). Hence, esketamine must be administered in a hospital setting so that a healthcare professional can monitor for sedation.

Each type of medication that’s used to treat depression has benefits and potential risks.

Psychotherapy

Talking to a therapist can help with managing negative emotions. Therapy sessions with a group or family member may be of benefit.

Psychotherapy, also known as “talk therapy,” is when a person speaks to a trained therapist to identify and learn to cope with the factors that contribute to their mental health condition, such as depression.

People with depression or other psychiatric disorders have found psychotherapy to be a highly effective treatment.

Psychotherapy is sometimes used alongside pharmaceutical treatment. There are many kinds of psychotherapy. Not everyone responds to each type.

Cognitive behavioral therapy (CBT).

Cognitive behavioral therapy (CBT), is a type of psychotherapy that helps you recognize unhealthy thought patterns and to identify what may be causing your negative reactions, behaviors, and beliefs.

Your therapist might assign you “homework” where you practice replacing negative thoughts with more positive thoughts.

Dialectical behaviour therapy (DBT).

The Dialectical Behavior Therapy (DBT), which is similar to CBT but focuses more on validation or accepting unfavorable thoughts, feelings and behaviors than fighting them, is called Dialectical Behavior Therapy.

It is believed that by recognizing your negative thoughts and emotions, you can make changes.

Psychodynamic therapy

Psychodynamic therapy is a type of talk therapy that helps you to better understand and deal with your daily life. Psychodynamic therapy is based upon the belief that your current reality is shaped and influenced by your childhood memories.

This therapy will allow you to reflect on your past and help you cope with life.

Light therapy

White light exposure can improve your mood and reduce symptoms of depression. Light therapy is used commonly in seasonal affective disorder (also known as major depressive disorder with seasonal pattern).

Electroconvulsive Therapy (ECT).

The use of electrical currents to cause seizures has been shown to improve clinical depression. It’s used in people with severe depression or depression that is resistant to other treatments or antidepressant medications.

During an ECT procedure, you’ll receive an anesthetic agent which will put you to sleep for approximately 5 to 10 minutes.

The healthcare professional will place four electrodes in specific areas of your head and cardiac monitoring pads on you chest. Short electrical pulses will be delivered for a few second. After treatment, you will not feel or convulse and will wake up in about five to ten minutes.

Side effects include nausea, headaches, muscle aches, soreness, confusion, or disorientation.

Sometimes, patients may develop memory issues. These usually occur in the weeks or months following treatment.

Alternative therapies

Talk to your doctor about other treatments for depression. Alternative therapies can be used alongside traditional medication and psychotherapy. Some examples include:

  • Meditation.Depression can be triggered by stress, anxiety, or anger. However, meditation can help to change your brain’s response to these emotions. Meditation practices have been shown to reduce the symptoms of depression and help lower the risk of developing depression relapse.
  • Acupuncture. Acupuncture, a traditional Chinese medicine that can help with depression symptoms, is one form of acupuncture. Acupuncture uses needles to stimulate specific areas of the body to treat a variety of conditions. Acupuncture may prove to be as effective and efficient as counseling in clinical treatment, according to research.

Exercise

You should aim to do 30 minutes of exercise three to five days per week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid drinking and using other substances

For a short time, drinking alcohol or using drugs may make you feel more comfortable. These substances can lead to anxiety and depression in the long-term.

Learn how you can set limits

Anxiety and depression can be worsened by feeling overwhelmed. It can make you feel better to set boundaries in your personal as well as professional life.

Take care of you

It is possible to improve your depression symptoms by taking good care of yourself. It includes sleeping well, enjoying a healthy diet, not allowing negative people to influence you, and engaging in fun activities.

Sometimes depression doesn’t respond to medication. Your healthcare professional may recommend other treatment options if your symptoms don’t improve.

You can choose from electroconvulsive therapy or repetitive transcranial magnet stimulation (rTMS), which will help you to manage depression and improve your mood.

Supplements

There are many supplements that can be beneficial for depression symptoms.

S-adenosyl-L-methionine (SAMe)

A few studies suggest that this compound may reduce symptoms of depression. People who were taking SSRIs experienced the best results. This research was not conclusive. More research is needed.

5-hydroxytryptophan (5-HTP)

5-HTP may increase brain serotonin levels, which can help ease symptoms. This chemical is made by your body when you eat tryptophan, which is a protein building block. More research is needed.

Omega-3 fatty acids

These essential fats play a vital role in brain health and neurological development. Your depression symptoms may be reduced by adding omega-3 supplements. There are conflicting results and further research is required.

