Anyone can feel depressed or have the blues from time to time, but depression—or major depressive disorder—is different. It can be an unrelenting malaise that can poison relationships and sap joy from happy occasions. The condition is common and insidious—it can creep up on you, changing your behavior to the point where you are avoiding friends, sleeping in, and losing interest in the things that used to bring you joy. Feeling lousy becomes the new normal. It’s important to know how to recognize the symptoms of depression so that you can seek the support and treatment you need to feel better. Here’s how to tell if you’re dealing with this mood disorder, which can range from mild to severe and also has a variety of different risk factors and triggers. Depression is not just one condition but can be a component of many different diagnosable mental health conditions.
What is Depression?
Roughly one in 14 adults 18 older, or more than 17 million people, had a major depressive episode in 2017, according to the National Institutes of Mental Health (NIMH). Research suggests that women are 1.7 times as likely to experience major depression as men. To be diagnosed with clinical depression, you generally need to have symptoms on most days for at least two weeks, according to the NIMH. Note that not every person with depression experiences all or even most of these signs—just having a few for an extended length of time means you should seek professional help from your doctor or a therapist.
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, pessimism, or irritability
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue; moving or talking more slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite and/or weight changes
- Thoughts of death or suicide, or suicide attempts
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Knowing the symptoms can help you get treatment early, but it’s also important to know that depression comes in many forms, including these common types:
- Major depressive disorder or clinical depression: Depression symptoms are present for two weeks or more
- Persistent depressive disorder: Depression symptoms last for two years or more
- Postpartum depression: Depression that can occur during or after pregnancy
- Psychotic depression: Depression symptoms that can include delusions and hallucinations
- Seasonal affective disorder: Depression symptoms that occur during certain seasons, most often winter, but also, less often, in summer
- Bipolar disorder: A mental health condition characterized by mood extremes, including episodes of depression as well as elevated mood known as hypomania or mania
How do you know if you or a loved one is at risk for depression? There seems to be a genetic link, according to the NIMH; having a severe illness like heart disease, cancer, or Parkinson’s disease is also associated with a higher risk, as are certain medications (some acne drugs or corticosteroids, for example). Some chronic conditions, like multiple sclerosis, are thought to cause depression beyond just the mental health impact of the condition itself. Not surprisingly, a major life trauma may trigger depression—divorce, abuse or an assault, a major move, job loss, or the death of a loved one, for example. Alcohol or drug use is associated with a higher risk as well—about one in five people with substance abuse issues have depression, according to the Centers for Disease Control and Prevention. However, anyone can develop depression at any time. While there are risk factors, depression can affect people regardless of age, gender, or socioeconomic status—you don’t need to have a “reason” to have depression.
The Science Behind Depression
While aspects of depression remain a mystery to researchers, the condition does seem to be marked by low levels of a neurotransmitter called serotonin. Many antidepressant drugs are designed to help keep more serotonin in play in the brain; this seems to stabilize or normalize mood, though the medications may take a few weeks to start working. In general, selective serotonin reuptake inhibitors, or SSRIs—these include drugs like fluoxetine, sertraline, and paroxetine—tend to be more effective for moderate to severe depression than mild depression. According to the NIMH, recent research has built on the role of genes in depression, suggesting that an elevated risk for the condition can be passed down from one generation to the next.
The shape of the brain may also play a part: The hippocampus—a brain structure in charge of emotions and memories—tends to be smaller in people with depression, and it can shrink in those with long-term depression. An imbalance of neurotransmitters (yes, serotonin, but also dopamine, noradrenaline, and glutamate) is associated with mood disturbances, according to research published in the Journal of Affective Disorders. The researchers also point to issues with the thyroid gland, low antioxidant levels, and inflammation in the brain as potential causes.
People with depression are less likely to eat healthily or exercise, more likely to use drugs or alcohol, and are more likely to have trouble sleeping. Making lifestyle changes, like getting more sleep or exercise can be challenging for people who are depressed, but they may help reduce symptoms. There is strong evidence to suggest that regular exercise can help alleviate depression symptoms. A 2017 review in Frontiers in Pharmacology noted that exercise has been found to be as good as antidepressant therapy in some randomized controlled trials, and the authors concluded it should be considered as a depression treatment—at least as an additive therapy—in its own right.
Depression often responds to treatment, although a solution that works for one person may not work for someone else. It may be helpful to read about the struggles and successes of other people with depression as you try to figure out the right steps for yourself.
- How to Deal with Depression: What Worked for these 16 Real-Life People
- I Battled Depression for 20 Years and This Is the Treatment that Finally Worked
- The Treatment That Finally Lifted My Depression After Everything Else Failed
- I Used a Light Therapy Box for a Week. Here’s How It Changed Me
- Depression Quotes That Capture Exactly What You’re Feeling
Tips for Dealing With Depression
If you suspect a spouse or someone close to you has this mood disorder, you might find this advice from psychologists on how to help someone with depression helpful, as well as these tips for dealing with a depressed spouse; you’ll also want to avoid the 14 things you should never say to someone with depression.
If you’re looking for a therapist, a good place to start is with the government’s helpline through the Substance Abuse and Mental Health Services Administration (SAMHSA)—1-800-662-HELP (4357). Another helpful page is a guide to therapy from the Anxiety and Depression Association of America.
There are numerous treatments for depression: Antidepressant medication, anti-anxiety drugs, talk therapy, light therapy (for SAD), and lifestyle changes like getting more exercise, eating healthy, and avoiding alcohol and drugs. Your best bet is to work with a qualified professional to determine a course of treatment that best suits your needs. Here are some more organizations that can provide guidance and help:
If you or someone you know has had thoughts of self-harm or suicide, there are people who can help. The National Suicide Prevention Lifeline (1-800-273-8255) provides 24/7, free, confidential support for people in distress, as well as best practices for professionals and resources to aid in prevention and crisis situations. (Here’s how one crisis text hotline is preventing thousands of suicides.)
Here are important sources of information about suicide prevention:
- Suicide Awareness Voices of Education
- The National Suicide Prevention Lifeline
- American Foundation for Suicide Prevention
- Suicide Prevention Resource Center
Have you struggled with some form of depression and feel like your experience could help others? We’d love to hear about it. At The Healthy, we believe that sharing your knowledge and experience about a personal health issue or challenge can take you one step closer to feeling better about or solving that issue for yourself. Click on this link to share your own experience and thoughts about depression.
We may use your story in future content that may help other people who are dealing with depression. We want to know about your obstacles and roadblocks, how you dealt with them, and who helped you on the way. What worked? What didn’t? And if it helps to tell your story, please submit a photo that we could share with other people.