Many of us experience short-lived emotional responses to challenges at some stage in our lives, with feelings of sadness, fatigue, and a loss of interest in things we usually pleasured.
These feelings can be a sign of depression for some people if they persist and begin to harm lives and family relationships.
Unfortunately, there is not one clear thing that causes depression since many linked circumstances can bring it on.
This article covers how to recognize depression and what are the possible treatments.
What Is Depression?
Depression is a mental health condition that manifests in feelings of sadness, tiredness, and low self-esteem, potentially having a substantial influence on a person’s ability to function.
Several factors lead to symptoms of depression, which vary from mild to severe and differ from person to person. However, they can affect you emotionally, mentally, and physically.
Anyone experiencing symptoms of a depressed mood and feeling easily overwhelmed for two weeks or longer could be suffering from depression.
Depression is a mental illness impacting a large proportion of the population. In 2019 researchers estimated that more than 18% of American adults experience depression symptoms in any given 2-week period (1).
When left untreated, depression can worsen and become a long-term disorder leading to various emotional and physical problems.
It can contribute to individuals self-harming or experiencing thoughts of death or suicide in serious cases.
Thankfully, there are many effective treatments for improving symptoms of depression, and, in the vast majority of cases, people make a full recovery.
Types Of Depression
Several types of depressive disorders exist, each of which has different triggers and can affect someone differently. Severity can range from mild depression to major depression.
Major Depressive Disorder (MDD)
Clinical depression, also called Major depressive disorder, occurs when a patient experiences severe symptoms that have lasted longer than two weeks.
They will find themselves in a near-constant state of feeling sad and a depressed mood while experiencing a loss of appeal in activities that previously brought satisfaction.
A major depressive disorder may have been triggered by stressful life events, such as the death of a family member, work stress, or a relationship break-up, and can lead to thoughts of suicide.
Persistent Depressive Disorder (PDD)
Persistent depressive disorder, also called dysthymia, carries symptoms often less severe than those associated with major depressive disorder. However, PDD is a condition that affects people for years rather than weeks or months.
The persistent depressive disorder often originates during childhood or adolescence, or in some cases, early adulthood. Those who suffer from dysthymia often lack interest in things and can sometimes not seek help, thinking that experiencing a low mood is just part of who they are.
The impact of the persistent depressive disorder on work, relationships, and everyday life can fluctuate and vary, and its effects can be equally debilitating or more severe than a major depressive disorder.
Perinatal Postpartum Depression (PPD)
Perinatal postpartum depression is a condition that can affect women during pregnancy and for up to a year after birth. It can come in three forms.
It is estimated that between 50% and 75% of women experience the baby blues after delivery, usually manifesting in uncontrollable bouts of crying, sadness, and anxiety. Perinatal depression is a severe condition that affects approximately 1-in-7 new parents (2).
Parents experiencing PPD will often experience guilt and cannot care for or show interest in their baby or themselves.
New mothers may experience postpartum psychosis following pregnancy in extreme cases, which requires urgent medical attention. The disease affects around 1 in 1000 people after delivery with symptoms including paranoia, delusions, or hallucinations (3).
Treatment for postpartum psychosis will usually include hospitalization, medication, and therapy due to the risk of suicide.
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder is an intense condition of premenstrual stress (PMS) that affects women in the days or weeks leading up to their period. Someone with PMDD will usually experience PMS symptoms and other symptoms, such as anxiety, major depression, or mood swings.
Symptoms begin 7 to 10 days before menstruation and stop around the onset of menses. During this period, they lead to significant levels of distress and problems completing everyday tasks and interpersonal interactions.
Due to the cyclical nature of PMDD, diagnosis can take up to a year, with symptoms being monitored across menstrual cycles over 12 months. Before diagnosing PMDD, health professionals will look for at least five signs and rule out other mental disorders.
It is estimated that premenstrual dysphoric disorder affects between 3 and 8% of menstruating females every year (4).
Bipolar disorder, often known as manic depression, is a personality disorder where people will experience alternating mood episodes of high-energy (mania) and major depression.
There are two common forms of bipolar disorder, bipolar I and bipolar II. Those suffering from bipolar I will experience abnormal levels of mania, often lasting for more than a week.
The highly energized level of physical and mental behavior is noticeable to other people and can put individuals in risky situations, potentially leading to death.
