True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for weeks or longer. We all go through ups and downs in our mood. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. Many people use the word “depression” to explain these kinds of feelings, but depression is much more than just sadness. Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don’t feel sad at all—they may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless. Whatever the symptoms, depressionis different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.
Causes of Depression
The exact cause of depression is not known. Many researchers believe it is caused by chemical changes in the brain. This may be due to a problem with your genes, or triggered by certain stressful events. More likely, it’s a combination of both. Some types of depression run in families. But depression can also occur if you have no family history of the illness. Anyone can develop depression, even kids.
The following may play a role in depression:
- Alcohol or drug abuse
- Certain medical conditions, including underactive thyroid, cancer, or long-term pain
- Certain medications such as steroids
- Sleeping problems
- Stressful life events, such as:
- Breaking up with a boyfriend or girlfriend
- Failing a class
- Death or illness of someone close to you
- Childhood abuse or neglect
- Job loss
- Social isolation (common in the elderly)
Symptoms of Depression
People who have depression usually see everything with a more negative attitude, unable to imagine that any problem or situation can be solved in a positive way. Symptoms of depression can include:
- Agitation, restlessness, and irritability
- Dramatic change in appetite, often with weight gain or loss
- Very difficult to concentrate
- Fatigue and lack of energy
- Feelings of hopelessness and helplessness
- Feelings of worthlessness, self-hate, and guilt
- Becoming withdrawn or isolated
- Loss of interest or pleasure in activities that were once enjoyed
- Thoughts of death or suicide
- Trouble sleeping or excessive sleeping
Depression can appear as anger and discouragement, rather than feelings of sadness.
Depression in Men
Depression is a loaded word in our culture. Many associate it, however wrongly, with a sign of weakness and excessive emotion. This is especially true with men. Depressed men are less likely than women to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. Other signs and symptoms of depression in men include anger, aggression, violence, reckless behavior, and substance abuse. Even though depression rates for women are twice as high as those in men, men are a higher suicide risk, especially older men.
Depression in Women
Rates of depression in women are twice as high as they are in men. This is due in part to hormonal factors, particularly when it comes to premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and premenopausal depression. As for signs and symptoms, women are more likely than men to experience pronounced feelings of guilt, sleep excessively, overeat, and gain weight. Women are also more likely to suffer from seasonal affective disorder.
Depression in Teens
In fact, irritability—rather than depression—is frequently the predominant symptom in depressed adolescents and teens. A depressed teenager may be hostile, grumpy, or easily lose his or her temper. Unexplained aches and pains are also common symptoms of depression in young people. Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing—even irreversible tragedy such as homicidal violence or suicide. But with help, teenage depression is highly treatable.
Depression in Senior Citizens
The difficult changes that many older adults face—such as bereavement, loss of independence, and health problems—can lead to depression, especially in those without a strong support system. However, depression is not a normal part of aging. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression, and so the problem often goes unrecognized. Depression in older adults is associated with poor health, a high mortality rate, and an increased risk of suicide, so diagnosis and treatment are extremely important.
Types of Depression
There are several forms of depressive disorders.
Major depressive disorder, or major depression, is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major Depression is disabling and prevents a person from functioning normally. Some people may experience only a single episode within their lifetime, but more often a person may have multiple episodes.
Dysthymic disorder, or dysthymia, is characterized by long-term (2 years or longer) symptoms that may not be severe enough to disable a person but can prevent normal functioning or feeling well. People with Dysthymia may also experience one or more episodes of Major Depression during their lifetimes.
Minor depression is characterized by having symptoms for 2 weeks or longer that do not meet full criteria for Major Depression. Without treatment, people with minor depression are at high risk for developing major depressive disorder.
Some forms of depression are slightly different, or they may develop under unique circumstances. However, not everyone agrees on how to characterize and define these forms of depression. They include:
- Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
- Postpartum depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.1
- Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.
Diagnosis of Depression
To effectively diagnose and treat depression, the doctor must hear about specific Symptoms Of Depression. While a physical examination will reveal a patient’s overall state of health, by talking with a patient, a doctor can learn about other things that are relevant to making a depression diagnosis. A patient, for example, can report on such things as daily moods, behaviors, and lifestyle habits.
A depression diagnosis is often difficult to make because Clinical Depression can manifest in so many different ways. For example, some clinically depressed individuals seem to withdraw into a state of apathy. Others may become irritable or even agitated. Eating and sleeping patterns can be exaggerated. A depressed person may either sleep or eat to excess or almost eliminate those activities.
Observable or behavioral symptoms of Clinical Depression may be minimal despite a person experiencing profound inner turmoil. Depression can be an all-encompassing disorder, and it affects a person’s body, feelings, thoughts, and behaviors in varying ways.
Treatment of Depression
Treatments for depression include:
- Medications called antidepressants
- Talk therapy, called psychotherapy
If you have mild depression, you may only need one of these treatments. People with more severe depression usually need combination of both treatments. It takes time to feel better, but there are usually day-to-day improvements. If you are suicidal or extremely depressed and cannot function you may need to be treated in a psychiatric hospital.
Medication for Depression
Drugs used to treat depression are called antidepressants. Common types of antidepressants include:
- Serotonin Selective Re-Uptake Inhibitors (SSRIS), including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
- Serotonin Norepinephrine Reuptake Inhibitors (SNRIS), including desvenlafaxine (Pristiq), venlafaxine (Effexor), and duloxetine (Cymbalta).
Other medicines used to treat Depression include:
- Tricyclic antidepressants
- Bupropion (Wellbutrin)
- Monoamine oxidase inhibitors
If you have delusions or hallucinations, your doctor may prescribe additional medications.
- Major Depressive Disorder and Stroke Risks: A 9-Year Follow-Up Population-Based, Matched Cohort Study (plosone.org)
- Brain Stimulation Relieves Depression With Fewer Side Effects (psychcentral.com)