Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.
More than just a bout of the blues, depression isn’t a weakness and you can’t simply “snap out” of it. Depression may require long-term treatment. But don’t get discouraged. Most people with depression feel better with medication, psychotherapy or both.
Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.
Factors that seem to increase the risk of developing or triggering depression include:
- Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic
- Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
- Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
- Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren’t clearly male or female (intersex) in an unsupportive situation
- History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
- Abuse of alcohol or recreational drugs
- Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
- Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)
Causes of Depression
It’s not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:
- Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.
- Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.
- Hormones. Changes in the body’s balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.
- Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.
Common symptoms of depression
Symptoms of depression can vary. They may manifest themselves differently from person to person. However, for most people, depression symptoms affect their ability to perform daily activities, interact with others, or go to work or go to school. If you suffer from depression you may often experience several of the following:
1. Feelings of sadness, tearfulness, emptiness or hopelessness
The most common symptom of depression is a feeling of sadness or emptiness that lasts for more than two weeks. A person may describe this symptom as a feeling of “hopelessness.” They may feel as if life will not get better and that this intense level of sadness will last forever. If this feeling lasts longer than two years it’s known as dysthymia. This is a type of chronic depression in which a person’s moods are consistently low.
2. Feelings of worthlessness or guilt, fixating on past failures or self-blame
Continual feelings of worthlessness, guilt, or helplessness often accompany the condition. People tend to focus on personal shortcomings or past failures. They often blame themselves when their life isn’t going the way they would like. Teenagers who experience depression commonly report feelings of worthlessness. They may report feeling misunderstood and start to avoid interactions with others.
3.Angry outbursts, irritability or frustration, even over small matters
Depression may cause people to get easily frustrated or angered, even over small or insignificant matters. This often relates back to a person experiencing levels of tension and fatigue that makes it difficult to get through the day. Men and women may display irritability symptoms differently from each other. Women often report feeling angry at one moment, and then tearful at the next. Men may appear volatile or aggressive due to their depression. Traditional male roles in society may also mean that a man displays irritability for not being able to “get it together” and overcome depressive symptoms.
People with depression often experience lack of energy or feel tired all the time. Small tasks, like showering or getting out of bed, may seem to require more effort than one can muster. Fatigue can play a role in other symptoms associated with depression, such as withdrawal and apathy. You may feel overwhelmed at the mere thought of exertion or going outdoors.
Depression is often the result of imbalanced chemicals in the brain. However, people experiencing depression may blame themselves for their symptoms instead. Statements such as “I can’t do anything right” or “everything is my fault,” become the norm for you.
6. Crying spells
People who have depression may find themselves crying frequently for no apparent reason. Crying spells can be a symptom of post-partum depression, which can occur in a woman after she’s given birth.
People with depression commonly lose interest or stop finding pleasure in activities that they once enjoyed, including sex.
Anxiety is a feeling of impending doom or danger, even when there isn’t a justifiable reason. Depression can cause a person to feel anxious all the time. A person may say they are constantly tense, but there’s no direct threat or identifiable source for this tension.
Agitation and restlessness, including pacing, an inability to sit still, or hand wringing, may occur with depression.
10. Lack of concentration
People with depression may have a difficult time remembering, maintaining focus, or making decisions. Fatigue, feelings of worthlessness, or feeling “numb” can turn decision-making into a talk that is difficult to accomplish. Friends or family members may discuss specific dates or events, but you may not remember just moments later due to concentrating lack of concentration. This inability to concentrate can lead to withdrawal in a depressed person.
Many people with depression shut themselves off from the world. They may isolate themselves, not answer the phone, or refuse to go out with friends. You feel as if you’re “numb,” and that nothing will bring you joy.
12. Sleep problems
People’s sleep habits are likely to change as a result of depression. They may not be able to fall asleep or stay asleep. They may wake up in the middle of the night and not go back to sleep at all. You may sleep for long periods and find that you don’t want to get out of bed. These symptoms lead to fatigue that can exacerbate additional symptoms of depression, such as a lack of concentration.
13. Overeating or loss of appetite
Depression can often cause a lack of interest in food and weight loss. In other people, depression leads to overeating and weight gain. This is because a person may feel so frustrated or miserable that they turn to food as a means to escape their problems. However, overeating can lead to weight gain and cause you to exhibit low levels of energy. Not enough food can also cause you to also have low energy levels and feel weak.
14. Thoughts of suicide
Thinking or fantasizing about death is a serious sign that needs to be addressed right away. According to the Mayo Clinic, thoughts of suicide are symptoms common in older men. Loved ones may not initially notice this thinking and pass a person’s depression symptoms off as age-related mental health changes. However, depression and especially suicidal thoughts are never normal emotions.
If you or a loved one is thinking of hurting themselves, seek immediate medical attention. At the emergency room, a doctor can help you get mental health care until these feelings subside.
15. Physical pain
Physical symptoms, such as body pain, headaches, cramps, and digestive problems also can occur. Younger children with depression commonly report physical pain symptoms. They may refuse to go to school or behave particularly clingy due to the worry about their aches and pains.
Depression symptoms in children and teens
Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.
- In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
- In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.
Depression symptoms in older adults
Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:
- Memory difficulties or personality changes
- Physical aches or pain
- Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
- Often wanting to stay at home, rather than going out to socialize or doing new things
- Suicidal thinking or feelings, especially in older men.
Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn’t treated, resulting in emotional, behavioral and health problems that affect every area of your life.
Examples of complications associated with depression include:
- Excess weight or obesity, which can lead to heart disease and diabetes
- Pain or physical illness
- Alcohol or drug misuse
- Anxiety, panic disorder or social phobia
- Family conflicts, relationship difficulties, and work or school problems
- Social isolation
- Suicidal feelings, suicide attempts or suicide
- Self-mutilation, such as cutting
- Premature death from medical conditions
There’s no sure way to prevent depression. However, these strategies may help.
- Take steps to control stress, to increase your resilience and boost your self-esteem.
- Reach out to family and friends, especially in times of crisis, to help you weather rough spells.
- Get treatment at the earliest sign of a problem to help prevent depression from worsening.
- Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.
When you have depression, treating your symptoms isn’t something you can easily overcome. You simply can’t will it away and “decide” to feel better one day. Instead, treating depression can require participating in psychotherapy or taking medications. These treatments (or a combination of these treatments) can help you feel better. If you experience depression symptoms, talk to your primary care doctor or mental health professional.