In contrast, while people suffering from bipolar disorder II experience manic episodes, they are less intense in manifesting themselves and don’t last as long as those with other forms of bipolar disorder.
People who experience a chronically unstable mood state may have a cyclothymic disorder, the third form of bipolar depression where mood episodes occur regularly.
While some periods of stable mood can be experienced, they are brief and last fewer than eight weeks.
Psychotic depression is one of the most severe psychiatric disorders in which patients experience delusions or hallucinations.
Delusions are things that people believe but have no basis in reality, while hallucinations involve people sensing things – through sight, sound, and smell – that do not exist.
This impaired sense of reality can put people with psychotic depression in dangerous situations, with delusions and hallucinations potentially leading to thoughts of self-harm, harming others, or suicide symptoms.
A person displaying psychotic tendencies should be referred immediately to a doctor.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder, sometimes known as seasonal depression, is triggered by seasonal changes and the shortening of daylight hours brought on by the autumn and winter months.
While many people experience “winter blues,” SAD is a more severe condition with many symptoms in common with other mental health disorders.
It is prevalent in countries that experience low levels of sunlight, such as in Scandinavian nations, and it’s estimated that approximately 6% of the US population experience acute incidences of seasonal affective disorder (5).
The onset of the seasonal affective disorder is most commonly found in young adults between 18 and 30 and significantly affects females more than males.
For some people, SAD will interfere with their quality of life and, in rare cases, can require hospitalization.
What Causes Depression?
Depression can affect anyone and be caused by one or more of several risk factors. Some triggers are genetic, some are biological, while others are down to environmental circumstances.
Common causes of depression include:
- A chemical imbalance in sections of the brain where certain chemicals manage mood, thoughts, sleep problems, appetite, and behavior.
- Fluctuating hormone levels in women, particularly during the postpartum period, menopause, and menstrual cycle.
- Reactions to early life trauma can provide a template for how your body reacts to stressful situations in adulthood.
- Having a less active frontal lobe of your brain. Whether this occurs before or after a major depressive episode arises is unknown.
A risk factor is a variable that is associated with an increased risk of disease. Depression is no different, with several risk factors affecting the likelihood of becoming depressed. They include:
- Gender – Major depression is twice as likely in females as in males.
- Genetics – A history of depression in family members increases the risk of you becoming depressed.
- Socioeconomic status – Financial problems and a perception of low social status are a higher risk of depression (6).
- Medications – Some drugs, including birth control and beta-blockers, could induce depression.
- Gender identity – A 2018 study found that the risk of depression in transgender people is nearly 4-times greater than in cisgender people (7).
- Substance abuse – Approximately 21% of people who misuse drugs or alcohol experience depression (8).
- Medical illness – People with chronic medical illnesses such as heart disease are about twice as likely to develop depression than people who don’t. It is estimated that up to 25% of cancer patients also experience depression (9).
What Does Depression Feel Like?
Several signs and symptoms may suggest that you are depressed. However, not everyone’s experience will be the same.
For some people, it may just be a case of feeling sad over a prolonged period, while others may find their emotional state and physical well-being worsen over time.
Depression symptoms can vary in severity, regularity, and intensity; however, experiencing some of the following signs can indicate that you have depression.
Feelings of sadness, anxiety, irritability, and worthlessness can lead to uncontrollable bouts of crying. Similarly, feeling unusually annoyed or angry can indicate depression.
At the same time, thoughts of death, self-harm, or suicide attempts are signs of severe depression and should be treated immediately.
Difficulty concentrating on tasks, making decisions, or remembering, coupled with decreased energy and feelings of fatigue, may lead to a loss of interest in hobbies and activities that you previously enjoyed.
You may find yourself moving or talking more slowly than usual and feel as though your brain is disconnected from your body.
In addition, you may think that the world around you is moving faster than you can function. Difficulty sleeping can occur with insomnia, over-sleeping, or waking up earlier than usual.
Meanwhile, physical symptoms include weight gain or weight loss due to changes in appetite.
In addition, chronic pain levels that don’t respond to treatment and aren’t caused by other medical conditions, such as headaches, joint pain, digestive trouble, and tummy pains.
While symptoms of depression can happen to anyone without warning, some signs occur more commonly depending on your gender and age.
