Depression is a common yet complex mental health condition affecting more than 16 million adults and 3 million adolescents in the US each year. People with depression feel sad, empty, or hopeless much of the time. It’s more than a case of the blues; depression looms like a storm cloud that won’t let sunshine peak through. It saps the joy of being with friends and family. People can lose interest in hobbies, sex, and other pleasurable activities, and they may have trouble eating or sleeping.
Some cases of depression have a genetic component, but lots of factors beyond an inherited tendency can spur and aggravate depression symptoms, including various environmental factors.
Sometimes people don’t acknowledge or recognize depression in themselves or others, so they fail to seek help from a health care professional. But without treatment, depression can linger for weeks or months–sometimes years–and can lead to worsening symptoms. Depression can wreck lives, friendships, and marriages and pose problems at school or work. Some people may turn to alcohol or drugs to ease their pain or consider some form of self-harm or suicide as an escape.
If you’re feeling depressed or suspect a loved one is struggling with depression, it’s important to reach out for help as soon as possible. Most cases, even severe depression, can be successfully treated.
Types of depression
Major depressive disorder or major depression is another name for classic depression, the type that thrusts people into a dark mood. To be diagnosed with major depression, you must have symptoms that interfere with daily life nearly every day for at least two weeks.
Persistent depressive disorder is a common, long-lasting form of depression characterized by low mood. People have symptoms for two years or more, but they aren’t as disruptive as in major depression.
Premenstrual dysphoric disorder or PMDDis a severe form of premenstrual syndrome (PMS) that can trigger severe depression in the week before a woman’s monthly period begins.
Medication- or alcohol-induced depression is a mood change caused by the use or abuse or alcohol, certain medications, and illicit drugs. Also called substance-induced depression, symptoms may occur when someone stops taking certain medicines or drugs too.
Depression due to an illness can occur alongside heart disease, cancer, multiple sclerosis, and HIV/AIDS. It’s normal for these diagnoses to be emotional, but if mood changes linger for more than a couple of weeks, you might have depression. Thyroid problems as well as other mental illnesses, such as anxiety and schizophrenia, can also lead to feelings of depression.
Disruptive mood dysregulation disorder is a childhood condition that results in irritable and angry mood; frequent, severe temper tantrums; and an inability to function in school. Kids with DMDD are at risk for developing anxiety disorders and depression in adulthood.
Bipolar depression, also known as manic-depressive illness, is characterized by unusually wide swings in mood and energy, including periods of depression.
Postpartum depression occurs after childbirth. Women may experience extreme sadness and have difficulty caring for themselves or their new babies. Men can have postpartum depression too.
Seasonal affective disorder or SAD is also known as seasonal depression. This type of recurring depression commonly strikes in a seasonal pattern, usually during the fall or winter, and disappears in the spring or summer.
What causes depression?
The exact causes of depression are unclear. Experts think there may be multiple factors involved. Many times, it’s the intermingling of two or more of these factors that bring on depression or make it worse. Depression causes include:
Your genes. Depression can be hereditary. Certain gene mutations may impede the ability of nerve cells in the brain to communicate effectively.
Changes in brain chemistry. Depression is often described as a chemical imbalance in the brain, but it’s not quite as simple as being too low or too high in one chemical or another. There are many ways brain chemistry is linked to depression. For example, women are more likely than men to develop depression, perhaps due to fluctuating hormone levels. Overproduction of the stress hormone cortisol has also been linked to depression. In addition, there’s a connection between serotonin and depression. Some depressed people have reduced transmission of this important chemical messenger in the brain.
Personality. A person’s temperament and upbringing are among the psychological and social factors that may influence how he or she reacts to stressful situations and views the world. As a result, some people may be more vulnerable to depression.
Environment. Stressful life events, such as a childhood trauma, relationship conflicts, and loss, may alter brain function in ways that make a person susceptible to depression.
Medical conditions. Depression often goes hand-in-hand with certain chronic conditions, such as diabetes, cancer, heart disease, Parkinson’s disease and Alzheimer’s disease.
Medications. Certain medicines are tied to depression. The list includes heart drugs such as beta-blockers and calcium-channel blockers; cholesterol-lowering statins; female hormones; anticonvulsants; opioids; and corticosteroids.
Substance abuse. Alcohol and drug use can bring on depression (and people who are depressed often use alcohol and drugs to cope with their depression).
How is depression diagnosed?
A depression diagnosis is typically based on a patient’s personal and family history of depression and reported symptoms. Patients may be asked to take a questionnaire to gauge the severity of their symptoms. A physical exam and lab tests can rule out other medical conditions, such as a thyroid disorder, that can cause the same symptoms as depression.
To be diagnosed with major depression, a person must experience symptoms on most days over at least a two-week period. Sometimes depression persists for two or more years. People can have multiple bouts of depression in their lifetime.
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