Depression, or major depressive disorder, is a very common mood disorder. It affects how an individual feels, thinks, and acts. Depression causes feelings of constant sadness and is associated with a lack of interest in usual activities. Most of us experience depressed or sad moments. However, when intense sadness lasts for many weeks or months and interferes with daily life, it may be something more serious. Depression can lead to a variety of physical and emotional problems and can affect social life, work, and home activities. Fortunately, it is a treatable medical condition.
Depression symptoms may include mild to severe symptoms, including:
- Loss of interest or pleasure in most activities once enjoyed
- Changes in appetite, weight loss or weight gain
- Depressed mood most of the day or persistent sad, anxious, or “empty mood”
- Feelings of hopelessness or pessimism
- Insomnia or hypersomnia
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Difficulty thinking, concentrating, remembering, or making decisions
- Increase in purposeless activity or slowed movement and speech
- Thoughts of death and suicide
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Symptoms must last at least two weeks and must represent a change from previous functioning. There are some medical conditions, such as thyroid problems or a vitamin deficiency, that may mimic symptoms of depression, so it is important to rule out general medical causes. Not everyone will experience every symptom, and each person’s presentation may be different. Some may experience just a few symptoms, while others may experience many. For a diagnosis of major depressive disorder, either depressed mood or loss of interest or pleasure is required along with five other symptoms. How long symptoms last may vary depending on the stage of the illness. It is important to treat early symptoms in order to prevent the illness from progressing to a more severe stage.
Depression affects more than 264 million people worldwide. It is the leading cause of disability in the world and is the most common neuropsychiatric disorder in the United States. 7.1% of the adult population (17.3 million adults) have had at least one major depressive disorder. Of those experiencing major depressive episodes, about 2 out of 3 report severe impairment. Women are twice as likely as men to experience depression. Depression can occur at any time, and one in six people (16.6%) will experience depression at some point in their life.
It is important to note that depression is different from sadness or grief/bereavement. There are some events, such as life transitions, ending of a relationship, death of a loved one, or loss of a job, that may cause individuals to develop appropriate feelings of sadness or grief. The grieving process is a normal part of life and may look different depending on the individual. It may also mimic symptoms of depression. However, sadness and grief are not the same as depression. They differ in the following ways:
- Grief and associated feelings may come in waves with memories of the deceased
- While for those dealing with depression feelings of worthless are common, self-esteem is usually preserved in someone who deals with grief
- Thoughts of death associated with grief are usually present when thinking or fantasizing about “joining” the deceased
Distinguishing between grief and depression is important in order to help people get the appropriate help and support that they need. It is also important to keep in mind that some symptoms may co-cooccur. For example, loss of a job may be due to a traumatic event or natural disaster.
Some people may experience depressive symptoms during the holiday months of November and December. For many, stress levels significantly increase during the holiday season. It is reported that this is true for about 38% of people. For those who already experience mental illness, holidays may make their symptoms worse. Many report being financially stressed and/or lonely during this period.
Some risk factors for depression include biochemistry, genetics, personality, and environmental factors. Some people experience a chemical imbalance in their brain, which can cause symptoms of depression. In addition, a family history of depression may predispose some for developing depressive symptoms. Those who do not have good coping skills in place or are easily affected and overwhelmed by stress are more likely to experience depression. Lastly, an exposure to traumatic events, such as abuse, poverty, or violence, can cause some people to be particularly vulnerable to developing mental illness.
There is some good news, however! Depression is the most treatable mental illness, with 80% – 90% of people responding well to treatment. Most patients experience at least some relief from their symptoms. The type of treatment will depend on the symptoms and severity. Some treatments may include medication management, counseling/psychotherapy, neurofeedback, brain stimulation therapy, alternative medicine, or self-help.
While there’s no sure way to prevent depression, some strategies may help:
- Getting enough sleep, eating a healthy diet, and participating in regular self-care activities, such as meditation, yoga, or exercise
- Take early action and learn ways to self-cope when stressful events happen and work on increasing your resilience
- Create a social support system, such as through family, friends, community, and common interest groups
- Seek treatment at the earliest sign of problems and consider long-term treatment for more severe symptoms in order to prevent a relapse or worsening of symptoms