Symptoms Of Depression In Women
With perinatal, postpartum depression, and premenstrual dysphoric disorder being disorders unique to females, it’s no surprise that major depression occurs nearly twice as often in females (10).
Females report being irritable, experiencing anxiety, mood swings, fatigue, weight gain, and dwelling on negative thoughts more often than their male counterparts.
Symptoms Of Depression In Men
Men experiencing depression are more likely to drink excessively, display anger, and take risks without regard for their safety.
In addition, other symptoms that a male may be struggling with their mental health include avoiding their families, missing social engagements, and working long hours.
This can lead to them struggling to keep up with their work and responsibilities to their families and displaying abusive or manipulating behavior in relationships.
Symptoms Of Depression In Children
Estimates show that 3.2% of children and adolescents between the ages of 3 and 17 have a diagnosis of depression (11).
Younger children will find it more difficult to express how they’re feeling, which makes it difficult to understand what the problems they’re facing might be.
However, where children find schoolwork or social activities more complex than before can be a sign of depression.
Symptoms of child depression include crying, decreased energy, clinginess, defiance, vocal outbursts, changes in appetite, and low self-esteem.
In addition, instances of a child getting into trouble at school, refusing to attend, or playing truant can be signs of crisis.
How Is Depression Diagnosed?
There is no single test that will diagnose whether or not you have depression or a particular depressive disorder.
Instead, diagnosis is based on various factors covered by the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, which includes symptoms, a psychological evaluation, and your family history.
This may also involve answering questionnaires, such as the Hamilton Depression Rating Scale or the Beck Depression Inventory, about your mood disorder and mental health over the previous two-week period and may also require some physical examination such as taking your blood pressure and testing thyroid levels.
Depression can exist with other mood disorders simultaneously, with one sometimes exacerbating the other. Although different factors cause them, the two medical conditions coexist together and may share some standard treatment.
Depression And Anxiety
Research shows that over 70% of people who experience depression also suffer from anxiety disorders.
Indeed, depression and anxiety share several common symptoms, including irritability, memory difficulty and concentration lapses, and difficulty sleeping (12).
Often one medical condition can feed into the other. For example, a person struggling with tasks at work or school or with their finances due to depression is likely to experience anxiety symptoms as they fall behind with their workload or sink deeper into debt.
Similarly, a person with an anxiety disorder may feel sad or experience feelings of self-loathing, triggering a worse depressive episode or crisis.
Depression And Alcohol
Many people with depression develop a substance use disorder. This is usually in an attempt to manage their symptoms without the intervention of a healthcare provider.
Alcohol misuse alone carries many complications, and many people use it to cope with feelings of depression. However, drinking alcohol, which is a known depressant, is likely to make the symptoms of depression even worse.
The more people with depression drink to cope with feelings of hopelessness and sadness, the deeper the depression will become and the more significant their dependence on alcohol.
What Are The Treatments For Depression?
The good news is that there are several treatment options for every mental health condition, including depression.
In most cases, one or a combination of the following treatments will help manage depressive symptoms.
Also, your doctor will work closely with you to find the most useful treatment options, whether psychotherapy, antidepressant medications to help change brain chemistry or alternative therapies.
Psychotherapy is a set of different types of interpersonal therapy used to treat mild depression, sometimes in isolation. It is also used alongside antidepressants for severe depression.
Cognitive-behavioral therapy (CBT) is a form of psychotherapy in which a mental health doctor supports the patient to solve concerns by recognizing negative thoughts for what they are and acknowledging when progress towards a goal, or resolution to a problem, has been achieved.
On the other hand, dialectical behavior therapy (DBT), which has its roots in CBT, emphasizes the need to accept unwelcome and uncomfortable thoughts, emotions, and behaviors rather than giving in to the brain’s natural urge to fight or try and hide from them.
The third form of psychotherapy that is an effective treatment for depression is psychodynamic therapy, which is designed to help the patient understand and cope with the challenges of daily life.
Counseling treatment and its effectiveness can usually be measured within a few weeks. However, perseverance might be required over a more extended period before helpful progress is felt in some cases.
Brain Stimulation Therapies
Brain stimulation therapies treat depression symptoms that are resistant to counseling and medication.
