Depression is a serious medical illness that requires treatment. We often equate depression to a feeling of sadness, and sadness can be one of its symptoms. However, depression is a lot more severe than everyday sadness, and can debilitate people’s lives when left untreated.
The World Health Organization lists depression as a leading cause of medical disability worldwide.
Luckily, depression is a treatable illness. By learning more about what depression is and how you can address it, you can start recovering from this disease.
Here are some facts and statistics you should know about depression. 
- Around 3.5% of the world population is estimated to suffer from depression. That’s 280 million people.
- In the U.S. nearly 20 million people go through at least one depressive episode every year.
- Over 15% of American adolescents went through at least one depressive episode last year.
- Although depression is a treatable illness, around 75% of people in low-to middle-income countries don’t receive treatment.
- Over 700,000 people globally die of suicide every year. Depression is thought to contribute to at least two-thirds of suicide deaths.
- About twice as many women have depression as men.
- Up to 80% of people who receive treatment show an improvement in their symptoms.
Symptoms of Depression
When we talk about “depression,” we’re usually talking about Major Depressive Disorder, the most common type of depression. To diagnose Major Depressive Disorder, mental health professionals use the Diagnostic Statistical Manual (DSM), which is considered the most important text for mental health diagnoses.
According to the newest edition of the DSM, the symptoms of depression are:
- Depressed or irritable mood: This is a definitive characteristic for most people with depression; people usually feel sad or down all the time. Children, adolescents, and men are likely to express this mood as irritability.
- Diminished interest or loss of pleasure, even in previously pleasurable activities: People with depression lose interest in the things that were once exciting for them.
- Significant changes in appetite or weight: People with depression may lose their appetite, which can cause them to lose weight. For some people with depression, the opposite is true.
- Problems with sleeping: People with depression usually have a hard time falling asleep at night (insomnia). They might also sleep too much (hypersomnia).
- Moving or speaking so slowly that other people notice: This symptom is especially common in depression with melancholic features. It is called “psychomotor retardation.”
- Fatigue or loss of energy: Many people with depression feel tired all the time, regardless of whether or not they got enough sleep.
- Feelings of worthlessness or guilt: Depression causes people to think of themselves in a poor light. They may feel worthless, as if the world would be better off without them.
- Inability to concentrate; indecisiveness: Depression can interfere with your ability to concentrate. If you have depression, you might find it difficult to focus or make important decisions.
- Recurrent thoughts of death or suicide: Not everyone who is depressed feels suicidal, but some do. The suicidal thoughts may be active, like having a plan for how or when you want to end your life. For other people, they’re more passive; for example, having thoughts like “I wish I could just go to sleep and never wake up.”
If you’re having thoughts of suicide, call the Suicide Prevention Lifeline at 1-800-273-TALK. If you have a plan to end your life, call 911, or visit your nearest emergency room.
To meet the criteria for a depression diagnosis, you must have had at least five of these symptoms, nearly all the time, for two weeks or more. The symptoms must also have caused you severe distress or disruption to your life.
For example, maybe your depression symptoms have caused you to have to call out sick from work. Or perhaps you’ve been in so much emotional pain that it’s affected your relationships.
On top of these official symptoms, other signs of depression include:
- Withdrawing from friends and family
- Using more drugs and/or alcohol than normal
- Decreased sex drive
- Feeling numb or empty
- Feeling physically sick or achy
Many different health conditions can cause some of these symptoms一especially ones like fatigue or lack of sex drive一so it’s important to see a doctor if you’re experiencing any of them. A medical professional can rule out other causes and provide you with the right diagnosis.
Causes of Depression
There isn’t just one thing that causes depression. While some people say that depression is caused by a chemical imbalance in the brain, recent research has shown us that the truth is a lot more complicated.
There are several factors that come together to cause depression, and these causes are different for each person. Brain chemistry is one of those factors. Others include:
- Genetics: There is some evidence that you are at higher risk of becoming depressed if you have a parent or sibling who is depressed.
- Gender: Women are twice as likely to become depressed as men. This could be explained by hormonal changes, societal discrimination, and a higher risk for stressful events like sexual assault.
- Stressful life events: For most people, the initial depressive episode is triggered by a stressful life event, such as a divorce or a job loss.
- Hormonal changes: Changes that happen during menstruation, pregnancy, and childbirth can cause some women to become depressed.
- Poverty: People who live in poverty are more likely to be depressed.
- Childhood abuse: The majority of people with chronic depression (depression symptoms that don’t go away for over two years) have experienced some type of traumatic event in their childhood.
- Personality: Certain personality traits, like perfectionism, low self-esteem, and neuroticism, have been linked to a higher risk for depression.
- Medications: Some medications list depression as a possible side effect. Some of these medications include beta-blockers and anticonvulsants.
