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What the Heck is Depression?

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You've heard the word, but what does it really mean?

Depression is a mental illness that affects 14.8 million American adults (ages 18 and older) in a given year.  It is often referred to as major depressive disorder or clinical depression. Although it is a common mood disorder, it is also serious.  It can be severe enough to impact your daily life including how you feel, think, handle daily activities, sleep, eat, and work.

There are several different forms of depression. The National Institute of Mental Health  (NIHM) outlines them here:

Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.
Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.
Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”

Signs and Symptoms

The signs and symptoms of depression vary from person to person. Some may only experience a few symptoms while others will experience them all. Here is what you need to look for:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

 

Risk Factors

Depression is one of the most common mental disorders in the United States. Research shows there are many risk factors for depression. This includes genetics, biology, environmental factors, and psychological factors.

Major risk factors:

  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications

According to NIMH,” Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.”

Depression can also co-occur with other mental illness such as anxiety disorders, eating disorders, etc.

 

Treatment

The good news is depression is treatable. The earlier treatment can begin, the more effective it is. Depression is usually treated with medication, psychotherapy, or a combination of the two.

Antidepressants are medicines often used to treat depression. They help improve the way the brain uses certain chemicals that control mood and stress. Individuals may need to try several different types of antidepressant medication before they find one that works best for them. It is important to note that these medications could take from 2-4 weeks to be fully effective and often come with side effects that change sleeping, eating, and concentration. Be honest with your doctor about how you are feeling.

Psychotherapy sounds like a big, scary word, but it just refers to several types of therapy. Often called “talk therapy,” psychotherapy is a key part of treatment. Your mental health provider will used evidence-based approaches specific to your individual treatment plan which may include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.

 

Beyond Treatment

Treatment doesn’t just happen at the doctor’s office. It must be applied to everyday life. Here are a few ideas for self-help strategies:

  • Try to be active and exercise.
  • Set realistic goals for yourself.
  • Try to spend time with other people and confide in a trusted friend or relative.
  • Try not to isolate yourself, and let others help you.
  • Expect your mood to improve gradually, not immediately.
  • Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
  • Continue to educate yourself about depression.

 

Resource: NIMH www.nimh.nih.gov