Talk to your doctor before you start taking supplements. Some may interact with medications, or cause adverse effects.

Vitamins

Vitamins are essential for many bodily functions. Research shows that two vitamins are particularly useful in relieving depression symptoms.

  • Vitamin B:Brain health is dependent on B-12 and B-6. Low vitamin B levels can increase your chances of developing depression.
  • Vitamin D: Vitamin D, also known as the sunshine vitamin is essential for bone, brain and heart health. Although there may be a connection between vitamin D deficiency, depression and other mental disorders, more research is needed.

Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven’t shown themselves to be effective in clinical research.

There isn’t a single test to diagnose depression. Your symptoms and a psychological assessment can help your healthcare provider diagnose depression.

In most cases, they’ll ask a series of questions about your:

  • Feelings
  • Get hungry
  • Sleep pattern
  • Activity level
  • Thoughts

Depression can also be associated with other health issues. Your healthcare provider may order blood work and conduct a physical exam. Sometimes, depression can be caused by thyroid problems or vitamin D deficiency.

It’s important not to ignore symptoms of depression. If your mood doesn’t improve or gets worse, seek medical help. Depression can lead to serious mental illness and may even cause complications.

If not treated, complications may include:

Depending on severity of symptoms, depression can be divided into different categories. Some people have mild, temporary depression while others are more severe.

There are two types of major depressive disorders: persistent depressive disorder (MDD) and persistent depressive disorder (PDD).

Major depressive disorder

Major depressive disorder, or MDD, is the most severe form of depression. It’s characterized by persistent feelings of sadness, hopelessness, and worthlessness that don’t go away on their own.

You must experience at least five of these symptoms in a two-week period to be diagnosed as clinical depression.

  • Feeling depressed the majority of the day
  • Loss of interest in regular activities
  • Weight loss or weight gain of significant magnitude
  • Sleeping a lot, or not being able sleep
  • Slow thinking or slow movement
  • Most days, fatigue or low energy
  • Feelings of guilt or worthlessness
  • Loss of concentration or indecisiveness
  • Suicide or death thoughts recurring

There are different subtypes of major depressive disorder, which the American Psychiatric Association refers to as “specifiers.”

These include:

Persistent depressive disorder

Dysthymia was once the name for persistent depressive disorder (PDD). It’s a milder, but chronic, form of depression.

To be diagnosed, symptoms must persist for at least two years. PDD can cause more problems than major depression. It lasts for longer periods.

It’s common for people with PDD to:

  • In daily life, you lose interest
  • feel hopeless
  • Lack of productivity
  • Have low self-esteem

Depression can be treated successfully, but it’s important to stick to your treatment plan.

Depression can be difficult to live with, but there are ways to improve your quality life. Talk to your healthcare professional to discuss possible options.

The Healthline FindCare tool can provide options in your area if you don’t already have a doctor.

Postpartum depression

Postpartum Depression is depression after childbirth. It is a common disorder following pregnancy and affects one in nine new parents.

It’s common for people to experience “baby blues,” or feelings of sadness or emptiness after childbirth. Many people find that these symptoms disappear within a few days.

If you feel empty, sad, or hopeless for more than 2 weeks after your childbirth, then you might have postpartum Depression.

Postpartum depression symptoms may range from mild to severe.

  • Feeling restless or moody
  • Feeling sad, helpless, or overwhelmed
  • Thinking of harming your baby or yourself
  • not having an interest in the baby, feeling disconnected, or as if your baby is someone else’s
  • Having no motivation or energy
  • Too much or too little
  • Too much or too little sleep
  • Trouble focusing?
  • Memory problems
  • Feeling guilty, worthless, or like a bad parent
  • Retirement from the activities you once loved
  • Resigning from family and friends
  • having headaches, aches, or stomach issues that don’t go away
  • Feeling empty and disconnected.

The dramatic hormonal changes after pregnancy are believed to trigger postpartum depression.

Bipolar depression is a condition that occurs when someone experiences a depressive episode.

Bipolar disorder refers to a mental disorder that can cause significant changes in mood, energy and concentration. It also affects your ability or willingness to do everyday tasks.

There are three types of bipolar disorder, all of which include periods known as manic episodes, where you feel extremely “up,” elated, or energized, and depressive episodes where you feel “down,” sad, or hopeless.

If you have bipolar disorder, it can be hard to recognize the harmful effects of each “mood episode.”

