Depression

What is depression?

Feeling down occasionally is a normal experience, but it can sometimes indicate a mental health condition known as depression or major depressive disorder (MDD).

Depression is a prevalent mental illness that impacts one’s thoughts, emotions, and behaviors. It can lead to feelings of sadness, low mood, or disconnection from everyday life. Physical symptoms such as fatigue and sleep problems can also accompany depression.

Depression symptoms can persist for weeks or months and can significantly hinder one’s ability to function in daily life. In fact, MDD is a leading cause of disability worldwide, affecting approximately 5% of the global population.

Some individuals may experience depression alongside additional symptoms, while others may only have MDD in specific situations. Examples include MDD with anxiety, MDD with psychotic features, perinatal depression (MDD occurring during or after pregnancy), and seasonal depression (MDD with a seasonal pattern).

What causes depression?

Depression is a highly prevalent mental health condition worldwide. While the exact causes are not fully understood, it is likely influenced by a combination of factors, including brain structure and function, genetics (family history), personality traits, and environmental factors.

Depression can affect individuals of all ages, including children, teenagers, and older adults. Although it can occur at any stage of life, it often begins during adulthood. Having a previous episode of clinical depression or a family history of MDD can increase one’s risk of developing the disorder.

Certain life experiences can also elevate the risk of developing MDD (major depression disorder). These may include difficulties in relationships, social isolation, job-related challenges, financial problems, experiences of childhood abuse, racial trauma, medical conditions, and struggles with substance use.

What are the symptoms of depression?

All individuals diagnosed with clinical depression will experience at least one of the following two symptoms:

• Persistent feelings of sadness, hopelessness, or emptiness for the majority of the time.
• Loss of interest or pleasure in nearly all activities.

In addition to these core symptoms, individuals with MDD may also exhibit a combination of the following:

• Irritability
• Feelings of guilt or worthlessness
• Changes in sleep patterns (either increased or decreased)
• Changes in appetite (either increased or decreased)
• Fatigue or low energy levels
• Difficulty concentrating or thinking clearly
• Restlessness or a sense of being slowed down
• Thoughts of death or suicide

It is worth noting that in certain cultures, depression may manifest with more physical symptoms such as pain, headaches, or weakness. Children and teenagers may also display different symptoms compared to adults, such as irritability and emotional outbursts.

How is depression diagnosed?

To be diagnosed with MDD, an individual must experience at least five different symptoms of depression.

These symptoms should be present on most days, nearly all day, for a minimum of two weeks. Additionally, they should be severe enough to interfere with daily functioning and not attributed to substance use, medication, another medical condition, or better explained by another mental health condition.

If concerns about depression arise, it is advisable to consult with a healthcare provider, particularly if the symptoms persist for more than a few weeks. An alternative option is to utilize Mental Health America’s online depression screening tool, which is freely available and can assist in determining whether seeking professional help is warranted.

During a consultation with a healthcare provider or mental health professional, questions regarding the symptoms will be asked. In some cases, a physical examination or blood tests may be suggested to rule out potential physical causes of the symptoms, such as thyroid issues or anemia.

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What medication can be used for depression?

There are various medications available for the treatment of depression, with the following being commonly prescribed as the initial options:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Atypical antidepressants

It typically takes around 1 to 2 months of daily use for these antidepressants to take effect. If there is no improvement in symptoms during this period, the healthcare provider may consider adjusting the dosage or trying alternative antidepressants since the response to medication varies from person to person.

What treatment methods are used for depression?

Psychotherapy is an effective treatment for clinical depression, either as a standalone approach or in combination with medications. It can provide insight into your thoughts, emotions, and behaviors, as well as teach you valuable life skills and coping mechanisms for managing your depression.

Research indicates that certain types of therapy are equally as effective as medications for treating MDD including:

• Cognitive-behavioral therapy (CBT)
• Interpersonal therapy (IPT)
• Psychodynamic therapy
• Supportive therapy.

In addition to therapy and medication, there are complementary and alternative treatments that can aid in improving depression symptoms. When used in conjunction with traditional approaches, these treatments may offer benefits. These additional treatments include yoga and music therapy.

In cases where therapy and medications have not yielded the desired results, brain stimulation techniques can be employed to address MDD. These methods, such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT), are typically reserved for specific situations.