- Drug and alcohol use: Having an addiction to drugs or alcohol makes you more likely to also have depression.
- Chronic illness or pain: People who suffer from chronic pain conditions are at high risk of becoming depressed.
Brain chemistry plays a role as well. Research has found that, in some brains with depression, the hippocampus is smaller. People with depression may also face interruptions in the way their brains release and reabsorb certain neurotransmitters, like serotonin. This is the idea behind why antidepressants are effective.
However, this isn’t the whole story. For many people, several of the factors listed above come together to raise their risk for depression. For example, they may be genetically predisposed to depression and then go through a significant stressful life event一which may trigger a depressive episode for them.
How likely you are to get depression is different for each person. On top of that, none of these “causes” is a life sentence doomed to depression. There are things you can do to treat, and prevent, depression, even with these risk factors.
Types of Depression
On top of major depressive disorder, there are other types of depression as well. Technically speaking, some of these “subtypes” are diagnosed as major depression with certain specifiers. Others are different mental health disorders altogether.
It’s important to get the right diagnosis, because the recommended treatment may differ depending on the type of depression you have.
Here are some of the most common types of depression. Remember that the only person who can provide you with an accurate depression diagnosis is a mental health professional.
Major depressive disorder with peripartum onset is more commonly known as postpartum depression. It is a type of depression that people go through when they’re pregnant or experience the birth of a child. This type of depression can be caused by the hormonal drop that comes with childbirth as well as the stress of taking care of a newborn.
Sometimes, depression comes on as part of bipolar disorder. Major depressive disorder is sometimes called unipolar depression. When depression is part of bipolar disorder, the person also experiences periods of mania before or after their depressive episodes.
The symptoms of mania include an elated or restless mood, impulsiveness, and a decreased need for sleep.
A major depressive episode is diagnosed when a person has had symptoms of depression for two or more weeks. People who experience symptoms for much longer than that 一 for two years or longer 一 may be diagnosed with persistent depressive disorder. Some people with persistent depression have less severe symptoms, but they last longer.
Seasonal affective disorder
Seasonal affective disorder, or SAD, officially known as major depression with seasonal pattern, is diagnosed when someone has depression symptoms only during certain times of the year. For example, someone may become depressed during the dark winter months, but feel totally better when spring comes along.
Other types of depression include depression with psychotic features, depression with melancholic features, and substance-induced depression.
Treatment for Depression
Up to 80% of people with depression see improvement in their symptoms with the right treatment. Usually, the recommended treatment is a combination of psychotherapy and antidepressant medication 一 but there are many things you can do to help yourself if you have depression, too.
The following methods and practices have been found to be helpful for people with depression.
Talk therapy can help people with depression to learn healthier ways of expressing themselves and coping with painful feelings.
A form of psychotherapy called cognitive-behavioral therapy (CBT) may be particularly helpful for people with depression.  CBT can help you recognize and challenge the ways that depression distorts your thinking. For example, depression may lead you to think, “Nobody loves me,” when that’s simply not true.
By challenging these types of irrational thoughts, you can start to release yourself from the hold that depression has on you.
Many people have found relief for their depression symptoms by taking prescribed antidepressant medications. These medications work by correcting some of the brain chemistry that is affected by depression.
Some of the most commonly prescribed antidepressants include:
- Selective serotonin reuptake inhibitors (SSRIs), like Zoloft or Prozac
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), like Cymbalta
- Atypical antidepressants, like Wellbutrin
There are other types of medications that cause more side effects, but might be prescribed if your initial prescription isn’t working for you. You might have to try out a few different medications before finding the right fit. Your doctor may also prescribe other types of medication, like anti-psychotic medication or mood stabilizers, on top of the antidepressant to help with your specific symptoms.
Physical exercise is not what people usually think of when they think of effective treatments for depression. But a fitness regimen has been found to be a very healthy habit for depressed people, and can go a long way in relieving symptoms.
Some studies have even found that physical exercise is just as effective as antidepressant medication for some people with depression.  However, if your depression symptoms are severe, you will probably need to combine exercise with another type of treatment.
Brain stimulation therapies
Brain stimulation therapies are a way of using electricity and magnetic technology to directly stimulate the brain. The main types of brain stimulation therapies that are used for depression are:
- Electro-convulsive therapy (ECT) 
- Transcranial magnetic stimulation (TMS) 
Both of these therapies have been found to be beneficial for treatment-resistant depression. That means that even if other treatment methods like therapy and medication haven’t worked for you, these therapies may still be able to help.
Of the two, TMS therapy is usually considered the safer option. TMS therapy has little to no side effects and has been approved as a safe and well-tolerated treatment for depression. However, ECT is a lot safer than it used to be, and it may be what’s needed for persistent or severe depression.
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