A depressive episode can happen to anyone:

  • Feel very depressed, hopeless or empty.
  • Feel restless or slowed down
  • Have trouble falling asleep? Are you waking up too soon or sleeping too much?
  • Have a greater appetite and weight loss
  • Talk very slowly, forget what to do, or feel they have nothing.
  • Trouble concentrating or making decisions
  • Feeling unable or unable do simple tasks
  • They are not interested in sports.
  • You may experience a diminished or absent sex drive
  • Suicide or death thoughts

Depressive episodes can be debilitating and last throughout the day.

Bipolar disorder can be treated and many people will experience fewer depressive episodes if their depression is under control.

Anxiety and depression can both occur simultaneously in someone. Research shows that nearly 70% of depressive patients also suffer from anxiety symptoms.

Though they’re thought to be caused by different things, depression and anxiety can produce several similar symptoms, which can include:

  • irritability
  • Memory problems or difficulty with concentration
  • Sleep problems

Both conditions have some similarities in their treatment.

Both depression and anxiety can be treated:

If you think you’re experiencing symptoms of either of these conditions or both of them, make an appointment to talk with your healthcare professional. It is possible to work with your healthcare professional to determine if you have anxiety or depression that may be coexisting and how they can treated.

OCD is an anxiety disorder. It is characterized by repeated and unwelcomed thoughts, urges, fears, and behaviors (obsessions).

These obsessions can cause you to repeat certain behaviors or rituals (compulsions), in an effort to relieve the stress.

OCD patients often experience a series of obsessions and compulsions. You may feel isolated if you exhibit these behaviors. You may feel isolated and withdraw from friends and social situations. This could increase your likelihood of depression.

It’s not uncommon for someone with OCD to also have depression. One anxiety disorder can make it more likely that you will develop another. OCD can lead to major depression episodes in as high as 80 percent of OCD patients.

Children can also be affected by this dual diagnosis. Children can feel strange due to compulsive behavior, which may have started at an early age. It can lead to withdrawal from friends and increase the risk of depression in children.

Psychosis is a mental disorder that can be present in people who have been diagnosed as having major depression. When the two conditions occur together, it’s known as depressive psychosis.

Depressive psychosis causes people to see, hear, believe, or smell things that aren’t real. This condition can also cause feelings of sadness and hopelessness.

Combining these two conditions can be particularly dangerous. That’s because someone with depressive psychosis may experience delusions that cause them to have thoughts of suicide or to take unusual risks.

It’s unclear what causes these two conditions or why they can occur together, but treatment can successfully ease symptoms. The treatment options include medication and electroconvulsive (ECT) therapy.

Knowing the causes and risk factors can help you recognize early signs.

People often find pregnancy exciting. It is possible for pregnant women to feel depressed.

The following symptoms are indicative of depression in pregnancy:

  • Changes in eating habits or appetite
  • feeling hopeless
  • Anxiety
  • Losing interest in activities or things you once enjoyed
  • An inexplicable sadness
  • Trouble remembering or concentrating?
  • Sleep problems include insomnia, excessive sleeping or sleepiness
  • Suicide or thoughts of death

Talk therapy and natural remedies may be the best treatment for depression during pregnancy.

While some women do take antidepressants during their pregnancy, it’s not clear which ones are the safest. You may be encouraged by your healthcare provider to explore other options until after the birth.

After the baby is born, depression risks can persist. Postpartum depression is also known by major depressive disorder and peripartum onset. It is a serious concern to new mothers.

Recognizing the signs and symptoms will help you to identify a problem early on.

Research has shown that alcohol consumption and depression are closely linked. Depression is more common than alcohol abuse.

Nearly half of the 20.2million Americans with substance abuse disorders had a co-occurring mental disorder.

A frequent intake of alcohol can lead to depression symptoms becoming worse. People who suffer from depression are more likely not to drink alcohol and to become dependent.

Depression isn’t generally considered to be preventable. It’s hard to recognize what causes it, which means preventing it is more difficult.

But once you’ve experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.

These techniques may be of assistance:

  • regular exercise
  • Get enough sleep
  • Maintaining treatments
  • reducing stress
  • Establishing strong relationships with other people

You may also find other techniques and ideas that can help you avoid depression.

Depression can be short-term or long-term. Treatment doesn’t always make your depression go away completely.

Treatment can often make symptoms easier to manage. Finding the right combination or medications to manage depression symptoms is key.

If one treatment doesn’t work, talk with your healthcare professional. Your healthcare professional can help you design a new treatment plan to manage your condition.

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