What Is Depression?

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.

Depression symptoms

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Thoughts of death or suicide

Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.
Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes.
Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can occur at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. There is a high degree of heritability (approximately 40%) when first-degree relatives (parents/children/siblings) have depression.


What actually causes depression is not fully understood by scientists. However, research suggests that it may involve some of the following risk factors:

  • Biological. With depression, there may be changes in the function of the brain’s chemicals, called neurotransmitters, that are responsible for mood, such as serotonin, dopamine, and norepinephrine.
  • Genetic. Depression may be a partially inherited condition. For example, people with a parent or sibling who has depression may be three times more likely to have depression than those who don’t.
  • Environmental. Life occurrences can also increase risk for depression. Some of the situations that may contribute include chronic stress at home or work, the death of a loved one, or a traumatic event like child abuse.

Medical conditions like Parkinson’s disease or a stroke, as well as chronic illnesses like cancer or heart disease, may also increase risk for depression. And while common medications, like birth control pills or Adderall, may cause depressive symptoms or mood swings, research has found that they are unlikely to cause depression.

How Is Depression Treated?

Depression is among the most treatable of mental disorders. Between 80% and 90% percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.
Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem or a vitamin deficiency (reversing the medical cause would alleviate the depression-like symptoms). The evaluation will identify specific symptoms and explore medical and family histories as well as cultural and environmental factors with the goal of arriving at a diagnosis and planning a course of action.


Medication: Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression.
Antidepressants may produce some improvement within the first week or two of use yet full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant. In some situations other psychotropic medications may be helpful. It is important to let your doctor know if a medication does not work or if you experience side effects.
Psychiatrists usually recommend that patients continue to take medication for six or more months after the symptoms have improved. Longer-term maintenance treatment may be suggested to decrease the risk of future episodes for certain people at high risk.

Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used along with antidepressant medications. Cognitive behavioral therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on the problem solving in the present. CBT helps a person to recognize distorted/negative thinking with the goal of changing thoughts and behaviors to respond to challenges in a more positive manner.
Psychotherapy may involve only the individual, but it can include others. For example, family or couples therapy can help address issues within these close relationships. Group therapy brings people with similar illnesses together in a supportive environment, and can assist the participant to learn how others cope in similar situations .
.Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions.


Electroconvulsive Therapy (ECT) is a medical treatment that has been most commonly reserved for patients with severe major depression who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant. ECT has been used since the 1940s, and many years of research have led to major improvements and the recognition of its effectiveness as a mainstream rather than a “last resort” treatment.

Self-help and Coping

There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improves mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.
Depression is a real illness and help is available. With proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, a first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. This is a start to addressing your mental health needs.


Some of the main types of depression are:

  • Major depressive disorder. This is the classic type of depression. The symptoms can occur every day and range from mild to severe.
  • Persistent depressive disorder. This chronic type of depression, also called dysthymia, lasts for at least two years. The symptoms are usually not as severe as those for clinical depression.
  • Postpartum depression. After giving birth, about 10% to 15% of new mothers experience this type of depression, which typically lasts for around six months. Men can also get postpartum depression, though it is not as common.
  • Seasonal depression. Also known as seasonal affective disorder (SAD), this type of depression occurs during times of the year when there is less natural sunlight. It usually starts in late fall or early winter and ends in the spring or summer.
  • Bipolar disorder. People with bipolar disorder experience extreme mood swings that first include periods of depression, and then later include separate manic episodes of high energy. These episodes may occur rarely or several times a year.


If you’ve experienced the symptoms of depression for at least two weeks, and it’s affecting your daily activities, you should see your doctor. You can take this quiz first to help gauge the severity of your depressive symptoms:
People with depression may experience some of the following symptoms associated with anxiety:

  • Nervousness
  • Irritability
  • Sleeping problems
  • Difficulty concentrating


Talking with a therapist can help you recognize negative beliefs and behaviors, and work to replace them with positive ones. There are many effective types of therapy for depression, such as:

  • Cognitive-behavioral therapy (CBT) is one of the first lines of treatment for depression. In fact, research suggests that CBT can be as effective as some medications for depression.
  • Dialectical behavioral therapy (DBT) combines CBT with meditation techniques to help you learn mindfulness, and become more aware of harmful thoughts and feelings.
  • Acceptance and commitment therapy (ACT) is a form of CBT that helps you accept difficult thoughts and emotions as a necessary part of life, allowing you to move forward and better manage your depressive symptoms.

Natural remedies

The following lifestyle changes can also help improve the symptoms of depression:

  • Exercise regularly. Physical activity boosts dopamine and serotonin levels in the brain, according to a 2017 study in the journal Brain Plasticity, which has a positive effect on your mood and lowers your stress level. Exercise can also trigger the release of endorphins, chemicals in the brain that increase feelings of well-being.
  • Eat healthy foods. About 95% of serotonin is produced in the gastrointestinal tract. According to a 2014 review published in the American Journal of Clinical Nutrition, people who ate a Mediterranean diet that included fruits, vegetables, whole grains, and fish were 16% less likely to experience the symptoms of depression than people who ate a Western diet, which generally includes foods like red meat, fried foods, and high-fat dairy products.
  • Get more vitamin D. There is some evidence that low levels of vitamin D may be associated with depression, as a vitamin D deficiency may impair the function of receptors in areas of the brain that control mood and behavior. Getting vitamin D through sunlight may help boost your brain’s serotonin levels. The World Health Organization (WHO) recommends getting five to 15 minutes of sun exposure two to three times a week.

How to help someone with depression

It can be very important to help a friend or family member with depression, although it may be somewhat challenging.
Low motivation and social stigma are among the factors that can prevent people from reaching out for help. “This can feel discouraging to friends and family members who are trying to help a loved one get the care they need,” Wittenborn says.
Here are some of the best ways you can help someone who may have depression:

  • Show your support, and be honest about what you are noticing in the person’s mood or behavior. “Sincerely express your concern, give a few specific examples of why you are worried — they have lost weight or they isolate themselves — and tell them you care too much about them to not speak up,” Talley says.
  • Encourage the person to seek treatment from a mental health professional. Offer to help them find a therapist and ask if they’d feel more comfortable if you go with them.
  • Although most people with depression don’t attempt suicide, ask the person whether they have thought about harming themselves.
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