Electroconvulsive therapy (ECT) uses electric currents to induce a seizure and is an effective treatment for clinical depression and depressive disorder with psychosis (13).
ECT treatment can induce side effects, including headaches, nausea, irritability, disorientation, difficulty concentrating, and memory problems. However, these retreat in the weeks following treatment.
Another possible treatment for severe depression is repetitive transcranial magnetic stimulation (rTMS), which involves an electromagnet painlessly delivering a magnetic pulse to stimulate nerve cells of your brain that control mood and depression.
Furthermore, light therapy is another treatment used to help people affected by SAD and involves patients being exposed to doses of white light emitted from a light therapy box. This can help regulate the patient’s mood through the activation of serotonin and reduce symptoms of depression.
In addition, there are several alternative therapies available for the treatment of depression, many of which can be taken alongside psychotherapy and antidepressants.
For example, research studies have shown that meditation can help change how your brain responds to depression triggers such as stress, anxiety, and anger.
As a result, practicing meditation can help to improve depression symptoms and reduce the chances of relapse (14).
Another alternative therapy is acupuncture, a form of Chinese medicine. The practitioner uses needles to stimulate body parts to treat several conditions.
Studies suggest that acupuncture may be as effective as talk therapy in treating depression and assisting other treatments to work better (15).
Most types of depression can be successfully treated with prescription medication.
The most common form of antidepressant is selective serotonin reuptake inhibitors (SSRI) which treat clinical depression by increasing the levels of the neurotransmitter serotonin to balance your brain chemistry.
Caution should be applied to taking SSRIs if you are pregnant, have glaucoma, or are on medication for another medical condition.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) work similarly to SSRIs. They also increase serotonin levels, but they promote norepinephrine simultaneously, another neurotransmitter, to treat depression.
However, SNRIs should not be taken if you have existing liver or kidney illnesses.
Tricyclic antidepressants (TCA) and tetracyclic antidepressants also work to increase the levels of serotonin and norepinephrine in the brain. However, they can cause more side effects than SSRIs and SNRIs.
In a situation where depressive symptoms don’t respond to these certain medications, doctors may try atypical antidepressants.
Atypical antidepressants, like monoamine oxidase inhibitors (MAOIs), work on influencing many different neurotransmitters to balance brain chemistry.
However, due to potential side effects, MAOIs are only prescribed when other medications have been found not to work effectively.
Other atypical antidepressants, such as N-methyl D-aspartate (NMDA) antagonists, are only administered in a healthcare environment where a mental health professional can monitor the patient for signs of sedation and dissociation.
Each type of medication used in treating depression has its benefits and risks. In addition, they should only be taken under the direction of a doctor.
Self-Help, Coping, And Natural Remedies
Prevention is often good or better than a cure alone. Leading a healthy lifestyle with plenty of exercise, eating a balanced diet, and giving yourself the chance to get quality sleep regularly are great ways of helping prevent depression.
For example, 30 minutes of physical activity 3 to 5 days a week increases the production of endorphins that improve your mood.
At the same time, a healthy diet is a crucial way of regulating your energy levels and helping with depression prevention.
Try and keep away from alcohol and recreational drugs. Although they may help you feel better in the short term, certain drugs can worsen anxiety and depression symptoms in the long run. Drinking is also not conducive to finding a regular sleep pattern.
One of the natural remedies consists of taking nootropics for depression, which have been proven to positively affect symptoms alongside a healthy diet.
For example, research suggests that S-adenosyl L-methionine (SAMe) has successfully eased symptoms of depression in people also taking SSRIs. However, the results were not conclusive, and further research is required (16).
Also, a wide variety of nootropic supplements, like Rhodiola Rosea and L-Theanine, assist with specific depression symptoms and support other aspects of brain health.
Depression is a diagnosis that can strike anyone at any time and with varying levels of severity.
When untreated, depression may become a severe health condition and hamper people’s ability to perform everyday tasks and maintain interpersonal relationships with friends and family.
Understanding the symptoms and signs of depression is the first step to recovery. If you think that you or a person close to you is showing signs of depression, it is essential to get professional medical support as soon as possible.
Several remedies have been proven to effectively treat depression, with many people leading successful lives without relapsing.
Even people who have a long-term depressive condition can function in near-normal lives with a proper treatment plan, support, and a healthy lifestyle.